Seven stitches and a broken wrist from a patch of black ice outside Walmart. That was supposed to be the whole story of that day. I even remember laughing a little when the paramedic helped me up off the pavement, embarrassed more than anything, telling him I was fine, I was definitely fine. I was not fine. But I didn’t know that yet.

The ER was busy that night. It was a Thursday in February, cold enough that the waiting room had that wet-coat smell, and the fluorescent lights were doing that thing where one of them flickers just enough to give you a headache. I was sitting on a paper-covered table in bay four, cradling my wrist, and the same paramedic who’d brought me in was still there finishing up his handoff paperwork. I didn’t pay much attention to him at that point. I was focused on trying not to cry because my wrist was throbbing and I hate crying in public.

He was checking something on his clipboard. Taking my blood pressure, asking the standard questions. How did I fall, did I hit my head, did I lose consciousness. I had my hospital gown pulled over my left shoulder kind of sloppily because I’d been cold, and I guess it had shifted. He stopped mid-sentence. Not dramatically. He just. Stopped. And I looked up because of the silence.

He was looking at my left shoulder. At the birthmark I’ve had my whole life. It’s raised and oval, about the size of a quarter, the color of dark coffee. I’ve always been a little self-conscious about it, actually. Kids asked about it when I was little. I used to make up stories about it. I don’t know why I’m even thinking about that right now, but I am.

“Where were you born?” he said.

I kind of laughed, confused. “I don’t really know,” I said. “My aunt raised me.

She always said my mom passed away the night I was born. I have a birth certificate but it just says the county.”

He set the clipboard down on the counter. Not tossed it, set it. Carefully. And then he looked at me in this way that I can’t fully describe except to say that it was not a normal paramedic look. It wasn’t clinical. It was like he was doing math in his head really fast.

“My name is Dale,” he said. “I’ve been a paramedic for thirty-one years.” He paused. “My very first delivery was in January 1995. Route 12. A snowstorm. There was a woman alone in a pickup truck, no cell phone, no hospital within forty miles. I was twenty-two years old and I was a volunteer EMT and I was terrified.” He said that last part quietly. Terrified. Like it still sat with him.

I don’t know when I stopped breathing normally. Somewhere in there.