Fall 1985. The glaring fluorescent lights pierce through my head as I walk down the dingy hallway that smells faintly of urine. I feel swollen. My skin is crawling and feels hot and cracked. A lone bead of sweat trickles down the front of my shirt, and I swear it smells of Southern Comfort. My eyes are on fire. I have never been so thirsty in my life. Or humiliated. The chief of my group — Medicine B — just laced into me in front of everyone for not ordering blood cultures on a patient newly admitted to rule out Pneumocystis carinii. Every fever of unknown origin patient was supposed to have them done. The man had died 4 hours later. It was evident that he was dying, the way he was Cheyne-Stokes breathing. I didn’t want to cause any further pain or insult to him. Dr. Miles O’Sullivan thought differently: “Pull a stunt like that at again and you’re out of the program!” he screamed at me in front of the entire team during morning rounds.

How much did I freaking drink last night? How am I still upright? Why can’t I remember?

The slow roil of panic starts again. Walk, I tell myself. It was just a bad night. Alcoholics don’t land prime NYC residencies or graduate at the top of their class. It’s not like I drink every night.

Nine a.m. Oh my god. It feels like 2 p.m. already. I’m not going to last through this day. Maybe one of the nurses will spot me some Tylenol. I should go to 2 Reiser — I asked on 4 last week. They’ll notice if I ask again. My pager hits my thigh rhythmically as I walk. Pass by two more stations to round on eight patients and then I can take a smoke break. Maybe even sneak in a nap somewhere. In my 3 months of residency, I’ve learned every nook and cranny of the hospital.

My beeper goes off. 2530 is on the screen. I stop at a wall phone and dial the extension.

“Hi, this Victoria from Medicine B.” I still feel funny about calling myself Doctor.

“Hi, this is Jill from 6 Michenburg, I need you here ASAP. A patient is trying to leave. I need you to start the against medical advice form.”

“On my way,” I sigh into the phone. Sign himself out, my ass. That nurse was known never to enter one of the red-signed “Fever of unknown origin” doors her entire shift. Food trays lingered outside the doors because no one brought them inside. More likely, the patient had cracked from the loneliness and isolation he felt. I am getting sick of those red signs on the doors. They might as well say, “Ignore me until I die.” At least I can sit with Rudy after I persuade this other guy to stay.

Rudy.

My Rudy. Skinny and deeply pockmarked with Kaposi’s sarcoma, he remained resplendent in a royal blue and scarlet silk kimono that he said his boyfriend Greg had given him in 1978.

During my first exam of him back in July, he grabbed my face and began scanning it. “Great cheekbones. Beautiful blonde hair. Something about your face tells me you’re not Scandinavian, though.” Strangely, I’m not uncomfortable with his scrutiny. I usually want to be invisible.

“Second-generation Irish,” I replied.

“I like the Irish. Always drinking that Catholic guilt away,” he drawled. “Hey, you wouldn’t have a cigarette on you?”

I hesitated. Suddenly, the need to hear this man’s story outweighed the potential trouble I’d be in. Besides, he was the first person who had been kind to me since I arrived in New York.

I pulled a Benson and Hedges out of my pack and handed it to him.

“It’s not a Gauloises, but it will do,” he sniffed.

“C’mon, I’ll smoke one with you — let’s go to the solarium.”

In the solarium he pulled his mask down, and I lit his cigarette for him and one for myself. We inhaled, then he exhaled a perfect “O” ring of smoke and said, “What’s your name, pretty Irish girl?” My heart caught — I was 234 pounds that morning; people didn’t call me pretty.

“Victoria.”

“How’d you wind up with such an English name — don’t the Irish hate them?”

I took a breath and explained, “There’s an ancient document in Ireland called The Book of Kells that was illuminated by 12th-century monks or something like that. When Queen Victoria visited Ireland in 1843, she autographed this priceless, centuries-old document. After that little incident, they wound up sealing it under thick glass. My mom always said she wanted a daughter as audacious as that, but I’m not,” I finished.

He laughed dryly.

“Well, we’re both named after royalty. I’m Rudy, a.k.a. Rudolph II, the Holy Roman Emperor, by way of Waterloo, Iowa.” He winked slyly and continued, “He never married, you know. Maybe he was a funny one, too.”

“I love it,” I ventured — “Should I address you as Emperor”?

He stretched and pointed out the window. “Did you know this building was built around the same time your Queen was running around autographing manuscripts? It’s called the Second Empire period. Look at that fence down there,” he gestured. I peered six stories down and saw a beautiful black wrought-iron fence I had never noticed before.

“Wow, it’s still in perfect condition.”

“Back then, a horse-drawn carriage would pull up, and the coachmen would hang their lamps on the fence. You can address me as the Emperor of the Empire. This is my domain,” he gestured with a sweeping flourish and laughed.

Rudy had since become more than a patient. I started every morning round with him and spent my nights on call smoking and ruminating about life with him. He was funny, sharp, and irreverent. He believed deeply in me.

“You’re going to save us all, my Queen. You’ll find a miracle cure and give it to us. Greg and I will grow old together.”

It was hard for me to see the future when my present was so damn hard, yet he was still able to, despite his physical wasting.

I marveled at his constant good humor as the beautiful men around him began wilting and dying. He felt each loss acutely but seemingly remained unfazed.

“That poor guy, his lover never came. I’m so lucky I have my Greg. When you’re gay in a small town, you make your own family. You and him and me — we’re family.”

Today, I needed him.

After spending a half hour persuading the 22-year-old patient not to leave, I went into the solarium and spied the familiar blue and scarlet silk kimono. I started to pull the pack out of my pocket.

“Queenie, I’m not in the mood today to smoke,” he coughed. “I’m not feeling so hot today.”

“OK,” I said, “I’ll catch you later. Do you need anything?”

“Yeah, I need you to stop doing what you’re doing to yourself. You look like shit today.”

I flushed.

“I was up late reviewing, I’m fine.”

He scanned my face tenderly. “I know, Victoria. It’s time to stop hating yourself. You’re worthy.”

How could he possibly know how much pain I am in? How much of an imposter I feel like? Does he know that drinking is the only thing that steadies me?

“Hey, I gotta round,” I said as I started walking.

“Victoria, I love you.”

“Yeah, yeah I know. I’ll be back.”

Fat chance, I’m not in the mood for it today.

As I finish the last of my rounds, my pager ignites, and I hear the overhead.

“Code blue, code blue, ground floor Michenburg.”

I break into a run — the whole team is supposed to report to all code blues to learn resuscitation techniques. I’m screwed if I’m late.

There’s a commotion when I get there. The doors of the hospital are open, uniformed police are milling about.

“He went straight down onto the fence. Guy’s boyfriend broke up with him.”

My knees buckle. I know before anyone tells me.

“Don’t go out there, Doc, it’s too late.” Hands claw at me.

I push past security.

In the glinting sunlight, I see the royal blue and scarlet fabric waving from the top of the fence.

Oh God, Oh God, please help him, help me. I can’t breathe. Everything is closing in.

I blindly walk down the street, sobbing and gasping. I stop to dry heave.

I halt at a little stone church and lurch down the basement stairs that I have seen people shuffle into before. People are sitting in folding chairs, drinking coffee and laughing.

“Can I help you?” a man asks.

“My name is Victoria, and I’ve been drinking too much. I think I’m an alcoholic.”

“Welcome,” the man says. The room bursts into applause.

You’ll always be my family, Rudy. I love you, too.