In Case of Emergency

About 100 pages in to reading Courtney Moreno’s In Case of Emergency, I was driving over the Bay Bridge with a group of coworkers. I am often anxious and sometimes when I cross the bridge I envision a dramatic accident – if the earthquake hit right now would the bridge collapse around us? Would I be able to escape the car if we fell into the water? On this trip, the accident was smaller – a car weaving through traffic hit a motorcyclist in front of us, who flew through the air and landed on his back in the middle of the road. In the sickening moment before he began to move his limbs and lift his head, as we all dialed 911 at once, I thought of In Case of Emergency, which follows a new EMT named Piper through the first months of her new job and a new relationship. In Piper’s EMT training all accidents become a series of abbreviations, a process of evaluation and response. I wondered what abbreviation would sound over the radio when this accident was reported, what route the ambulance would take and who, on their team, would act first upon arrival and how.

In Case of Emergency is a book about trauma, and disaster, and the body. Piper’s patients are middle aged men experiencing sudden cardiac arrest; commuters stabbed by a stranger on the bus; overdosing addicts; gang members shot in alleys; office workers with chest pains. At the core of the novel is the task of how to function in the knowledge that it is a matter of time before the emergency happens to us, or our parent, or our partner. Describing these disasters, making us watch, Moreno asks us to consider what the body can mean in its proximity to trauma. For much of the novel, Piper is slowly consumed by this question. On a particularly gruesome call that will occupy her memories for months, Piper observes a team of surgeons working on a dying teenager – “All that yelling across his body; nothing anybody does seems related to him. Where is he in the midst of it?”

Moreno’s treatment of the relationship between the body and what happens to it is one of the novel’s greatest accomplishments. Piper, with her medical background, often frames scenes of high emotional intensity with explanations of the physiological phenomena behind them. A delicately detailed account of balance and the inner ear precedes an evening with her new girlfriend, who still excites and disorients her. A night of sex is followed by an “Ode to dopamine. Seratonin. Nitric acid and oxytocin.” There is a cynical temptation, when we describe the mechanics of the body, to explain away the emotional experience of being embodied. But for Piper the chemicals and operations of the body never negate the feelings associated with them. “The real wonder of the heart,” she tells us, “lies in its physiological properties. Each and every cardiac cell a living and microscopic battery, the SA node acting as a conductor for rapid fire electrical signals, the valves and chambers opening and closing, emptying and filling… But even so. None of this explains what you know to be true… none of these structures can tell you what you most want to know.” If we are mazes of valves and vessels, we are also all of the things that they make possible.

After an exceptionally awful accident, Piper spends several weeks on leave from her job and in near isolation – a response which strikes me as deeply rational. There is no solution to the problem of the body, no lasting way to save it. The biker on the Bay Bridge got back to his feet, and I did not plummet into the water below, but we both have emergencies waiting down the road. Like Piper ,we can’t keep our loved ones safe forever – we can only decide whether to continue to love them. Moreno cannot give an answer but she does give us a decision to make.

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