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And Elena, flat on the table this whole time, gel on her stomach, two heartbeats galloping out of the speakers, stares at the ceiling and says:

"I want a raise."

Chapter 12

The Ghost

LUKE

There’s a baby-name book in my scrub pocket. Preston put it there.

I’ve read forty pages. I know which names are common in our zip code now. I know you don’t rhyme twin names; I didn’t know that a month ago. Last night I read a forum thread on twin sleep-staggering – two hundred posts across nine years, ending in a divorce – and when Preston found me at 02:00 he said nothing, which was worse than anything he could’ve said.

“It was informational,” I told him. “Not emotional.”

“Of course,” he said, and turned off the lamp, and I lay in the dark running hypotheticals in my head.

At work, it’s starting to show. Today I ordered a repeat CBC on numbers that didn’t need repeating. I checked a med dose three times, and the pharmacist asked if I was all right. I said I’m fine. She looked at the title of the book sticking out of my pocket knowingly and said, “Uh-huh.”

Twelve weeks. Two heartbeats. My focus has a leak in it, and apparently everyone in this department is allowed to say so except me.

At 18:20, a father carries in his eight-year-old. The kid could walk. The kid wants to walk. Distal radius, closed, textbook – he came off a scooter and the scooter did what it was designed to do, break a bone. The kid’s fine; he’s already enjoying the arm and the story behind it. The father isn’t fine. The father has said “I looked away for one second” to four different staff members, like he’s rehearsing testimony in front of a jury.

I set the arm, cast it, and let the kid pick the colour. Then I give the father the speech, because he needs it more than the kid needed the cast: children break bones. Bones, especially on children, are built to be broken. A broken arm from playing at eight years old isn’t a judgement on your parenting skills. It’s proof the kid has a good childhood. He breathes for the first time in an hour and thanks me three times.

Then I walk away feeling like a fraud, because the brownstone has three floors, forty-one stairs, a radiator in every room, and I’ve baby-proofed none of it. And there will be two of them. Twins strategise and coordinate. The forum was clear.

At 19:00, Mamá’s shift ends. She stops at the board on her way out, tells me there’s arroz con pollo in the break-room fridge with my name on it – literally, on tape – and that Elena needs more iron in her diet, and she’s going to pick up more prenatal vitamins for her. Then she goes home.

At 19:40, the board updates. Bay 3. Laceration, forehead, minor trauma. The name reads SILVA, J.

Silva is the forty-fourth most common surname in New York. We get two or three a week. None of them has ever made me stop walking, so I don’t stop walking now. I pick up the chart, and pull open the curtain.

“Mijo.”

Residents ask me sometimes what a cardiac arrest feels like from the inside. I tell them I don’t know. I know now. The curtain rings are very loud, and then nothing is.

My father is sitting on the gurney with a two-inch gash over his left eyebrow, holding the gauze triage gave him, and he’s grinning at me like I’m the best thing he’s seen all day.

He’s older now. Sixteen years older. Greyer, thinner, the good looks gone loose over time. But the grin I remember yearning for as a kid didn’t age. Nothing that mattered to him aged.

“Look at you,” Julio Silva says. To the room, to the ceiling, to the nurse restocking the cart who has no idea what she’s just walked into. “A doctor. My son, a doctor.”

There’s a version of this where I walk out. I distantly note this to myself: the option existed, I saw it, and my hands picked up the suture kit anyway. He’s bleeding. I fix the people who are bleeding. That’s the job. Nobody said anything about which people get fixed, just that they do.

“How’d it happen?” Neutral. A doctor’s question.

“Ah, it’s stupid.” He waves the gauze. “A ladder situation. I was helping a friend replace a lightbulb, the ladder had other ideas – you should see the ladder.” He laughs. The laugh hasn’t aged either. “Two stitches, right? Three?”

“Five.” I glove up. “Maybe six.”

“Six! From my son. You know what I paid for stitches in eighty-nine? Forty dollars, and the guy was a veterinarian.”

I irrigate and numb it. He doesn’t flinch at the needle, and he talks the whole time, and it’s good talk. It was always good talk. He could always make anything sound like it happened to both of you.

I place the first stitch. My hands are steady. The hands are fine. It’s everything above the hands.

He’s talking about a baseball game. I know the game before he lands on it. August. I was eight. Box seats someone owed him, a foul ball two rows over. I’m eight years old and my father’s hand is on my head and the stadium smells like rain that hasn’t started. Mamá packed sandwiches that day because she said the concessions were a racket, and then he bought me a pretzel anyway, and winked, like the pretzel was a secret we were keeping from her together. That was his gift. Everything was a secret you were keeping together.