It was always the same vision of a dream: himself, prodding along in a dark cave, ankle-deep in a black, viscous substance. Inevitably, a vague sense of apprehension, of mild confusion, as if he came into the cave purposefully but forgot what that purpose was. And the cave was a slick black, the walls bleeding with black, and the light not light but a dim illumination in a shade of lesser black. He would attempt to steady himself by grasping at the slippery walls unsuccessfully, until utter blackness would envelop him, either from the black liquid rising below or the roof of the cave above collapsing in.
He would awake abruptly, soaked in sweat, his heart beating uncontrollably. A glance at his phone would tell him that, despite a night of meagre sleep, it was time to get ready for work.
—
Andy was a simple man in that he saw life as a benign pawnbroker who asked for something and gave something in return. That was the closest thing he had to a life philosophy: he was filial in exchange for his parents’ care, he endured medical school for a chance at a stable career, and he went to Mass every Sunday in exchange for God’s blessings.
Andy was easygoing, obliging, almost a gentleman, though he did not think of himself in such terms. His demeanor was kind and he approached life with a smile, despite often being deeply unsure of himself. He was fairly intelligent, but not quick. He maintained a cautious, open-hearted posture towards life, with the expectation that life in return would be fair, if not kind.
After medical school and the glow of graduation, photos, and well wishes subsided, Andy knew that his next step was to enroll to become a junior doctor in Malaysia. He had heard whispers of what this job title entailed: the obligatory abuse, both mental and physical; the overbearing consultants who smirked and bullied their way through life; the breakdowns, tears, resignations; the suicides.
During his first day of work, Andy prepped himself to be cheerful, though the fear of being exposed as a fraud ate at his insides. He had imagined that the initial adjusting period would be tough but fair, but he was quickly disabused of this notion by two events that took place on his very first day.
The first occurred when he misplaced a pen when a senior doctor required it; for this he was dressed down as being completely useless: if an empty-headed newbie could not be trusted to provide a pen when necessary, what good was he?
The second involved an encounter with the same senior who interrogated him on the most common therapies for Prader-Willi syndrome, a rare genetic disorder. Light-headed with nerves, Andy failed to give a straight answer. For this he was berated, told that he wasted his medical degree and that he was a prime example as to why the Malaysian healthcare system was failing. Worse, Andy dropped a piece of paper under a patient’s bed and stooped to all fours to retrieve it; for this the senior remarked that he looked like a dog and was probably more useful playing the role of an animal.
—
Things will get better, Andy told himself. Things can only get better.
But fate loves to contradict the isolated idealist, and every day a dagger would be driven deeper into Andy’s patchy armour of hot-air optimism. Even as he expected to better adjust to his excretory working environment, hoping to become more competent and gain a measure of dignified composure, Andy never did, for the abuse flowed freely, gratuitously, every hour of every day, and he never found the inner space to dissipate and reorient.
And so the days tumbled forward, one after another, and instead of growing in stature as a practitioner of medicine, Andy shrivelled on the inside, his blood flowing cold. Mistakes were made, foolish mistakes, such as the mislabelling of blood bottles and forgetting x-ray appointments. His feet became shifty with uncertainty; he seemed to always be running in panic or paralyzed with fear. With Andy’s deterioration in full view, his seniors smelled blood and easily became more vicious, like vipers sensing a cornered prey. They began to mock him even more openly, questioning how he made it through medical school and why he even bothered in the first place. At every corner they made sure Andy knew that he was a waste of time, of space, and that his selfish, twisted desire to pursue medicine had placed everyone at an unbearable inconvenience.
Andy felt that he was suffocating, and his spirit withered like a plant without water. His breathing became uneven and often too rapid; he felt like crying but tears would not come. In Andy’s mind, only Christ’s Passion — the Son of God mercilessly tortured for the sins of the world — made any spiritual sense. Gone were the memory and joy of the Annunciation, the Transfiguration, even the Resurrection.
The dark broodings of his soul caused him to return repeatedly to the black cave of his dreams, and Andy understood that his night visions were his soul’s desperate attempt to allegorize his current state of being. He searched Scripture for answers to his present predicament, but time and again he would stop, breathless, as if by the guiding hand of Providence, at the words of Ezekiel 18:20:
“The soul who sins must die.”
—
There were many things that Andy loved: Mozart, cool evening runs, Arsenal, a warm plate of KFC. However, as time went by, Andy forgot his loves; further: he forgot what love even was. He was practically living at the hospital, drifting mindlessly through the nights and days and nights and days, overworked, yelled at, scoffed against, made to feel invisible. He became numb, as if his feelings, like a machine, just stopped working. He became a sorry shadow of a person.
Increasingly, Andy would climb to the roof of the hospital for fresh air, attempting to recover a sense of self. He would close his eyes, breathe in and out, in and out, but all that was accomplished was a disturbance of air. The inescapable truth was that Andy was slowly slipping beyond the reaches of hope, and a black darkness was eclipsing all faculties of reason. Andy felt that the words of Ezekiel must be true, that his career was sin, he was sin, and as it was written, so it shall be done:
“The soul who sins must die.”
—
Andy was holding the ambu bag for a patient, an inflatable device that needed to be compressed every few seconds to simulate breathing. This was a monotonous task and Andy was soon staring at the late afternoon sky outside, lost in thought.
“Andy!”
He turned to the senior who barked his name and saw in his eyes an appetite for frivolous cruelty.
“Did you notice that the patient shitted on the bed?”
Andy had not.
“Wa.. very clever, come, I clap for you.”
The senior performed a mocking slow clap.
”Come to think of it, you’re pretty shit yourself so it makes sense you don’t notice your own kind when it is around.”
The senior laughed.
“Tell you what, let me handle the ambu bag, you clean the shit. No, don’t ask the nurse to do it. You do it cause that’s what you are.”
—
After the ritual humiliation, Andy rolled up his sleeves, cleaned his hands, looked himself in the mirror and did not recognize himself. He returned to the hospital roof, intending to attain a sense of reprieve, but the darkness that had entered his soul began to fill him to the brim, and all of nature echoed, all of nature echoed.
Andy looked up. It was as if a celestial earthquake tore the skies asunder and a terrible beauty cascaded forth. From his elevated position Andy could see households flickering to life as the dusk deepened; lights that represented families whole and together. And the night was singing, singing with the steady hum of traffic, the evening crickets, the gentle night breeze. And from within, more music: the languid whistling of a punctured soul emptying its grievances; yearnings and afflictions like bile pouring forth as if from a single fissure split wide open.
As Andy entered into a state of calm and his heart quietened unto rest, he could now hear the great, silent symphony that was at play all around him. The symphony of the great night sky: sweet, sweet night; seductive, effusive, generous, infinite. His soul, rising as contrapuntal to this vivid sound: a choir of desire, a lament of dissipated dreams, a requiem for hope in its final death throes.
During these fleeting moments when beauty and pain collided, Andy’s world contracted to a close, the music of life and all its accursed absurdities and contradictions ringing in his ears. And he felt both inspiration and fear at what he knew in his heart of hearts was the right thing to do.
Taking in the sweep of humanity before him, the sky, the good earth, and the distant horizon, Andy felt again the familiar feeling of liquid lapping at his ankles, only this time it felt like clear water. A swell of emotion, a final bow, gratitude for a well-intentioned life that would just not stop breaking apart, Andy exhaled and took a step off the cliff into the liberating waters below.
