Near the unassuming corner of 57th street and Columbus avenue in the frenzied heart of Manhattan, a tall, thin young man lay sprawled on the sidewalk, his chest heaving. He wore a filthy trenchcoat over a tattered and stained navy-blue suitcoat and trousers. His body lay just outside the shade of the awning of a small business whose window sign read Saul's Tailoring Shop. The man occasionally writhed from side to side and then stopped.
It was the very shank of winter - a blustery day in the city, a miasmic city full of Existential fury. It was now lunch hour for the business crowd. The masses of businessmen and women went about their appointed rounds. The skyscrapers were edified against a cerulean sky and their jutting shadows dwarfed the rushing crowds on the street. The stifling traffic, cabs and trucks, honking and bleating, crept past the young derelict choking on exhaust fumes.
The man shivered with fright and cold. His chest spasmed with pain. He coughed violently as masses of passersby walked over and around him. He lay facedown on the street drain. His blonde crew cut was tainted with filth, his bare ankles blistered beneath scuffed-up dress shoes. Death seemed to lurk over his dry-heaving body. Panic glazed his eyes. He wasn't unconscious, but silent and still.
A hot-dog vendor, who had been watching the prone man for twenty minutes, walked up to where he lay motionless.
"Hey? You all right?"
"No."
"You want me to call a cop or something?"
"I am Sergei," mumbled the man. "I have been to the Isle of the Dead. You know?"
"What are you saying?"
No answer.
"Okay." The vendor shrugged and muttered, "Crackhead." He slowly walked back to his cart.
The young man had been sleeping in a hotel near 45th until he was kicked out; then it was Central Park - until the cops forced him to move on. He couldn't remember his last meal. His face was handsome.
He'd been nodding in and out of narcoleptic stages when two medics from nearby Saint Luke's Hospital appeared, dispatched in response to a concerned 911 call. They approached him slowly and cautiously.
"Hey, Mister. Mister . . . Come along with us."
He didn't move. The medic spoke again.
The young man lifted his head.
"That's it. . . . Get yourself up, now. . . . Gooood . . . That's it, now."
The man managed to stand up with their help. They walked him to the ambulance. He mumbled, "Isle of the Dead. . ."
The driver radioed in to his dispatcher:
"We've got a Caucasian male, no identification, early twenties. He probably hasn't eaten - really out of it. Dehydrated, emaciated, irregular breathing, not responding much . . . possibly drugs. Low pulse rate, blood pressure ninety over sixty."
At the emergency room of St. Lukes, a hospital gown replaced his torn clothing, and they put him on an IV drip.
"Yeah, he's dehydrated," assessed the nurse.
He sobbed on the bed. He tried to speak but only slurred in intervals.
"Rachmaninoff . . . have . . . been to . . . Isle of the Dead."
"Okay, that's fine," coached the nurse. "Now, is that your name? Where do you live?"
He didn't understand.
"You look like you haven't eaten for a while. You don't look like a druggie to me. Mental illness, maybe? Who knows?"
"What have we got here?" asked the doctor, picking up the patient's printout off the end of the bed
"Seems to be delusional. All he seems to say is 'I am Rachmaninoff,' or some Russian-sounding name like that. Like Sergei something. That might be his name, right?"
"Probably not. Don't you know your composers, Gwen?"
"A shopkeeper said he saw him busting into businesses, raving about the Isle of the Dead or something. Saying he was going to be on the cover of Time magazine. Then they saw him lay in the gutter all morning. Said they figured him for dead. He has no wallet, nothing."
"Looks emaciated, way underweight," said Dr. Kennedy, looking at his patient whose blank expression silently spoke of mental anguish. His pale face was a portrait of tortured features.
"So, he thinks he is Rachmaninoff, eh?" the doctor continued. "It's okay there, young man. We'll take care of you. Give him a change of clothes, and we'll get him transferred to Behavioral if he starts coming around. No medical insurance here, obviously. If he doesn't eat in a while, he's a goner. Keep that intravenous drip for a good while."
"Yes, Dr. Kennedy. I'll finish up his chart in just a minute and bring it back to you," she said.
"Good."
