I am forty-seven years old. I have been working in Lampedusa for four years. Before Lampedusa I was in Catania, in general surgery, and in Catania, on a November morning, I had a panic attack in the operating room while I was about to clamp a hemostat, and after that day I requested a transfer and they gave it to me.

In Lampedusa I thought the sea would bring peace. I thought that at least the sea you know, you see it, you know what it does. In four years I have counted corpses fourteen times. Today the fifteenth arrived.

It was thirteen forty. The patrol vessel CP three-twenty-two had hooked the boat at three in the morning, eighty-five miles from Lampedusa, in the Libyan SAR zone. For ten hours it had held course toward the harbor through driving rain, and when they brought it in the radio of CP three-twenty-two said only: "Eighteen confirmed dead, five alive. Hypothermia." I climbed into the empty ambulance and waited at the Favarolo dock with Vincenzo, who is the island's forensic physician and who is sixty years old and wearing a grey shirt.

I counted. Number one, male, fifties. Number two, male, thirties. Number three, pregnant female. Number four, child. Number five, child. Number six, child. I stopped. Vincenzo looked at me. I went on. Number seven male. Number eight female. Number nine male. Number ten female. Number eleven male. Number twelve female thirties, red dress with white flowers, wound at the temple, braided hair. Number thirteen male. And so on through eighteen, a thin boy with white trainers still laced.

The five survivors were placed on the other tarp, four metres from the eighteen. Three weak adults with swollen feet and hollow eyes, one critical woman with a cut on her thigh losing blood slowly, and a child in respiratory arrest, who appeared to be ten years old and who had been pulled out last because he was under two adult bodies, and when Andrea, the patrol vessel commander, lifted him from the bottom of the boat, beneath his back there were two broken headphones, an empty water bottle, an identity card with no photograph. The Frontex mediator was a Senegalese man from Saint-Louis who speaks Wolof, and when he looked at the child and then at number twelve he said to Vincenzo: "Same dress, in small. Under the child's shoes there is a red cloth with white flowers." Mother and son.

Vincenzo came close to me. He had the forensic form in his hand, and eighteen pre-printed lines, and a ballpoint pen, and eyes a little red, but not from the sun. He said to me: "Carmela, you decide. I already have the form to sign for the eighteen."

Vincenzo is a decent man. Vincenzo was giving me the child.

I look at him. The skin is ashen but warm. The chest rises a few millimetres, every four seconds. The pulse oximeter reads sixty-two, sixty-one, sixty. I can intubate him here, on the tarp of the Favarolo dock, beside number twelve who is his mother, and who still has no name. I can load him into the ambulance, twelve minutes to the island's polyclinic, mobile oxygen, some chance.

My hands open the intubation kit before my head has finished thinking. I open the tube. Tube number five, diameter for a ten-year-old child. The laryngoscope blade is already fitted. Vincenzo says quietly: "Yes." I do not look at him. I crouch down. I tilt the child's head. I open the mouth. I insert the blade. I see the vocal cords on the second attempt, I pass the tube, I inflate the cuff. I connect the Ambu. The saturation climbs to seventy-two, to seventy-eight, to eighty-four. Vincenzo says quietly: "Good."

The ambulance is ready. The child is loaded onto the stretcher, in induced coma, intubated, with another nurse beside him. The driver, Sandro, has the engine running.

I stay on the tarp. My hands are trembling. I count my breaths. I was already doing it before, even in Catania, even after the good operating rooms. I reach forty-nine. I stand. I walk toward the patrol vessel CP three-twenty-two, across the eighteen tarps laid out in parallel. The patrol vessel commander is Andrea, he is thirty years old, fisherman's hands. I ask him: "Number twelve, female thirties, red dress. Do you have a name?"

Andrea checks the notebook. He says: "We don't. Someone said: Mariama. I don't know if it's her. There were seventy-seven of them on board."

Mariama.

I return to the child's tarp. The tarp is empty, the child is in the ambulance stopped ten metres away. But his shirt has been left on the tarp, a yellow shirt with a dog drawn in pencil. I take a permanent marker from my pocket, walk to the ambulance, signal to Sandro to wait one more moment, climb in, uncover the child's left wrist, and write: Mariama. Seven letters. The R is a little crooked.

Sandro looks at me. He says: "Sure?" I say: "Sure." I climb down. The ambulance leaves at fourteen twelve.

I return to the dock. Vincenzo is signing the form with eighteen lines. He does not look at me. Then he looks. He nods.

The patrol vessel CP three-twenty-two leaves the harbor at eighteen thirty for another sighting, six miles to the south. On the dock the eighteen tarps remain, the rags, the open intubation kit. On the left wrist of a child who is now at the island's polyclinic I have left seven letters in marker.

Mariama. The R crooked.