Zach cradles the woman's vagina and tells her to push. The woman screams. Zach thinks she is somehow aroused but not in a sexual way. Under her breath, the woman is talking to herself and making indecipherable statements. Zach wonders what the woman is trying to convey. She is breathing heavily and begins crying hard. Zach worries about the woman becoming too emotional. He looks at the woman's face and sees blood vessels surfacing across her forehead. He thinks the woman will explode. He has a mental image of the woman giving birth to a mushroom cloud. He imagines being afraid of having to tell the woman that she has given birth to a nuclear explosion, that radioactive particles are emanating from her womb. "I've changed my mind," the woman says. "I want the drugs." She grunts and swallows with her eyes closed. "Too late," Zach says. "You're almost there," he says. He looks down at his hands and wishes they were magnetic claws that accelerate labor, that exert a pull on all placental matter. The woman presses her ankles against the foot stirrups and coughs. Her vagina opens awkwardly around Zach's fingers. Zach accidentally touches the woman's clitoris. Zach tries to make a comforting noise. "Almost," he whispers softly into her cervix.
Zach is a medical student in New York City. At the hospital, he is responsible for changing bedpans and diapers. He sometimes delivers babies in emergency situations. He thinks, "The medical profession is the only field that is universally altruistic." Zach feels happy. After work, he walks to the subway in his scrubs. People look at him and think he is already and doctor. Zach realizes he has nothing to read and becomes aggravated. On the train, he reads the advertisements on the walls of the subway car. The advertisements say, "Budweiser: The Great America Lager." Zach inhales and tastes the particles in the subway air. He feels the particles coat his lungs and he becomes anxious. Zach feels he is unable to keep his teeth from grinding. His chin muscles become sore. He chews his lip. When he rolls his tongue across his teeth, he thinks he feels a tumor in the bottom of his jaw. Zach closes his eye and imagines he is back home in Idaho. Zach wonders where he is, wonders why he is where he is, wonders why he is wondering. Zach thinks he has intricate ways of torturing himself.
In his apartment, Zach can hear his roommate doing yoga in the living room. He thinks, "I should exercise more for the health benefits." He tells himself that he is too busy and doesn't have enough time to be 'health conscious'. Zach imagines his is an indentured servant. He imagines the Mayor of New York City is his indebted master. Zach feels depressed and becomes hungry. He cooks a Hot Pocket in the microwave and watches the cheese bubble from the foil. He wonders if the microwave runs on alpha, beta, or gamma rays. He wonders which ray is more 'lethal.' He eats his Hot Pocket and wonders if he is poisoning himself radioactively.
Zach lies in bed and rests for a while. He feels his blood flow though his veins like a polluted river. He runs his hand through his hair. When he looks at his fingers they are covered in hair. He thinks he is dreaming but can't be certain. He becomes nauseous and his chest begins to throb. He sits up and can feel his arteries palpitate beneath his ribs. He wants to cough but is breathless. He thinks his saliva tastes metallic. Zach doesn't know what to do. He puts on his shoes. He runs out of his apartment and hurries down the stairs into the street. A group of kids are skateboarding on the sidewalk. The sound of their skateboards against the cement grates on his eardrums. He falls backward and lies there. He stands and walks to a bench on the corner. Mucous is running down his face and he saws his nose with his sleeve. He cannot control his breathing and wants to expel. Zach measures his pulse. "I will be fine," he thinks. When he regains his composure, he is lying in bed. When he opens his eyes, he wants to scream as if angry, as if scared, as if disappointed and confused and unable to control it.
Zach walks into a deli and comes to the beer section. He considers American or imported beer. He buys a six-pack of Budweiser. He thinks, "Buying American products with help simulate the economy." He walks to the subway and rides to his apartment. He drinks and watches a bootlegged copy of The Motorcycle Diaries on his laptop computer. Zach reads the subtitles and feels lethargic. He thinks about exercising but feels too lazy to walk to the gym. He lies on his floor and does fifty push-ups. He becomes tired and feels awkward. He touches his liver and feels hepatitic. He drinks another beer and wonders if he'll be hung-over tomorrow. He thinks about Che Guevara and feels sad that that he can't leave everything in his life behind. He thinks, "Like Che Guevara did in The Motorcycle Diaries." He thinks, "I want to explore too." He tells himself that is okay because he is more responsible than Che Guevara because he is mature and has a job. Zach feels having a job gives him society's approval and becomes depressed. He pictures himself on the back of Che Guevara's motorcycle. He wishes he was Che Guevara's friend. He imagines he is friends with Gael García Bernal, the actor who plays Che Guevara in The Motorcycle Diaries. The thought of this makes Zach happy. He drinks half of another beer and goes to sleep.
Zach is fastening an IV to a man in a recovery room. Zach can smell the man's diaper and isn't sure what to do. A man is lying on a bed and says something sickly and indecipherable. "What's that?" Zach says. "Is everything okay?" The man coughs and makes a motion with a limp wrist. The man's skin is old and leathery. Zach wonders if the man has fought in any wars, if he has shot anyone, if he has been shot or shot at himself. He wants to ask the man if he has fired an AK-47. Zach wonders what it would be like to be a solider. He thinks, "I'd like to feel the thrill of battle." Zach wishes he had enemy. He wonders if having an enemy somewhere would give his life meaning in some strange way. He can see the man is pointing a television remote. Zach looks at it. "What do you want with that?" he says. "I can't reach," the man says. His voice is hoarse. Zach picks up the remote. He tries to be patient while the man asks him to turn on the television. The man's eyes become very excited. Zach smiles a little. He thinks he is having feelings of compassion. He almost holds the man's hand. He thinks about feeling compassionate and has feelings of weakness. Zach turns on the television. When the screen ignites the man leaps out of bed. He says, "I think I'm cured." Zach looks startled. The man looks startled. He takes his diaper off and pulls the IV out of his arm. The man says to Zach, "Are you an angel?" Zach doesn't know what to say. He thinks he can feel radio-waves pouring from the television and spreading throughout the room. Zach hands the television remote to the man and writes what happened on the man's chart. The man holds the television remote like a magic wand. He is naked. He kisses the remote with his lips and rubs it against his nipples. Zach leaves the room and the naked man is alone.
A pornographic movie is watching Zach from his laptop. An Asian woman is staring at him. She is wearing bikini and lying on a bed. Her bed in is a dorm room, or someplace. She says, "Hajimemashite" and begins to undress. She says, "Shitsurei shimasu." She moves her hands down her chest to her ribs and stretches. She says, "Suki desu ka?" Zach doesn't say anything. He maximizes the screen and wonders what the woman is saying. The woman says, "Kudasaiiiiiiiiiiiiiiiiiiiiiii" and closes her eyes. Zach smiles. The camera takes a close-up of the skin around the woman's ribs and slowly grazes up to her contorted face before slowly pulling back. Zach can see what the woman is doing to herself. To Zach the woman's face is emblematic of human hunger, or desire, and her actions are emblematic of the measures humans take to satiate their hunger or—he thinks—the measures humans take to resist satiating their true hunger. He feels confused. The woman says, "Kore o kudasai" and begins to murmur. She looks worried and her face carries a concentrated expression as the camera pans over her limbs. Zach thinks, "She looks hungry." The woman pulls out a ripe-looking banana from beneath a pillow and rolls it over her body. The woman moves her legs and blankets fall off the bed. Zach wonders if the woman thinks the banana is a real penis, if the banana is coated in any type of pesticide, if it matters. He wonders what the woman's gynecologist would say to her right now. Zach's vision becomes blurry and feels cataractous. The woman looks anxious. She says, "Hai hai hai hai hai" and makes the banana disappear. She whispers something indecipherable under her breath and shakes a little.
Zach wants to stop thinking things. He leans his head against his desk and feels the oils from the pores of his skin. He doesn't know why he is what he is. He thinks becoming a doctor will be morally redeeming. He doesn't know why he is where is. He tells himself, "Living in New York City is culturally rewarding." He thinks, "I should move to South America, or someplace, where the weather is nicer and I can be happier." He feels reflexive and inanimate. He thinks about his family in Idaho, his mother and father. His brother. He wonders what they are doing. He pictures them as cold and bored. Zach sits at his desk for a while and doesn't move. He wonders what he has to do to feel 'good'. He feels a spasm in his throat and thinks he has lymphatic cancer. He walks to his bathroom and looks at his reflection in the mirror. He stares at himself with squinted eyes. He thinks, "I am just hiding my emotional purposelessness with my work. If I enlisted in the army and shot terrorists with an AK-47 my eyes would squint the same way and I would feel the same." Zach wonders if feeling the same in a different place doing a different thing would feel different.
Zach's roommate is at yoga class and he is happy to be alone. He goes into the kitchen to get a glass of water. He drinks and puts the glass into the dishwater. He thinks he can taste lead but he ignores himself. Zach looks at the dishwasher. He isn't sure if the dishes inside the dishwater are clean or dirty so he runs the dishwasher again. He thinks, "To be safe." He turns on the radio and opens the windows. He sprays the counters and tabletops with Lysol and wipes them with a paper towel. Zach wants to call his house in Idaho and ask someone in his family a question but he can't think of anything he wants to know. He listens to the radio and tries to recognize the music that's playing. Zach goes to his couch and sits. He breathes in the Lysol vapor in the air and isn't sure what to do. He wonders in what quantity Lysol becomes 'fatal'. He turns the radio off and turns on the television. Zach changes the channels a few times but only sees commercials. He feels cold and goes to shut the windows. When he gets to the window, Zach can see a neighbor looking at himself in a mirror in an apartment across the street. The man is naked and rubbing his stomach. Zach wonders if the man ever feels the way Zach does. Zach doesn't want to be seen so he closes the blinds and crawls into bed wearing all his clothes.
Zach dreams. He is paddling a canoe down a wide river. He passes crocodiles, cornfields, and other people in canoes. When Zach sees the cornfields he thinks he recognizes his surroundings but can't be certain. He breathes and thinks, "This water smells hepatitic." He touches his liver. Zach paddles down the river until he comes to an island so he steers his canoe towards the island and gets out. He sits down and thinks about what he should do. He waits for an idea but no ideas come to him. He contemplates nothing for a while and watches the water as it passes, aware of the vacancy inside him but not willing to think about it deep enough to analyze.
Zach can't find his cell phone. He calls his number from a landline to see if he can hear it ring. Someone answers. A voice says, "What do you want?" Zach feels confused. He says, "What do you mean? This is my phone." The voice whispers, "Not any more." Zach says, "Well thanks a lot" sarcastically. "You're welcome," the voice says. The line is quiet and Zach doesn't know what to think. He feels awkward that he and the voice have nothing to say to one another. He cannot tell if the voice is male or female. He wonders if the voice on the line belongs to an attractive person. A minute passes. The voice says, "Aren't you even interested to know who I am?" The voice is sounding more female but he isn't positive. "Sure I'm interested," Zach says. He sits down as his desk and tries to make himself comfortable. "What are you doing?" the voice says. "I am sitting down," Zach says. "Why are you doing that," the voice says. Zach thinks to himself. "Because I don't want to be doing anything else," he says. "Because I'm sick of doing things that I don't want to do and because I don't have a choice." There is silence for ten seconds. "You do have a choice," the voice says. "My choices suck," Zach says. "Maybe you should kill yourself," the voice says. "You're an asshole," Zach says to the voice and hangs up the phone. He stands up and looks around his room. He kicks his chair and it falls over. He kicks it again and again, as if to take revenge for having to live on this planet day after day, alone.
Zach is preparing a patient for an x-ray. The patient is a woman. Her skin is white and Zach can see her blue veins through her white skin. He and the patient are alone in the x-ray room with a table and various instruments. There are tangles cords and a computer consul with blinking lights. Zach is mentally protecting the patient from contamination by not touching anything. He walks over to the sink to wash his hands with antibacterial soap. He imagines the radiation particles on his fingers screaming as the soap burns through their membranes. Zach thinks, "It is impossible to kill every single particle." He wonders what the particles will do if they get inside the patient. He pictures the shape of these particles. He thinks, "They are shaped like stars dipped in caramel." He imagines the particles invading the inside of the patient's stomach and when the patient moves the particles melt her abdominal cavity. Zach looks at the woman. She has her arms resting beside her body. She is quite and thinking about her x-ray. Her palms are moist. Zach looks at the blue veins in her arms and is unable to concentrate. Zach wants to pour antibacterial soap all over her body. The woman is motionless on the table. Zach asks her if she is feeling okay and the woman nods to answer affirmatively several times. He wraps her in a lead blanket and says, "There you go." Zach turns around and waits. He closes his eyes and imagines an Asian nurse through the window of the x-ray room. She has a serious facial expression with her arms folded across her chest, mouthing the letters "B . . . A . . . N . . . A . . . N . . . A . . . " slowly to Zach over and over.
There had been days before Zach moved to New York City and became a medical student—years, decades even—where all he did was sit at home and wait for something to happen. "This town sucks and there is nothing to do" was the overarching theme of his mindset then, waiting for something to happen at the mall, at work, at Starbucks, watching television, spitting tobacco juice in a Styrofoam cup. Sometimes Zach would try to make himself angry by thinking about how empty his life was, how useless and anesthetized everything seemed, but then he felt that didn't matter, and all that was left was a cold deadened sense of aimless monotony. Other times, depression would overcome him, appearing spontaneously, and he would try to restrain himself from crying by pressing his palms into his eyes to seal his tear ducts. Zach often believed, then, that nothing in life was of any worth, and there was nothing any one person could do that would be of lasting worth to another person because people are unable to fully understand one another because every person is preoccupied with filling their empty lives with empty, immaterial things and thoughts. The only thing Zach could really feel was the apathetic sense of not wanting to be human, which made him feel powerless because he knew that there was nothing he could ever do to change what he was—tomorrow and the day after he would wake up still himself, in the same skin, as the same species, knowing things would still be the way they had been for his entire life and the things that make up life would never change—depressing things, exciting things would always be the same things: Zach sitting in his room alone, trying to keep himself from feeling sad, from feeling happy, from feeling.
Zach rolls over and climbs out of bed. He gets up, slips on his sandals, and turns down the thermostat. He walks into his kitchen and pours a glass of milk. He wonders if the cow from which the milk came from was given steroids. He considers the effect this could have on his milk's 'purity.' He wanders to his desk and checks his email. Zach imagines someone somewhere doing something exciting. He wonders if this person entered the world by birth canal or cesarean section. He wonders if this impacted the person's life in a positive or adverse way. When he walks back through his apartment, he notices that the television is on, pouring black light across the room. Zach sits on his couch and swallows a mouthful of milk. He looks at the television and begins to feel upset. He wants to smash the television screen. Zach feels weak and obedient. He thinks, "I want to feel revolutionary." He is filled with the strong desire to pour his glass of milk into the television's posterior vent in an effort to destroy the appliance, he thinks, "Or something." Zach takes another gulp of from his glass, walks into his room, and slowly climbs into bed. He drinks the rest of his milk looking at his reflection in the dark screen.
Zach is working at the hospital overnight. He is supposed to be collecting bedpans. He sits in a swivel chair and spins around. He can feel the centripetal force pulling his eyes from his sockets. He stands up and feels dizzy for a few seconds and sits back down. He can feel his heart beat and wonders if he has caused himself brain damage.
Zach gets out of his chair and walks into a vacant recovery room. He looks at himself in the reflection of the window. Zach thinks he looks uncomfortable in his scrubs. He looks out the window and turns around. He steps on a cord and feels his ankle roll a little. Zach decides to lay himself across the clean sheets of the hospital bed and plants himself face-first into the pillow. Zach lies on the bed; holding the pillow to his face and feeling his breath warm and moisten the pillow's fibers. He rolls over and spots a splotch of blood on the ceiling. He grinds his teeth. He thinks, "I'd like to realize something." Zach stands and walks into the hallway. He wishes he could run away but isn't sure to where. He returns to the swivel chair and closes his eyes. He squeezes them tight until his forehead cramps. Zach doesn't move or speak. His silence is an argument he can't understand.