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“Mommy, Ethan wasn’t at school today.”

I have practiced not reacting. Night after night, watching myself in the mirror as my wife reads the most surprising or disturbing news she can find. She can still tell when I flinch, but Carlos is six and has not quite developed that level of emotional intelligence.

But he knows that I know. As a district nurse, one of my responsibilities is to call and check on all absences for the day. The district loses money when the seats aren’t full, so truancy excuses must be documented. The list undergoes departmental review and missed classes attributable to illness are forgiven. At least they compromised on sickness-related absences. If they hadn’t I would be out of a job and the remaining children would be getting no education because the school would be closed. Some is better than none, right?

“Mommy!”

“Yes, love?”

“Why didn’t Ethan come to school today?”

I don’t have to lie. “I’m not sure. I haven’t had a chance to call his Mommy yet.”

“When you talk to his Mom, can you make sure he is okay? I was worried about him.” Carlos pauses, taking a bite of food and chewing it slowly. “And I missed him, but he still owes me a sandwich.” He beams, showing the gap where he lost his first tooth.

“Sure thing, bud.” I grin back and take a bite of my own dinner, then look across the table at Eleana. “What about you, sweetie? How was your day?”

Eleana is twelve and mopey. The food on her plate has been migrating around in indiscernible patterns as she pokes at it with her fork. If half my kindergarten cohort was dead by the time I hit sixth grade, I would be mopey too.

“Fine.”

That’s about as much as I get from her. Pilar often extracts an entire sentence, but it’s easier for her, being half jokester, half calming presence. Eleana doesn’t respond as well to me. I’ve tried to joke around with her, but my jokes are really, really bad. I don’t blame her for not engaging.

“Can I be excused?”

I wince. I don’t practice for this one in the mirror, though maybe I should start. Usually I don’t mind if she gets up from the table early. She’s practically a teenager and can regulate her own food intake.

But tonight is MicroFree night.

“Honey, it’s Friday and you know what that means.”

“MicroFree,” she grumbles under her breath. With so few clean ingredients, it’s hard to get it to taste good.

“That’s right. So, will you please finish your food?” It’s more of a plea than a command.

“Fine,” she says, pushing the beans and rice into a pile and scooping it into her mouth in two huge bites. “Can I go now?” she asks in a hot potato voice, mouth full of food.

I nod in resignation and she leaves the kitchen.

“Mommy, can I be excused too?”

He smiles because he likes to push buttons. It’s the age I guess.

I try to channel Pilar. “And why do you want to be excused?” I ask, my voice rising as I throw out my hands, threatening to tickle.

“Uh … to …” he twists his mouth up, thinking. “Go to my room!” He yells the last word and I actually tickle him.

“Finish your food, you nut!”

I finish my salad and hand wash the dishes. What I wouldn’t give for a dishwasher. I listen as Carlos runs through the house with a dinosaur toy in one hand and a helicopter in the other. T-rex flies in his alternative history.

I had hoped there might be some MicroFree leftovers, but Carlos is growing and eats more than he used to. I can only afford to buy it once a week and our accounts are empty afterward, but it’s worth it. At least, that’s what I tell myself.

One plastic-free meal a week was shown to reduce lifetime risk of cancer, not to mention increase fertility and reduce hormonal abnormalities.

As the concentrations got higher, the changes hit earlier. That’s why Eleana has lost half of her classmates. The childhood gastrointestinal cancers were a surprise. Some people are more genetically susceptible, but the constant assaults on our DNA repair mechanisms subvert even the best genes.

That reminds me. I have to call Janelle.


“Hello?” a husky voice answers.

I’ve had to call Janelle before and this is not her.

“Oh hi, um, Ashwina?”

“This is, who is calling?”

“Sorry, this is Ana Real, Ethan’s school nurse. Today was really busy and I did not have a chance to call during business hours. I apologize for having to disturb you at home.”

I have spoken with Ashwina before, but she does not usually answer Janelle’s phone. She is a pleasant, albeit private person. Not one for small talk.

The line hangs empty as I wait for Ashwina to respond, and I soon realize she will not.

“Could I speak with Janelle?”

“She is not feeling well.”

Probably the chemotherapy. Janelle and Ashwina are some of the youngest parents at the school. Pilar and I are some of the oldest, some of the most spared from the early-life onslaught of toxic petrochemical byproducts.

“I’m so sorry to hear that. Is that why Ethan could not come to school today?”

“Yes.”

I sense that the conversation is over.

“Thank you and again, sorry to bother you.”

The line disconnects without another word.

Poor Ethan. He had missed school for this before. Poor kid is racked with anxiety about Janelle being ill. I can’t blame him. Watching your mom die of cancer at twenty-two. His psychiatrist tries to load him up on antidepressants, but it’s normal grieving and nothing is going to change the fact that his mom is going to die before he turns seven.

Illness, I check on the form.

The back door opens and Pilar comes through with a weary smile.

Her hair is caked in mud and gray dust from twelve hours of rooting through garbage, trying to separate it into components. Pilar is eight years my junior and had always wanted to be a veterinarian when she grew up. She loves horses. When they became endangered, she vowed to protect them and care for the sick ones.

But Pilar could never pass the entrance exams for vet school and horses are extinct. Sometimes things don’t work out the way we plan.

She blames, rightfully so, her neurochemistry. Being older, I didn’t have quite the same intensity of exposure growing up. I can tell that I’m not all here sometimes, but I did manage to pass nursing boards. Barely.

Her job is important and she doesn’t mind it. She contributes, separating out the pieces so they can be appropriately reprocessed. So that microplastics don’t rain down on us any more than they already are.

“Hi,” she grins. “Kiss?”

We play this game every night and I feign disgust. Really, it would be okay if she kissed me. She’s covered in dirt, but I work with kids. A little dirt and grime doesn’t faze me, though the possibility of plastic dust does give me anxiety. That’s why she always strips down before she comes in. Plus, it means I get extra time to see her naked.

“Ugh! Mom! Put on some clothes!” Eleana has apparently snuck back into the kitchen under cover of the dishwasher noise.

Pilar grins. “If you don’t like it, look away.”

Eleana rolls her eyes and heads for the refrigerator, launching my blood pressure into the stratosphere.

What are you doing?”

The studies show that the benefit of microplastic-free meals has a dose-response relationship with time until the next microplastic ingestion, i.e., the longer Eleana waits before she eats microplastics again, the less likely she is to have all of the negative health consequences. That’s why we do it on Friday night. They can sleep in and lounge around until I prepare Saturday brunch.

“I’m still hungry!” She doesn’t bother to turn around and say it to my face, instead studying the refrigerator shelves.

“Ellie …”

“Listen to your mother.”

She grunts, closes the refrigerator and heads upstairs, but not without a final jab. “Put on some clothes!”

If she was actually mad, she would have said nothing.

“Want me to ask for her swab tonight?” asks Pilar.

I nod, biting back the frustration preceding and that to come. Eleana has been refusing the swabs over the last week and it is going to reach a boiling point. Very soon.

“What did she say last night? That she still hasn’t gone?” Pilar steps into the decontam shower alcove we spackled together off the entryway and waits for me to answer before pulling the chain.

“Yeah,” I sigh. “I’m hoping it’s because she barely eats.”

Pilar nods and pulls the handle, flooding herself with the water-chemical mixture. It is easier to remove the plastic from water when you don’t want to drink it.

Maybe it’s not how much she’s eating…. I wait for her to finish the shower, until she can hear me again. “Do you think she’s lying?”

Pilar dries off and tosses the towel into the hazard bin. Even her nudity can’t distract me from rising panic. “Why would she lie?” she asks, still casual, pulling on her home clothes.

“Maybe she is scared. Maybe that’s why she’s been so standoffish.”

Pilar wriggles a pinky in her ear, digging out the last of the chemical shower.

“I think she is just twelve,” she says, flashing a smile. “But I’ll ask.”

“Okay. Bring me your swab and I’ll get mine and Carlos’s.”


I find Carlos, already in the bathroom.

Not a good sign.

When I walk in, he is doubled over, arms across his abdomen. At the sound of the opening door, he lifts his head, face strained and red.

“Are you okay, buddy?”

He looks away sheepishly, trying to hide evidence of recent tears.

“My … my tummy hurts, Mommy.”

His back is clammy and sweaty as I rub my hand across it to comfort him.

“It’s okay. Can you tell me where it hurts?” I hear the panic in my voice, but force myself not to alarm him further by looking into the toilet at what I fear is there.

“I … I don’t know. I was just … just playing and then all of a sudden it felt like … like it hurt so bad and I ran in here and I sat down and then it just … I made a mess.”

He lowers his eyes from mine to the floor, where I direct my gaze.

I don’t need to see what’s in the toilet to feel faint. The bright red stain on his underwear tells me I won’t be needing to run the test for him tonight.

“It’s okay, it’s okay.” I hug him tightly, telling him as much as myself. Blood is a gastrointestinal irritant. Too much in the colon and you’ll get diarrhea. Uncontrollable, sphincter-disrupting diarrhea. So uncomfortable that you can’t make it to the toilet on time.

“Everything okay in here? Eleana and I already did our…” Pilar stops when she sees the underwear on the floor. We lock eyes and she speaks where I cannot. “You want to take him or should I?”


Eleana was worried about Carlos, speechless. Pilar stayed with her while I took Carlos to the hospital. Eleana has not hugged me that long in a year.

Carlos was mostly just scared. The blood looked worse than it actually was. I checked his blood pressure before leaving the house and it was within normal limits. His sclerae were not white, he was not orthostatic, he was mentating fine. It looked bad, but the total volume of blood loss was probably small. My nursing experiences sometimes help at home.

But blood in the colon means cancer until proven otherwise.

It used to be that they would check you every ten years with a colonoscopy once you hit age fifty. But with extremely high rates of colon cancer in children, they had to change the guidelines. Then they had to develop new, extremely sensitive tests. Hence, the nightly rectal samples.

“Do you have to call yourself to ask why I’m not in school tomorrow?” he asks as we sat in the ER colonoscopy suite. An entire enterprise had sprung up in response to the increased need. Billboards, internet advertisements, cloud commercials, all announcing no waiting for children’s colonoscopies.

“No, bud,” I say, forcing a smile. “I know why you won’t be there.”

“Do you think I have what Ethan’s mommy has?”

Kids, always more perceptive than you give them credit for.

“I don’t know. They’ll be in to check you soon and we’ll find out.”

I rub his head, thinking how the acrid smell of blood-containing stool must be the norm in the pediatric wards.

The door opens and a team of scrub-wearing people come through with a caravan of colonoscopy and anesthesia equipment.

“M. Real, we’re going to have to ask you to leave for the procedure.”

I knew intellectually that this was going to happen, but it doesn’t make it any easier.

“It’s okay, Mommy. I’ll see you soon,” he says reassuringly, patting my hand. There is no fear in his voice. I leave before he can see my tears.


To distract myself in the waiting room, I do some math and try to decide whether I’ll be able to afford MicroFree for Eleana and Carlos after this procedure. Our accounts are already empty. This could knock out the next six months of MicroFree Fridays. It’s almost as hard to think about as what they’re going to find behind the closed doors of the colonoscopy suite.

MicroFree makes the organic food movement of the twenty-first century look downright affordable. Organic was twenty, maybe thirty percent more. Microplastic-free is five or ten times more expensive. It is not, cannot, just be one ingredient. Consider something as simple as an apple. Not only does the apple have to be microplastic free, but so does the water I use to clean the knife that cuts it, the water to wash it.

Thinking about how quickly the costs escalate makes me dizzy. The beans, potatoes, and rice we ate earlier? Think of all the MicroFree water I used to cook beans and steam rice. I cope because I know it is benefitting Eleana and Carlos.

But maybe I have not done enough?

I look up at the clock. He’s been back there for two minutes. I might be sitting out here for an hour. If there’s a mass. If they have to biopsy. If they do RapidPath on the specimen to tell us if the polyp is cancer or just a pre-cancer. The anticipation is suffocating, like someone is sitting on my trachea.

I am not alone, gagging for relief from the rainbow of microscopic hydrocarbons that choke us. You know things are dire when the annelids that live on hydrogen sulfide vents are dying, not from extreme pressure, extreme heat, or literal brimstone being blasted in their worm faces, but from tiny pieces of plastic fishing net, having killed in the sunlight and now making their way into the dark for a second execution. The deteriorated net settling alongside the trillion other pieces of plastic that a faceless corporation of shortsighted assholes forced down everyone’s throats even when we begged them to stop. When we told them we were tired of digging up compressed dinosaurs and processing them into plasticized tombstones for ourselves.

I try to distract myself from the negativity and walk to the receptionist’s desk.

“Can I have a buzzer?”

So routine, so commonplace is my, our, scenario that they have buzzers for when your child’s colonoscopy is done. Like we’re at a restaurant waiting for an open table.

But it does give me a chance to step outside where I can breathe. The air moving gives me the temporary illusion that my head is clearing.

It’s chilly though. And wet. That sweet spot before the precipitation turns to sleet or ice, but cold enough that you are expecting snow. I hadn’t even noticed the rain on the way to the hospital.

The cold, the water draw me away into a dark place. I think of the documentary I watched about the ocean’s trenches and the pollution there. The hadopelagic zone is very far away from the self-important beings living on the surface, but perhaps if we had been more sensitive to their plight, we would have saved a generation of children from the horrors of colon cancer.

I walk timidly in the rain falling into the uncovered square courtyard, the chill reminding me that I am alive, that I have emotions to feel. I keep my mouth closed though. No more tasting raindrops. Not after the study that showed that it was raining plastic. Of course, nobody could see it. Who knows how long it had been going on when it started blocking up the sewer treatment plants. They blamed infrastructural disrepair, disarray of funding mechanisms. They said it was from people flushing things down the toilet. But even samples from Denali showed microplastics in the rain. There weren’t any sewage treatment plants there. I’m pacing myself into a frenzy, angry at ourselves, the companies, at everything. So frantic is my walking that I run into another distressed parent.

“I’m so sorry,” I mumble.

They look at me, eyes as nervous and bloodshot as my own.

“S’okay,” they say and take a puff of a cigarette, turning away.

Drawn out of my anger trance, I look around and see all the other anxious parents. Some smoke, some pace, some on their phones talk animatedly, others simply sit in the rain, head in their hands.

During my survey, I stop walking and an unsolicited touch brushes my shoulder. I turn slowly, expecting perhaps the gastroenterologist come to give me a report.

“Anx-Gum?” she asks, holding a stick out.

“No thanks.”

“I’d use it myself if it didn’t interact with my medications, so I know a parent who might need it when I see them. I keep some on me just in case.”

I can’t parse why she does not see that I’m not interested in chatting. I study her face, thinking maybe I will see something there that explains why she is like this.

Instead, I see something familiar, though I cannot say what. Maybe the curly hair? The dark brown eyes, almost black in the dark? The light brown skin? Any one of these could be it, but they don’t add up, despite not being able to shake the notion that I know this person. My head is too clouded with emotion to make any connections to the world outside this ER waiting area microcosm.

“First time?”

I nod, hoping this will be the last question. Just because she looks familiar doesn’t mean I want to keep this conversation going.

“Not even my first time this week!” She chuckles. “Name’s Rhonda. Welcome to our sad little support group, if you can call it that,” she says, sticking out her hand, which I find myself shaking.

I don’t have the head space for this.

“I’m sorry, but I’m not really in the mood for conversation. And I’m really not sure why you are so chipper.”

“Ah. That’s okay,” she nods and withdraws her hand. “You’re not the first person to be upset with me because I’m not down on everything. I’m around a lot, so just find me if you need me.”

I start to respond, but stop because what am I supposed to say to that.

“Gotta take it one day at a time.”

Uh, thanks Master of Trite?

“That’s true,” I say, faking a smile as I walk away to be near the parents who won’t talk to me.

The rain has picked up and my shirt is damp and clings to my skin. Just when I’m getting back into my thoughts, someone else starts talking to me. This is hell’s waiting room.

“Rhonda’s a real piece of work.” The stranger frowns, then smiles. “Means well, but most folks out here are too upset to hear the positive. Like me.”

Maybe we will get along.


Fiora and I do get along. We’ve been trading tirades about the vicious inhumanities that have brought us to where we are.

We were the penguins on Big Oil’s beach, drowning in their slick. The tanker that was their bullshit campaign hemorrhaging lies into our mouths, our eyes, our lungs.”

She is half-yelling at this point, drawing looks from some of the other parents. I don’t care because I’m eating it up, agreeing with every asperous consonant she spits. Hearing her speak my frustrations is liberating, therapeutic.

“We lit their slick on fire and watched them burn, dancing and hollering hoarsely for joy with their boot off of our necks. But when the smoke cleared, when the embers cooled, the plastics were still there.”

My blood cools momentarily, remembering the miraculous work done after Big Oil was toppled. People strung themselves together, jury rigging with meager resources to save their planet, even if the rich were fervently trying to destroy it. Scooping with hands, sticks, nets, whatever they could find to rid the ocean of the plastic islands swirling in the currents. We planted trees. Pilar and I planted five of our own. Now I don’t know if Carlos will see them grow taller than he is.

“Will it be merciful for them to die young?” I’m surprised to hear myself speak the words. “Maybe it’s better not to have to live in a world where the affluent actively seek to extinguish the rest of us.”

I’m spiraling. I can’t focus on anything but the lunacy of a world which has left me with a cancer-riddled six-year-old in the emergency room colonoscopy suite, standing in the rain, making me believe it’s all my fault.

Fiora senses it and tries to commiserate. “We didn’t learn anything. The megacorporation vacuum after Big Oil’s fall gave us a false sense of security. ‘They’ll never come back,’ we said. But Earth was still broken and we took hope from anyone that offered it, not seeing them for who they were.”

We’re starting to draw a crowd, moving out from under the protective eaves. I’m not sure if people are listening because they like the message or the spectacle, but I can’t stop myself. I feel the frustration, the fear for Carlos given voice.

“They kept their word only to those that had managed to come out on top.” I spit in disgust. “The health gap widened and widened until it became bimodal. Again. Them and us. The wealthy and powerful versus the rest.”

I’m on a roll. “MicroFree sells us microplastic-free food, water, and supplies. We eat it up, literally and metaphorically. Because we want what is best for our children.” Involuntary tears are welling up and the words choke me on their way out. “Because it fucking works,” I squeak and have to clear my throat. “And we are somehow not broken enough to realize that we’re edging back to where this all started. Our memory is too short to keep up the outrage.”

I stop, because I don’t know what else to say. I look at the gathered faces. I see tears, I see anger, I see sympathy. A few come forward and embrace me, then go back to their corners of the waiting space. There is nothing else to be said. The wind and rain pick up to emphasize finality.

My buzzer goes off and I look at Fiora. That was too quick.

“Go.” She smiles at our shared misery. “Good luck. It was nice to meet you.”

I nod, still too emptied of emotion to speak. I run inside. I stand over the recovery room bed, rainwater dripping onto the floor.

The gastroenterologist looks at me quizzically and I realize that it’s not because of the rain, but because he is waiting for me to answer his question.

“Do you understand, M. Real?”

“No, I’m sorry, could you repeat that?” I couldn’t hear over the sound of my heart pounding in my ears.

“It’s not cancer.”

He’s still talking, but I don’t hear him.

My mind is a maelstrom. He’s okay  … he’s okay! My boy is okay! But what about next time? What about the next time he bleeds? And the microplastic isn’t going anywhere. He’ll have cancer next time, definitely have cancer next time. But not if I can buy him more MicroFree. But how will I afford it after this colonoscopy? I’ll have to come up with simpler MicroFree Fridays. We will continue to live paycheck to paycheck. I’ll join the school board and the absences review committee. Pilar can work weekends. It’ll have to be MicroFree Fridays and MicroFree Mondays. He can’t…

“M. Real?”

I’ve been staring into space for who knows how long and the doctor is gently holding my hand.

“I know this can be a traumatic and overwhelming situation, but I want you to know he does not have cancer.” The doctor is smiling. I don’t think he is patronizing me. I think he does not get to deliver good news like this very often.

“Do you have any questions, M. Real?”

“What …” I know I need to ask a question. It will come to me… “What was it?” Yeah, that’s the one.

“A plastic bezoar.”

“A what?” That can’t be good.

“A concretion of microplastics formed in his large intestine. It blocked and irritated the lining of his colon, which resulted in the bleeding you saw. We removed it and he should be good to go home with you. The blood loss was minimal.”

“What … what should we do?”

He squeezes my hand. “The best you can.”

“What does that mean?”

He shrugs. “As much MicroFree as you can afford, though I know it is difficult. There are some assistance programs out there. Occasionally, you can get a coupon. I’ll put plastic bezoar on the insurance information and that will trigger a phone call to you. It’s not much, but it might get you a meal a week.”

I stand staring at the place where he was for minutes after he has moved along to his next patient. “A meal a week?” I practically shout before the jubilant laughter begins. The bedside nurse eyes me, but says nothing.

Carlos is groggy, but awake. I give him an enormous hug.

“Am I all better, Mommy?”

“You sure are, buddy. You sure are,” I say, rivulets of tears cutting through the angst.

He smiles, and gives me a high-five.

I will grovel before the MicroFree juggernaut and thank them for every tiny morsel of hope they pick from between their gold-plated teeth and throw to us, their abattoir-ready sheep, lining up around the block.

I will stop eating if it means they have more MicroFree. With this bezoar-related waiver, it might be doable. I’m salaried, but Pilar can work overtime to supplement with additional MicroFree. Their neurocognitive development has to exceed mine. They will pass the entry exams, make decent money, and have the exclusively MicroFree for their kids, who will then surpass them. In two generations, they can be in positions of power. They will be able to change things.

At least, that’s what I have to tell myself.

I sigh and hold his hand in mine, grateful that this time everything worked out okay.


It is two in the morning by the time we get home. Carlos’s eyes flutter as I carry him in, but he immediately falls back to sleep when I put him in bed. Despite my best efforts, the stairs are creaky and Eleana comes running to our bedroom to ask how he is doing. Pilar sleepily rolls over, having already heard the news.

“Is Carlos okay?” It’s more demand than question.

“Yes, he is fine. Just a plastic bezoar. Too much plastic irritated his tummy and made it bleed.”

She looks at me through sleepless eyes, “What is a bezoar? Why didn’t you call and tell us?” She looks up at Pilar to find an apologetic face.

“I thought you were asleep, Ellie. I didn’t want to wake you.”

“How could I sleep?”

She pulls away when I reach for her shoulder.

“Don’t touch me!”

“Eleana, please stop shouting or you’ll wake him. He had a long night,” I say resignedly. Post-adrenaline malaise is seeping in.

She lowers her voice, but does not relent. “Why didn’t you tell me?” She glares at Pilar. “I was so … so …”

Anger breaks into tears. I see my own reaction, the conversation with Fiora in my daughter. She is just like me. Guided by emotion, sometimes consumed by it.

“He’s okay, honey. It was a plastic blockage. No cancer. He is going to be back to normal by tomorrow.”

After a minute, the sobbing diminishes and she leans into me. Pilar floats over to join our embrace.

“We’re going to be okay. One day at a time,” she says.

I knew that overly positive woman Rhonda at the ER reminded me of someone.

Eleana wipes the tears from her face and looks up at us, but her lip trembles as she speaks. “He … he can have my Friday dinners. I’m older and stronger. I’ll be okay.”

The three of us are sobbing and hugging again, Pilar and I talking across each other trying to reassure.

“It’s okay,” we say in unison and I win out over Pilar. We lock eyes and I know I have her approval for what I’m about to say, even though we haven’t discussed it. “Mommy and I are going to work extra, change jobs if we have to. We’re going to get more MicroFree for both of you. The doctor said we could get one ration a week because of this and I think if we work more we could make enough money to get it at least three, maybe four times a week.”

She smiles at me. What a day. A hug and a smile. It’s like she’s three all over again.

“I like that plan.”



Jason P. Burnham (he/him) is an infectious diseases physician and researcher. He loves many things, among them sci-fi and speculative fiction, his wife, son, and dog, metal music, Rancho Gordo beans, and equality (not necessarily in that order).

Twitter: @AndGalen

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