“The receptionist. She’ll be back in a minute.”
“Oh, well, thank you, but I really can’t wait,” Allison said looking at her watch. “Looks like I just missed the visiting hour and I really have to get back to work. I just wanted to leave this plant for one of the patients.”
“She might still let you go back. They’re not that strict about the visiting hours.”
Allison was about to say something when the heavy double doors opened behind her, startling her. A lady carrying a clipboard came out, immediately spotted Allison and asked if she could help her.
“I told you she’d be back,” the young woman wrapped in the blanket cocoon interjected before Allison had a chance to reply. “I was just showing this newcomer the ropes, Gracie. She was looking a little lost,” the young woman called out from her blanket cocoon to the lady whom Allison guessed to be the receptionist.
The most prominent thing about the receptionist seemed to be her clipboard, which she held onto like an archangel with a fiery shield, ready at any moment to lift it up in protection of all the sick in her charge. The next thing she noticed was the laminated identification tag which the woman wore clipped onto her collar. Allison did a quick comparison with the picture on the identification tag and the woman’s face. The picture looked different than the real face. So often that seemed to be the case, Allison thought. Next to the picture was the woman’s name in black bold letters: Grace Courier. Later, all Allison would remember about the ICU receptionist was her name. She would try to recall her face, but no real image would come to mind; just a shadow carrying a clipboard and an identification tag with an indiscernible picture above the one thing that stood out about the woman: her name. How strange, Allison would later think, that most acquaintances faces were remembered but not their names. With Grace it would be just the reverse.
“I was just going to leave this plant for one of the patients, Vicky Dooley,” Allison said in response to the receptionist’s offer to help. She realized she hadn’t signed the small card that was affixed to three purple plastic prongs on the end of a long purple plastic stick which emerged out of the soil of the plant.
“Oh, just a moment, let me sign this card then I’ll be on my way.” Allison pulled the square shaped envelope off the prongs and pulled the card out which read ‘Get Well Soon’ in fancy cursive on the top. Allison bent over the receptionist desk, with pen in hand, trying to decide what to write; just a short message to be sure, there wasn’t room on the small card for much more than a line or two.
She finally just decided to sign the small card: Sincerely, Allison. It already said ‘Get Well Soon’ and there was nothing more she had to say to Vicky. Sure it was impersonal and perhaps not truly sincere but social prominence dictated one occasionally stoop to little white lies in order to maintain the image of a gracious lady. And so she signed the card in her perfectly pretty, curly lettered cursive hand. She wrote Vicky’s name on the small envelope, enclosed the card, and presented it to Grace Courier.
“Would you see to it she gets it,” Allison said, feeling something urging her to leave as fast as she could, something as certain and compelling as the force that had brought her there in the first place. “I’ll try to come back later when I have more time.”
“You can visit her if you like,” Grace Courier said. “She hasn’t had any other visitors since she was brought here this morning.”
“But I thought visiting hours were over, and besides, I really need to get back to work.”
“We do make exceptions, particularly for those that…” Grace hesitated. Allison knew what she was going to say… for those that have no one.
“For those patients with very few visitors,” Grace finally said looking Allison in the eye as if to make her understand the real meaning behind her words. “Are you a friend?”
“I was. I mean, we used to be friends. We haven’t seen each other in over twenty years.”
“I think she really could use a visitor if you can spare just a few minutes,” Grace Courier persisted, much to Allison’s astonishment. Everything seemed topsy-turvy about this visit. When her grandmother was in ICU it was like trying to get past the Gestapo to get in to see her, now here was this woman practically begging her to go in for a visit. “Uh…” was all Allison could say in reply. Not very eloquent for a former Toastmaster and graduate of Dale Carnegie but her wit always seemed to fail her when she was caught off guard like now. She spent the entire morning psyching herself up to see Vicky and now she’d just psyched herself out of it (which hadn’t taken nearly so long). She looked at her watch and mumbled something about the time and getting back to work. The thought came to her that perhaps now really would be the best time because it would have to be a short visit in order for her to get back to work on time.
“I can only stay for five minutes.”
“That’s fine. We encourage short visits up here so the patients don’t get too worn out.”
“Are you sure it’s all right?” Allison asked.
“Listen honey, I have a knack for knowing when a patient needs company more than they need rest. I don’t know what that poor gal’s situation is but I get the feeling she’s got nobody. I just came from back on the unit and they said she was conscious and asking if there’d been anybody by to see her. Last I heard they were still trying to get a hold of her next of kin but they weren’t having any luck.”
“I don’t believe she has any next of kin.”
“Hmmm, they said something about a brother out west.”
“Brother? No, she’s an only child.”
“Step brother then, or maybe brother-in-law. I can’t remember exactly, but I know there is one male relative.”
Allison thought that sounded plausible. Maybe she’d married at some point and did in fact have a brother-in-law.
“Oh, well, you get on back there. Don’t worry! They know nobody gets past me without my blessing,” Grace Courier said with a wink as she made a playful shooing gesture with her clipboard.
Allison stared at the double doors. Anxiety and apprehension stiffened every muscle in her body. She felt it particularly in her throat; the sensation of a tight hard knot lodged between the pharynx and esophagus. She swallowed hard. She wished she had some water to wash the feeling away. She turned around to ask Grace how to get to Vicky’s room. Grace was gone. Who knows where? Perhaps Grace’s pager went off and she had to run down the hall to head off the frantic family members of a loved one brought up from the emergency room; those desperate relatives who fretted, cried, or prayed openly while following behind a fast moving gurney wheeled by medical personnel calling out commands to one another in terse, no-nonsense tones, their sights focused on a single goal: to get them safely to ICU where dwelt the one hope of life.
Or maybe it wasn’t anything nearly so dramatic that caused Grace’s disappearance. Perhaps she just discreetly slipped into the corner of the waiting room where she changed the linen on pillows, propped up cushions on the sofa, or made a fresh pot of coffee. Time moves at two polar opposite speeds around ICU: with the breakneck urgency of those responding to a life or death crisis, or the tiresome standstill of those who can do nothing but wait. Grace had moved on to either one time zone or the other. Allison’s eyes scanned the waiting room but she didn’t see Grace. Not surprising. It wasn’t well lit in the waiting room and Allison’s vision had dimmed over the years. With a long quivering sigh, Allison resigned herself to the inevitable. There was only one thing left to do. Go through those double doors and find Vicky.
Vicky’s nurse explained that she began to take a turn for the worse the previous night. She said it was one of those things where they could look back and see that it was coming, but at the time, who knew? The nurses had a hard time waking her up yesterday. That was the first clue the nurse told Allison. Hepatic encephalopathy begins to show itself with day/night sleep reversal and decreased responsiveness. Like all things with Vicky, it happened fast. It could have been any number of c
omplications from the liver disease that triggered it, or it could have been hastened by the medication they administered to get her through withdrawal. Had they not caught it and begun treating it when they did, she could have gone into a coma and died.
“Encephalopathy? I don’t know much about medical things but I do know that has something to do with brain disease,” Allison said as she and Vicky’s nurse walked down the long corridor of the unit lined with alcoves, thinly partitioned, where lay the sick and dying, all exposed with sliding glass doors open for easy monitoring and quick access.
“Right,” the nurse said in response. They had stopped in between two alcoves and Allison tried her hardest to focus on the nurse’s words but she was distracted by the beeping and humming noises from life support machines, the sound of nurses conversing, and worst of all, the cry of a patient moaning in pain.
“I’m sorry, could you repeat that,” Allison said, trying to tune out not just the sounds but the disturbing sights and smells as well.
“Her liver can no longer break down toxic substances like ammonia, so what happens is these substances begin to accumulate in the blood and travel directly to the brain and central nervous system. It’s a very serious condition.” The nurse, who seemed to be of the older more experienced variety of RNs, explained in a clear concise manner.
They were still stopped between two alcoves and during the course of the conversation Allison realized that one of these beds was Vicky’s. She glanced at the card with the room number on it–2013. Of course Vicky would get something with the number 13, Allison morbidly mused to herself. Nothing but bad luck. She looked over her right shoulder and there was room 2013. All Allison could see was a shape that, at passing glance seemed startlingly small, almost as if it was a child. She looked again just long enough for her mind to get a snapshot of the image: a frail form, spidery atrophied legs that stretched out from under a gown and long unkempt hair spread out on the pillow, once a lovely auburn color, now a drab grey, terribly thinned and completely robbed of any former body and luster. The head on the pillow was turned away so the face couldn’t be seen from where Allison stood outside the alcove. Judging from what she could see Allison was relieved. She didn’t want to see the face. Just the quick snapshot image she’d taken in at a glance was enough of a shock.
“How is she?”
“Better, still disoriented but a bit more alert and responsive; not quite so groggy which is definitely a good sign. She’s not out of the woods yet. She’s due to have another dose of Neomycin in about an hour,” she said looking at her watch. “That’s an antibiotic that stops the intestinal bacteria from converting protein into ammonia,” the nurse went on to explain. “She’s responded pretty well so far so we’ll see how she does.”
Allison wanted to ask the nurse if she would go in with her, just at first, just until Vicky was aware she was there, but she was shy about asking. It was strange to Allison that she felt this way. She had long since overcome all that awkward shyness and lack of confidence from her fat school girl days. She had learned to be confident, assertive, comfortable with anyone, not afraid to ask for what she needed… until the break-up of her marriage. That old awkwardness she hadn’t felt since she was a kid strangely crept back into her life. She stuttered and stammered and tripped over her words at times. It made her feel so ashamed, so angry with herself.
The nurse, perhaps sensing Allison’s reluctance, stepped into the alcove just ahead of her.
“Vicky, you have a visitor,” she said in that higher than usual, sing-song pitch that nurses so frequently acquire when addressing certain patients. It was the same tone that nearly everyone on the nursing home staff used to speak to her grandmother. It seemed to Allison a condescending tone and cadence; one so often taken with the elderly, children, or the simple-minded, none of which Vicky was.
Allison was still so focused on the nurse and her hopes that she wouldn’t just leave her there alone, that she really hadn’t looked at Vicky yet. She avoided it, but now she knew she had to. Slowly she turned toward the bed.
Chapter 36
Seeing Vicky up close like this triggered a sudden physical weakness in Allison that ran from her thighs up to her chest and back down again. She feared for a moment that her knees would buckle. Usually she wasn’t the type to get swoony. In fact she could only recall two other incidents where she was similarly affected.
Once when Alex cracked his head open after jumping from the sofa to the loveseat and crashing into the wall. Allison remained calm at the time as her injured son soaked one dishtowel after another with blood while they waited for the ambulance. It was when she noticed bone sticking out, the sudden shocking glimpse of his skull at the site of the injury, that she reacted so violently. The other time was when she was just a kid and she saw Alfred Hitchcock’s classic The Birds on TV. It was the sight of a dead man with two gaping wide hollows where his eyes had been pecked out.
Vicky’s eyes were open but they might as well have been lifeless gaping hollows inside the gaunt sagging face. Her color was a pallid grayish-yellow, the color of a four day old bruise beginning to heal. Her body was an odd mix of shrunk and swollen, with emaciated limbs sticking out of a bloated trunk, like toothpicks stuck in a potato. Allison was not at all sure she would’ve recognized her at this point. Nine and a half months ago on the street there was still something there of Vicky that she recognized, but not now. She tentatively stepped a bit closer to the bed, still afraid to touch her, afraid of getting tangled up in the tubing that seemed so intricately attached to her, tubing that pumped life-giving fluid and oxygen into Vicky’s body.
“Hello, Vicky. It’s Allison. Remember me?” Allison said, wondering if her voice was too chirpy and sing-song, too loud and condescending.
“Hello,” was all Vicky said in a groggy, croaky, weak, and unfamiliar sounding voice.
“I brought you something,” Allison said. “It’s a plant. I know how you love plants. You always had such a green thumb.” Allison put the plant down on a bedside table, and for a brief moment Vicky’s eyes tracked the movement of the helium balloon attached to the plant.
The nurse busied herself with changing the IV bag. She made a remark that she would finish up and leave them alone to visit. Allison let her know she didn’t have to hurry.
“Remember me from Camelot?” Allison said turning her attention back to Vicky.
“Camelot,” Vicky said without expression so that Allison didn’t know if it was a question, an affirmation that she remembered, or merely a meaningless Polly-Parrot repetition of what Allison had just said.
“Yes. Camelot, remember? We lived there a long time ago. We were neighbors. We lived in the same apartment building. You lived downstairs. I lived upstairs.” Allison felt more comfortable moving a bit closer to the bed.
“Vicky,” the nurse said fixing her attention on the patient. “Can you tell me what day it is?”
“Sunday?” Vicky said in a voice so weak you had to strain to hear her.
Pity began to stir in Allison. Here was someone who once spoke her mind so fearlessly and without hesitation in a voice that could always be heard. Now her listeners were straining to hear her tentative uncertain response.
“What’s the date? Do you know what month it is? What year? When is your birthday? What’s your social security number?”
Vicky’s responses were poor attempts at guessing followed by nervous little chuckles of embarrassment, like what a naughty child might do when caught in a lie. The nurse made brief eye contact with Allison just long enough to give a slight frown and shake her head, a sure signal that this was not good. The nurse made a humorous but somewhat patronizing remark to Vicky about her inability to remember, but then said something about at least she was awake and that was a good sign. The word awake was not the most accurate description of Vicky’s state, more like semi-conscious. Her eyelids drooped and seemed about to shut entirely.
“Don’t go to sleep on me. We need to give you
some more medicine in about ten minutes,” the nurse said in that chirpy, sing-song, too loud of a voice that Allison knew Vicky would never put up with if she weren’t so sick.
“Not that stuff that makes me crap!” Vicky muttered the words through a thick tongue, yet coherently enough to be understood. It was only there for a moment then it was gone again; but just for that moment, Allison thought she caught a glimpse of the Vicky she once knew in the distorted features.
“No, not this time,” the nurse said in regard to Vicky’s comment. “We’re going to give you another dose of Neomycin. That’s the antibiotic, not the laxative.”
The nurse turned back to Allison and said in a lower more normal tone of voice, “We had to give her Lactulose, to get some of those toxins out of her intestines.”
“Do you need to use the bedside commode?” the nurse asked Vicky.
“No,” Vicky moaned, her voice returning to the timid, weak, scratch of a voice.
For the first time since Allison arrived at the hospital her injury from the accident started to hurt. She’d almost forgotten about it.
“Are you all right, hon?” asked the nurse who picked up on Allison’s discomfort, despite her attempts at hiding it.
“I’ve got a cracked rib. The pain kind of comes and goes,” Allison said, allowing herself to wince now that the nurse knew.
“So what happened to you?”
“Car accident. I got in a fight with an airbag and the airbag won.” It was an over-used and tiresome response to the question, and it wasn’t all that funny to begin with, but Allison didn’t know what else to say when people inquired about her injury.
“Oh, my! Here sit down,” the nurse said pulling out a chair from the corner”
“Seat belts are a great invention, but I’m beginning to think airbags are overkill,” Allison said as she sat down slowly and carefully so as not to exacerbate the pain.
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