Doctor Bennet is a tall, thin redhead. I’m a small girl myself, and I’m pretty sure we have the same waist size. He’s a foot taller than me, too, so I think I have him beat in the thigh and calf muscle mass as well. He wears well-fitted slacks when he’s attending, and trim white shirts with thin ties of every color. I’m not sure I’ve ever seen him repeat a tie, which is impressive, and every one of them is as thin as a ruler. A thick tie would look like a dinner napkin on him. He’s holding a medication cup between his thumb and forefinger, and he holds it out to me.
“Caroline,” Bennet says, in his formal way, although he does smile. “I was glad to see you on the schedule tonight. This is from the pharmacy. Benzos for your detox patient.”
I take the cup and thank him, bobbing my head wearily.
“How’s the night been?” he asks.
“Cuuunnnnnnnnnt!” comes a throaty reply from inside the room. I blush and reach over to close the door softly. I look about and see that two nurses at the nearby charting desk are staring at us.
“About like that,” I say.
Doctor Bennet doesn’t laugh, but his eyes do. “I see,” he says, putting his hands on his flat hips.
“And I have another admission,” I say. “I don’t think I’ll be leaving any time soon.”
Bennet checks his watch. He knows night shift switches over soon and that if I haven’t admitted my last patient I haven’t done any of my charting. And that means I’ll be here well into the morning.
“Tell you what,” he says, and he gently plucks the medication cup back from me. “I’ll take care of our friend here. You get to your admission.”
I could hug him. Then I blush again because of how totally out of line that would be. Wouldn’t the girls at the charting desk like that? God knows what kind of firestorm that would set off. Thankfully I’m already sweaty and red from the general work day, so the blush blends right in. I give him a breathy thanks, and if he sees how desperately relieved I am, he doesn’t let on. He glances briefly at the pills, nods at me, and just walks right into the room.
“Now that’s quite enough of that,” he says, and his voice is hard and final, and it works. The patient shuts up. Another thing about Doctor Bennet. He may look like a reed, but he’s got an incredible bedside manner. He sets patients right. Sometimes that means he cracks down on them and sometimes that means he’s gentle, but either way it’s always what they need.
But I’m already gone, down the hall, into the next room and to my admit. And not a second too soon, either, because when I knock and open the door he’s already sitting up and probing his IV line, looking to pull. It’s a miracle the bed alarm didn’t go off. That might just have been the straw that broke the nurse’s back.
“Whoa, whoa! What are you doing?” I ask, a little too desperately. “Let’s just sit still for a second, shall we?”
I skid over and grab his arm and check that the line is secure, and I’m so flustered that it takes me a minute to realize that he hasn’t said anything at all. I look up at him and realize he’s as surprised to find me holding his arm as I am to find him trying to pull his IV line. I can tell he’s a Navajo, and what with the late hour and all the nastiness with my last patient, I brace myself for more trouble, but it never comes.
“Sorry,” he says, and he takes his fingers off of his line. His face is smooth and dark, not ravaged or ruddy like some of the Navajo that I come across, and his eyes are clear and deeply brown. The kind of brown that is at the bottom of a jar of honey. I suppose eye is more appropriate, since one is wide and alert and the other looks like it caught a baseball. He’s also young. My age. Maybe younger. And short. Shorter than me. But cut in that stringy, athletic way. And by now I realize I’m staring.
“…It’s just, I don’t think I need to be here,” he says. “I didn’t want to bother anyone. Thought I might just slip out.”
He has a touch of the Navajo accent, the careful emphasis on each word, and I can’t help but smile. This smile is nowhere near the manic smile I was fighting down in the hallway outside. This one relaxes my face.
“Slip out? You can’t really ‘slip out’ of a hospital, I’m afraid. We have to sign you in and out. Plus, you just got here.”
“I feel fine, now, really,” he says. And now that he’s not going anywhere, I pick up his chart from the foot of the bed.
“Ben Dejooli,” I say. “Navajo?” Whenever I see a patient uncomfortable, I start talking. Sometimes they don’t even answer me, but it does settle them more often than not. If anything, it’s simply better than the sterile white noise of a hospital. “What’s Dejooli mean, if you don’t mind me asking? I work at the Chaco Health Clinic once a week. I like to hear about Navajo names.”
This stills him, and he looks at me with a newfound interest.
“It means ‘gone.’”
“Gone?”
“Well, it means ‘went upward.’ But things in Navajo have a lot of different meanings. I think it’s more like ‘gone.’”
He seems distant all of a sudden, and I wonder if I screwed up by going down this line of conversation, so I bring it back to the task at hand.
“Says here you lost consciousness on the reservation. A Daniel Ninepoint called in the ambulance, and when you were non-responsive they bypassed the clinic and brought you straight here.”
Ben looks down, and I can see that he’s ashamed. A lot of Navajo men are ashamed of illness. They associate it with weakness.
“I woke up in the ambulance. Tried to get them to turn around. They wouldn’t listen. I’m fine. I don’t need to be here. I just passed out is all. Haven’t you ever passed out?”
“Not that I can remember,” I say. But the answer is no. I would remember. I remember everything. And I would be such a hypochondriac about it that I’d probably check myself into the hospital as soon as I woke up. “It’s most likely nothing, but we still need to check some things. See if you concussed yourself. I see you have a black eye.”
“That’s from before. So Danny found me?” he asks, grimacing.
“Don’t know about that, but he called the ambulance.”
“Great,” he says, shaking his head.
“I take it he’s not a friend of yours.”
“He’s my partner.”
Wonderful, I think. He’s gay. Naturally.
“I’m a cop. He won’t be too happy with me. I wasn’t supposed to be where I was when I passed out.”
I blink. A cop. Why am I so relieved he has that kind of partner? What is going on here?
“Where was that?” I ask, to keep him talking.
“The Arroyo.” He rubs gently at his face and taps softly around his eye. “Never mind. Look, I really need to go. I gotta straighten this out.”
I’ve found that when a patient tries to derail an admit—which happens often because there are a whole litany of questions I’m supposed to ask—it’s best just to power through.
“The black eye is from earlier? Before you passed out at the Arroyo?”
“Yeah.”
“Is it from a fall?”
“Yeah. I fell into a fist.” He says this looking down at his lap, but I laugh. Then it strikes me that he might be offended, so I cut it off with a cough. I’m still working on Navajo humor.
“Well, sometimes concussion symptoms show up late. Did you feel nausea, or light headedness after you were hit?”
“He didn’t knock me out,” Ben says, a little defensively. “He only got in one punch.”
“Sometimes people can lose consciousness for only a second and don’t even realize it. Usually there’s disorientation and nausea afterwards. “
Ben pauses, and I can tell he’s not telling me something. It’s very hard to fool a nurse. We may miss things on our own, but we can usually tell if you keep things from us.
“No nausea,” he says softly. “But…”
I wait.
“But I was…I don’t know. Things got blurry and I couldn’t talk, so I sat down
for a second. But it cleared.”
“And this was before the Arroyo?”
“Yeah. Yesterday morning. It was a rough day.” He eyes his uniform, folded, with his belt and badge hanging neatly from the chair nearby. His gun he’ll have to get from the checkout desk at the front entrance. He looks uncomfortable, more than just embarrassed. He’s swallowing and brushing at nothing on his forehead. He looks up at the hanging bag he’s connected to and then down at the bed. He crinkles the sheets, and he starts breathing faster. I’ve seen this before too. White Coat Syndrome. I think some part of him is terrified of the hospital.
“Listen, Ben, we’ll get you out of here as soon as we can, but—”
“Do you smell that?” he asks.
“What?”
“That smell, it’s like a…a burning smell. Is something on fire?”
I look around myself and even try a subtle sniff of my armpits while he’s ghosting his head back and forth.
“Nothing’s burning, Ben. It’s okay. You’re okay.”
I do something I rarely do uninvited, which is step forward and lay a hand on his shoulder. He reaches up and tries to wrap his fingers around my wrist. I’m expecting him to throw my hand away, but when he grips me he just holds on. All the while he’s sniffing, moving his head a fraction of an inch and sniffing again. He looks out of the small window as if he’s expecting to see someone there, then he blinks several times, and all of a sudden he’s under control again. Or at least faking it well. He looks up at me and even manages a shaky smile. He plucks his fingers away and sets his hands in his lap.
“Like I said. Tough day, that’s all.”
I unclip a small pen-light from my breast pocket and look into his pupils, and he allows it. There is no delayed dilation, no trouble tracking. None of the symptoms of a concussion. But rather than make me feel better, this gives me a cold, clammy feeling. Like water is dripping down my back. I’m an oncology nurse, and two things here raise huge red flags for me. One: he smells a smell that is not there. Two: when he tried to grab my hand, he missed by a good six inches on his first attempt. Like he was swiping at a missing ladder rung.
“Ben, was that time after you got hit the first time you smelled something burning?”
“I think so. Near enough, anyway.”
“How many times have you had to sit down to get your bearings?”
Ben shrugs. “A few. I don’t drink as much water as I should, and I think I’m kind of dehydrated—”
“Think with me here. More than twice?”
Ben nods.
“More than five times?”
Ben nods.
“More than ten times?”
Ben thinks, then shrugs. Which might as well be a nod. I swallow.
“It always goes away,” he says, but he’s eyeing the equipment again and picking lightly at the skin on the back of his hand. He’s trying to look around me and out the door.
“Ben…are you alright?” I ask.
His face finds mine and softens. “Yeah, really, I am. I just…I don’t like hospitals.”
“Not many people do,” I say, by way of reassurance, but it comes out sounding condescending, and I shake my head. I’m not normally like this around patients. I keep the second-guessing and endless over-analysis out of the patient rooms. Usually it hits me around three in the morning. Or three in the afternoon. Whenever I’m supposed to be sleeping.
“Sorry. What I mean is that it’s normal to feel stressed out in a hospital. It’s a proven effect. It’s called White Coat Syndrome. It skews a lot of our blood pressure readings.”
Ben nods and manages a half smile. I can tell he knows about White Coat and that he also knows what he has is worse, but I don’t want to press him. He’s eyeing me with this soft, tired, lopsided wink, and it’s ludicrously endearing. Probably because he doesn’t mean it to be.
“I don’t even know your name,” he says.
“Caroline.”
“Caroline,” he says, nodding. “I know you’re just doing your job. But I’m fine, and I really want to go. No offense.”
When you work on a cancer floor, you see cancer everywhere. Melanoma on arms and backs at the gym, liver cancer in the pallid, red-nosed strangers you pass on the street, lung cancer in the chronic, wet cough of someone next to you in line. You learn to dampen down the desire to smack some medical sense into these people, but the urge never really leaves you once you’ve worked on an oncology floor. Right now I really, really want to grasp Ben Dejooli by the shoulders and tell him to hell with what he wants. What he needs is to get an MRI immediately, and if he’s lucky, it’ll say that all he’s having are cluster migraines or that it’s vertigo or something.
But that’s me running away with myself again. That’s three a.m. Caroline. If I let her loose, it’s all over.
“How would you even get home?”
“I’d take a cab.”
“A cab from here to Chaco? You know how expensive that is?”
He taps his teeth together and nods.
“There’s nobody you can call?”
“There are people I can call. But I’d rather take a cab.”
I shake my head at the stubbornness of men in general.
“Well, if you really want to go, you and the attending physician have to sign an AMA form.”
“What’s that?”
“It’s a form that says you’re leaving against medical advice.”
“Whose?”
“Mine.”
He ponders this, and me, for another moment before nodding. I take a big breath and throw up my hands.
“All right. I’ll get the doctor.”
I leave the room before I can say anything else. I don’t know why this guy is affecting me like this. I’m acting like a nursing student, not an experienced RN. Actually, I’m acting more like a pining teenager, if I’m completely honest with myself.
I find Doctor Bennet at the computers drinking a large, black coffee. He’s both hunched over and tucked under the desk, and he makes the chair he’s sitting in look like it belongs in a kindergarten class. He looks up at me and presses his lips together. No doubt I look like a flustered hen. Except sweaty. It’s amazing how working nights throws off your internal temperature. I’m freezing one second, then I’m clammy the next.
“What’s up?” he asks.
“The patient is nine seventeen wants an AMA.”
“That was quick.”
“He’s insistent. I think he has a problem with hospitals.”
“And what do you think? Should we let him go?”
This is another reason why all the nurses love Doctor Bennet. He asks us what we think. Yeah, I know, it doesn’t take much. But you would be absolutely flabbergasted at the number of doctors who treat us like hospital accessories about on par with the vending machines.
“They brought him in because he blacked out, but I can’t find any evidence of a concussion. He’s responsive and alert, aside from the paranoia. He’s not complaining of any pain.”
“Well, if he wants to go and he can go, we gotta let him go.”
I deflate a little at this, and Doctor Bennet sees it.
“What’s the problem? I’d have thought you’d be relieved.” He checks his plastic Timex watch. “You’re already here past shift change.”
“It’s just…he’s complaining of a burning smell. And I think he may have some visual impairment. Depth judgment issues.”
“Is he driving?”
“No.”
Bennet creaks back in his chair and crosses his long arms over his white coat.
“And this isn’t his first episode. He said he’s had at least five of these incidents in the past.”
“You think he may have a brain tumor,” Bennet says.
I don’t answer him, but that’s answer enough. It’s always a strange thing when you pull out the word ‘tumor’ in a diagnosis. It’s such a heavy word. Nobody wants to say it. We get as used to it on the oncology floor as I
think anyone can, but it’s still heavy, even to us.
The other reason I stay quiet is because technically nurses aren’t supposed to diagnose anything. That’s what the white coats are for. I know a lot of doctors who would laugh my concerns off as the nervous ramblings of a young nurse, but like I said, Bennet is different.
“You’re serious about this, aren’t you.” It’s not a question, it’s an observation.
“I know it’s not really my place to say—”
“Of course it’s your place,” he says, stopping me as he gets a call on his phone. He snaps it from the table and answers it with a gruff “Bennet.” He’s quiet for a moment, and I look elsewhere. There are about a million things that I should be doing, but none of them seem all that important at the moment. Bennet says, “Can they wait?” and then he waits for a moment. “Then they’ll have to wait,” he says. He clicks the phone off and looks up at me, and his brow softens again. As he unfolds himself and stands tall, he grabs his stethoscope and drapes it around his shoulders.
“Let me get a look at him,” he says.
When we walk in to Ben Dejooli’s room, Bennet has the AMA clipped to the board in his hand.
“Hi, Ben,” he says, pulling the low stool out with his foot and sitting down in front of the bed. He grabs Ben’s charts and flips through them, and there is a silence that would have been awkward if I was the only one here with Ben. But Bennet makes it seem like an expectant silence. Like a conductor about to take the stage.
“So you passed out,” he says.
Ben nods. I can tell that he is weary. He doesn’t want to go through all of this again.
“Did Caroline tell you that she wants to count out a brain tumor?”
Ben widens his eyes. Which is an amazingly restrained response. I have to lean back on the door frame, but Bennet moves on. His delivery is so straightforward it’s as if he’s told Ben that he might be allergic to cats. And because Bennet doesn’t treat the elephant in the room like an elephant, it doesn’t become an elephant.
“No,” Ben says, looking up at me. I can’t hold his gaze. This is the first time I can ever remember turning away from a patient like this.
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