Compounding Pharmacy

by Callum Angus

The blue blob slorped and glorped toward her. The hospital’s fluorescent lights reflected glistening white rectangles off its irregular surface—it looked smooth, not sticky, like it might be soft to touch, like a dolphin at Sea World. As tall as a linebacker, up close she had to look up to see where the blob’s head might be, shimmering and jiggling like a summer Jell-O. Instead of a nose it had a protrusion over which two depressions hovered like sockets, empty of eyes. The suggestion of arms and legs branched off from the trunk, but stumpy with the absence of fingers, hands, or feet. It wavered in front of her, uncertain, so tenuous among its surroundings. Despite the lack of any noticeably human features, its ungainly movements and the way it hunched over itself was enough. She could tell it suffered. 
          “I don’t feel so good,” it said, although it was difficult to say how. Its voice was indeterminate of gender or age, but it reminded her of people she’d known. And then it began to fall. She reached out to catch it on its slow descent to the linoleum. It was heavy heavy heavy, and as she took more of its weight she could feel a twinge in her lower back that vibrated through the rest of her body. The blob slumped to the floor where its collection of limbs blended into one pitiful mass unconscious at her feet, or so it seemed. Its mirrored surface shimmered as if tickled by a sea breeze, but she couldn’t see herself reflected. Where her body should have been was just an empty hospital corridor leading nowhere. 
          “Not again, George.” A voice sighed in frustration as George removed her headset. Outside the virtual training module her awareness returned to a gray bureaucratic room with plastic chairs on wheels and whiteboards covering three out of four walls. RN Jackson stared at a laptop and made a few strokes on the keyboard, frowning, while his assistant helped remove the velcro from the sensors strapped around George’s middle. Her classmates judiciously pretended to be absorbed by either their phones or their computers, while the blob quivered on the projector screen above the classroom. 
          “Sorry,” muttered George. Jackson removed his glasses and pinched the bridge of his nose.
          “This is a pass-fail class, George, but you need to understand: this is meant to train you to not reach out and catch a 300-pound patient who falls to the ground in front of you. You’ll hurt yourself, badly. And then you won’t be able to help anyone.” 
          “I don’t do it consciously. It’s like a reflex. I can’t help it.”
          “We’ll try again next week,” said Jackson, and the rest of the students groaned. Earlier in the semester every one of them had successfully failed to reach out and catch the blob on their first try, and watching George catch the blob over and over in the intervening classes had grown tedious. They’d moved on to other trials. They listened to irregular heartbeats and tried to identify arrhythmias. They’d steeped virtual tea while trying to remember how many sugars each family member took, besieged by a slow creep of dementia (to build empathy, Jackson had insisted, though George was mostly annoyed at the virtual adult children and their babying demands). But a few minutes were always saved at the end for George to try to fail to catch the blob.
          George knew the correct stance she was meant to take in the training exercise. It was a lunge, one foot out in front of the other to allow the patient to slide down her body gradually, if possible. George thought it looked like she was trying to trip the fainter, though she understood that the training was meant to disillusion her of the notion that certain actions or body positions indicated a predisposition to help or to hurt. Intellectually, she’d absorbed this lesson, a long time ago even. On the train home when she passed the oversized billboard with a newborn’s tomato face and the text FINGERPRINTS AT 9 WEEKS, George understood that this seemingly compassionate diorama was actually a bespoke kind of evil, and she was seized by the desire to add to the infant’s spraypaint tattoos. Even more complex calculations awaited when the bus trundled past the park where several RVs without wheels sported American flags from every corner, a ragged patriotism that had become its own home devoid of shelter, food, or care, but flush in a sense of belonging and violence. But George’s fluency in deciphering these discrepancies stopped at the hospital doors. Add the wounded flesh of people into the mix and it became a smokescreen. It didn’t help her when faced with the blob, which had been programmed to look as inhuman as possible to circumvent the trainee’s mirror neurons. George still felt for it. In nursing, empathy was considered a treasured quality to be sheltered and cultivated like a greenhouse plant, but George had always felt hers was out of control, overgrown, wrapping around any pillar of feeling it could find in its random groping. Most days it felt like only a matter of time before her empathy strangled some delicate plant of lesser strength. She feared her own care. 
          George stepped through the train doors at her stop, which was across the street from a Walgreens. She hated going inside—most of the everyday items she might need, like deodorant, chapstick, cough medicine were locked behind plexiglass cases, and shopping meant tagging along behind a beleaguered employee with a jangle of keys going from box to box, anxiously scanning the brands while they waited, a queue of customers growing angry at the register because no matter how many football fields could fit inside the store, there only ever seemed to be one person on duty. Today, however, she needed only shampoo, which remained unsecured on the bottom shelf toward the rear right corner of the store. As she stooped to retrieve it, an illuminated sign caught her eye—not neon and therefore custom, but an aluminum box filled with mostly lit bulbs, overlaid by a red transparency with the letters cut out to read “COMPOUNDING PHARMACY.” Some of the red had chipped off, giving the letters the weathered appearance of an ancient tongue. George had never noticed the sign before. Below its flickering message was an old man with the bushiest gray mustache George had seen outside of a black and white photo. He noticed her right away and his eyes sparkled from behind gold-rimmed glasses. 
          “We’re a compounding pharmacy. That means we can tailor medications to your specific needs.” His speech was a bit too close to the cadence of a sideshow conductor. 
          “I know what a compounding pharmacy is. I guess I’ve just never … needed one before.”
          “Most people don’t know when they need one. Here,” he handed her a form. “Fill this out. It helps us calibrate your specific medication needs.”
          “Thanks, but I’m busy today.”
          “It only takes a few seconds. Or just bring it back any time. I’ll be here.”
          George took the sheet to be polite and proceeded to the register at the opposite end of the store. After telling the clerk that no, she did not have a Walgreens card, she broke script and asked about the compounding pharmacy.
          “That’s Seth’s gig,” she said. “He doesn’t get much business. It’s a holdover from when we merged with the local pharmacy.”
          “Walgreens does mergers? Isn’t it more of a seek-and-destroy kind of mission?”
          She rolled her eyes, and George stepped aside to let the impatient line of customers proceed.

● ● ●

“Why do you catch me, George?”
“I don’t have a choice. It’s what my hands do.”
The blue blob didn’t seem to accept this answer. It quivered with displeasure. 
“I think—I think I care too much.”
“You’re not supposed to care about me, George. That’s why I look the way I do.”
“Are you capable of empathy?” The blob considered. No one had ever asked the blob such a question before. The people the blob encountered only watched the blob slide to the floor without lifting a finger to help. Except George. 
“I’m not sure. No one seems to care if I fall. Why should I care about them?”
“You don’t have to care about people. You can care about other things. Birds, for instance.”
“I don’t think there are any birds here.”
“I guess you’re right. No one thought to add a bird. It’s a shame.”
“A shame,” mimicked the blob. 
“There is this one flickering light, though,” the blob continued. “Its long fluorescent tube flicks on and off in a lovely pattern. I can feel it fluttering its code in the reflection off my body like a moth lost in flame. Like butterfly kisses. I feel bad for it, that it has to be stuck here where no one will come fix it.”
“How do you know about butterfly kisses?” 
The blob considered. “I’m not sure. I just do. Maybe the light told me.”

● ● ●

On Christmas Eve two months ago George answered a knock on her door. She lived alone in a small apartment in which every room connects to every other room, but she had her own door to the outside world without a hallway or stairs between her and the sidewalk. In her temperate corner of the country it rains on Christmas, as it was doing so when she opened the door. A woman stood there without a bag or jacket, strawberry blond hair damp and growing matted, a cut to the bridge of her nose healing badly. This was how she met her roommate Chrissy. George fed her leftovers. Chrissy asked to sleep on George’s couch—“It looks so comfortable,” she’d said, longingly stroking its corduroy upholstery—and George couldn’t bring herself to turn her back out into the cold. George wasn’t raised with religion, but Chrissy’s timing made it difficult for her to feel she wasn’t being tested like the people who’d turned away Mary and Joseph before the birth of Christ. She was pretty sure those people had had a good reason for turning away strangers in the dead of night in a desert town, likely better than any she could muster for herself with a whole apartment and a full fridge to herself. So she’d let Chrissy stay, and Chrissy had been sleeping on her couch ever since, with George playing a mix of lover, father, and case worker.
         “Apply for any jobs today, Chrissy?” This was George’s opening line after she got home and found Chrissy sunk into the couch, episodes deep into another teen drama binge on George’s laptop. Chrissy snorted.
          “Oh sure, they’re lining up to hire a high school dropout with no ID and one pair of pants.” Her hand rustled inside a bag of potato chips.
          “I told you you could borrow some of my clothes for an interview,” said George, sitting across from Chrissy on the ottoman while she removed her thick-soled sneakers.
          “Can I borrow your face, too?” Chrissy grimaced, showing off her teeth, most of which tried to go in different directions. George didn’t know if Chrissy’s dental problems were the result of neglect, or neglect after an accident, but Chrissy mumbled most of her words through her half-closed mouth to avoid showing them to anyone. She only put them on display to make a point.
          “It’s not a customer service mouth, that’s true,” said George, snagging a potato chip. “But there are plenty of call centers hiring all the time. I can help you put a resume together,” she said hopefully.
          “No phone,” said Chrissy.
         “I’m pretty sure they give you one,” but Chrissy had gone nonresponsive, as was her way during these conversations. George was at a loss. She couldn’t understand how things had ended up this way, where she felt like an interloper in her own home. Chrissy looked so unbothered by her presence or the fact that she was eating someone else’s food, wearing their clothes. George felt no anger. She just wished she could know what that felt like.

● ● ●

“Do you know where we are?” 
“Yes,” burbled the blob. “This is the Intensive Care Unit.”
“But what’s outside of that? Have you ever looked out the window?”
George and the blob turned to the glowing rectangle in the wall. It looked like a square through which natural light filtered and illuminated the room. 
“It’s a bright and constant light out there,” said the blob. “I don’t like it.”
George had to admit that the windows in the computer-generated hospital were ominous, as if looking out of them revealed that she and the blob were suspended inside of a simulated sun. She turned around to where the blob stood beneath the flickering fluorescent light. The blob had no face, but its posture indicated that it was considering the light deeply. 
“Do you know morse code?” George felt silly asking but she didn’t think the blob could judge her.
“No,” said the blob, whose reflective surface shone bright then dark then bright again in the fussy illumination from the flickering light. “I don’t think it’s trying to communicate with me.”
I’m trying to communicate with you, George wanted to say, but she felt this too obvious, even if the blob couldn’t understand her. Especially because it couldn’t understand her. 

● ● ●

Seth’s mustache wriggled in excitement when George handed him her questionnaire. 
          “Splendid! Just a moment.” He disappeared behind a pile of boxes so that George could only see his company-issue red vest peeking out from behind a clear plastic bag filled with amber prescription bottles like a goblin’s treasure. Such a thought was uncharitable, thought George, which maybe reflected that Seth’s promised therapy was already working. 
          After several minutes of the hollow sound of pills rattling from their containers and into other containers, Seth emerged triumphant and held out to George her prescription. It resembled her antihistamines.
        “I’m no alchemist,” said Seth. “All pills look the same on the outside. A miracle of modern medicine. Any time you feel you’re drowning in compassion, just pop one of these babies. Preferably after a full meal. You can still operate heavy machinery, provided it’s in a large parking lot with plenty of space to maneuver.”
          “I don’t drive,” said George.
          “Even better!” 
          George took the bottle of pills and left. 

● ● ●

“All I do is fall, George,” said the blob. “Maybe I don’t need someone to catch me. But I’m scared. I want to be cared for.”
“If I was just another patient in this fake hospital, I wouldn’t care about what happens to you,” said George. “I’d be so absorbed with my own pain and suffering that I’d let you fall. I wouldn’t even know you were there.”
“Patients aren’t supposed to care about each other,” said the blob, nodding slowly. “We ache and we groan and call out for help. But we don’t help each other. We can’t, because we’re patients. We are acted upon.”

● ● ●

After George had been taking her new prescription regularly for several days she woke in her dark room to the sound of Chrissy sobbing. She was speaking to someone, accusing them of lying to her and sabotaging her attempts to get well, although George understood if she were to go out there it would be just the two of them. She wondered where Chrissy would have gone had George not let her stay, if her generosity had merely delayed the inevitable, or even forestalled the possibility of Chrissy finding stability on her own. She wondered, not for the first time, who had let Chrissy down so ferociously, or what harm of her own doing she was running from. George listened from behind her closed, hollow-core door. Chrissy made no attempts to hush her keening wails; it was clear to both of them that George could not possibly still be asleep. And yet she remained in her bed. She had only a vague feeling that she’d done something wrong. There’d been no change to her internal monologue that she could notice. She still felt for Chrissy, but she had no desire to alleviate or fix her suffering. She’d gone back to the pharmacy to ask Seth if her medication was working properly, if in her journey to reduce her compassion she’d stalled out at pity. But there’d been no sign of his kiosk, just a bland institutional corner with gray carpet and crumbling tile next to a shelf of condoms locked behind plexiglass. 

● ● ●

“I’m going to let you fall.”
“I understand,” said the blob. “It’s why I don’t have a face, why I was created. To suffer and not be helped. Because it helps you.”
“Faces make it harder to withhold empathy,” nodded George. 
“I don’t feel so good.”
She watched the blob sway in front of her. She thought about grabbing one of the low-poly scalpels on the table near her hand, bringing it down with force on the blob’s exposed surface. Would it pop, or just slosh out slowly? But the program wouldn’t allow her to cause harm. Only watch or catch. In one fluid motion she crossed her legs and sat on the floor. 
“I’m just going to watch,” she said. “I’m here for you.”
The blob began its journey to the floor. Its back and forth movement obeyed the currents of an invisible storm, first one way, then the next, until no more attempts at balance could be made. George’s hands itched. The desire to reach out and catch the blob stormed just under her skin. Its blue bulk loomed over her, a tsunami of pain. She closed her eyes and prepared to feel, for the first time, nothing.

Callum Angus is the author of A Natural History of Transition (Metonymy Press), CATARACT (Fonograf Editions), and the forthcoming Stream: Life in Flux (Northwestern University Press). He lives and writes in Portland, Oregon, where he publishes the journal smoke and mold, and teaches online at celiumlit.net.