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The name on the tracking board didn’t jump out at him immediately. The April night was passing sluggishly, and his overtired mind dragged on with it. On second glance, a distant gear clicked into place. He cursed under his breath. A nurse was staring at him.

“Ross?”

“What’s the story on the patient in B12?”

“Nothing too exciting, EMS brought him in passed out, history poly-substance abuse.”

There were a few more patients to see first, but Ross poked his head into B12 as he passed by. It was him.

They had already grown apart by the time Ross graduated medical school. For years though, Jarrett’s dingy bungalow on the north end of town was a strange fixture in Ross’s life. It was a haven where his thoughts quieted and he acted on muscle memory alone. Scorch the foil and listen to the rocks crackle. Feel the confidence surge upward through him and out his normally filtered mouth. There they would all plan their departure to somewhere warm and underdeveloped where they could execute the elaborate business ideas they had. During those heady nights, he believed it all. Yet unfailingly, once the surge subsided and he had slept off his exhaustion, he would go back to school without a second thought. It made him feel incredibly powerful and subversive to move so seamlessly between this world and his stable professional life.

Ross examined Jarrett quickly and gingerly, imagining the shame if he awoke and recognized him. As he had continued through medical school, the creeping guilt became impossible to ignore. One day he ran into one of the guys on his way to work. In the clear daylight, the pimpled skin and skittering eyes made Ross’s chest drop. They didn’t turn it off when he left. While he easily abandoned them when he had exams or other commitments, they remained a sad, fixed backdrop. His visits to Jarrett’s house tapered off sharply after that meeting, and they never questioned him. Years later, while doing ride-alongs with emergency medical services, Jarrett’s neighborhood was a frequent destination for pick-ups. Ross would look at his colleagues and gauge how they would react if he told them that the people they picked up could be brothers or cousins of his old crew.

It was a quiet moment in the department, and Ross retreated to the back room with his dinner and charts. Jarrett was still on his mind. Soon he would wake up, see Ross, and the façade would shatter. It was a lie with which they were all complicit; a necessary moral elevation so one could be appropriately stern and authoritative. Ross asked his patients to use his first name, but his boundaries were firm beyond that. Here he was and had always been an occasional social drinker, unfamiliar with the cigarette, scornful of street drugs. He denied his intimacy with the smell of stale alcohol and the pressured speech of crack users. Here he was detached, stern when appropriate, and occasionally gently condescending. He wore the role so comfortably within the emergency department that this was as honest as the other sides to him. Then came days like today when he felt so pulled apart that he was sure someone would point out the fault lines.

It was morning. The winter skies had given way to a grudging gray dawn, the earliest yet this year. The nurses had alerted him that Jarrett was starting to wake up. He walked in as Jarrett was blearily opening his eyes. Ross braced himself for the recognition; the surprise clouded with painful embarrassment. It came. Ross cleared his throat.

“Hey friend, give me an hour and we’ll get out of here and catch up, okay?” Ross checked behind him; no one had heard. He turned back to breathing shallowly, but still in a single piece.