Emergency Room

by Caroline B. Cooney

  She could not think about Seth, either. Why must she always lash out at him? How did other girls just enjoy boys? How did they relax and flirt? Why was she either at war or at a loss?

  Emergency Room 7:16 p.m.

  THE MOB OF POLICE had thinned out. The ER was rather like the ocean, with schools of fish coming and going. Groups of cops or doctors or student nurses or sobbing families were swept in and out, as if by tides, and where they went or where they came from was often hard to tell.

  Seth stationed himself at the ambulance bay to see the motorcycle accident come in. Trauma would want him around in case they needed an errand done, but if they didn’t, he’d get to watch.

  The victim was almost completely covered with sheets, and there were four EMTs, one at each side of the stretcher, rushing him straight into the Trauma Room, so basically he saw nothing.

  Seth was irked. No fair covering up. He tried to remember that somebody was in agony under that sheet. Who was Seth to want to gape and stare and calculate the man’s chances?

  I’m a future doctor, that’s who I am, thought Seth. Calculating as they come, or so I’m told.

  He followed the stretcher into Trauma.

  The Trauma team was ready, having had perhaps five minutes between the GSWs and this MVA. When the sheet was lifted, there was much less blood than Seth expected. Basically the body was shredded from the waist up, looked fairly okay from the waist down, and the face was no longer very facial.

  Ambulance attendants hovered around, frowning over clipboards, trying to fill in their various forms. There was more form-filling at City Hospital than body-healing. Seth looked over the EMT’s shoulder to see what was being checked off.

  If vehicular, was victim — driver? passenger? pedestrian?

  Trauma source — sharp object? blunt object? firearm? toxin/drug?

  Source — contact sport? fight/violence? machinery? self-inflicted?

  Seth hoped shortly to witness some machinery, sharp object, and fight/violence stuff. Then he glanced at the man’s date of birth.

  The man was one year younger than Seth.

  He was a kid. He’d be in high school!

  Seth looked away from the pieces of paper and back at the real patient. The boy was naked, although somebody had ineffectively flung a sheet over his lower body. He was now hooked up to two portable monitors and had two IVs running.

  The nurses were scrubbing the boy’s torn flesh with an actual brush, getting the tar and pebbles and sand out. The way you would scrub a broiler pan with baked-on drippings. Hard.

  The doctor was a thin, gray-haired woman. “What shall I call you, son?” said the doctor. “Alex?”

  “Alec,” said the boy, mumbling through his terribly damaged mouth. “Am I dying?”

  “I hope not, Alec,” she said. “But flesh and bone don’t do well when it hits pavement at that speed. We’ll do what we can.”

  Seth was shocked. Why hadn’t the doctor reassured this kid? What was with that little lecture? It was late in the day to bother warning him about the effects of pavement on skin. She looked kind and grandmotherly, and here she was letting this kid he there all bare and exposed to wonder if he was dying!

  “Blood gas,” called somebody.

  Blood gas was an analysis to gauge the levels of things like oxygen, nitrogen, and carbon monoxide in the patient’s blood, but Seth did not know how it was done nor why a special technician was called. He watched closely.

  The tech took the patient’s wrist firmly and bent it backward, until the tendons and small bones were visible. A two-inch needle was stuck between the bones deep down into the wrist. The tech wasn’t getting blood from a vein — one of the blue lines along the surface — but from an artery, safely hidden deep within the body. Getting arterial blood was no picnic for the patient.

  It took the tech three tries, during which Seth winced more than the boy on the bed.

  Blood began to fill the large tube attached to the needle. To Seth’s horror and shame, his stomach began to roil. He swallowed hard, trying to control his gut.

  “Get out,” said a nurse, moving him swiftly to the door. “Don’t even think about throwing up in here.” She went out with him and shut the door behind them both, firmly. In the relatively dull hall, away from the sight and smell of Trauma, his stomach calmed and he could pretend he hadn’t been about to vomit over the doctors’ feet. The nurse washed her hands at the wall sink. Handwashing was so continual that lots of people carried their own hand lotion around with them.

  “Why did the doctor talk to the motorcycle accident so roughly?” Seth asked her.

  “Roughly? Dr. Gold?” The nurse was startled. “She’s wonderful.”

  “She didn’t reassure him that he wouldn’t die.”

  “We don’t lie anymore,” said the nurse. “We used to, twenty years ago. But it’s his life and if he just ended it, he has a right to know.”

  The Waiting Room 7:30 p.m.

  THE ADMITTING NURSE LOOKED at Roo without any expression whatsoever. “Possible fever?” Barbie repeated. She was not sarcastic. She was not anything. She was just a nurse who then took the twins’ temperatures. They had no temperatures. “It’ll be a long wait tonight,” she said to the mother. “Do you have a private doctor you can call?”

  Roo shook her head.

  Barbie shrugged. She filled out separate sheets for Cal and for Val. The top sheet would go to the Pediatric ER so the doctors there could decide when to see the babies. The bottom sheet would go to Insurance. Barbie had made her own decision about the importance of these illnesses: Of the three boxes (Immediate, Urgent, Nonurgent), both Cal and Val were checked Nonurgent.

  Roo read the handwriting upside down. “Mother claims fever.”

  So the nurse knew perfectly well that there was no fever. Roo turned quickly away, unable to meet the nurse’s eyes. Luckily a pale and sweating woman with a sliced-open palm was right there, dropping into the patient’s chair with a thud of need. The nurse now had better things to do than consider Roo.

  Nonurgent patients, Roo knew from experience, might truly wait hours. Your runny nose did not ever come ahead of your gunshot wound. Since she hadn’t come in order to be seen anyhow, Roo was willing to wait hours. Strangers found the twins adorable and the Waiting Room held at least four middle-aged women who could be coaxed to hold a twin.

  Just to be out of that terrible apartment gave Roo hope that she could endure. That somehow she would get through the summer and the twins would get easier and life would not be so very terrible.

  Of course it was only May. Summer had yet to begin.

  When Roo was pregnant and refused to say who the father was, her own parents had said, “Do you understand that if you have this baby, it will be for eighteen years? Do you understand that? You aren’t even eighteen yet yourself!”

  Well, she had had two of them, and no, she had not dreamed how hard it would be for eighteen days, never mind eighteen years.

  Well, forget that.

  Roo set to work on two black women whose mama had had a heart attack and who were waiting to talk to the doctor. They were happy to chat. They watched as much TV as Roo did and the three women traded opinions of talk-show hosts.

  Val got whiny. She was always the first to get whiny. Roo said to her new friends, “I’m so tired of holding her. I mean, there are two of them. I just get so tired.”

  “Would you let me hold her?” asked one, right on cue. “I love babies.”

  Yes! thought Roo, handing Val over.

  Immediately Cal began screaming. Jealousy definitely began with birth.

  The second woman looked knowingly at Roo, and Roo knew that they knew what was going on. Perhaps they had been there themselves, or seen it before. But they knew, and willingly they bailed her out for a while, cuddling the twins. She wanted to fling herself upon their soft breasts and be comforted, too.

  Of all the things Roo had not understood when she was pregnant, most of all she had not underst
ood that she would never be first again. The babies would always come first. She had not known what discipline it would take — discipline she lacked — to put her children first and set herself aside time and again.

  But for a few minutes, Roo didn’t have to think heavy thoughts.

  She was light and young and airy again. Burdens lifted

  At a low table sat two small Puerto Rican girls, coloring. Their little brother was in a stroller, the cheap sack-type, in which his little body was folded up like a loaf of soft bread. Roo was amazed to find herself actually worrying about somebody else’s baby, about his spine, whether it was good for him to sit like that.

  The little girls colored furiously.

  Roo had been so good in art. Mr. Hanrahan had always wanted her to go to college for art. Why, sophomore year Roo had designed posters for every event in school. The musical, the dance club’s performance, model UN, Ecology Day…

  Junior year, of course, she spent giving birth.

  Roo looked longingly at the crayon table. An old paper cup held maybe a dozen crayons. All the good colors were gone. But there was a stack of white paper, waiting.

  She didn’t ask permission. The ladies might say no. She just left Cal and Val with them, slid over four or five seats and took one of the tiny oak chairs around the table. “Hi,” she said to the little girls.

  They said nothing back but smiled sweetly.

  “What are you making?” she said. “Castles? Oooh, that one’s pretty. I’ll make a castle, too.” She took the navy crayon and in moments her castle covered three overlapping sheets, full of courtyards, knights, moats, flags, towers, and crenellated bastions. The little girls were awestruck.

  The smaller one spread her finger wide on a sheet of fresh paper and slid the paper and her hand toward Roo.

  Roo traced the tiny hand and then drew wonderful rings and bracelets and a beautiful watch. She made long terrifying fingernails and they colored the fingernails green because they had no pink or red.

  The Waiting Room surged and changed.

  People tired of wondering when their turn would come and just went home without ever being seen by a doctor.

  Families got hungry and went to the cafeteria.

  Taxis arrived to take discharged patients home.

  Friends wandered in, found the place was closed to visitors, and wandered away.

  Security guards came and went. All they ever did was make sure nobody smoked inside, or showed drivers where short-term parking was, or coaxed staggering drunks to leave. Nobody felt threatened by them, or even interested.

  The big outer doors, opened by an electronic eye, admitted two very gaudily dressed young men.

  Trouble.

  The electronic eye saw only height, and opened its doors for anything above three feet. Human eyes, turning toward the motion, saw much more than height.

  Anna Maria looked down at her paper and colored hard. The atmosphere of the room changed. People were stilled. Their eyes ceased to roam and their pages ceased to turn. Nobody was sure anymore what they were waiting for. Several decided they weren’t so sick after all, and when Trouble moved toward the turquoise chairs behind the coloring table, those patients drifted casually toward the exit.

  Members of KSI. About half the room knew what kind of money they made, and how they made it, and what cars they drove, and what weapons they used. The other half of the room could make a good guess.

  José was too little to draw any conclusions. He dropped his bottle and the loss of it started him screaming. Grown-ups hated screaming babies. Drug dealers were especially irritable grown-ups. They would really hate screaming babies. Anna Maria bent down quickly, retrieved the bottle, and popped it into José’s mouth. She prayed to the Lord Jesus that that would shut José up.

  She knew one of them. Dunk. She did not know if he liked the nickname or hated it, so she would never have taken the risk of using it.

  Dunk was her mother’s age. Maybe twenty-three or four. He had the kind of white complexion that does not look finished: too white. Bread that needed more time in the toaster. He was thin — rail thin, sick thin — but at the same time, he was puffy from his own drug use. His face and throat were bloated like a rotting fish. He was immaculately groomed. Jewelry gathered at the open collar of his beautiful shirt. His tight-fitting pants, shiny with gold-and-black threads on a white background, fit him so closely that what he carried in his pockets was outlined as if Anna Maria had crayoned it on the cloth.

  A bulge as round as a hamburger roll filled his left pocket. Anna Maria knew it was a roll of dollars. Sometimes he added her mother’s money to that roll.

  In the other pocket, sagging heavily, was a handgun.

  Anna Maria kept her head down and continued filling in the green grass on her farm picture. Next to her, the pretty young mother was oblivious — had seen nothing, had understood nothing. Anna Maria often felt older than older people, and she did now — worrying that the young mother would do something stupid.

  There was a reason why they didn’t allow visitors in the treatment area when there had been a gunshot wound. Drug dealers never shot in order to wound somebody; they shot to kill. A wound was a mistake. Mistakes could be corrected.

  Anna Maria did not mind at all if drug dealers killed each other.

  But she minded a lot if she and Yasmin and José got in the middle.

  Every security guard had headed for the ambulance bay. The nurse was examining an incoming patient (a young black boy who had broken his leg playing baseball, eager to have a really good heavy cast to show off in school); on the phone with a patch; and holding a second phone with a doctor wanting to question her.

  The Waiting Room was jammed with people. But for a few minutes it was oddly unprotected. Unsupervised.

  Anna Maria added a row of tulips to the bottom of her drawing. The young mother added a princess in a beautiful flowing gown.

  Two feet away, Dunk and his partner took their time. Doctors rushed, nurses rushed, ambulances rushed, but drug dealers took their time. Nobody pushed them. They had time to swagger and show off. Nobody got in their way. And people that did ended up on the pavement, while their blood spurted out of them.

  “Let’s draw wedding gowns,” said the pretty young mother to Anna Maria. Anna Maria continued to pretend she spoke no English, but she watched as the wedding gown materialized from the stubby green crayon. She knows nothing, thought Anna Maria. She’s stupid. I’m stupid, too, for coming here.

  We have to get out of here.

  Emergency Room 7:37 p.m.

  I MIGHT BE PARALYZED, thought Alec, but I’m no vegetable. That is a really cute girl.

  He looked up at her, genuinely distracted from his pain and fear. She was so pretty. Short crisp black hair was like artwork. Large hazel eyes, wide with worry for Alec. Ruddy cheeks, hot pink. She loomed over him, even though she was small. Lying down gave Alec such different perspectives. Faces were huge. Bodies were mainly shoulders and breasts.

  “Mr. Whitman?” she said. She flinched a little, looking at him.

  How bad is it, he thought, that she can’t look at me?

  “He can’t talk with the airway,” said somebody. “Here’s his wallet. Go through it and get what you can.”

  He could see how reluctant she was to go through his wallet.

  There was nothing in there but his driver’s license and a few dollars. He had no credit cards. He wasn’t old enough. Alec could not see what they were doing. The collar that kept him from moving his neck also kept him from seeing anything that wasn’t directly above him. He felt like a horse wearing blinders. Many people moved around him, but he could see only their heads, not what their hands were doing.

  The room spun a little and he wondered if he would get old enough for credit cards. Was this dying — this spinning around? Or just plain old dizziness, nothing to sweat?

  The Waiting Room 7:40 p.m.

  TROUBLE STOOD UP AND swaggered toward the Admitting Nurse. He shot h
is cuffs and thrust his skinny ankles out to show off his beautiful boots. His watch glittered on his wrist.

  Anna Maria watched from behind her long dark eyelashes.

  “I wanna see Tillotson,” said Dunk.

  “Tillotson?” repeated the nurse, not looking up from her paperwork. She cradled a phone against her cheek but did not talk into it.

  “He got shot. I gotta be with him.”

  “No visitors right now,” said the nurse, looking up. She had no more expression on her face than when Roo claimed the twins had had fevers.

  “Tillotson’s my brother,” said Dunk.

  The nurse surveyed Dunk’s pasty white skin. “He’s black,” she said.

  Dunk grinned. A gold-and-scarlet emblem had been glued to one of his front teeth. “You got a problem with that?” said Dunk.

  The Waiting Room listened, both entertained and afraid.

  “No visitors right now,” repeated the nurse, shifting her gum to the other side of her mouth. “Hospital rule. No visitors when there’s a gunshot wound.”

  Dunk stabbed his long fingers at the nurse. “I gotta be with him.”

  “No. No visitors.” The nurse began speaking into her phone. She was describing a festering wound that should have come for treatment days ago but had waited and now would need a plastic surgeon.

  Dealers walked and waited with a special sway. They owned the street and they owned their customers and it was in their feet and their stride. Dunk stood as if he owned the linoleum and the hospital.

  But he didn’t. The nurse did.

  Dunk left the admitting desk slowly, controlling his anger and yet letting it roll out over the Waiting Room, so everybody there could see it, and feel it, and panic about it. If he couldn’t make the nurse tremble, he could see to it that the rest of them did.

  Anna Maria was afraid no security guard would come and afraid that one would. She was afraid to go back to coloring and afraid to get up and move the stroller.