Having devoted the last 20 years to working as a paramedic in the Hell’s Kitchen–Times Square district of New York City, Maggie Dubris brutally blurs the distinction between life and literature in Skels, which conveys the overwhelming feelings one has during epic moments of tragedy. Narrator Orlie Breton gives vivid descriptions of the dead or dying interspersed with passages about the close personal relationships she’s formed with fellow medics. Glimpses into Orlie’s experiences with the living make graphic scenes of death more believable. In one, Orlie elaborates on her need to “look at [a] man as a bunch of organs.” A man cut in half by a subway train is especially grisly. Dubris captures that hurried sense of absurdity that other authors, like Denis Johnson, have tackled in the emergency room–trauma story genre. And like Johnson, Dubris harnesses a dry, sick sense of humor that rescues Skels from being pure, unrelenting nightmare. Enter Weenie, the drag-queen friend of Orlie’s roommate. Weenie’s need to be fabulous 24-7 provides comic relief, especially when she’s hurling witty insults: “In your dreams, little worker ant!”
But it’s the sheer depression one experiences after exposure to poverty that forms the core of Skels. Throughout the book, homeless people are the ones most often calling for help. Dubris modeled these characters after various 19th-century writers such as Jack London, Whitman, Rimbaud and Mark Twain, imbuing them with writing skills. The Albino scrawls nonsensical verse all over city walls. After witnessing the death of an elderly lady in Harlem, Orlie returns to the woman’s apartment to discover yellowing paper bundles of riddles and letters. Dubris fictionalizes past homeless, alcoholic and drug-addicted patients to distance herself from their sordid situations; but by exposing the reader to these destitute scenes, Dubris forces us to face pain.