King

Dr. Ezekiel Washington understood there were things wrong with his wife. Just before his night shift, Mrs. Chinasa Okoro Washington said she had something to tell him.

"Ezekiel," she said. He stiffened. Not because of her tone or because she spoke with her back to him. She was beautiful from the back and the front. Even her shadow had made him take notice when they first met ten years ago. He stiffened because she called him Ezekiel. She had always—always—called him Eze.

"Eze means King in Igbo," Chinasa had smiled the words out on their first date. And the "Eze" she used did not sound like an abbreviation of Ezekiel, it sounded like a whole other, better name.

Chinasa was raised in Igboland proper, she would often say, in Enugu State, Nigeria. She had moved to the US as a teenager. Ezekiel was an American who traced his ancestry, through DNA tests, to the Temne of Sierra Leone and the Ashanti of Ghana.

"Ezekiel," Chinasa repeated herself, aware of how her name choice would be interpreted, as though she were removing her wedding ring and throwing it into the garbage. She had turned to face him, her arms folded across her chest, pushing up her bosom so her cleavage was robust in her V-necked house dress. Thankfully, she still had a gold band on her left hand.

"We are going to my mother's," she said.

"When?" Ezekiel asked.

"We will not be here when you come back from your night shift." Her words hung in the air like water vapor on the most humid of days, filling the space, making everything uncomfortable.

"Okay. And you are telling me this now?"

She hissed under her breath. "Be thankful I am telling you."

There was a sign above the door where all the healthcare providers entered. It was meant to be a sort of pep talk: leave your problems at the door, come in ready to work, something to that effect. Ezekiel had walked under that sign at the beginning of every shift. He saw now how cheap it looked, how crooked it hung. In fact, it was dirty and needed to be washed.

Ezekiel believed the first patient he saw always defined his shift. For example, if he saw someone with vaginal bleeding, then the shift would be full of pelvic exams. He had so many such if-this-then-that scenarios over his years of practice, he felt his belief had verified.

"Can you come see this patient, Dr. Washington?" a nurse asked him even before he had a chance to put his bag in the breakroom, before he could grab his burgundy stethoscope or put on his white coat and load his pockets with other tools of his trade.

"She keeps yelling and not making sense." The nurse had Ezekiel's attention, and she spoke fast to ensure she kept it. "She signed in with chief complaint of chest pain, but her triage EKG was normal and her family said she had a cath recently that showed clean coronaries. Plus, she is only forty-two. Not sure what is going on, but she is in there hollering. Can you come see her first?"

So this was it. This night would be full of patients who could not articulate their story, Ezekiel thought. Just like the wife who was leaving him.

He looked through the rack of white coats to find the one with the words Ezekiel Washington, MD, embroidered on it. I am Eze, he thought. The only time he went to Nigeria, he had introduced himself to someone saying, "My name is Ezekiel, but my wife calls me Eze, you know, like I am her "King" in Igbo." The man smiled as if saying, "And that is how it should be." And Ezekiel, in this foreign land, thought he had found a friend.

He asked the man, "And where is the Eze, the King in this place?"

"Igbo enwe eze," the man had said with the matter-of-factness one would use to declare it was going to rain when the sky was already dark and raindrops were already dampening forearms.

"What does that mean?" Ezekiel had asked.

"The Igbo have no king."

Ezekiel went straight into the room of the yelling patient. She raised herself up off the stretcher, then flung her whole body back, never looking at him or at anyone. She looked like someone in need of an exorcism. Her elderly parents sat next to her, staring, confused.

"Does your daughter have any medical problems?" Ezekiel asked.

Before they could answer, the daughter did a body flip, nearly falling off the stretcher.

"Ms. Jasmine," Ezekiel yelled, trying to be heard over her screams. He grabbed both her ankles to steady her.

And there it was: one leg was cold.

"Think ischemia. Super crazy patient? Consider ischemia." He had heard this, said this, and here it was: Jasmine's aorta's catastrophic rip. That mightiest of all blood vessels, erupting out of the heart itself, curving and heading straight down the back to deliver bright red arterial blood to the whole body. That aorta. Somewhere it had splintered, and in doing so had failed in its duty to give Jasmine's right foot life. Jasmine yelled and wept because of this internal crisis the world could not see. Her leg was dying.

The wheels of the emergency department moved so very fast now, like a sprinter slow to react to the starting gun but summoning super human strength to win the race.

Ezekiel saw many patients after Jasmine was taken to the operating room by the cardiothoracic surgeon. He loved Dr. Morton, who had a head full of grey hair and the physique of one much younger. All Ezekiel had said was "Pulseless..." and Dr. Morton had said, "I am on my way," and then, even that late at night, he was already there.

Ezekiel's other patients were able to tell their stories, contrary to his expectations for this shift. Mr. John Malcolm, for instance, had been in the emergency department for over 24 hours. He had been put on a psych hold because, when he had come in two days before, he had been psychotic. Now he felt much better. He said he was no threat to himself or others. He wanted a re-evaluation by the psychiatric service.

"All I am asking is for them to talk to me again, Doc. There is really no reason for me to be here." He had a clean-shaven, well-moisturized head and a bushy goatee he kept caressing with his index finger and thumb, relishing the feel of the hair he still had.

"Okay, we can set that up," Ezekiel said. On reassessment by the mental health provider, it was felt by all involved that Mr. Malcolm could be discharged. And so he was.

At shift end, Ezekiel was starving. There was a fast food spot built for folks like him, just off work, needing something quick and heavy. But the hospital parking lot's exit was blocked by something or someone.

It was a naked man. There was an officer, standing apart, coaxing him from a distance, waiting for backup. The officer did not want to wrestle down a naked man who was bigger than him. The naked man was unashamed. The mind that would have instructed him on shame was failing him. His genitalia dangled in the air while cars blew by. He walked with a wide gait through the middle of the street as though that was what the street was made for. Ezekiel dared to think he knew the beginnings of this man's story: a man broken by burdens this world would not help him bear, who asked for help often enough but was told to wait, or a man who had never asked for anything even though he needed everything.

When it was Ezekiel's turn to pass by, the man looked towards Ezekiel. He had one hand on his hip, the other stroking his bushy goatee.

Ezekiel drove by quickly, intent on avoiding recognition.

He had been wrong about Mr. Malcolm. He considered now that he was also wrong about his wife, who was headed to the airport with their daughter that very morning.

"Let us talk about this when I come home from work," he had said.

"We will see," Chinasa had said. It was the same way she would say, "We will see," when she was invited to go dancing by her friends—the friends without a toddler who was still committed to staying awake whenever her mother sought sleep, without a disagreeable husband whose moods shifted unpredictably, and without jobs that commandeered time both inside and outside the office. In truth, Chinasa’s life was full of all these challenges. So when faced with invitations to frivolity, she would always say, “We will see.” It was her polite way of never outright refusing a request, never saying “No” directly to someone’s face.

As Ezekiel drove away from the mad man he had only recently certified as sane, he began to consider that perhaps there was nothing wrong with his wife. Hesitantly, Ezekiel un-blemished her, scrubbing her image with soap and water, making her clean and shiny again in his heart and mind. There were things wrong in their union. There were things wrong with him. If his marriage was an ischemic foot, he had not sought immediate re-perfusion of the dying tissue. He had gone about his life like nothing was out of balance, like he could not become broken and naked and mad.

Eze turned his car in the opposite direction of his house. He was going to the airport.