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The First Thing You Think

I studied the pointer finger where it rested on a bed of reddening slush. Mom choked the steering wheel, pale, on the verge of a full faint. I remained serene, or perhaps detached would be more accurate. Wasn’t it strange that I’d always thought my body was the same thing as me? The thing in my lap was no longer my finger but merely a finger, and I was still me. How much of my body could go away before I stopped being me?

“Fingers can be reattached for up to six hours,” Mom said in a tone that would have sounded confident if her voice weren’t shaking. “Everything will be fine. Everything will be absolutely fine.”

It will be fine, I agreed privately. Even if Mom was wrong and I lost the finger forever, I’d continue growing up. My other fingers would grow larger while this one decomposed like that bird Grant Welker found on the soccer field.

As if in a dream, I watched my good hand reach into the styrofoam cooler. Now that it was chilled the finger felt more alien than ever. I lifted it closer to my face and a frisson passed along the length of my jaw like the curtain of an incipient rainstorm.

Mom smacked my hand and the finger fell back among the ice cubes. Before I could read her expression, she hastily used my shirt collar to wipe a line of drool from my chin.

I began to cry in earnest for the first time. The physical pain was intense but distant. My thoughts, though… nothing could be closer.

It was an illness, I supposed, and must be suppressed. No one had to tell me that. The expanse of my life became visible to me: I would meet a woman and marry, advance in a career, raise children—a long and happy life that anyone would be lucky to have. But there, at the end of it, I still died alone, separated even from those at my bedside by the secret it was already my burden to keep.

The emergency surgeon set up a screen between my face and my hand and injected a local anesthetic. There was nothing they could do to conceal the tugging. As soon as we were alone, Mom knelt beside me.

People reacted to everything twice, she said, quickly and quietly. The first thing you thought was often wrong, not because you were stupid but because it was put in your head by someone else—your parents, a pastor, a teacher, or maybe someone not so good. Conditioning, Mom called it, an involuntary reflex, the same way a mallet to the knee can make your foot twitch ("my" foot, I thought). The second thing you think is what you truly believe. "Never forget that," she said. "You choose what to believe."


That’s why, when my roommate Tommy tripped and fell hands-first into the bonfire nine years later, I wasn’t concerned by my first thought. In fact the aroma of charred flesh wasn’t worth remarking upon at all. The important thing was that my second thought was to remove Tommy’s rings and wrist watch before the swelling began. I pointed at someone I didn’t know, I didn’t know anyone there except Tommy, and made sure their eyes met mine to avert the bystander effect.

“Call 9-1-1 now,” I said, firm but calm. They fumbled in a backpack and finally withdrew a phone.

I emptied a plastic water bottle over Tommy’s hands and marveled at the sense of euphoria that washed over me. It felt good not to think, to be drawn outside myself. Perhaps that was how normal people felt all the time.

“It’s your calling,” Tommy said when I visited him in the hospital room. He pointed his entire bandaged hand at me. “Everyone else stood around and watched but you didn’t waste a second. Who knows how bad it could have been if you weren’t there?”

I opened my mouth, but found I had no words to say. It didn’t seem wise to admit I’d compulsively learned and relearned first-aid procedures for the last nine years. I fidgeted with the fine scar, like a thread of silver twine tied just below the middle knuckle. In a way the finger was never truly mine again. Full motion returned within weeks but sensation didn't. The part of me in it had died. It was a stranger, a mere puppet whose strings I held. A finger. Meat.

Tommy mistook my silence for humility. He grinned, and the warmth in it made me flinch. “I’m serious,” Tommy said. “You shine under pressure. Most people don’t have the stomach for it.”


The call came in shortly before three in the morning. The guy was perfectly healthy except that he was dying. Streams of sweat poured from his pale forehead into his eyes, and he made no sound apart from his rapid, shallow breathing.

I’d learned early on that pain wasn’t like in the movies. In reality pain clamped jaws shut, squeezed breath from lungs, even crushed its victims into unconsciousness. The worst suffering was often silent. When I touched the man’s belly, the sound that escaped his throat was hardly louder than a whisper but chilled my blood worse than any scream could.

A fellow student, hovering in the doorway to the bedroom, suggested acute appendicitis. I shook my head. The pain was on his left side, not his right. Intestinal torsion. Our trainer’s face tautened and I knew I was right.

The next week a group of classmates and I asked around the hospital to find out how the guy was doing. The surgeon’s face assumed the same grim expression as our instructor. A colectomy had straightened the patient’s bowels but some of the tissue had died due to restricted blood flow. The resulting infection would kill him. A week ago he’d been the image of fitness and now he would spend his last few days lucid and helpless.

A lot of trainees quit after hearing that. More would quietly resign in the following weeks. They couldn’t live in a world where sleeping in the wrong position could set a healthy person in a spiral around the drain. Not me. I already knew it was all meat. No, for someone like me there was only one stone in the universe that must remain unturned forever.


I arrived on the scene with my partner, a bald guy named Jace who told me he’d been working EMS for eighteen years and was never surprised.

He looked surprised now.

The factory packaged candy, only today it had processed two and a half fingers. One Rob Bergquist was in charge of monitoring a broad spool of cellophane as it fed into the machine. It was Bergquist’s third straight night shift, each exceeding fifteen hours. He didn’t quite fall asleep, only lost his balance, but his weakened mind reached out to stabilize himself on the three-foot-long blade that sliced the cellophane. By the time Jace and I arrived, only one of the missing digits was accounted for and it was beyond repair.

Jace beelined to Bergquist. I could only watch, paralyzed, as he withdrew bandages from his bag and started wrapping what was left of Bergquist’s hand. Someone pointed at the machine. It was still dripping. The other fingers are under there, someone said. The words reached my brain but the part of my brain that made decisions had shut off. For the first time since I was nine years old, I hesitated. Like the bystanders at Tommy’s bonfire party I searched the crowd, searched for someone to do my job.

“Hey,” Jace barked, and there was something in his voice that drew me back to reality. “What the fuck are you waiting for?”

Mom taught me something else, too: the right thing to do was so often also the thing you’re most scared of. What was I afraid of at that moment? Only my first thought, the one that didn’t even belong to me. Not once had I ever chosen the wrong thing to believe.

I dropped to my knees on the sticky floor to look for some meat.

One finger revealed itself immediately. It had simply rolled off of the belt and onto the floor. It was hard to know for sure without the other fingers for reference, but I suspected it was the pinky. Pinkies had a slight inward curve and a meager look, atrophied in the way of things picked last again and again. From a million miles away, Jace called that Bergquist was stable. It was time to go. The ring finger was still missing, but not everyone gets back what they lost.

I stuffed the finger into my breast pocket and army-crawled backwards across the sticky concrete. The blood would come out of the uniform—there’s only one kind of person who knows how to wash bloody clothes better than a first responder—but I vowed to replace it anyway. It’s what a normal person would have done, right?


Jace caught me in the hospital parking lot just as I slid the key into my car door.

“You heading home or stopping at Joe’s first?” he said.

What he meant was, Are you too messed up to fall asleep sober? My moment of hesitation hadn’t gone unnoticed. My heart pounded in my chest. What conclusions had he drawn? “I’m good, man,” I said as assuringly as I could muster. “Looking forward to some shuteye.”

Jace forced a smile and I understood that he was really trying to apologize for yelling. I grabbed his upper arm and he grinned for real.

“Rain check?” I said.

“Bet,” said Jace.


I don’t know how it got there. The polygraph will show that I really believe that. I don’t remember finding it on the factory floor, wrapped in plastic and tied with a ribbon exactly like a piece of candy. I don’t remember putting it in my pants pocket. I didn’t even know what it was until I dropped it onto my dining room table like it had burned me. I collapsed into a chair and covered my face.

You did it on purpose.

That was my first thought. I joined this profession knowing the opportunity would present itself one day. This has all been a ruse and I was stupid enough to fall for it myself. Tommy said I was born to help people. That was never true and I knew it. I wanted meat.

Trembling, eyes still covered, I allowed this first thought to play itself out. It never got easier, even after all these years. The thought wasn’t mine, just like my numb, throbbing pointer finger wasn’t mine. After several minutes of deep breaths I searched for my second thought.

No one would ever know.

I pinched a corner of the bag, rushed to the sink, flipped on the garbage disposal. I held the don’t look at it over the drain but the pointer finger, the puppet, didn't let go. After all, this new little voice wasn’t incorrect, strictly speaking. Everyone agreed the last finger had been reduced to mush by the machinery.

I beat my temples with the heel of my free palm but still the bag wouldn’t fall

How long will you keep saving others and hating yourself? You do. You hate yourself, and you can’t even ask for help. It didn’t matter to normal people how the thought got in your head. Those goddamned normal people whose worst problem was a drawn-out divorce or some credit card debt, they had no idea how lucky they were. They’d call you a freak no matter how many lives you saved.

How many times can you think something before you believe it?

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