I. Dialysis: the process of cleansing the blood by passing it through a special machine; necessary when the kidneys are not able to filter the blood.

I get there at five a.m. and feel the morning sharp and time-broken, trained like the paperboy to circuit through the neighborhood and toss itself onto the lawn. When I close my eyes, I hear the incoming geese floating over on feather as they look for a space without snow. They say it is spring and they say that the man I am picking up doesn’t have much life left to go. I open my eyes, fog-blind, and slip across the ice up to the concrete stairs, stooping to pick Larken’s newspaper out of a flower pot nearly empty but for the pool of ice slicked across its bottom.

After I knock on the door, I hear Larken’s muffled shout, a humph through the walls. I set the newspaper down on the welcome mat, and run back to the driver’s seat to wait next to the heater.

Larken soon comes out, and I move away from the heat, get ready to hold his arms in the position I have been taught, which is not a positioning that feels native to the arm’s preference for looping, or for grabbing on and never letting go. He laughs at this diligence, as he does every morning, three days a week when I come pick him up. Then he smacks my shoulder with his newspaper, which he will spread out on his lap all day as his blood leaves impure and then comes back froam its clinical communion. I smile at him and he chucks my chin before climbing up inside the bus. Each day I watch his age multiply with the needle holes in his arm.

I do not pick him up afterwards; that is Edley’s job. Edley helps him up the stairs, holding his cup of ice as Larken clutches the brass of his stairwell and pulls himself upward. At the top of the stairs, Edley hands back his cup and Larken slurps the lingering snow cone to replenish the liquid that has thickened outside of his veins and come back a poisonless sludge.

I’m glad that I get to pick him up. We make our way through the snow because a kidney does not acknowledge the danger of ice and tire; it simply sputters and fails. Larken sits quietly, and the empty space of the bus does not seem empty but simply quiet. I look frequently through the rear-view mirror to see if I can see Larken as the lampposts whip their strips of illumination across the bus and then whip them back. In the second’s lighting, I see him sitting there, accepting that this moment will not last much longer.

When we get to the hospital, he moves slowly down the stairs, waves his newspaper at me, and it is the last moment I will see him with everything that is him in his blood, with his body soiled and human, with all his limbs attached, before transcendence is achieved in a machine’s erasure.

II. Colostomy bag: colostomy is a surgical procedure that creates an opening (stoma) on the abdomen for the drainage of stool from the large intestine (colon). The colostomy bag is the plastic container that contains the drained stool.

David is too large for me to follow protocol, since he carries on his oversize wheelchair three backpacks, a grocery bag full of newspapers and two flower pots, each one on a knee. The motor of the lift groans under the immensity of his bulk, and I can’t help staring at the back of his head, where I’m sure I can make out papier-mâché chunks of flour mired inexplicably in his hair. Either that, or the back of his head has erupted through gnarled hair and ejected its white matter into the surrounding environment.

As I watch him maneuver around into his spot, I notice again that each of his ankles has the same diameter as his thighs. If things weren’t the way they are, I would lift up his jean pants and wrap my hands around these ankles, feel the girth between my thumbs. Instead, I watch his ankles until he has positioned himself perfectly, and then I pretend I wasn’t watching. After this, I go over to tie him down.

I have to strap him in and this is always hard with all his gear, which I have to lift up, set down, push aside. I shove my body through the small spaces between the bus wall, the seats, and the belts on the floor, which I have to wrap around the base of him. It is a strange intimate feeling, as if I know and he knows and everybody else couldn’t possibly know, that the wheelchair is part of him; and I am touching him, out here in the public, running my fingers across his steel bars, a strange skeletal exterior. When I clasp the belts around the chair, it is medieval sensuality: the rack, the stocks, a quartering.
I reach and stretch a strap, pull it tighter, and I hear a phht, followed by a liquid, green like tobacco in water. It drips across the bar of his chair and onto the floor.

“What is that,” I ask him, and he tells me it’s his bag. “And what’s in it,” I ask him and he tells me it’s internal fluids. “What,” I ask him, and he looks me in the eye and says, “Shit. It’s shit.” What kind of man has green shit, I wonder, and then I smell it, not like normal shit, but like something indefinable, sweet and puckish at once. I stand up, a businesswoman suddenly, and David’s eyes follow me as I step outside of the bus and void my stomach onto the green lawn of his apartment building. When I am done, I feel embarrassed and wipe my mouth. I go back inside, sprinkle some concealing powder on the bus floor as David looks out the window. Then I take him where he is going.

III. Amputation: the removal of a limb

I pick Ms. Henderson up at the hospital and there is nobody with her but a nurse, who tells me to be gentle, like I don’t know, and makes sure that her IV drip is still attached to the wheelchair. I take her into the bus, lift via machinery the parts of her that remain, that might remain for a while longer. When she’s in place, I have to rearrange her blankets to attach her in, and I wonder what would happen if a wheel came off her wheelchair, just like that, popped off and removed itself, went back into the hospital.

She talks as we drive away, and the other passengers in the bus are silent under the sound of her IV murmuring, the whisper of where it went, what they do with a removed part.

She wonders out loud if they will cremate it for her, and if she can have it in an urn on her bedside table, so she could feel that it wasn’t so far away from her. I wonder if they package it up after the surgery, drop it into a plastic bag, wrap tape around its bulk, the blood still smearing against the white plastic. I wonder if they have a repository, a place for safe keeping, perhaps something like a laundry bin with a pile of throwaways labeled “Anne’s arm,” or “Joe’s foot.” I wonder if each limb is as blue or black or torn away from itself as Ms. Henderson’s was before they took it away from her. I imagine that no matter how diseased or gangrenous it was, it must have felt, like love, indiscardable.

Ms. Henderson sits behind me, murmuring, wondering where it has gone, whether they are treating it well, whether it will somehow be able to survive without her, keep walking, develop its own mouth perhaps, whether she will pass it on the street some day, and say, “that used to be a part of me,” have a flicker of longing and repentance, feel the heat swash through the body, pain the only means to recognize what once was there.