Medical Records
During the Vietnam War I performed alternative service in a suburban Denver hospital—I was an orderly on a surgical recovery floor. After completing the required two years of service I transferred to Radiology, where over a period of months I was able to collect all my shifts into a 36-hour block on the weekend. For over two years I went in at 6 pm on Saturday and left at 6 am Monday; this allowed me to both pay for and attend school full-time in Boulder.
The x-ray tech I worked with was already doing a similar shift, and because weekend shifts were always a challenge to fill, the hospital didn’t object. If things weren’t too busy Saturday and Sunday night I could nap on an IVP table between ER cases, and the tech did the same, sleeping in the department lounge. On Monday mornings I took a city bus to downtown Denver, then caught the Denver-Boulder regional bus which dropped me off in Boulder in time for morning classes.
The following are excerpts from notebooks, usually jotted down each evening. Names have been changed.
1 Diane
During the time I worked on the surgical recovery floor (2 North) I usually ate lunch in the hospital cafeteria with some of the floor nurses, but being an orderly I was quite invisible, except as an occasional sidebar audience.
Diane whittled away on her fried chicken.
The cafeteria, bright, was filling with the sounds of eating and conversation. The skin on her chicken was tough—she labored inordinately for each piece.
Slipping a chunk of white meat into her mouth, Diane said, “Did you know one of Ana’s kids is dead?”
Peg and Connie paused their chewing; their faces showed surprise.
Diane continued: “You remember Jaime and Ana, and little Brian. They had twins last year and named them Jaime and Jimmy.”
“That’s really dumb—I hope it was Jaime!” Connie laughed and turned to me. “Isn’t that awful? I shouldn’t say that.”
“I thought it was dumb, too,” Diane said. “But that’s what they named them.”
“How did it happen?”
“Well, Ana was working nights.” Diane scooped up some mashed potatoes. “Jaime was right there, but he was playing poker. It was little Jaime who died. He drowned in the tub. I guess he was a little antsy that day so Jaime put him in the little chair in the tub because he liked that. If he hadn’t been in the chair he would have been okay because he was a sturdy little guy, he was about nine months, and could have lifted his head out. But he fell forward with the chair on top of him. Brian was right there and kept calling ‘Daddy, Daddy’—he’s only 18 months, but Jaime didn’t pay any attention. Brian had called a couple times before and there hadn’t been anything wrong. So Jaime kept playing cards.”
We all shook our heads.
Diane continued: “When they found him they brought him next door—one of the kids there had taken a first aid course, but it didn’t do any good. By the time Ana got home the ambulance had already taken him away. They didn’t call her at work because she was about to come home anyway.”
Connie mumbled “That’s pretty awful” through her chef salad.
Diane swallowed. “And you know how Ana is—she was blaming herself. It’s really sad, because Jimmy was her little pet, and Jaime was Jaime’s. So she was saying, ‘Oh, if only I had paid a little more attention to Jaime maybe this wouldn’t have happened,’ and ‘If only I had been a little more careful.’”
Diane, Peg, and Connie all agreed it wasn’t Ana’s fault, and started on their desserts.
2 Thora
Thora was the head nurse on 2 North; her strictness, combined with her self-assurance and her ability to handle any emergency made it clear she was not to be messed with. No-one second-guessed her, even behind her back. Perhaps in her late thirties, she was tall, smart, athletic-looking, and had a deep but pleasant voice.
I soon ran afoul of Thora for the following reason: I was punching in two to three minutes late every day (though the hospital rule was that you could be up to seven minutes late before your pay was docked).
To start my six-month review meeting Thora cheerily complemented me, saying that since I’d started, my work had been excellent and my attendance had been perfect, which made me her steadiest employee in that period, but—and here her tone and expression switched from cheery to intimidating—my 100% record of being two minutes late was totally inconsistent with everything else. She said she knew I’d rented an apartment less than 100 yards from the hospital entrance, so there was no possible explanation for the pattern but intentionality, and she was not going to tolerate it.
Busted.
I did have a bit of a problem with “authority.” Without really thinking through what I was doing, I indeed had been timing my arrival as some sort of under-the-radar protest against “the man”—definitely not Thora, who was a terrific manager and who also supported the COs who worked in low-level positions throughout the hospital. From then on I was consistently on time.
The nurse’s station on 2 North was long and shallow, positioned at the intersection of 2 North’s two hallways, which formed a “T”. A second room ran along the back of the nurse’s station, also long and shallow, with a separate entrance, and the wall between the rooms was opened with a full-length pass-through. That back room had a long counter along the pass-through and several chairs, which is where orderlies and other staff sat between tasks.
At that time I was going to school part-time at the Denver campus of the University of Colorado, working my way through a textbook on advanced calculus; Thora had given me permission to study during the brief periods when there was nothing to do.
The sight of me studying, and for that matter my very presence seemed to annoy Diane and she rarely missed the chance to append any comment that referenced me with a demeaning twist such as “while he’s back there doing his arithmetic.”
Her insults amused me, and I never reacted. But I did think there was something about her that, well, just didn’t add up…
3 Pappy
Starting with this entry I’d moved down to Radiology, though the events often happened on 2 North.
Late one night I went up to 2 North to say hello to folks. Pappy and I were talking in the nurses station—Pappy was a stout, small, Licensed Practical Nurse; a compassionate, quiet woman of perhaps 50.
A tech from the cardiopulmonary lab walked by and said, “Mr. Teller’s about had it.”
I looked up in surprise. “The same Mr. Teller from 2 ICU? You’re kidding—I thought he looked better last week.”
They shook their heads gravely, and the CPL tech continued on her way.
“Was he terminal to start with?”
Pappy nodded. “Do you remember when he was up here in Room 7?”
I admitted I did not.
“He was, and he told us then, ‘I know I’m going to die, so just let me.’”
“They never do, do they.”
There was a short silence. The conflict between medical practice and patient self-determination hung between us in the bright light of the nurses station—after the first time you care for a human being tied to life with drugs and machines, or being turned into a 150-pound seething tumor, it’s not helpful to discuss it yet again, so we just feel like hell while following protocol.
Pappy spoke up. “After this sort of thing I’m grateful that my parents didn’t linger.”
I nodded.
“What would I have done? No. My mother came here on a Saturday and she was gone by Thursday. And my father, he sat down in a chair”—Pappy shrugged—“and that was it.”
I suddenly felt empty, vulnerable. My parents were still alive at the time—everyone I knew had at least one living parent. I saw that my parents were a curtain, a buffer between me and my own mortality, and I saw the frailty with which my mind protected itself from what would inevitably become my turn. I imagined the death of my parents, and for the first time what their thoughts about their own mortality might be.
“And my brothers,” she continued, “they both died without lingering.”
“I’m so sorry—was it recently?”
“No, a long while ago. They died within a month of each other. And both young. Let’s see… Gregory was… twenty two. He was a cook at a hotel in Topeka. Just walking home from work one evening and he collapsed in the street. By the time they got him to the hospital he was gone.”
“What happened?”
“Pneumonia.”
A call light went on.
We looked at each other. Pappy hadn’t told me yet about her other brother. I wondered across what gulf of experience—of tragedy—our eyes met.
Pappy rose to answer the light, and I went back down to Radiology.
4 Harrison, Everett, and Yamaguchi
Harrison, Everett, and Yamaguchi stood in the radiology processor room. The films I’d developed were dropping from the processor with the plopping of plastic-on-plastic, and Everett, the resident radiologist on call, put them up on the view box. Harrison’s patient was having an emergency barium enema—it was late Sunday night. Yamaguchi was there to look at a possible foot fracture.
The patient’s colon hung like a white convoluted ribbon in the films. Everett traced the bowel pattern with his finger and remarked “I see six possible diverticula on this film; perhaps there are more on the other side.”
Harrison sighed. “No, it can’t be—there’s no sign of inflammation.”
Yamaguchi laughed. “Well, there goes a new set of golf clubs.”
Harrison’s response was another sigh.
5 Mrs. Larson
I entered the patient’s room: “Marie Larson?”
The nurse turned to me. “Yes, this is her.”
“I’d like to take you down to X-ray.”
Mrs. Larson, a wiry octogenarian, looked at me curiously. “What’s that, sonny?”
I raised my voice. “I’d like to take you down to X-ray.”
“What’s today?”
“X-ray! I want to take you to X-ray!” I shouted.
“X-ray. Sure, sonny. Dear, get my hearing aid from that box in the drawer.”
The nurse took out a small cardboard jewelry box and handed it to Mrs. Larson.
“Thank you dear, it’s so hard to hear without it, you know.” She gave me a stern look with her sparkling eyes. “This cost 400 dollars!”
“That’s a lot of money.”
“Yes it is!”
We helped her to a sitting position; she was pretty spry and could get around herself. She had a mischievous look about her.
“Yes, this is a nice hospital. We have a hospital in Thermopolis, you know. Oh yes, they have therapy rooms and a rehabilitation center and—”
The nurse was putting on her slippers. “Thermopolis?”
“Thermopolis.” Mrs. Larson affirmed it with a tone that apparently should have cleared up the matter. Then: “Don’t you know where Thermopolis is?”
“No, I can’t say I do,” the nurse replied.
Mrs. Larson looked astonished. The nurse turned to me. “Do you know where it is?”
“No, I never heard of it.”
“Never heard of it!?” Mrs. Larson looked as if she couldn’t believe her ears—or believe the ear with the hearing aid anyway. “Never heard of Thermopolis!” She laughed at our ignorance.
I eased her into the wheelchair. “So, where is it?”
“North of Casper, maybe a hundred miles. Never heard of it?”
“That must be several hundred miles from here.”
“Yes, it is, sonny.”
“How many people live in Thermopolis?”
The nurse smiled. “One, I’ll bet.”
“Thirty -five hundred.”
“Oh, that’s a pretty big place,” I said.
“Yes it is. Thermopolis is pretty big.”
When I brought Mrs. Larson down to Radiology, she immediately started talking to Jocelyn, the head x-ray tech on weekends, about Thermopolis. Of course Jocelyn had never heard of it either, and once more Mrs. Larson was dumfounded. When she started describing their lovely hospital again—the therapy rooms and the rehabilitation center—she added one more: the ‘separation center.’
I bit: “A separation center? What’s that?”
Mrs. Larson gave me a wise, mother’s smile. “Sonny, that’s where they separate you from your money!”
6 Elevator scene
I was waiting for the elevator on Two when a resident and intern walked by: the intern was in front.
The intern hesitated where the hall divided to the right and left. “Which way?”
The resident stopped next to him and unfolded a hard, thick sheet of paper, and examined it for a moment. “Room 209.”
The intern started to move, but a hand gesture from the resident made him pause.
“And no matter who she is give her a rectal.”
7 Jocelyn
I’d been chatting with Thora on 2 North and came back down to Radiology. I entered the department lounge where Jocelyn was was drinking a diet root beer and munching Fritos.
She looked up as I entered. “Something up?”
“No, just came back to get something to eat.”
“You remember that hip and knee we did late at night last week?
“Uh, I’m not sure.”
“It was about four in the morning, after we did that other woman—what was her name…
“Was she kind of heavy?”
Yes, you remember her now?”
“Well, not really. How old was she?”
“Seventy.”
“Uh…” I was drawing a blank on anything else.
“Remember? She was favoring her right side, we even had to have the nurse hold her so she wouldn’t turn and fall off the table.”
“Oh that’s right. She kept trying to turn…”
“Now you remember? McCarthy. Does the name ring a bell? Marilyn McCarthy.”
“That’s right—okay, got her.”
“Well she’s dead.”
A short silence as we stared at each other.
“Were you setting me up?”
“No. I was reading the paper and there it was in the obituaries. The minute I saw it I thought the name looked familiar and I went and checked the book and sure enough, there she was.
8 Cindy
I got out of the shower on 2 North about 11:20 pm. The nurses on the evening shift, which was to end at 11:30, were watching the clock.
Wendy, one of the team leaders, and Jolene, the secretary, were discussing Cindy, who’d apparently called to say she she’d been in an accident and was going to be late.
The three of us began to debate the pros and cons of getting out of work by having an accident, and came up with more of the latter.
Jolene said, “Well, it seems like Cindy is always late—if it hadn’t been for the accident it would have been something else.”
Wendy asked, “Are you ticked at her?”
After a slight hesitation Jolene said ‘no’ in a subdued tone.
“Well, I am,” Wendy said.
“I am too!” Jolene replied.
I mentioned that the roads were probably pretty slick because of all the snow and the cold temperatures.
“She was probably hurrying,” Jolene said, “because she always leaves ten minutes before she has to be here. I live in the same area, and I always give myself twenty minutes—I keep telling her she should leave twenty minutes early but…“
The conversation drifted for some time, and then Cindy walked into the nurse’s station. She looked, as usual, like she’d just jumped off the cover of a ski magazine: tall, thin, long blonde hair, wearing a way-too-short white uniform under her open down parka.
She was shaking slightly; her lower lip trembled.
Jolene spoke first: “Cindy—are you okay,? You look like you need to sit down and have a good cry.”
Cindy said ‘no’ in a quavering voice and crossed the nurse’s station.
“What happened,” Wendy said.
“Oh, it was my fault. And I didn’t have my driver’s license—so now I’m going to have to go to court!” The thought of this seemed to terrify her. One of the nurses whistled under her breath.
“Was your car completely wrecked?”
“No, it wasn’t too bad.” She lifted her arms then dropped them in despair: “But it’s probably going to cost me a thousand bucks!”
We all assured her that it wouldn’t cost that much.
“I even left twenty minutes early too,” she said. “I tried to call you earlier, but the cop wouldn’t let me. I said I have to notify the hospital, they’re waiting for me to show up, but he wouldn’t let me. I told him you guys would either be really mad or worried about me, and I just wanted to let you know what happened, but he wouldn’t let me call. I even asked him if I could call on that radio of his and he said, ‘I’m sorry ma’am, that’s against regulations.’” She looked as if she was about to burst into tears. Her voice broke as she said, “He really wasn’t a very nice man.”
We all purred our agreement.
As she turned to hang up her parka she remarked, “So he didn’t let me call ’til they got the other car out of the ditch.”