Natalya

MEDICAL EXAMINER REPORT

GROSS DESCRIPTION:

The autopsy is performed approximately 26 hours after death. Permission is by the mother of the deceased. When I read your name on the toe tag, I don’t believe it right away. Then I see your ankle tattoo, faded but still the same shape.

It’s late and I am alone in the morgue. I lean in close to you. I open one eye with a blue-gloved hand and stare at the dilated pupil. I press my fingers into your inflated cheeks. Through the excess tissue, I feel the familiar shape of your face in my hand.

“You can’t choose the things you remember,” my mother told me one afternoon, while she cleaned and gutted a fish in the white mouth of my grandmother’s kitchen sink. “The important things will find you.”

I remember this: the sharp scent of raw fish that stuck to my mother’s hands for the rest of the evening; the seaside town in rain, smelling rotten and alive at the same time; the smudges in your eyeliner as we stood under the awning of a shuttered convenience store; me with the bag of onions my mother forgot, and the slimmest cigarette I’d ever seen like a lollipop stick between your lips.

You knew I wanted to kiss you. That’s what I heard in the crackle of paper and dry tobacco each time our eyes met in that small space. A cold wind swept in from the coast and the coming winter cut its teeth on our ears. We didn’t know each other yet. Between us there was still the strangeness of a stranger’s body trapped near your own. We didn’t know each other yet but you closed the space between us and blew smoke too close to my face. I couldn’t speak, only stare at your cracked lips, plaster skin and that round, graspable chin.

When the rain eased, you stepped back onto the sidewalk, but I stayed so I could watch you toss the cigarette butt into a puddle and walk away.

I never thought I would find you so many years later and so many miles from where we met. Yet here you are, unexpected and fruit-flesh pale. I have forgotten many things from that year. My mind smoothed out what my skin couldn’t. Despite this, your dark bun and the pinkness behind your knees clings to my mind.

CLINICAL SUMMARY: 

You, the patient, are a 41-year-old female with a medical history significant for diabetes, chronic tobacco use, COPD, and teaching me how to coax an orgasm with my tongue. For several days prior to the event that took your life, you complained of dyspnea. Your mother found you only hours after your death, lying on the carpet in the apartment where you lived alone.

Our history began in the last summer of high school. I came to your town because my grandmother died, though I never told you this. That lakeside colonial you dropped me off at was hers. My father had grown up there. He learned to swim in that lake and spent summers cycling through those neighborhoods. Throughout my childhood, I visited my grandmother, between summer camps and over long weekends, but only after her death did we spend so long in that house. It brimmed with my grandparents’ long, full life. My parents didn’t know what to do with its remains and had to spend a month carefully sorting, discarding. They brought me not because I was too young to be unattended, but because a few months prior, I had been sent to inpatient care for cutting myself. No one dared to leave me alone.

I saw you for the second time on a Sunday morning, as I tried to swim across the tiny lake between my grandmother’s house and yours, bored and taken with its smallness. My long limbs, which had come in a sudden growth spurt the previous year, were still new to me. I thought I could catch anything within my new wingspan’s breadth. Barely halfway, I grew tired. I stopped to tread water, panting, and wondered if I could drown in that shallow lake. How many minutes until I stopped fighting for the surface. How many hours until my parents noticed I had not come home. How many years before people stopped thinking about me, dead or alive.

This is when you, skinny as a carving knife, emerged from the trees on the opposite bank. I recognized you immediately by the shape of your limbs and the lines your arm made as you dropped the cigarette from your mouth to your side, flicking ash. A nymph-thing masked in smoke. You looked my age but there was something animal about the way you leaned against the tree, like you were listening. Did you see me swimming or were you looking at something beyond my bobbing head? 

Because I couldn’t bring myself to drown in front of you, I swam back to my side of the lake. But I searched for you everywhere: the paths in the woods, the kitschy town center, the mall in the next suburb. You were nowhere until you were walking across a parking lot towards me, no longer fantastical. Just another teenager, like me.

EVIDENCE OF INJURY:

Your body is entirely unscathed. No bruises, no wounds. Not so much as a bit of peeling around your fingernails. There are some new creases and stretch marks but the texture of your skin is exactly as I remember. I always envied it.

In medical school, I discovered that suicide is contagious, especially with teenagers, and this filled me with dread. I could have been the first link, dragging a chain of unknowable length into an unknowable non-existence. I remembered you then, your mouth around the phrase, “You have to be afraid to live.”

EXTERNAL EXAMINATION: 

You, the subject, are 62 inches tall and weigh 140 pounds. Your body is well-developed, well-nourished, albeit slightly overweight for your stated age. You have a blue-gray tattoo on your ankle: blurred Cyrillic letters. I can’t read them but I still remember how you spoke his name out loud as you sat naked before me.

There is dependent lividity, algor mortis, and rigor mortis that keeps your arms open. I try to fold them against your sides but they keep springing back out, your tendons unwilling to release their last pose. Once, your hand flies out and almost slaps my face. My startled gasp echoes through the morgue. Before I can stop myself, I say your name out loud. I plead with you to be still. My voice sounds strange, ricocheting between walls that never hold tenderness. Fluorescent bulbs buzz through the following silence like summer insects.

“You don’t live here,” was the first thing you said to me, a statement rather than a question. I had just unlocked my bike outside the grocery store in the town center. I couldn’t identify your accent, though I could guess something Slavic in your name. When I replied that I didn’t, and I didn’t know anyone, you seemed to sparkle with home field advantage. We exchanged names. I thought the Capri Light you pulled from its pink-and-white box was a piece of candy until you lit it. You offered me one, but I declined because I had never smoked before we met.

I was nervous for our walk, palms sweating as I dragged my bike along with us. I hardly paid attention as you pointed out places you liked amongst the storefronts, until you stopped at the little one-screen movie theatre and pointed at the marquee. “I love this place the most.” 

I listed moderately artistic movies I knew, hoping to impress you, even though some of them lulled me to sleep. I was reluctant to admit I had never seen your favorite, Coffee & Cigarettes.

You offered to watch it with me, and I caught your ash-and-soap smell for the first time as you stepped closer and said, “Come over.”

I replied, “Sure,” but I meant yes yes please yes.

Your head is not deformed and you have no scars. Your sclerae, cornea, and lenses are clear. Your nose and external ears are beautiful, petite and pale like the imperfect end of a half-molten candle, but unremarkable, their passages clear. Your lips and gums show no lesions. Your neck is symmetrical and has no unusual masses. Your clavicle, breasts, protruding abdomen, all of your flesh is unremarkable, unlike mine.

I pull up a sleeve to show you how well my scars faded. It has been years since I made the most recent one.

INTERNAL EXAMINATION (BODY CAVITIES): 

On the strip of balcony outside your mother’s third floor apartment, I pretended I was having trouble with the lighter so that you would lean in close. The scrape of the wheel striking flint was crisp in our ears and contained between our cheekbones. You offered me the flame, cupped like a fluttering insect in your waxy rose lotion. I liked how your apartment faced away from the lake, towards the sea. Over your shoulder I saw the broken Maine coast, beach-less and wooded, a series of lakes widening out into the Atlantic. The smoke tasted barely bitter, faint enough to keep puffing as you watched.

Inside, we played the film on your computer monitor, sitting on the bed with a screw-top bottle of red blend. At first I joined you each time you opened the window and lit another Capri, dangling one arm out into the evening, but past the third I couldn’t keep up.

I remember that the film was black and white and there was a lot of talking, mostly about nothing. It appears this way in my head: a few images, one or two lines of dialogue. Wrinkled faces and checkered tables, ceramic cups and ashtrays blooming with cigarette butts. I didn’t like it very much, and after a while, I gave up on paying attention.

The sky blackened slowly as the sun dipped into the opposite horizon. Your room filled with cool air. There was still about a quarter left in the movie when you tossed your shirt aside and unclasped your bra. The rest of the evening is a blur of fingers and teeth. On the brink of your second orgasm I realized the film was ending because it was silent and completely dark, your breath caught in that hitch of anticipation before you came.

As you smoked again afterwards, limbs dribbling into the moon-wet night, I noticed the black lettering on your ankle. When I asked what it was, you turned from the misty window. Your tongue flicked Artur’s name in a way mine never could. The love of your life, an older man from your hometown. I grew anxious as you told the story and began to gather my clothing quickly. I had never been on any side of unfaithfulness. I felt naive when you laughed and said, “Don’t worry, he lets me fool around.”

I wonder what happened with Artur. All I know about your relationship is that photo you showed me decades ago, the two of you on a rooftop in Moscow, a place you promised you’d return to. Your file cites you as a US citizen with an address in the city, unmarried. As I make the first incision, your hand finds my waist. Your fingers brush my hip like you’re reaching for me. I hold your arm down with my elbow and push the blade deeper.

The standard thoracic incisions are made. Your pleural cavities contain a moderate amount of clear yellow fluid which I must measure, reduce what’s inside you to cc’s. I unravel you on the cold table. I split a seam through your center, tug and rearrange the jeweled yellow fat. Everything within is slick, threatening to slip from my grasp. I catalog every centimeter of you, weigh each organ with equal care. Your skeletal muscles are dark red-brown, of normal firmness and bulk. Your ribcage is intact. There are many things I never asked you. Even with my hands around your heart, my fingers tracing your vertebrae, you are a stranger.

HEART: I first saw my wife from afar, too. On a blinding January afternoon, I passed her alone in a classroom on the way to my advisor’s office. The tight, tumbling chaos of her hair writhed in the sunlight. She flipped a page in her book and didn’t look up to notice how long I watched her before walking along. I never told anyone this story until now, how mythical she looked then with dark eyelashes, thick eyebrows, a round face like a thumbprint in her curls. We met later, in the same study abroad group. She introduced herself as Emma, and though I had never heard her name, my heart rioted in my chest, I know I know I know I know you. 

Emma doesn’t know about you. I never thought she would need to. I recount all this because it was nothing like when you told me your name in front of the grocery store. My whole being stilled at the sound of your voice—muscles, organs, mind. Rigor mortis. You finally understand how it feels. 

With its fat peeled off, your heart weighs 296 grams, heavier than average. The walls are thickened by calcified yellow plaques. The myocardium, in contrast, is soft and mottled. I describe you with words I’ve written countless times. Smooth. Moderate. Transparent. Yet you were never any of these things.

GENITOURINARY SYSTEM: After we started hanging out, I told my parents I’d befriended a few local kids and they were happy to drop me off wherever to meet up with them. Really, it was just you, but they didn’t ask questions. They were relieved to have me out of the house, where they listened to my every step and tensed each time they heard silence.

My mother and I kept a strict routine when I returned home each evening. I stripped down to my underwear and she checked every inch of me for fresh cuts. When she was done we spent the rest of the night in front of the television. My father joined us to watch a late night talk show. They asked about my day, but each question felt heavy with the big unanswerable ones they never voiced. My father placed one hand on my shoulder and left it there for a long time. My mother watched me the way she must have watched my mouth open and close when I first lay beside her. Each act of affection was a small humiliation.

Your right kidney weighs 111 grams and the left weighs 120. Your bladder and uterus are normal. You have never carried a child.

GASTROINTESTINAL SYSTEM: Most afternoons I spent with you seem indistinguishable now—hotboxing your mother’s SUV, driving aimlessly while the trees sipped and swallowed the sun. I saw every shade of your face on those roads, the painted yellow and white lines ticking past your sunglasses. While my parents emptied my grandmother’s house, stripped all the places touched by our family’s fingertips, I catalogued your features white and gold and pink and blue, then flickering in and out of the dark with each passing streetlight.

In sparse towns we found quiet streets to park and fold down the rear seats. The nearest houses glimmered faintly between the trees. The windows fogged up from our bodies, sticky and panting in the air conditioning. On clear days, the crickets were deafening, and on others we listened to the rain. Curled together in the back of your mother’s car in pitch black, you traced your fingers over the ridges on my thigh.

“I knew a girl in Moscow who did this kind of thing,” you whispered one evening, tapping the marred tissue. Click, hiss; your cheek and lips came up in quivering snatches of yellow and gold, then disappeared. “I don’t get it. Why?”

I could have told you about each scar then. How the first cut was an accident. While helping with dinner, I was careless with my mother’s sharpest kitchen knife. I didn’t recall how it slipped, only that when the crisp mark swelled with blood, my heart suddenly returned to my chest: I know I know I know.

“It feels good,” I said, unable to explain anything more. I followed the cherry in an arc from your mouth to the gap in the back window. I imagined Artur lying like this by your knee in the cinder block apartment complex where you met. My nostrils filled with smoke.

You switched on the car light and climbed to the front seat, skin sallow under the tiny bulb. The glove box fell open with a thunk. You returned with your mother’s Swiss army knife, and I held my breath as you sat cross-legged and slit the inside of your leg. A tiny red streak appeared, bubbling until a thin line slid down your thigh. I had an impulse to lick it up, tease the opening with my tongue.

“It stings,” you said.

I pressed one finger next to the wound to find that it barely cracked. “You didn’t go deep enough.”

You lay down and rested your head on my leg. “I’m afraid of blood. I can’t look at it any longer. It makes me sick.”

I wasn’t sure if it was the blood that made you sick, or me. My skin gave away how many times I had done this, how much more blood I’d drawn. “You didn’t have to do that,” I said.

If you had asked, I might have explained how I stole one of the X-Acto knives from the art studio at school and tucked it under my mattress. I started out very careful. I enjoyed the power of counting secret wounds for several months, though the nights I made them were murky. My game ended one evening when my mother returned home from work early. I stood before her in my towel, damp and exposed, and she looked me up and down with her house keys still clutched in one hand. She slapped me and began to cry.

Instead, you asked, “What are you afraid of?”

I thought of the lake. The green water turned my scars to ripples and my limbs into disappearing things, unrecognizable. “Nothing,” I said.

You laughed. “That’s stupid.”

“Why?” I took a napkin from the center console and wiped up your blood.

“You have to be afraid to live.”

You sat up. I realized it was almost ten, and you called Artur at eleven each day. We dressed and you drove me home, the Swiss army knife rattling in the glove box each time you turned.

Your gall bladder is surgically absent, a no-show to our reunion. All the parts of you that could have once been sick are what we call grossly normal and unremarkable, no tumors or ulcers to be found. I check your thigh for that cut but it was so shallow, it didn’t leave a mark.

ENDOCRINE SYSTEM: I can’t examine your thyroid because of the limitations of this autopsy so I will just write this: when I’m asked why, I remember being fourteen at a fitness class in school when I saw myself in the mirror, working the candy-bright dumbbells up and down, my sneakers squeaking off the hardwood, thudding onto the plastic step, and staring right into my sweat-polished face, I thought, what am I doing here, and then, what am I, and suddenly the clapperboard hit my throat and my blood screamed cut, cut, cut and the whole scene was reduced to a tick-marked screen behind a long, fat lens and I squinted, trying to make out where the set ended or what lay beyond it but I couldn’t, the lights were too bright and I didn’t know who I was outside the script and the dumbbells slipped from my grip and hit the ground and there is still a dent on that floor and I haven’t been able to forget my own eyes since.

RETICULOENDOTHELIAL SYSTEM: Your spleen has substance, slightly enlarged and firm, which I find ironic. I never moved or upset you. I never even heard you raise your voice.

The first time Emma saw me naked, she stopped everything to stare. She ran her hands along the marks just like you did once. “If I ever see a fresh one, this is over,” she said with a hard edge to her voice, and I nodded, assuring her, “I’m past it.” Like this, we lied into each other’s mouths for the rest of our lives.

The temptation never left me. I’m in my best years now. I see a therapist once a week and nothing bad happens if I skip a session. Still, sometimes I think about every kitchen knife we have, black handles jutting out of their wooden block.

Emma, fierce heels and unflinching cerise mouth, never has patience for finicky painters and catty art dealers. Despite this, she gives me chance after chance, because we all have to be weak to something.

An incision in your spleen reveals a small imperfection: an area of infarction, pale as a pink moon.

LUNGS: The rest of that summer passed in a swift daze. My parents cleared out my grandmother’s house. Rugs rolled up, furniture and antiques sold, the books, clothing, and kitchenware picked off from the lawn during several tag sales. Everything else in a bin at the nearest Goodwill. We filled a rented van with the important things: photo albums, family heirlooms, my grandfather’s glasses. Soon the house was empty.

I can no longer pinpoint the last evening you and I spent together, but I remember taking one last dip in the lake before we drove home. The water in Maine is never warm, even at the end of summer. I stared up at the stretch of flat blue, strands of clouds like scar tissue across it, and wondered if I should tell you I was leaving, whether you would care. I tried to imagine what you would say, but I could only picture you sitting cross-legged on the balcony, shrugging, taking a drag and not looking at me. Staring out at the sea that separated you from someone else. Fear, colder than lake water, slithered into my veins. My body came alive at something so petty. I pulled my head underwater. Bubbles flew from my mouth and nose, but I couldn’t ignore the ache in my chest as the last of my breath left me. I surfaced into the creamy sky coughing.

I received your text the week later, Hey, are you around? I wasn’t so I didn’t reply and you never contacted me again. 

Your lungs have a combined weight of 723 grams. They are the usual shape, but full of carbon and plaques. You must have switched from Capri Lights to something harsh and heavy, even though you told me that thick, stubby cigarettes looked ugly in a woman’s fingers. I imagine you felt death come for you. I picture you lighting a cigarette on some balcony in the city, waiting. Instead of traffic, you heard pines chatter in the wind and tides lap the soil. 

I’m sorry I never said goodbye.

EXTREMITIES: I pull back your skin looking for everything I never understood about you. I put my fingers in your mouth, feel around your teeth. Your tongue is dry. You don’t even twitch when I prod your uvula. Your nipples, soft and wide, won’t bead up if I pinch them. If I pluck your ribcage, you won’t recoil. No matter how I touch you, you remain still, peeled apart like pithy citrus.

I seal the fissures and wipe the smears from your skin. I try to arrange your body symmetrically, but your limbs and breasts keep falling askew. There is so much more to you — stomach folds and dimpled thighs. The girl from that summer was only a sliver of the person you became. I lean in and hold your round face in both my hands, your earlobes’ familiar fit in the crook between my thumb and forefinger. Obscenely, I still want to kiss you. I want to bite your cheek to see if it tastes the same. Instead I release you, and pull the sheet back over your face. This is the last time I see you.

CLINICOPATHOLOGIC CORRELATION: 

Emma and I spent a semester in Italy. We spoke the language better than our classmates, so while they were in Rome and Florence, we stayed alone in a small town with a university that only offered classes in Italian. We often had coffee before class, dinner on pleasant evenings. My host family had a beautiful garden and patio where we would sit with wine, a soda can ashtray, and a Marlboro between my fingertips, talking for hours after everyone had gone to sleep. One hot night, our faces barely lit by the splatter of yellow windows and sickle moon, I kissed her. 

“I was wondering how long it would take,” she said as I pulled back. I thought of you then, how you cornered me between the movie and your window. You never waited. 

You died naturally, of acute myocardial infarction. After I shut you away in a drawer, I wonder if I was trying to recreate my evenings with you that first summer with Emma. Hold a mirror to the last time I wanted to devour someone cheek first. 

SUMMARY AND REFLECTION: 

I still don’t know if I loved you, yet you linger within me like an apparition. I carved my deepest cut right before I took the MCAT. I still have a slanted seam across my forearm. It needed many stitches and the doctors told me I was lucky my hand remained steady after it healed. That night, with the shower running, the tiles turning red all around me, I thought of the tiny slit on your leg and how much that hair-thin wound hurt you. As I fainted, the sound of water became the engine of your mother’s SUV, the rush of the highway, and then your breath in my ear.