by Jane Stern
I order it on Amazon.com the minute I get home from class. I pay extra for overnight shipping although the test is still months away. Dot, who is extremely thrifty, immediately starts asking me who we can borrow a copy of the tape from. Deceitfully I do not tell her I have a copy. I want it all for myself. At least for now.
On my home treadmill, I put the tape in the video machine hooked up to the TV in front of the treadmill. Pass EMT-B is a six-part play, the star of which is a tidy young woman with a Dorothy Hamill haircut who progresses through all six practical scenarios of the national boards.
Needless to say, she does everything perfectly. She is to be our role model if we want to pass. I hate her. I hate her robotic delivery and the way she looks so humorless. I hate how her polyester uniform pants do not make her ass look fat. I hate that I have to act just like her in order to pass the test. I watch the tape twice a day every day. I watch her hook semiautomatic defibrillators up to real people pretending to be patients. Frank tells us that our patients will be National Guard recruits, and that we are not to talk to them before, during, or after the test. To do so is an automatic fail, Frank says.
When I am not watching the tape I am sitting in class. Tonight’s class is about head injuries, and I am thinking about the fact that my father had a steel plate in his skull and how it made him go into uncontrollable rages. I don’t know much about how he was injured so badly, except some hastily explained story about how he was playing near the trolley tracks in Harlem when he was eight years old.
As I child I never questioned the story or wanted to know more. My father was a very private man, and plagued by mental problems. When we sat together at Saturday-afternoon matinees at the Loews theater on East Eighty-sixth Street he clicked his tongue and hummed and cracked his knuckles and made weird ticlike facial movements. I could see the unevenness of his skull illuminated by the movie screen; his forehead caved in slightly and then came sharply out, where the plate must have been. For years I dreamed about Frankenstein’s monster chasing me. I especially hated the big ragged stitches on his head. I always went to my mother for comfort after a bad dream, never my father.
My father could be charming but was unable to hold a job. His unpredictable rages would sever ties as soon as he blasted his boss wherever he was working. For a few years he stayed home, painted flowers and sailboats on canvas as a hobby, and waxed and rewaxed the family car. My mother supported the family selling handbags at a posh shop on Madison Avenue and then became a dental hygienist. When I was eight my mother packed some suitcases and ran away with me when my father was out walking our dog. We moved into a brownstone apartment thirty blocks uptown from where we had lived as a family. That summer my mother left me with our housekeeper and took a Greyhound bus to Juárez, Mexico, and got a divorce against my father’s wishes. My father never forgave her, and as revenge he threatened to kill us both.
This is when my phobias started. I was afraid to leave the house—with good reason, I realize now. My father never actually attempted the murder, but he sat for hours at a time under the window of the brownstone where my mother and I lived. I could see him peering up at the window with binoculars. I kept waiting for the sound of heavy monsterlike footsteps on the stairs. Through the walls I could hear his hard breath.
I am finding myself growing more and more anxious as Frank lectures to us and shows us pictures of what a skull looks like after it has been whacked with a baseball bat and a steel pipe. Frank calls the brain the Big Cheese, his version of Harry’s Big Kahuna nervous system. We are told not to be impressed by the massive bleeding that comes from skull lacerations, but to pay attention to assessing any visible bone fragments of the skull.
Frank teaches us how to use the Glasgow Coma Scale to gauge a person’s level of awareness. He does not explain why it is called the Glasgow scale. I imagine unconscious Scottish people lying motionless on the cobblestone streets.
Frank is showing a picture of someone with dark circles under the eyes—the distinctive raccoon eyes of a neurological injury. The picture looks like me when I wake up in the morning after forgetting to take off my eye makeup. “The patient will present with the possibility of blurred vision, double vision, tunnel vision, ringing in ears, dizziness, loss of equilibrium, nausea, feeling that their hands are burning.” I feel a menopausal hot flash starting, I am burning up. Dot is busy taking notes. I suddenly feel very cold and lonely.
I think about my father. He was born in New York City in 1899, when ambulances were still horse drawn. I imagine a crowd of people pulling him out from beneath the trolley and throwing him in the back of a wooden-framed coach. I wonder what hospital they went to and who the surgeon was. Was it a miracle that he lived? They didn’t have EMTs back then, they had undertakers who would take you to the hospital. If you didn’t survive the trip, your body went back with them to the funeral parlor.
I sneak a Valium out of my purse and swallow it dry. I make a note on the margin of my notebook to talk to Tom Knox about my father’s head injury. I watch Dot take her left-handed notes. I reach out and touch the end of her jacket, which snaps me back to reality at the feel of it. Remembering that I am no longer a child is soothing, as is the reality that I have a husband like Michael to go home to. It is important to know that there will not be anyone waiting under the window to kill me.
6
May 13. That is the date of the national boards. I transfer this precious memo from the class bulletin board to my notebook, then write it on the back of another piece of paper and on the napkin for the caffé latte that I have brought to class. In case I lose anything I have backups.
As the class draws to its end the paramedics have become slightly more approachable. Frank’s paramedic partner from the hospital stops by the class one evening. His name is Billy Mapes and he tells us a short history of how there were once no EMTs. In 1968 the Department of Transportation signed the “white paper,” the original document that set out guidelines for what have since become the protocols and guidelines EMTs follow. It was also a way for the government to deal with the highly trained paramedics who were coming back from Vietnam with nothing to do with their skills. The 1970s were the birth of the modern EMT, the pioneer days, so to speak.
Frank and Billy stand in front of the class. They look like two thick bricks in the military-style uniforms issued to them by Norwalk Hospital. I envy the big gold-rimmed patches on their shirts. EMT-P, the highest rank. I like their snub-nosed military-style boots and their pants with extra pockets for scissors and notepads.
Billy goes to the back of the room, pours himself a cup of coffee, and sits as Frank finishes the lecture. “A—B— C,” Frank drones. He is talking about radio dispatching, and even he knows it is boring.
“A—Accuracy: Know what you want to say before you say it.
“B—Brevity.
“C—Clarity: Don’t scream into the goddamned radio!” he screams at us.
My head is filled with facts, facts I know and more facts I fear I don’t know. They float like jellyfish in and out of my mind, nebulous and hard to grasp. Some moments I remember how the heart pumps, other times I see it as a big lacy valentine and am unable to recall a single thing about all the tubing that a real beating heart has hanging from it. I have become single-minded. I have no time to think about anything but passing the exams.
“If you pass my class, you will pass the national boards,” Frank tells us. I pass his class, the written and the practical exams, and it is still a month until the national boards. I have become a walking factoid machine, spewing forth information about things few other people care about. When I am at Tom Knox’s office I alternate between striking up bonhomie between two “medical professionals” and cringing at my lack of knowledge about the mysteries of the human body. I mispronounce words. I don’t quite grasp concepts. I am not a doctor, I am not a nurse, I am not even an EMT yet. But with my stethoscope sticking out of my pocket, throwing around the terminology, I feel pretty cocky. I have go
ne from knowing nothing to knowing something.
Tom Knox shares medical school stories with me that I relish, about people passing out when they see their first cadaver, things like that, but I am afraid of the leap it is going to take to go from seeing gory slides in a classroom to seeing the real thing.
Michael cuts his hand on a shard of glass while lowering a storm window at home. I hear him cursing. I walk to where he is and make myself look at the injury. I feel faint. “It’s different when people you know and love get hurt,” Frank has told the class. I can only hope so, because the sight of Michael standing in the kitchen with blood pouring down his wrist is a hideous sight.
“I’ll call 911,” I say with some apprehension and some glee.
Michael rejects the idea. “It’s not that bad,” he says. The dish towel he is holding is now red. I tell him to apply pressure, which he does, and to elevate it. I get some ice cubes, put them in a plastic bag, and hold it outside the towel. The blood seeps awhile longer and then finally clots. We peel back the wrapping and look at the wound. It is long and deep, right above the knuckle.
“I really think you should go to the ER,” I tell Michael. “I’ll drive you.”
He rejects the idea.
“I’m going riding,” he says. “I have to see my horse.”
He clumsily places a Band-Aid around the cut and heads out the door. I follow him. He gets in the car and I get in with him. We drive to the barn where we stable our horses, about forty minutes away from the house.
When we park at the barn I see the veterinarian’s truck is there; he is inside giving shots and worm medicine to some of the horses. Michael brings his horse in from the paddock and starts to saddle him. His finger starts to weep red again. If I tell him three times to go to the hospital, it is officially nagging, so I say nothing. I am relieved to see Michael walk over to Ned, the vet, and remove the Band-Aid to show his finger.
“That’s nasty-looking,” Ned says. “Looks to me like you need stitches.”
“Can you do it?” Michael asks. He trusts vets over most all doctors.
Ned shakes his head no and recommends Michael seek out a doctor soon.
Michael’s horse, KT, is put in his stall and I drive Michael to a local storefront walk-in clinic. He will have no part of a hospital. From the waiting room I can hear him yelling in pain as the doctor puts in the stitches. I start to feel woozy again.
It dawns on me daily that very soon I am actually going to work with living people instead of mannequins like Rescue Randy. Before Frank’s final exams, each of us in the class will spend a day at the emergency room of the local hospital. There we will assist nurses and doctors with anything they ask of us.
By the time my rotation comes up there have been ten or so people from the class who have been on hospital duty. The word back at the classroom is that life in the ER is dullsville. Hard to believe, but apparently nothing happens. One of the women from the class reported she filed her nails for hours during her shift, another read a book, another slept on an empty hospital cot.
I pick Monday as my shift day. I figure the weekend is when most activity happens and Monday will be quiet. I think it will be nice to have eight hours of downtime. I could use a manicure and some sleep myself. I bring my textbook with me to read and study for the final exam.
I am wearing a clean white shirt and pressed slacks. “No jeans,” Frank has read us from the rules for the ER. When I get there the charge nurse is supposed to take care of us and tell us what we need to know. I present myself at 10 A.M. I can’t find the charge nurse. The doctors will not make eye contact with me. I wander around peeking into the cubicles at the patients. Finally I locate someone in charge and announce my presence. They write a makeshift press-on label that reads JANE STERN, EMT STUDENT, and stick it on my shirt. It does not inspire confidence. I try to look pert and helpful. I fall in step behind nurses. “Can I help?” I ask. They ignore me.
I am not helpful because I don’t know how to do anything. They do not have the time or inclination to teach me. I feel like an interloper, and I am.
I try to look busy, I walk briskly from room to room. I greet the patients who lie in bed looking miserable. No one comes to a hospital ER on a Monday morning unless they are really sick. “Hello,” I say brightly.
“I have to take a shit,” someone moans at me. Another person is drunk and belches loudly when I come near him.
Another man, in the late stages of cancer, does not respond to my salutations. “I’ll get your nurse” I tell them all, and walk away. The last thing I will do is tell the nurses what to do or where they need to go.
Monday is the busiest day in the ER. It is the time when everyone who has been sick all weekend finally gets in touch with their doctor, who tells them to go straight to the hospital, or when they finally stop biting the bullet and go because they are about to die.
My perky chatting with patients comes to an end soon. I am still in the way but the nurses are finding jobs for me. They do not acknowledge me, but just motion to me as an extra set of hands to help hold down a patient or administer a procedure—that’s all I am given as directives.
“You,” they call me. “Come here.”
I have slung my stethoscope around my neck so I look like one of them. I am wearing heavy steel-toed boots that looked uniformlike when I put them on and now look vaguely Nazi-ish. I look like I am ready for guerrilla combat.
“You,” the head nurse says. “Go to number ten and help out.” Number ten is the curtain-draped cubicle in which a woman with advanced Alzheimer’s and a host of other problems has been taken to the ER by her daughter.
“Hi, I’m Jane,” I say to the daughter, who is my age. “What seems to be wrong with your mother?”
What seems to be wrong is that her mother, Alice, slipped into a coma a week ago. I look down at the bed. Alice has already been here for two hours and is hooked up to various monitors that beep and flash. Her eyes are closed, her white hair, in loose threads unraveling from a bun, falls around the pillow. She is old and small, child-like, actually.
“She won’t wake up,” the daughter tells me. She has been this way for some time.
I touch Alice’s arm. I look at her chart. I see her name.
“Hello, Alice,” I say.
Alice opens bright blue eyes and looks directly at me. “Hello,” she says back.
The daughter lets out a scream, followed by cries to the Virgin Mary. “It’s a miracle!” she cries. The nurse comes running into the cubicle.
“What’s happening in here?” she says accusingly at me.
“It’s a miracle,” the daughter is still yelling. She points to me. “She brought my mother back.”
The nurse glares at me. “What did you do?”
“Nothing,” I stammer. “I just said hello.”
The daughter has her arms around me. She is thanking the Blessed Virgin, she is thanking me. The commotion is causing a scene. I try to back out of the room.
“No, you can’t leave,” says the daughter. “You saved my mother.”
I mumble something about being right back and take my miracle-working self away before more crowds of people form.
I am actually feeling pretty terrific. Maybe I am a healer of some sort, able to pull people out of comas. I stand in the center of the aisle as a patient on an ambulance cot is pushed into Room 6.
“You!” another nurse yells at me, breaking my moment of basking. “Come here.” I float in, thinking another person needs my laying on of hands.
“Spread his butt cheeks,” the nurse says to me, and pulls down the sheet. She is holding a rectal thermometer, and this is a three-handed job. I have never spread a stranger’s ass before. The patient is having a seizure and an oral thermometer can’t be used. I take a deep breath and grab a butt cheek in each hand and pull. She inserts the thermometer. We wait a few moments for it to register. I think of small talk to make. Nothing comes to mind. She whips out the thermometer and briskly walk
s out of the room. I am left holding the man’s butt apart. I stand that way for a few moments and then realize it is probably safe for me to let go. I walk out to the sink, strip off my gloves, wash my hands, and reglove.
“Come in here,” someone yells at me. In Room 4 there is a knot of nurses and orderlies. Before I go in I can smell booze. On the hospital bed is a man in his early forties. He wears an expensive suit, tasseled loafers, a gold signet ring on his finger, and a handsome, heavy watch. He was found passed out in his car on the Merritt Parkway heading into work during rush hour.
“We need to undress him,” I am told, so I start helping the nurses get him out of his clothing and into a hospital johnny coat. This would normally not be too hard to accomplish except that this man is undergoing what the intern tells the charge nurse is “the worst case of DTs I have ever seen.” The delirium tremens brought on from going cold turkey after a weekend orgy of booze and drugs have left our guy jerking around and levitating from the bed like Linda Blair in The Exorcist. “Call all the interns,” I hear a doctor say. “They should see this.”
“You,” the nurse says to me. “Get him undressed.”
I am left alone with this man who every five seconds thrashes his body into a position of rigor, then goes limp. An arm flails out, a leg. His head rolls from side to side. He is strapped to the bed, and like a magician I must denude him through his tie-downs. I manage to take off the suit jacket. It has a Paul Stuart label inside. The watch is a Breitling, his signet ring is from Harvard. I unbutton his shirt and between his thrashing manage to get it off him. He is now in a strap undershirt. I step back to catch my breath and take a good look at him. He is handsome, but I notice he is wearing fake bronzer that stops at his neck. His body is a funny yellowish color.
The nurse comes in. “What’s taking so long?” she says. “Get his pants off, we have to take a rectal temperature.” I yank at his pants, then his boxer shorts. “I’m sorry,” I mutter to him because he obviously didn’t start his day thinking he was going to be dying in the hospital ER with a stranger pulling down his pants. We turn him on his stomach and I spread his ass cheeks for the nurse. I now have a specialty in the wonderful world of emergency medicine.
