John Elving knew what to do when the first cramps came. He’d been spotting — and talking (listening) to his parents about what lay ahead — for three days. Now he felt badly for having rolled his eyes so much. Because, while he had indeed seen his father execute Protocol and summon Champion Medical Services (CMS) countless times, now that it was happening to him, and the pain was closing in on him, he was glad not to have to think. The seventh-grade boys who’d already Begun had shared little more than bravado upon returning to school, but John’s parents had left no detail unsaid. He owed them for this.
John raised his hand before moving gingerly from his desk chair to the floor, carpeted for this very purpose. As he curled his body into the fetal position and activated his state-issued wristband for the first time — red, for obvious reasons — he tried to breathe. It’s time, he told himself. You’re ready. John didn’t realize he’d closed his eyes until they opened in response to Mr. Simon’s touch.
“Very good, John,” Mr. Simon said softly. “You’re doing great. May your Designated Supports touch you?”
John nodded wordlessly. Dileep and Andrew rose from their desks to kneel beside John; they laid their gentle hands on his upper arm, excited to participate and proud to be of use. John now grasped the difference between knowing what to do and being prepared. Because John wasn’t prepared — for his sacrum and every deep, primal thing in his abdomen to be locked in a vice, nor for the thick warmth oozing out of him. And although this blood was a badge of honor, it felt violative for leaving him without his consent. Disobedient for staining his underwear and skin.
John’s mind was a jumble of panicky thoughts. One sprung from his lips. “Mr. Simon,” he whispered, his eyes still shut tight. “Tomorrow’s test — ”
“Never mind that, John,” Mr. Simon interrupted, his voice calm but firm. “Humankind needs the Brotherhood to fully engage with our bodies’ strength not just to give life, but to harness our power. This fortitude will become one of your most important assets. Do you understand?”
Not really. John understood the basics, of course — that menses would cleanse him, and turn over the new sperm he’d need to put life into a woman’s womb. But the rest was foggy. His dad had tried to explain why conquering menses made him a better lawyer, but John wasn’t so sure what one had to do with the other. John trusted that menses must yield profound results, though, if the government was willing to subsidize the process, and businesses and schools willing to prioritize it.
John felt CMS arrive before he heard them. Andrew and Dileep had backed away and fifth period history exhaled in collective relief.
“John, we’re going to place the heating element on your back now. OK?” said a mezzo-soprano near John’s ear. He nodded. Four more hands expertly rolled him onto the heat-wrap before securing it around his waist. It cocooned his entire torso in the perfect bind that not only eased the knots inside him, but made John feel protected somehow.
“Can you stand, John?” asked another CMS tech with a southern twang.
“Yeah,” John said, hoping this was true. He allowed the CMTs to help him up; he was vertical just long enough to see the red “CMS” logo on the terrycloth recliner before falling into it. One of the CMTs immediately draped a blanket over John’s lap. He was glad for this, because as soon as he stood, he’d felt a disconcerting gush between his legs. And while he knew that the greater the blood loss, the greater the valor, he couldn’t bear to expose his body’s inner-workings to his classmates before seeing them himself.
John’s recliner began to roll at a deft clip, flanked by three CMTs. The one who hadn’t yet spoken activated its massage function.
Be brave! Be true!
You are the Brotherhood and the Brotherhood is you!
Give life! Stay strong!
Your body’s power can’t be wrong!
John couldn’t help but feel buoyed by his classmates’ solidarity. It was happening. It was his turn. He did feel brave — he would be true to the Brotherhood of which he was now an official part. And he would, one day, give life.
John’s courage waned as soon as he was wheeled down the school’s front ramp. It was too quiet. And causing him to leave school in the middle of fifth period did not, in fact, feel like something his body was supposed to do. Also: why was his the only CMS vehicle out front? Lately, it seemed to John that at least three boys left Ridgefield Junior High by CMS every day. John winced; neither the heat nor massage could distract him any longer from the cramps, stickiness, or low-grade nausea that had recently joined his bodily revolution.
“Almost there now,” the third CMT assured him. John’s recliner rolled up the vehicle’s ramp and locked into place. One CMT sat on John’s right while another stowed the ramp, shut the doors, and sat on John’s left. The third jumped into the driver’s seat, hit the flashing lights, and pulled away from the curb. An invigorating lemon-eucalyptus smell made John breathe deep.
“You’re doing great,” the sturdy blonde who’d stowed the ramp said with a smile. She then lifted the blanket to assess John’s bleeding while the CMT on his right — the mezzo-soprano with a salt-and-pepper bob — examined his pallor. “Would you prefer pills or intravenous medication?” Although not totally sold on the idea, John’s dad convinced him to opt for the latter. “CMTs are the best venipuncturists in the world,” he’d promised.
“Umm, IV, please.”
“Smart.” The mezzo-soprano had warm brown eyes that crinkled when she smiled. She pulled vials of Zofran, Dilaudid, and Valium from a bin while her partner quickly removed John’s pants, cleaned his crotch with warm solution, and swathed him in government-issued menses underwear, sweatpants, and socks.
“I’ll restart the massage function as soon as we’ve got ya comfortable,” a CMT assured him. “And honey,” she added while expertly massaging his vein into compliance, “your dad’s on his way.” John’s breath quickened with pride as he pictured his dad leaving work with a First Time Guardian Escort.
Then, in the blink of an eye, the world was put right. John hadn’t noticed the needle go in (his dad wasn’t kidding about the venipuncture), but the massager was back on and every muscle in John’s body had relaxed. He was calm and sleepy, as though he’d been sitting in a beach lounger. His nausea had been replaced by voracious hunger. And, somehow, the CMTs knew it all.
“There’ll be a meal waiting for you. What would you like?” asked the blonde. “You have iron, magnesium, sugar, and a little caffeine in your IV, but we still like for you to order something from our iron and chocolate menus at the very least. You may also have a soda.” John smiled. His parents usually didn’t allow soda, but they’d signed the state’s permission form without hesitation. (“It’s only once a month,” his mom had said.)
“You’ll have a diuretic in your IV too — for the bloating — but not until we get to the Club, where you can pee,” said salt-and-pepper with a wink.
The meds precluded John from worrying about what it would be like to pee amidst the blood — or, far worse, to poop. He’d spent days fretting about this, even though his dad had assured him that he wouldn’t have to confront his own output during menses — ever — if he chose not to. This was no longer a concern, thanks to John’s IV cocktail. He lazily selected a cheeseburger from the iron menu, a triple-fudge-brownie sundae from the chocolate menu, and a Coke with extra ice.
“Who’s that?” John asked, craning his head to look out the front windshield. A woman chanting the slogan on her handmade sign (Giving Life Means Giving BIRTH!) was being escorted away by the time John approached his destination.
“Oh, just a yahoo who thinks she can create life by herself.” The blonde CMT rolled her eyes. “But look — here we are.”
In two shakes, John was wheeled into the Champion Med Club. It did not look medical. It was every bit a club.
The walls were lined with framed photos, portraits, and CMS campaign slogans. You are strong! You are virile! Your sacrifice matters! CMTs who’d died caring for our soldiers. Men who’d become government, business, and athletic leaders despite menses. (“If I can live with Premenstrual Dysphoric Disorder,” promised one smiling baseball star, “so can you!”) And most impressive of all, a massive oil painting of Purple Heart Recipient and Five-Star General Wesley Headley, who’d suffered an entire menses cycle while in combat without any CMS aid. Once, John’s dad had wondered aloud whether Headley’s story was more inspirational fiction than fact, but his grandfather’s stern rebuke ensured that the topic was never broached again.
John was too groggy to appreciate the gravity of the moment. Only when he walked out of the CMC six days later would a lump rise in John’s throat as he embraced his initiation into this fearless club. Only then could he sense the strength he was beginning to harness.
It was at the elevator bank that John’s CMS team transitioned him to CMC care. Two fit, smiling women in their late twenties, both wearing navy scrubs with red and white piping at the seams, stood at the ready. One took a small device from her pocket to scan John’s wristband.
“Hi,” she said, bending down to look directly into John’s face while her partner took his pulse with two fingers. “I’m Claire and this is Janice. We know you’re just Beginning, so it’s our special privilege to welcome you.”
“Absolutely,” Janice said with quiet kindness. Her short, natural curls that fell somewhere between an Afro and tight ringlets framed her heart-shaped face. “Pulse is 75,” she told Claire softly, who tapped her handheld device.
“Shall we get you settled in?” Janice asked, squeezing John’s shoulder. “I believe there’s a decadent meal on its way. You won’t want to miss it.” Claire nodded in cheerful agreement. John nodded with a dreamy smile before allowing his eyes to close again.
Janice and Claire rolled John onto the elevator en route to the fourth floor. It would be months before John noticed the second elevator bank that serviced floors 12 through 15 — the Permanent Ward. This was by design, of course; no need to evoke fear about the rare endometriosis and dysmenorrhea cases that warranted rooming at the CMC until menopause. John couldn’t have known then that his own DS, Dileep, would take up residence on the Permanent Ward in eight months’ time. The more John visited Dileep there — and ate the delicious food, hooped on the pristine basketball courts (indoor and outdoor), and came to know Dileep’s young, energetic teachers — the more he wondered whether the government kept the Permanent Ward quiet so that men wouldn’t ask to live there. Especially because these men were worshipped. Their willingness to face the pain, and give life in spite of it, was the bravery that defined them. John had only heard whispers of those who didn’t engage with their blood, who avoided it with hormones or surgery — those who did not give life. These forgotten souls were a caste unto themselves. A sad group of stunted men who’d failed to master their own bodies or harness the power within. They would never know Brotherhood — only life lived on the margins.
By the time John awoke in Room 412, the sun was starting to set beyond the sheer shades Claire had lowered over his floor-to-ceiling windows. He blinked a few times before his dad’s face came into focus.
“Hey Buddy,” Dad said over the top of his newspaper. “Did you have a good rest?”
John was still getting his bearings. He vaguely remembered his trip there, and the white board hanging on his door — “Welcome to the Brotherhood, John Elving!” — that the CMC staff had signed. He also remembered devouring every bit of his meal and slurping his Coke so fast that his eyes watered. But that’s about it. John’s dad wheeled a chair up to his bedside and pressed the nurse call button; it’s almost as if he knew John had just been reminded of the unwelcome weight in his abdomen. He swept his son’s bangs reassuringly from his forehead.
“The first day is the hardest,” he whispered. “You’ve done great. And remember…”
“The pain makes me stronger,” John dutifully recited. “And I give life.”
“That’s right, sweet boy.”
A moment later, John frowned.
“What is it?” his dad asked.
“Tell me again why men give life…if women give birth?” John’s voice trailed off as he sensed that he’d said the wrong thing.
“Son.” John’s dad resumed stroking his hair. “The egg waits for the sperm. Without the sperm your body works so hard to turn over, the womb would remain empty. There’d be no life to give birth to.”
John nodded. Of course.
Janice knocked at the door. “How are we feeling?” she asked in a tone that respected John’s ongoing effort to come all the way to.
“OK,” John said.
“Maybe a little out of it.” John’s dad winked.
Janice nodded, sanitized her hands, and rolled a padded stool up to John’s bed. This hospital-like gesture jarred John: it didn’t jibe with the rest of Room 412, which he now realized looked very much like his bedroom at home. He lay in a full-size bed made with the same flannel basketball sheets, extra pillow, and navy-blue duvet, and the desk-chair his dad now occupied was a dead ringer for his own. An X-Box console winked at John from beneath the TV. He wondered whether this room had been customized for him, or if he just happened to be the prototypical thirteen-year-old boy.
After John rated his pain and bloating — on a scale of one to 10, a five and six, respectively — Janice typed some notes into her iPad. “Next month, we can adjust the drip so you wake up from that first rest with no cramps at all. But you’d be a little groggier. It’s a matter of personal preference,” she explained. John watched as Janice pulled the IV pole that had been tucked discretely behind his bed closer. “You’re doing so great already,” she said as she attached some fresh new tubing, “but after another couple of months? We’ll have things” — she sent a chef’s kiss into the air — “just perfect.”
John wondered if he’d still find his strength, and really be part of the Brotherhood, if he avoided cramps altogether. But Janice — not for the first time, nor the last — read his mind. “It’s all about balance and pacing. A years-long dance,” she said. “You’re just Beginning.”
John and his father nodded silently, one in wonder and one in fervent agreement. Janice slapped her knees. “Now. I’m going to have a quick look and get you really comfortable. Sound good?”
John didn’t want to be exposed — not to Janice, definitely not to his father, and, if he was shedding as much blood as he feared, not to himself. But with the touch of an iPad, a scrim glided down from the ceiling to John’s waist. He instinctively looked to his dad, who continued to smile and pat John’s shoulder as if all of this was totally normal.
“Great urine output,” Janice said after examining the catheter bag. John felt his covers slide back ever so slightly and heard the Velcro border on his sweatpants release. More Velcro sounded and John’s blood-containment garment was gone — he heard it hit the medical waste bin.
“Is it bad? The blood?” John asked before he could stop himself. Janice answered his dad’s gentle laugh with her own.
“Not at all,” she said from behind the curtain. “This is medium first-day output — at most.”
John couldn’t believe this and wondered if it was true. He’d been sure he was going to need a transfusion. A warm solution bathed John’s crotch again, more things hit the waste bin, more Velcro crunched, the covers fell back over the side of the bed, and the scrim disappeared.
“Tomorrow, we’ll bathe,” Janice explained. “But for now, everything looks great.” She walked back around to his IV pole and whispered, “sleep tight.” Within seconds, John had nestled back into his pillows and succumbed to the overwhelming urge to close his eyes. He wanted to stay up — and access the cache of questions that had bubbled to the surface just minutes ago — but then he heard someone snoring, and vaguely suspected that that someone was him.
John awoke to bright sunlight piercing the sliver of space between the curtains and the floor, and to the sound of voicemails playing at the nurse’s station across from his room:
“First message,” said a mechanical voice. And then, “Hi, this is Ben Gould, ID number 787212. I’m hoping for an Express this morning; I started around four a.m. and am of course heading to the beach — my one vacation a year! — tonight. I’m three days early, so I believe I’m guaranteed a slot. Thanks.”
“Second message.” “Paul Childs here,” the next man said in clear, clipped voice. “My cycle’s been unpredictable — you can look it up, number 368910 — but I started an hour ago and am presenting our quarterly earnings tomorrow at noon. I can’t reschedule again, so I’ll need the Express. Thanks much.”
John was pretty sure he heard a whisper about how everyone needs the Express followed by a giggle and a hush.
“Third message.” “Um, hi. It’s Justin Kim, and I think I want to use my Emergent Express today? I’m a med student, things have been crazy…and I’m proposing tonight. So I lost track of my cycle — took me completely by surprise — and I’ve got the hot air balloon, photographer, and champagne service booked — all non-refundable. I’m, uh, just gonna show up when you open? Thanks. Oh — I’m 446550. Thanks again.”
John stretched and grabbed the room’s master remote from his nightstand. With it, he opened the heavy navy curtains and raised the sheer beige one. He felt flush with relief: he’d made it through the night and, somehow, felt both completely rested and completely awake.
“Isn’t that something?” asked a friendly new nurse, Nancy, after answering John’s call button. (There’d been a note to Please call upon waking — DO NOT get out of bed alone! affixed to the room remote.) “Would you believe I started here before we perfected that drug?”
In response to John’s befuddled expression, Nancy explained. “The menstrual sleep-aid in your IV. It took the NIH years to get it right — something that lets you sleep soundly but doesn’t make you groggy the next day. My patients sure do like it!” She chuckled good naturedly, causing her gray braid to twitch atop her breast. “Why don’t you look over this breakfast menu while I take a peek?”
John used his hands to push himself to sitting. He gasped when he felt a rush between his legs. Nancy helped him scoot back down and kept a hand on his shoulder while assuming a more serious tone. “That’s just physics,” she said quietly. “When you sit up after lying flat all night, gravity releases whatever’s been waiting to get out. All perfectly normal.”
Despite his best efforts, John began to pant.
“Stick with me, kiddo,” Nancy urged as she moved with haste. She scanned John’s watch, summoned the scrim, and gloved herself in no time. “Just breathe.” John heard and felt all the familiar sounds and sensations of cleaning and changing. “Your output is completely normal,” Nancy reassured him, “but I’m going to do a little suction to get some of this gone before you sit up again. It’ll feel weird, but it won’t hurt. Then I’ll change your garment from Overnight to Super — that’ll make all the difference. Can you trust me?”
Nancy peaked around the scrim to smile at John. A wide-eyed nod was all he could manage.
While warm solution bathed him, John felt a gentle tugging and heard a faint, windy whir near his penis. The contest between the suction and thick menstrual goo made John squeamish. “Breathe, honey,” Nancy reminded him. And then it was done. Nancy reached into a rolling set of drawers for fresh garments and changed everything from John’s waist down — and, according to his watch, did something with his catheter. She rolled up the scrim and ungloved. He felt better already.
“Did you just give me the — is it called ‘the Express?’” John asked.
“Oh my goodness, no,” Nancy explained. “That’s for when you’re older and have some real fortitude — some good fight — under your belt. The kind you’re getting right now.” She smiled. John swelled.
“But…what is it?”
“The Express? It’s a short procedure to clean out the flow for one month.” John couldn’t help but perk up. “One,” Nancy repeated. “And it does involve anesthesia, which comes with some risk. But most importantly, it’s one less opportunity to give life, or to harness your own strength. General Headley never had an Express in his life.” She glanced quickly at John out of the corner of her eye. He hung his head.
Nancy changed tacks. “Here we go — let’s sit you up,” she said. John was ginger. “We’ll go slow and it’ll be fine — you’ll see,” Nancy said. And thank God, this time, it was. John’s new, dry garments made him feel human.
“Is it normal to wear a Super? At my age?” John asked shyly.
“Oh yes. On your first full day, first thing in the morning? Nearly everyone needs a Super.”
“And you could probably do with less, but since this is your first, we’re sticking with Super, just to be safe.” John fiddled with his hands. “Now: breakfast time. OK?” Nancy smiled. “Then you can call your folks if you want, and we’ll put together your just-right first day at the CMC.”
After John inhaled a short-stack, two sausage links, two bacon strips, two scrambled eggs, a bowl of berries, and some OJ, Nancy and her partner, Jane, came to do his orientation. Although he’d called his parents just so they could hear his voice — they could access his data remotely from his dad’s watch, of course, and had checked on him overnight — something in his nurses’ demeanors told John he wouldn’t want his parents around until later. They exchanged those glances adults exchange whenever they’re supposed to be casual, but are actually bracing for something awkward.
“We’re going to show you an informational video,” Jane said, the remote to John’s flat-screen in her hand. “Of course, you can watch it as many times as you want or need to,” she added, “but you can also jot questions down on your tablet. And that’s private, by the way — nothing you write goes into your file, or to your parents.”
Suddenly, John wasn’t listening. His breakfast had hit bottom and he needed to go to the bathroom. His face reddened and he started to sweat.
“John?” Nancy asked. She glanced at Jane in that conspiratorial way again. “Is it the video, or a bowel movement?”
“I…have to use the bathroom.”
“No problem,” Jane said as both women sprang into action. They helped him sit up and swing his legs over the bed. His watch beeped as his pulse climbed.
“Oh now,” Nancy said kindly. “It’s nothing like you’ve built up in your mind.”
“What about my…?”
“I removed your catheter when I did the suction,” Nancy assured him. “You’re untethered. Just move slowly — everyone responds differently to the meds. We’ve got you.”
And they did. Each of them had a practiced lock on one of John’s elbows as they guided him towards the bathroom — his first trip there. He was pretty steady on his feet, considering he hadn’t stood for a day. But John was weak. His body’s fuel was oozing out of him faster than the CMC could replenish it. His insides worked overtime and his outsides betrayed this fact: he looked pale, tired, and overwhelmed. He shuffled his feet. Every corner of his abdomen clenched; his sacrum, beneath the drugs’ obfuscation, was tight. It was hard to tell which rolling cramps came from where. The propaganda, the pride, that grownup feeling — all of it evaported as John wobbled to the bathroom. He was moving through mud, and the effort involved in doing so made him feel broken. Yet here he was, walking to the toilet to take a shit, just like he did every day, like it was no big deal — as if whatever was about to rush out of him wasn’t too much. As if the large bidet toilet and enormous bathtub laden with jets weren’t foreboding. A thought wafted through John’s defeated mind: there’s no way Wesley Headley did all of this alone, in battle, without garments or drugs, Nancies or Janes. No way. He was almost too tired to feel ashamed of how easily he’d caved to his body, or how completely he’d failed to master it. Almost.
By the time John approached the commode, Nancy had taken both of John’s elbows so that Jane could rip off his bottom garments like a pair of NBA warm-ups. He was never exposed — John now realized that someone had untied his state-issued top in the back so that it fell nearly to his knees. His watch sounded a new alarm.
“You can do it,” Jane said. “We’re steps away.” She placed a pull-cord in John’s hand while Nancy lowered him onto the toilet, typed something into her tablet, and left.
It would take years for John not to overcome that first-day dread. It was impossible not to catch the pink cast of the toilet water out of his peripheral vision when it flushed behind him; impossible not to be overwhelmed by the layers of cramps expelling multiple substances simultaneously; and impossible not to feel the sticky residue left around his penis after the bidet tried to wash the blood away. He couldn’t even enjoy the whirlpool bath — that turbo-cleaned all the right places — that Nancy and Jane had festooned with lavender. In fact, John wouldn’t sleep a wink during his own sons’ first nights; the visceral sensory memories of these traumatic moments would prove too much to let go.
The only plus side to John’s ordeal was that he was too enervated to be totally mortified by the video Nancy cued up for him. This was the one thing his parents hadn’t mentioned: apparently, boys should masturbate regularly during their cycles because orgasm relaxes cramps. And, apparently, there were various age-appropriate masturbation aids available on his tablet and upon request. (Men, John would learn during his first cycle after his 18th birthday, were encouraged to enjoy conjugal visits to achieve this purpose. This explained the shy women and men — who weren’t staff, and didn’t appear to be visiting sons — John regularly saw slipping in and out of the CMC. This did not explain how a man with first-day flow could possibly want to have sex, or ask someone he cared about to endure it. “It’s a mitzvah,” John’s first college girlfriend, a Jew, would assure him gravely — although she didn’t seem terribly disappointed when John declined her offer.)
John wouldn’t soon forget that afternoon — the time his mom spent puttering around his room, clicking cheerfully away on her laptop while his dad played endless rounds of X-Box with him. Nor would he forget his parents’ willingness to carefully catalogue, at John’s detailed direction, the congratulatory baseball cards Uncle Logan had sent while John attacked another iron-rich dinner and chocolatey dessert. It had been as though his folks had been waiting by the door, expecting the call John tried so hard to cloak in fake calm, and known just what he needed. Their understanding normalized John’s lack of bravery. It let him start to forgive himself, and remain open to the possibility that he would, eventually, learn to harness his strength.
By the time Jane had finished John’s nighttime preparations and reconnected his IV (“another great night’s rest will do you good,” she’d assured him), John felt substantially more at ease. He fell quickly to sleep.
“You must be so proud of your boy,” Jane said quietly to John’s parents after closing Room 412’s navy curtains. Although she didn’t mention it, Jane had stayed late to see John off to dreamland herself. It’s what she’d want someone to do for her own son, who to Jane’s amazement, would turn 10 the following week.
“We sure are,” John’s mom said with a smile that was all too familiar to Jane — tired, triumphant, relieved.
“Beyond,” his dad choked.
After re-checking John’s IV, Jane rubbed a few drops of essential oil gently behind his ears. “We’ll take the best care of him,” she assured John’s parents. Their arms intertwined behind each other’s backs, they smiled and nodded their thanks before gazing in disbelief at the young man lying before them.
Jane knew they wouldn’t notice when she brought her right hand to her lower back to rub the knot growing there. After changing clothes and grabbing her purse, Jane slipped into the staff restroom. She rolled her eyes: as anticipated, she’d leaked through the super-plus tampon she’d inserted just two hours ago. She retrieved a new super-plus and pantiliner from her purse, washed up, and swallowed three Advil from her own pillbox — borrowing from CMC provisions was a job-threatening no-no — with a handful of water from the tap. As she drove home, Jane thought only of the soft give of her children’s sleeping cheeks, just waiting for her to kiss them, and the once-monthly scotch-rocks she’d enjoy with her dinner.