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I’d needed an eye exam so to safely start taking hydroxychloroquine, which is a synthetic version of quinine if you remember Heart of Darkness and Kurtz’s madness, him glugging the antimalarial, and behind him the skulls being used as fence caps. I wasn’t going to the Congo. But for my autoimmune condition, hydroxychloroquine (Plaquenil) is usually prescribed as a first course of action.

Quinine is a naturally occurring material, found in a certain tree bark, while hydroxychloroquine – synthetic – only mimics its quinoline, its ring-system structure. Marketed and sold as Plaquenil, the drug might damage your ability to see colour. Therefore, in order to begin, you need an eye exam.

I went, as my insurance – in 2018, through Obamacare – dictated, to the Moody Eye Clinic in Philadelphia, adjoined to one of the university hospital systems in this city of universities and their hospitals, or perhaps the other way around.

I’ve never worn glasses and was entirely new to the world of eye clinics, it was an extremely busy place. It most resembled the feeling of being in a busy bus terminal in Santiago, Chile, when I was 21 – now I was 35. It became clear the deal with this clinic is that you are there all day. People, most on the older side, were camped out in a dingy and enormous atrium, an enormous waiting arena, with numbered tickets withering in their palms.

That is what your appointment got you, I soon found out, an opportunity to be handed a ticket.

I sat there in a flimsy striped summer dress realising I was hungry and freezing in the air conditioning, and my nipples were lengthening and hardening. I had not, even in my mid-thirties, reconciled myself to even a light foam padding in bras. Or bras really. I wore camisoles under clingy and short dresses. I hadn’t been looking too deeply into many mirrors, with no professional job to keep me in that kind of line.

I was working at an upscale corner grocery (a wall of dried, sugared fruits, kiwis, curling dried papayas, but specialising mostly in fish and wine, after all it was called Sea & Poison). 

I was older than my coworkers, who were “rising seniors” and would stay for a year. I’d been there for about three years, having risen before (incompletely, I’m a dropout) at a Midwest arts college, then I had returned to Philadelphia – this city of hospitals – and worked for a decade at the Ritz, then changed over to Sea & Poison, I was a writer and I was writing. I didn’t pluck my eyebrows or groom myself much beyond showering. It wasn’t that I wasn’t vain, I was. But I was more beautiful at this time. Not meaning because I was younger (again, 35) in 2018 than I am now – now I’m 41. More, my health has in recent years put my beauty on an unexpected chopping block. It’s less linear than getting old. There are certain drugs – drugs beyond Plaquenil – I’ve taken that changed the texture of my hair, changed the image, a beautiful image, scratched the image. This was unexpected, that’s all. These drugs have knocked something off centre, have scratched at my face and hair. They have helped me enormously. I don’t know what to say, I’m saying I have a cracked appearance. 

It’s not a pity party, it’s a character sketch.

Insofar as you’ll need to be looking at me, that your mind should fill me up with its own swaying cognitive and toxic reeds if we are to do this, your imagination should touch me with its ridiculous poison.

I’m sure I’m beautiful, in the way people are because they are standing, or how they are, the how-tilt about being, because of that notorious enough beauty of breathing and being. Because I am loved, because God loves me. Birth of July: to me, feeling hot is almost everything that’s out there.

After a few hours in the waiting arena, at Moody, I was called up to get my baseline eye test. An ophthalmologist’s assistant noticed I was reading Teju Cole’s novel Every Day Is for the Thief (thank God I brought a book – at the time my phone being flip) and we talked about Cole’s autofictional return to Nigeria, his hopes and disappointments about modern Nigeria, and she, the assistant, told me she had always suspected she was Nigerian, that her ancestors had been taken from Nigeria. She had always felt Nigerian, when she met other, certified Nigerians. I remember hoping in this conversation to affect attunement, and receptivity to her frankness, her openness – frankly, her chattiness – which after all is expected in Philadelphia, this city of hospitals, and, honestly, a city of chitchat. It helped that there was a big machine glommed onto my entire face, through which she studied only my eyes, only scientifically.

She called in the ophthalmologist, her boss, since she was done with her initial exam, and he thanked her quite gravely, because it turned out this whole time we’d been talking Teju she had been catching something troubling during the exam, a narrow angle I had in each of my eyes.

In an alarmed and commanding tone, this ophthalmologist – who seemed to be in his eighties and would remind anyone of the actor Max von Sydow – told me that I must go immediately to a new floor and wait there – particularly the Sydow of The Exorcist (1973), where the actor plays the older priest arriving to do the exorcism of the tween, Regan.

“I believe we should begin,” Father Merrin (I am looking it up just now, watching a short YouTube clip) says upon arrival, to young Father Karras.

“Do you want to hear the background of the case first, Father?”

“Why?”

I was, this priestlike figure next explained to me at the Moody eye clinic, susceptible to a sudden blindness. He appeared to be panicked, so impatient, and he ushered me directly onto the elevator and he wished me well – gravely again, and sounding exceedingly alarmed, tired, he was old, but also busy, considering the waiting room, which I realised did not remind me of a backpacking trip to South America from my early twenties as much as Ellis Island, and he not Merrin from The Exorcist but an even older von Sydow of Hannah and Her Sisters (1986), where he acts as a cuck.

I invoked the genocide of Congolese people. I wrote at the start of my novel about Kurtz in Heart of Darkness using their skulls to decorate his fence posts, with these paper skulls that were once, if you unwrap the paper, and shred the frame (the literature), souls.

It makes me think of how there is no character sketch, no beginning of a book or anything, that genocide doesn’t sway right into the insides of. From the start. No enunciation of a person, or a story about what happens with that person, that isn’t already describing how we’re offset by enormity. Big evil. To get to know a character I’m trying to say, is to look at me, a descendant of a different genocide altogether – dark, curly brown hair, brown eyes, slim – trait, trait, another trait – cracked – offset by piles of bodies or rivers of bodies, bodies made small by being multiplied by more murderers.

How does a person you are getting to know, someone in a novel, walk around or through these piles, and what kinds of sentences, as well, use their commas and dashes and more places inside of them, things like clauses, to show somehow and I don’t know how the way the piles (of people) bulge, embolden, bloat and collapse the shape of sentences, but more, I think I wanted, when I began this novel, to try invoking a frame narrative, as Heart of Darkness is one of the most famous of these out there.

Why Sea? Why Poison? Is my place of work of so much importance to this writing? There is no actual sea in Philadelphia. Only a veritable sea of hospitals. The medical professionals in their blue and green scrubs aquamarise all of our city, at all hours. The flow of medicine, blood, and bedding. There’s poison.

On a break from Sea & Poison, back in 2018, I skipped my lunch to do my blood draw at LabCorp, where patients from all the surrounding hospitals in Centre City pooled into rows of metal chairs with their orders for different kinds of draws. We looked like actors on audition, nervous with our scripts. I had to give sixteen tubes of blood, which made me faint, but the technician who drew my blood wasn’t allowed to give me anything to drink. Liability. I swallowed ferociously at myself, trying to drink from my own throat, with my head down, for about ten more minutes. The results, a week later, showed I did have the suspected autoimmune problem, accounting for the ways my fingers had swol- len and stiffened, and the first thing would be to get the eye test, to be cleared to try hydroxychloroquine.

It’s not quite quinine.

“Call Moody today, they are always so backed up for appointments.”

By the time I had my appointment – my ticket – at the Moody Eye Clinic, I’d waited four months since I’d gotten those upsetting results. I’d been mercifully prescribed a course of Prednisone to take, to wait out my entry into a potentially longer-term treatment of Plaquenil. It seemed a shame, though, that I couldn’t live on Prednisone. Within two days of starting it, my stiffened fingers could bend and were back to normal size. Before this miracle (of Prednisone, the steroid) I’d been walking around under the moon fantasising about sawing my hand off. I’d been hoping the whole moon in all its dirty gibbous heft would come down and kill me. Do it. Getting this prescription for hydroxychloroquine (Plaquenil), by way of the eye exam, spelled the end of Prednisone, which had been the first and so far only solution to my suicidality.

But everyone looked so worried when they heard I was on it, like it was this angel you can only kiss so much, before it turns into poison or a person. Everyone made that certain face, when they heard about the Prednisone, like I was in love with someone in prison.

But now I was at the Moody Eye Clinic and it was only promulgating more problems! These narrow angles in each of my eyes!

I went upstairs and another ophthalmologist confirmed, after some hours, that I was in danger of sudden blindness, the shapes in my eye (the angles) told her so, just as the initial assistant had found. I should get a laser surgery, it was determined, which would effectively drill holes into each of my irises, preventing this sudden blindness from ever popping out its crazy claw and crossing out colour, and more, shapes, for a forever, my forever.

We would have to schedule this surgery out, but in the meantime, I was to hurry down to the basement of the clinic and there a technician would collect photographs of the insides and especially the backs of both eyes, which this second-floor eye surgeon would need later, to calibrate her aim.

I’d been at Moody for over eight hours and I was starving, shivering. Going mad. The photos in the basement took hours. The technician kept swab- bing my eyes with these long, dark Q-tips, and force-feeding my bedraggled eyes more kinds of drops, some cherry red, that she held above my face imploring my eyelids stay stretched by her assistant, widely, and that they be static for prolonged sequences while I waited for my corneas to once more feel the staining splash, and to keep my eyes open for more, new drops raining so slowly, a stuck rain that kept coming.

I left only when the moon was bright as a hexed white plate, so openly gibbous that night, the moon confessing it was whole, that it had been this whole time, and I was faint from lack of food and water, my body empty and cold and my eyes fortuitously weeping. My fingers, as ever at that time, now that Prednisone was really over, were frozen and painful, from the autoimmune disease that was the reason for all of this – the eye exam – in the first place. I cried walking home, my phone long dead, my nipples at this point in the cold practically bigger than my small, beautiful breasts. My nipples were so long and uninhibited by the decency of a padded bra and so they pointed at everyone, at children, pointing at the parked cars, they pointed to my apartment, at my boyfriend, Mari.

He was sitting in our little living area, with Janine. .