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2017 Toronto Book Award Nominees

By 49thShelf
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Congratulations to the nominees! And check out the features on our blog, an excerpt from IN THE BLACK, and conversations with the authors/editors of SCARBOROUGH and ANY OTHER WAY.
I Hear She's a Real Bitch

I Hear She's a Real Bitch

also available: Hardcover Paperback

A sharp and candid memoir from a star in the restaurant world, and an up-and-coming literary voice.

Toronto restaurateur Jen Agg, the woman behind the popular The Black Hoof, Cocktail Bar, Rhum Corner, and Agrikol restaurants, is known for her frank, crystal-sharp and often hilarious observations and ideas on the restaurant industry and the world around her.
I Hear She's a Real Bitch, her first book, is caustic yet intimate, and wryly observant; an unforgettable glimpse into the life of one of t …

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The first time I could’ve gotten drunk but didn’t, I was eleven. We were at Greg Harper’s* house playing a make-believe game of Star Wars. Greg was a lanky ginger into sci-fi and British comedy and he was mildly funny so he coasted on that. He played the comedian so well that you almost forgot his nerdish leanings. The premise of our game was flimsy: Greg and Alan were Han and Luke, and Kristy was Leia because she had sprouted boobs and was really pretty, which of course meant all the girls whispered about what a slut she was while maintaining phony friendships with her.
     There was nothing to suggest at that time that Kristy had ever even kissed a boy, though even if she had, it wouldn’t have made our slut-shaming any less awful. The way we interacted as eleven-year-old girls was a good introduction to female group dynamics, and I was definitely not just a casual observer. As an adult, I’ve noticed these childish patterns on a loop and can still shock myself with how callously dismissive I can be of women—men too, but I tend to be more generous with men’s shortcomings. I’m an admittedly bad feminist; I know that I have this horrendous, learned double standard. It’s just that I have a strong negative reaction to what I see as a wishy-washy need to please and I find that trait more often in women than in men. I wish I could be more patient, as a woman is expected to be. If I allowed myself to clearly and fully remem­ber the awful things I whispered and gleefully took in back then about “Titsy” Edmunds (not our best work—it didn’t even rhyme) I know I would be horrified. What I do remember well is the feeling of belonging and the power of gossip: alliances constantly shifting, hopping back and forth between the two most popular girls, the hypocrisy of these relation­ships a baseline for how women exist in group friendships, especially as children. Two “friends” are always finding com­fort in talking shit about their other “friend,” who may be prettier, or better dressed, or more popular with the boys, or none of those things. (But a judgment that a girl is “prettier” is often at the heart of it. The patriarchy’s culturally agreed-on baseline for prettiness in those days defaulted to skinny-yet-curvy white girls—thank christ that’s starting to change.) Kristy’s social status was confusing, both relying on and hin­dered by the power of new breasts, but it didn’t matter—she always got to play Leia, and I always got stuck with C-3PO.
     After our game ended (once the Death Star had been destroyed, presumably) Greg casually sauntered into the base­ment with a six-pack of beer, like it was something he did all the time, and my first reaction was, “No! Drinking is bad and we aren’t supposed to do it!” My rebellious nature was still a couple years from maturation, but my fight-y nature wasn’t, and I argued with and shamed the boys, going so far as to dump at least one lukewarm beer down the toilet. It was Miller High Life, and it was 1987, when Miller High Life was pre-ironic, yet even with its third-banana (behind Pabst and Labatt 50) iconic hipster status just a decade away, the toilet still seems like an appropriate place for it. It got me thinking, though. If Greg and Alan were refusing to speak to me for weeks over this small thing, dumping a beer down the toilet, they must’ve been pretty mad about it. And if they were so mad, drinking had to be awesome. It was a primitive logic.
     As girls of eleven or twelve-ish, we were at the age where our parents could leave us alone for an evening and didn’t have to worry about boys rapping on windows with cans of warm beer looking to “be boys”—that was still a couple of years off, despite Greg’s early adopting. In grade 7, I would shoot up a fast few inches, becoming very Skinny Legs and All, the book by Tom Robbins that I eventually read for its title and loved for its everything. When I see eleven-year-old girls today, sashaying around in crop tops and jean shorts cut so high that I’m discomfited, I wonder if I’m remembering “eleven” wrong. But I think it’s a pretty different “not-quite-a-girl-not-quite-a-woman” world now—something about the Internet.
     I mean, obviously the unattainable beauty standards for women are rooted in the patriarchy, but now that most west­ern kids can fall through Google’s looking glass and have total access to everything, girls are too quickly, within a pack mentality, making themselves into miniature versions of their sexy popstar heroes. I don’t want to be all old-man-shakes-fist-at-cloud, but though we still learned our roles—to be the prettiest, the sexiest, yet somehow demure—it just wasn’t as fast a slide into clothing as sexual display when I was a kid. We didn’t even grasp what was happening, even if, biologi­cally, the approving looks from boys were a jolt we knew we liked. We are raised to compete with other women, but within a societal expectation of “sisterhood”—a challenging para­dox that ends up supporting the patriarchal status quo.
     Perhaps it was because I intuitively rejected the social cues I was picking up as a girl, but for whatever reason I had more fun playing with boys. They wanted to build forts and climb trees and play Capture the Flag. They were my people—a friendship preference I haven’t been able to shake. I’ve been on a constant search for equality-based female friendship, but it’s eluded me, especially as I age and my requirements become ever more specific. Where are the forty-something stepmoms who are fundamentally it-getty and can afford occasional elaborate dinners? Are they at bars? Is there a Tinder for cool stepmoms? Not that I don’t have close female friends, but I’ve always felt more at ease with boy-besties. And yes, I realize how “not like other girls” garbage this sounds.
     Dwayne, my first boy-pal, lived at 10 Scarbelle Lane, the cul-de-sac that sprouted off the top of Scarboro Avenue (Scarboro, no “u-g-h”—how many times did I say that as a kid?). We bonded immediately. Not in a crush sort of way—I had no special feelings for him “down there.” (“Down there” was something I had discovered at nine or ten thanks to my love of shimmying up and then sliding down the poles that supported the swings in the school playground—a precursor to my mother’s as yet undiscovered “shoulder massager.”) Dwayne had a ramp for jumping his BMX bike. Either my parents wouldn’t buy me a BMX or I decided it veered too strongly into representing myself as not a girl (for all my tomboy leanings, I definitely wanted to be the kind of girl that boys liked). But that didn’t stop me from racing Dwayne’s bike up and down the street and sometimes finding the cour­age to go up the ramp, though never committing quite enough to really catch any air. One afternoon, I’d gotten up a lot of speed and was screeching toward him when, out of nowhere, he jammed a stick in the front wheel spokes. I flew over the handlebars and scraped myself up pretty badly. I was so upset and shocked, I grabbed my non-BMX bike, which I’d lazily dropped on Dwayne’s lawn, and limped home so he wouldn’t see me cry. I was so embarrassed and pissed off. Was this what boys did to each other? Stood there while you hobbled off muf­fling your tears? Laughed at skinned knees with little stones and pits of asphalt buried so deep it would take my mother hours to clean?
     This was a first peek into a lifelong struggle with my joy at the company of men and my occasional wish for just a little more compassion (a quality so often attributed to women) from them. This is partly why I’m so happy to see gender lines starting to blur: for starters, women not being afraid of their confidence or assertiveness, and men embracing, well, other men in a non-sexual way. Men are trained not to cry. Women are trained not to demand things. These are ridiculous standards. I hardly ever cry, and I am constantly demanding things, yet I still catch myself falling prey to a standard societal expectation of what it means to “be a man.” I am always trying to upend gender roles, even deeply ingrained ones, like the ludicrous idea that “having balls” means being tough. To paraphrase come­dian Sheng Wang (who apparently came up with this despite the Internet insisting it was Betty White, much to her chagrin): “It makes no sense. Balls are delicate little sacks that can’t take a hit. But vaginas? Vaginas can take a pounding.”
     Eventually Dwayne apologized, after, I suspect, his mother made him, but it was never the same between us. I didn’t trust him any more and I just stopped going around to his house and his BMX ramp. Two years later, by the time we were taking the bus to different high schools, it was like we’d never met.
     That awful bike spill was around the time I started crush­ing on Greg—Star Wars, beer-toting Greg—who somehow, between grades 7 and 8, became (to me) the most handsome thing ever, even more handsome than crowd favourites Rob and Julius. But Greg liked Christine (they all liked Christine), a cute-as-a-button fashionista (seriously, this kid knew what was up) who was the unofficial group leader at school, and was constantly rich with choice re: boys to like. Mine was an awful, all-consuming crush—a theme for crushes all my life. I’d find any excuse to be around him, and his likes were suddenly my likes. We did legitimately have one thing in common, though: Inspector Gadget. Despite the torture of not having my feelings for him reciprocated, I was grateful to have someone to discuss that morning’s episode with. There was no fake-liking the brilliance of Penny always cleaning up after the bungling Inspector. I thought it was gold, and I’d wake up extra early to eat breakfast before it was on, because there was no eating in front of the TV in my house—ever. For some reason my parents never counted this morning cartoon indulgence against my half hour of evening television (an hour on Sundays).
     Every morning my dad would make orange juice from fro­zen concentrate, and every morning I’d want to drink it right away, before all the ice crystals had melted. He’d butter toast, slice grapefruit, and my mom would stir up some instant oat­meal, while my much younger brother, Jonathan, would ride around the kitchen on a plastic cow on wheels with an air pump that made it moo—the only place in the house, aside from the bathroom, that wasn’t carpeted—getting underfoot. If I could manage to scarf all that breakfast down, only then could I watch Inspector Gadget.
     My parents’ parenting of me always felt like a combina­tion of the tight grip of paranoia and an irresistible urge to just let me do as I pleased, so they seemed incredibly grateful my brother was so much less defiant. Although, once I cut off the air pump on that awful cow in a fit of annoyance, with the intention of rendering it silent forever, he figured out he could just blow into the hole to make it moo, so that was pretty defiant.

I very clearly remember the first time I did get drunk, at thirteen, just as the school year was kicking off my final year before high school, as trees were turning from bright green to deep gold and red, a visual ode to Boy George and Jamaican flags. We’d planned the night for weeks, knowing that eventually my parents would be out some Friday night to attend the ballet or the symphony. That night finally came, and I huddled in the living room with my three closest friends, Kathleen, Christine, and Caroline. My parents didn’t even ask why we seemed giddier than usual, though I doubt they even noticed—the four of us together always ended up in fits of giggles and whispers.
     The moment we heard the garage door shut behind my parents, we raced to the liquor cabinet, which was, because of the lack of reverence my parents had for liquor, more like an ordinary cupboard beside the fridge than a cabinet. (Naturally, I’d prefer a more dedicated display if I were to keep liquor in the house. I don’t—with three spots all with great cocktails mere steps away, there’s simply no need.) My parents didn’t drink much while I was growing up, although I eventually learned my dad kept a bottle of sherry in his desk drawer, which sparked in me a lifelong love of the stuff. I imagine he’d sit there punching numbers into his adding machine—a pre-computer, large-scale calculator whose gears you could hear grinding away even from the kitchen, a floor away—and sip­ping sherry, just a little bit.
     I dragged a plush chair from the kitchen table to reach the cupboard. Everything inside looked weird and foreign, and as I gingerly pulled out bottles and passed them down, antic­ipation grew. I hopped off the chair and we struggled to open the stuck-on caps. Eventually, through sheer force of will, we twisted them off, immediately noticing that what was inside the bottles smelled even more foreign than they looked. Up until that point, while I’d had a thousand sips of my dad’s beer foam, I’d never smelled anything like gin. I put it to my nose, and was almost immediately knocked back by its aggressive astringency. It smelled like something I imagined would be better suited for polishing silverware than sipping in cocktails. At thirteen I couldn’t imagine why anyone would ever want to drink something that smelled like it would tear a hole in your gut. Now, of course, I can’t imagine a more mundane life than one without gin-and-tonics.
     After sniffing a few of the spirits and not really knowing the differences between them—they all smelled like they’d kill you—we narrowed it down to the options with “chocolate” or “fruit” on the labels, eventually settling on crème de menthe and some Swiss chocolate almond liqueur. Both smelled sweet and delicious, so I bravely sipped them. But the flavours were distracting to my mouth, the tweaks of alcohol off. Still, that didn’t stop me—or Kathleen, Christine, and Caroline—from gulping directly from the bottles. In that moment, we were convinced that if we used glasses my parents would know we’d been using them for liquor. It never occurred to us that we could wash and put them away before my mother and father got home.
     We passed the bottles around for a while, getting louder and more giggly as the night went on. On first pass we couldn’t have had much more than the equivalent of one proper adult drink. But man, either we were wasted, or we just believed we should be so hard that we became so. We spent the evening stair-diving—a not entirely smart thing to do sober, let alone drunk, but then we weren’t entirely smart. We scurried to the top of a carpeted stairwell (which, at that time, in the suburbs, meant any staircase) and I positioned myself, banana-style—an arched missile perched on the top step—legs flailing behind with my pals gamely holding on to them. I was face first, splayed out on a pathetic-looking towel I’d plucked from the linen closet, posi­tive that if I used a fluffy white one my mother, a woman with “display” tea towels, would surely know what we’d been up to. We counted down—“Three! Two! One! Geronimo!”—they released my legs, and I zoomed down the stairs at lightning speed, somehow not chipping a tooth. Screaming with laugh­ter, we took turns, and as experience and liqueur emboldened us, simply releasing legs was exaggerated to the point of actively shoving each other down the fourteen steps, rewarding our survival with sips of crème de menthe between rounds.
     We drank enough sickly sweet liqueur that, in conjunction with the stair-diving, it was all just too much for my stomach, and at some point during the night it rejected its contents. Somehow I managed to puke into my metal garbage can in the middle of the night and sneak it to the toilet in the morning without my mom noticing anything was amiss. And no one else was busted—everyone’s parents had picked up their daughters around 10:30 and either didn’t smell the booze or didn’t bring it up. The perfect crime.
     After that night I don’t think I touched alcohol much until high school. I went to a huge school with a great academic program, which is why my mother insisted I go there instead of the high school my elementary school streamed into, and where all of my friends, except for Greg, were going. Like me, he was going to Woburn Collegiate, a 2,000-student school a bus ride away from my house, and while I was excited that we’d be going to the same school, once we arrived there, I real­ized that something had happened—rather, something hadn’t happened to him—during that strange summer full of para­lyzing fears of the unknown between primary and high school. By the time I noticed what hadn’t happened to Greg, our lock­ers were in the same corridor and I towered over him, skinny legs and all. Surrounded by new boys, most of them tall and unknown, Miller High Life–drinking Greg Harper no longer had my attention.

* Name changed

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City of Toronto Book Award finalist; A Globe 100 Best Book of the Year

Scarborough is a low-income, culturally diverse neighbourhood east of Toronto, the fourth largest city in North America; like many inner-city communities, it suffers under the weight of poverty, drugs, crime, and urban blight. Scarborough the novel employs a multitude of voices to tell the story of a tight-knit neighbourhood under fire: among them, Victor, a black artist harassed by the police; Winsum, a West Indian restaurant …

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In the Black

In the Black

My Life
also available: Hardcover

A remarkable memoir about achieving prosperity in the face of relentless prejudice

In the Black traces B. Denham Jolly’s personal and professional struggle for a place in a country where Black Canadians have faced systematic discrimination. He arrived from Jamaica to attend university in the mid-1950s and worked as a high school teacher before going into the nursing and retirement-home business. Though he was ultimately successful in his business ventures, Jolly faced both overt and covert disc …

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Life on the Ground Floor

Life on the Ground Floor

Letters from the Edge of Emergency Medicine

Do no harm is our most important rule, but we break it all the time trying to do good.
In this deeply personal book, winner of the 2017 Hilary Weston Writers' Trust Prize for Nonfiction, humanitarian doctor and activist James Maskalyk reflects upon his extensive experience in emergency medicine. Splitting his time between a trauma centre in Toronto's inner city and the largest teaching hospital in Addis Ababa, he discovers that though the cultures, resources and medical challenges of the hos …

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G is for ground.
I’ve been cutting down my shifts in the last few years so I can spend more time on Ethiopia. I work about ten a month now. It’s just enough to keep my skills up. Fewer, and my fingers fumble.
     When I graduated, I did twice as many. During those months, being in the ER was simpler than it has been since. My flow was natural, my hands steady, and my patients’ faces grew as indistinct as the date or time. It was the hours outside of work that started to hurt. It is easy to ignore your own worries when there is a never-ending list of worse ones placed in front of you. My rela­tionship failed. Friends fell away. Beauty too. I felt fine.
     I wasn’t. Fatigue caught up with me and I slowed down for a minute, looked around, wondered where everyone was.
     If we in ER gather in community, it is to talk about how to resuscitate a baby, to poke needles into fake plas­tic necks, or to practise for poison-gas subway attacks. We don’t practise joy, how to stay well in the face of all the sickness.
     Doctor, Nurse, heal thyself.
     Or not. Those who work in the ER burn out faster than any other type of physician. I’m not sure if it’s the shifts or the long, steady glimpse of humans on their worst day.
     I think most of us would say that it’s not the sickest that affect us, that it is the minutes in contact with them when we feel most well used. In a macabre way, we hope for the next person to have something really wrong with them, but it is more rare than you’d imagine to see a criti­cal patient in Toronto, even in the trauma room, someone whose system needs the order the alphabet can bring.
     Most of the work here is in minor. ERs are open all hours, and since the service is free, people often come in early, instead of an hour too late. Sometimes there is nothing wrong with their bodies at all. There are so many measures in place to keep people well, or to catch them before they get too sick, I can go weeks without intubat­ing someone. Worried minds, though, latch onto subtle sensations that magnify with attention, and lacking con­text, they line up to be reassured. The two populations, the sick and the worried, mix together, and separating them keeps us up all night.
     Suffering souls, though, there is no shortage of them. They circle this place.
     Some sleep right outside, on sidewalk grates, wrapped in blankets, waiting. One is splayed in the clothes he lives in, face pressed against the metal grille in a deep, drunk sleep. Every few minutes, a subway passes below the grates, and a rush of warm air flutters his shirt like a flag.
     Businesswomen spin in and out of an office tower’s revolving doors. They cross the street, eyes dancing between their phones and streetcar ruts, pretending not to notice the figure on the ground. Shoppers with bags from the Eaton Centre dangling from their arms lean into the road looking for taxis, jump out of the way of rushing cars.
     A guy across the street notices the body. He glances at it, then at the hospital, makes a calculation that there must be no better street grate in the city, and moves on. Others step over him, as if he was downtown city furniture.
     Within a few blocks of my ER, there are a dozen shel­ters for abused women and the homeless. There are health clinics for indigenous people, gay men and women, refu­gees, detox centres, beds for kids who’ve run away from home. On my way to work I pass them, pierced, dyed, smoking. Sometimes I’ll see them in the ER, shyly pulling away a bandage from the cuts they made on their arms.
     Seaton House, a men’s shelter just up the street, holds more than five hundred. It has an infirmary for the old and the sick, a special floor where the most craven alco­holics are given brandy every hour, so they don’t die on those grates. A patient told me that the floors are patrolled by gangs, and if you’ve a bag, they will pin your arms from behind and rifle through it, taking what pills or dol­lars there are.
     “They call it Satan House.”
     He was new to Toronto, to big cities even. He sat on our bed, his bag empty and eyes wide.
     “I can’t go back there. Drugs. Bugs. Fights. Can I stay here? Just one night?”
     Sorry, man. Here’s a list of other shelters, a central access number, a sandwich, a prescription for the medicines you lost, a number for our social worker who can help you fill it, a bus token, a bandage for your foot. But I’m sorry, this ain’t no hotel.
     He held his backpack tight, under the sheets, shook his head, no fucking way. Security hoisted him from the bed, a guard on each arm, walked him down the hallway, out the door, into the night.
     We give out clean needles, single-use vitamin C sachets so people can dissolve crack or black tar heroin in its acid instead of sharing lemon juice and scarring their veins. Some people come in just for sandwiches, or to use the phone. Others, to sit in a chair.
     One of my colleagues rolled a man in a wheelchair out into a storm. The man had been pretending he couldn’t walk, but when Jeff’s back was turned, he would stand, grab hand sanitizer from the wall, and drink it down. He’d been doing it for hours before someone noticed. After Jeff pushed the man out, he sat back down at the desk in minor, began angrily filling out the man’s chart, paused, then slammed his pen down and, furious, snowflakes melting on his scrubs, wheeled the man back in. Our trust gets broken and broken and broken and broken, but underneath it is an even deeper caring.
     A few years ago, I heard an overhead page—“Dr. Maskalyk to triage”—and I walked out, to help decide which way to direct a stretcher I’d guessed, and instead saw a bailiff who touched me with an affidavit, dropped it, furled, on the ground.
     “Sorry,” the registration clerk said to me, bashfully. “I thought he was a friend.”
     I picked up the rolled paper. A lawsuit. It named many doctors. I couldn’t remember the complainant.
     I got his chart from medical records. It didn’t cue me. I’d met him once, two years before. I could remember the night. So busy, running from minor to major every few min­utes. I have a vague memory of his back, but not his face.
     The chart was mostly empty. “Flank pain” was his complaint, and I scratched in only a few physical findings. In the margin was a note from the nurse: “Verbal order, Maskalyk, morphine 5 mg IV.” You get calls like that all the time, from a worried nurse, asking for pain relief for someone writhing in a stretcher. Sure, sure, I would have said, after I asked a few questions, 5 milligrams.
     In the years that had passed, I had touched a hundred backs, seen many people in pain. This man was fine. There was no bad outcome. He had CT scans, MRIs, all negative. His charge to me was that I contributed to his opiate addiction. He named every doctor who had crossed his path.
     The case dragged on for years. My lawyers kept tell­ing me that it would go no further, but it kept limping. Every few months, another letter, until whoever was helping that man exhausted what money he had and the case was dropped.
     Some of my colleagues haven’t been so lucky. Some­times that person with back pain that sounded the same as the hundred before in fact has a hemorrhage, or an infection, and becomes paralyzed. I received an angry letter from a family doctor who said I was incompetent for not x-raying the leg of a young woman he had sent to the ER. She hadn’t fallen, hadn’t endured an injury. I examined her leg. No swelling, no chance of a break. Not blue, good pulse. No emergency as far as I could tell. Does it hurt when you do this? Stop doing that, I said, every doctor’s favourite piece of advice. Rest it, see if it gets better. It didn’t. The bone had a tumour in it.
     Shoulder pain in a drunk man, sleeping it off in the hallway. This time, I got an x-ray. Negative. The pain persisted. I CAT-scanned his neck. Broken. The pain was from a pinched nerve. He hadn’t complained of neck pain, couldn’t remember falling. But I didn’t feel along his neck until much later. I should have. I didn’t even put a collar on before I sent him to scan. A screaming radi­ologist called me in minor. “What the hell are you doing sending him up alone?”
     First shift, after I graduated. A pharmacy student with severe asthma. Often, patients with chronic disease know what they need. Adrenalin, intramuscular, he said, requesting our most powerful drug. I found a nurse, told her what I wanted, stepped away to write on his chart, turned back to see the colour drain from her face, watched him fall back onto the bed. How did you give that adrenalin? I shouted, my finger already on his neck. Intravenous, she said, knowing her mistake, that in a living person, it must never go straight into the blood, that it is too much for a beating heart to take.
     Shit, I said, lacing my fingers together before ham­mering down on his chest.
     He lived. I told him what had happened, then my chief and the nursing supervisor. The patient understood, probably better than anyone in the world. At least my asthma’s gone, he said, wincing as he tried to sit up.
     I could go on. No matter how careful I try to be, I make mistakes. The next one is just waiting.
     We are taught all kinds of things as we work our way down the alphabet. To spot a hurt person, to remain sus­picious, to learn from our errors. It can be difficult to rest from the worry.
     “You will fucking too see this patient,” I said to a resident who refused to assess a woman with AIDS who couldn’t stop vomiting long enough to take her pills and had nowhere to go. “Because it’s your fucking job, that’s why.” Anger shook me.
     “You stupid jew cunt!” a patient yells at my colleague.
     “Handshandshands!” a security guard shouts as the man they are watching undress pulls a knife.
     “I have hep C, and if any of you come close, I’ll spit in your eye!” another man, scratched and bruised, screams, five cops holding him down. He was released from prison a day before, having served twenty for murder. In his hours of freedom, he beat another man nearly to death. “Come here,” he says, looking at a nurse behind me. “I dare you.”
     I’ll sue you. I’ll stab you. I’ll come back with a gun and kill all of you. You’re a shitty doctor. You’re an ugly nurse. You’re an idiot. Goof. I want a second opinion. I want to kill myself.
     Dying person, dead person. Sick person. Lying person. Faking. Manipulative. Poisoned. Raped. Dead. Screaming. Crying. Writhing in pain. Hopeless. Afraid. Confused. Alone.
     Wow, must be stressful, people say.
     You get used to it, we answer.
     Ground floor, downtown, ground down. Suffering can be contagious, and no matter the job you do, it just keeps coming back.
     Your world view skews. If you don’t make an effort to balance it, the ER becomes your new normal. Like a home, you turn to it for what you need. Your colleagues seem like the normal ones, because they can joke while a man, shot dead, lies behind them.
     Daddy, a colleague’s daughter said, all you do is work, sleep, and drink. A nurse told me after a string of five days in a row, she took a bottle of wine to bed, and cried.
     It’s hard to make it ten years here. Some don’t make it two. It’s worse for the nurses. They spend more time at the bedside, unobserved, unprotected. They watch people die over hours, asking, “Am I going to make it?” again and again. I get asked once. “We’ll do what we can,” I say, and move on.
     The ones that last are changed. The shifts, the swearing, the shouts of pain, the anxiety and sadness and anger pour­ing from strangers. Miss a decimal place and someone’s dead. Drug seekers lie to your face so they can flip pills on the street, and you grow suspicious of those in real pain. The addicts and alcoholics who circle this place, lost and dying, whom you can’t help and no one else wants. A security guard had his nose broken one week. A nurse, a chunk of hair ripped from her head. She waited until it stopped bleeding, then finished her shift. I haven’t seen her since.
     We work when we are sick, masks over our faces so we’re not contagious. I broke my arm, and didn’t miss a day. We have a silent agreement to not ask for help. Sick­ness becomes weakness, weakness a sickness.
     It’s rare to connect with the people I treat. The ones I do best for wake up in the ICU, in a sedative haze, not sure what happened or whom to thank. We deliver more dead babies than live ones. No one shouts, “Mazel tov! It’s appendicitis!”
     We don’t develop relationships with patients, claim that we prefer it that way. We dive deep, straight, unapologetically, unsentimentally, into a person’s worst fears, ask them about sex, drugs, who’s hurting them, why they’re hurting themselves. We look in their eyes, watch them cry, put needles into their veins until they’re plump with water, dab blood from their cervixes, know their bodies more intimately than they ever will. When the new shift comes in, we go home and try to live in ours.
     I sat in my first suit, tugging at the cuffs, and told the doctors across the table, ones who were deciding whether they would let me into their emergency training program, that I thrived on the type of challenges the ER presented. I didn’t mind odd hours and had healthy habits to make up for tough nights. They nodded, satisfied, and I walked out, past a half-dozen nervous young men and women, their answers the same as mine.
     We get ground down anyhow. The pace, we’ll say, images of mangled limbs we take with us wherever we go. It’s hard to leave, even if you know you should. It feels good to be surrounded by those who know what you do, to whom you don’t have to explain.
     Some of us make it through. Some drink. Some smoke. The ones who last best, laugh. Even about the black things. Especially about the black things. Without the absurd, there is only tragedy.
     A woman, twenty, fell down twenty stairs. One eye was swollen shut. She wouldn’t answer to her name or open her other eye. She pushed at the nurse’s hands that tried to help her, again and again, sought to climb out of bed. I sedated her until she was still, and did a CAT scan of her brain. The scan showed bruising, blood in the grey matter where there should be none, a slick of it pooling inside her skull, squeezing her brain tighter and tighter. I called the neurosurgeon, a German, and explained what I saw.
     “So she needs the OR,” I said over the phone.
     “Is she . . . pretty?” he said in a heavy accent, chew­ing, swallowing.
     “I don’t know . . . I guess so.”
     “Zen we must to do everysing,” he said, and hung up the phone.
     A few hours later, nurses and I recalled the conversa­tion as we switched back and forth for CPR. We laughed, above an old woman’s still heart, caught ourselves, turned our eyes back to our work, and fell into smiles.
     You can see those who are edging out. When we’re unable to meet the sadness, or to laugh about it, cynicism takes hold. Even worse, anger. We curse nurses on other floors for being too slow. We criticize our colleagues’ decisions, their flow, their bad day, forgetting that they, like us, are just trying to make it through a shift, a week, a month, a life, surrounded by all the pain.
     Last, we curse our patients. This is a final sign. Touch­ing many people, but being touched by none of them, they close like a flower that no longer sees the sun. It’s as if every person takes away from you something you need.
     Not her again, a nurse says under his breath, as a volunteer places a chart of a regular on the desk, as if this wasn’t the point of the place, as if this didn’t happen twenty times a day.
     People think that to make it through, we become inured, develop some kind of barrier, beyond emotion. It doesn’t work like that. You can offer an illusion of indif­ference, even tell yourself that you’ve got it handled, but all that tough stuff makes it in just the same. What shuts down is the part that turns it around.
     There’s too much to do, a next patient to see, and if you’re never told how important it is to work on anger and fear as it comes up, you put it off, and the frustration diffuses into all aspects of your being, its origins almost invisible. You can get so behind, you abandon the proj­ect. Then, on that fateful day, when you have a chance to do something right for someone you don’t know, or cut a corner, you say to yourself, “Fuck it.”
     The end has come. Time to quit.
     People do. Plenty. I’ll see them in the hall after many months, when I used to see them every day. Miss us? I’ll ask. Yeah, they say, I do, some of them wistful. But I just couldn’t do it anymore. It wasn’t good for me.
     What they mean is, instead of just the worries follow­ing them home, some numbness did too. Joy started to seem for fools, because while there are many things we will never know, what we do know for certain is that one day, a bullet meant for someone else will whip through our body, our foot will turn on a dog’s toy on the second stair and we will fall, or a cough will tickle our chest then sputter a tablespoon of blood, and in an instant we know what it means.
     It’s here.

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Any Other Way

Any Other Way

also available: eBook
tagged : gay studies

The story of how Toronto came out as one of North America's leading hubs of queer activism and culture. Toronto is home to multiple and thriving queer communities that reflect the dynamism of a global city. Any Other Way is an eclectic and richly illustrated local history that reveals how these individuals and community networks have transformed Toronto from a place of churches and conservative mores into a city that has consistently led the way in queer activism, not just in Canada but internat …

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