by Jon Cohen
Spending too much time around the house, he thought. That’s the problem. You get a little dippy. Last week, instead of his Polident tablets, he’d dropped two Alka-Seltzer tablets into his denture cup. His dentures turned a light green, which Iris had not failed to notice. The week before that, he had poured V-8 juice on his Frosted Flakes, and ate three spoonfuls before he caught himself. Fortunately, Iris had not yet come down to breakfast.
Christ. I’m deaf in one ear, I got no teeth, I’m missing my right hand, and now I’m going senile. Senile’s the thing.
“Senile’s the thing, right, Duke?”
You go senile and they put you right in the Home. Course now, this ol’ hook may present them with a little problem. Yep. I’ll be able to fend them off for a while. Unless I lose the damn thing, which is likely the way things are going. Hell, Iris’s a nurse, she’ll take care of me. I don’t know, though, being a patient of hers might go pretty rough. No. I’d rather be in the Home. No. They’d take my dentures, take my hook—I’d sit around in one of those rolly chairs and pee-pee on myself all day. Least Iris would keep me tidy.
Duke licked his bowl clean. “Think I’m getting dippy, boy? No, I’m just cooped up here too much.”
The thing was, he never thought he’d have to live without LuLu. They just snatched her away from him, like they snatched his hand. He thought the two of them would go together, in bed, like it was their honeymoon—instead of their whole lives stretching before them, the end of life would await them, and when he’d imagined it that way, he wasn’t frightened. But with LuLu gone—the entire business scared the bejesus out of him. He’d never, ever discussed it with LuLu, but he’d been counting on her. He should have discussed it—maybe she would have hung on, waited for him. But she couldn’t have waited. The stroke would’ve got her, just like the engine got my hand. Things get you. Iris’ll tell you about that, all her hospital stories.
“Come on, Duke, let’s go for a walk. Maybe we’ll see somebody we know.” A joke, of course, since he didn’t know anybody in Waverly. He wasn’t much for knowing people. He had LuLu and he’d figured that would be enough. And all the moving from town to town. You don’t get attached to people that way. Iris helped to fill up the hole a little, the hole that LuLu left. She knew how to get on his nerves, which helped to pass the time.
Arnie started off down the block with Duke up ahead, trotting along dragging his leash. Sometimes he’d be on his walk with Duke and he’d stop suddenly, almost midstep, and look around, and not know where in God’s name he was. Which town, of all the towns over all the years, was he in? Not only which town, but what year? It started happening after LuLu died of her stroke—she was his bearing, and she’d left him, stranded on a sidewalk, lost in time and place. Where was home? Home was where LuLu was, and LuLu was nowhere. He’d come in after an hour or two, and Iris would look at him a minute and then say, “Boy, that was a long walk.” You don’t know the half of it, Arnie would think. He was lucky he made it back to the house at all. He’d go right upstairs and lie on his bed, sweaty and nervous, and try to recall LuLu’s face, place her firmly in this room, in this house, so he wouldn’t lose himself again.
Arnie tipped his hat as a middle-aged couple walked by. They barely looked at him. See? They know. I’m unconnected and they know it. LuLu, I didn’t learn how to do it. Even at work, all the different auto shops and garages, I paid attention to the cars, not the guys I worked with. I should’ve had beers with them, I should’ve stayed put in one town. LuLu, we were supposed to go together, that was the plan. Why didn’t you know that?
He walked on for a few blocks, following Duke. Finally, Duke stopped and waited for him. They stood together, and Arnie lifted his hat and mopped his brow with his handkerchief. The pincer mechanism on his hook jammed and he had to work the thing loose, then he put the hat back on his head.
“Don’t ever get one of these, Duke, they’re a pain in the ass.” He almost stepped off the curb when he saw a whole parade of cars heading up the street. A funeral. The lead car, a big silver Lincoln, kind of jerked to the left as it drove by, and the engine sputtered and died. The other cars jammed on their brakes as the Lincoln coasted to a stop. Duke wagged his tail, which he always did when a car was near. Arnie figured he was remembering the old days when he used to throw himself in front of them.
Jim Rose got out of the car, looking like he wanted to say a few dirty words. Arnie remembered Jim Rose because he’d used Rose’s Funeral Home when LuLu died. He wouldn’t ride in the Lincoln, though, as hard as Jim Rose tried to persuade him. First, what was the point in having a fancy car with no parade behind it—it was only him and Iris, and another carload of ladies from LuLu’s church. Second, a Lincoln was a piece of shit under the hood, and he wouldn’t soil his pants by plunking his ass down in one.
Arnie stepped off the curb and joined Jim Rose and the other men who’d pulled over to have a look at the jumble of wires and metal, which obviously baffled the hell out of them. He enjoyed himself a minute, listening to their expert advice. Then he said, “Mr. Rose, you need some assistance?”
Jim Rose, looking real hot and real close to letting loose with a string of those dirty words, eyed Arnie, then eyed Arnie’s hook, and said, “No thanks, old-timer. We got it.”
Arnie smiled. So you think. He moved away and idly walked around the car. Two people sat in the Lincoln, a woman about his age, and a… he guessed it was a man, wearing a baseball hat pulled low and a purple scarf. How about that? Arnie nodded and the fellow nodded back ever so slightly, then scooted down in his seat. Mighty peculiar business, Arnie thought. He glanced at the woman again; she looked pitiful and wilted from the heat.
Jim Rose tried the engine, but the only thing he got was a clicking sound. Arnie looked again at the woman, then moved to the front of the car. “Here. I’m a mechanic. You stay put, Mr. Rose, and hit the ignition when I say.” Arnie fiddled with the distributor cap a minute. “Okay, now hit ’er.” The car kicked to life. Arnie went around to the driver’s window. “You need a new cable.”
“Thank you,” said Jim Rose. He turned his head and said, “You all right, Mrs. Malone?”
“I’m fine.” She craned herself over the man in the hat and scarf and said through the window to Arnie, “Thank you, sir,” and smiled.
The man in the hat and scarf stared at Arnie’s hook. Arnie looked at him and then said, “Yeah, son. I guess we all got something.”
The man looked like he was about to speak, but Jim Rose touched the accelerator and the Lincoln moved off down the street.
CHAPTER FOUR
IRIS SAT in the conference room at the far end of the Intensive Care Unit, waiting to take report from day shift. The Unit looked wild. They had a new one in bed 7, a gastrointestinal bleed. Two docs were in there with three nurses, trying to hold the guy down. GI bleeds were almost always alcoholics, about as messy and ornery a patient as you could get. Respiratory and a bunch of other people crammed into bed 8, tubing somebody and setting up a vent. So a bleed in 7, thought Iris, someone crashing in 8, the Tube Man in bed 12, and one other ventilator patient in 5. So that’ll be three people on vents when they finish tubing 8, and the rest of the beds were stable cardiacs, and stable post-ops. A full house—twelve patients.
“Place looks crazy,” said Libby, a permanent evening nurse, walking into the conference room and glumly dropping into a chair.
“Tell me about it,” said Iris. “You see what’s in 7?”
Libby did a cheerleader chant. “Give me a B, an L, a double E, D. What’s that spell?”
“Alcoholic,” said Denise, walking in. “Let’s hear it for the alkies.”
“What’s your guess?” said Libby. “A fifth a day, or a case of beer a day?”
“Both,” said Iris.
They peered out the door and saw the bleeder pull free from a nurse and take a swing at the doctor who was trying to insert a Blakemore tube down his nose.
“Naaah,” said Denise. “Looks li
ke a social drinker to me.”
They all laughed. What else could they do with eight hours of trying to subdue a bloody wild man ahead of them?
Libby said, “It’s not just us three, is it?”
“No way,” said Denise. “I’ll quit. I’ll go up to the nursing office and rip up my time card in front of them.”
Iris nodded at Denise’s threat, then picked up the phone and paged the supervisor. The call-back came immediately. “Mrs. Beeman, Iris here. You sending us anybody else?… No, we don’t have two empties, the place is full.… No, the bleeder didn’t die in the Emergency Room, he’s in bed 7.…”
Denise and Libby rolled their eyes. Denise mouthed “Tell her I quit.”
“…Yeah, and somebody’s crashing in 8.… I don’t know who, I just got here.… Okay. Okay. Good. Good, we’ll take her. Fine. Bye.”
“Let me guess,” said Libby. “They’re sending us a nurse’s aide from Rehab.”
“Nope, an RN from Orthopedics.”
“A real live RN? Honest-to-God competence?”
“It’s Dolores Winston.”
“Oh shit,” said Libby and Denise in unison, “the Terminator.”
Dolores had earned her nickname a year ago when she was pulled from the floor to work in the Unit. She had removed the tape from the airway of a patient on a ventilator, then left the airway hanging there to go answer another patient’s call light. Then she forgot about the ventilator patient and went into the back room for a cigarette. The patient coughed out the unsecured airway and coded. They managed to resuscitate him, just.
“We’ll give her the stable patients,” said Denise.
“Give her the dead patients, that’d be safer,” said Libby. “Give her the Tube Man, he’s a no code.”
“I’m taking the Tube Man,” said Iris, who was charge nurse for the evening. She felt something strange in her chest when she said his name, and swallowed hard.
“Suit yourself. Then give her a couple of cardiacs and a post-op,” said Denise. “I’ll take the GI bleed, what the hell.”
Libby and Iris clapped. Libby said, “Give me the guy crashing in 8, and split the rest however you want.”
“You two are wonderful,” said Iris.
“Just keep the Terminator out of my patients’ rooms,” said Denise. “Here she comes.”
Dolores walked in. Cute as a button and dumb as dirt. She had the second-nicest body in the hospital, after Leona. What, are they testing me tonight or something? thought Iris. She had never trusted beauty. She didn’t believe it somehow, that it lasted, that the right people had it, that it wasn’t in some way corrupting. She frowned at Dolores, cute Dolores with her little nose and her bouncing honey curls.
“Hi guys,” said Dolores. “Looks like I’m in the Unit tonight.” She turned and surveyed the chaos in 7 and 8, then demonstrated her usual understanding of critical situations. “Doesn’t look too bad out there.”
Libby and Denise rolled their eyes behind her back. Iris bit her tongue.
Report from day shift was a disaster. Even Dolores seemed to get the message. “I don’t think I want to be here,” she said when report ended.
An encouraging sign of intelligence, thought Iris. “That’s the correct response, Dolores.” No nurse from the regular floors liked to be pulled to the Unit. The Unit was the dumping ground for all the patients too sick for anyone else to handle. Very few were “walkie-talkies,” patients who could engage in normal human communication and locomotion. Most were bed-bound and had a minimum of two IVs and a drainage tube. Even the so-called stable patients were time bombs, especially the cardiacs who looked good one minute, then you’d glance up at the EKG monitor and their hearts would suddenly start pumping at 180, then go flatline.
Iris said to Dolores, “I’m going to have to give you three patients, Dolores. You see how busy it is.”
Dolores swallowed.
“But they’ll be pretty stable,” said Iris, hearing in her own head the tick tick tick of the time bomb. “Beds 1 and 2 are both cardiacs who are doing pretty well. Keep your eye on 2, he goes into heart failure at the drop of a hat. You heard in report how they had to load him up on digoxin and Lasix, so stay on top of his lungs. I’m also giving you 6, who’s a fem-pop bypass second day post-op. They’re not sure if his grafts are working, so watch his circulation, especially his right foot—it looked dusky on day shift, and they couldn’t get all his pulses. Okay? Shouldn’t be too bad, really, Dolores.”
Dolores smiled weakly, and her honey curls seemed to lose the bounce they had before she’d heard day shift’s report.
Iris went into 7 to help out with the GI bleed. He’d thrown up a good basin or two of blood, she could tell from looking at his gown and the saturated bed sheets. This guy looked like he belonged in a big city hospital, not in a place like Barnum Memorial. Barnum served Waverly, Upper Providence, Smithfield, and three or four other towns. They all had their alcoholics, and more than a few of them came in just like this guy. Iris read the patient’s name posted on the door: Harvey Mastuzek. Denise had hold of Harvey’s thrashing legs, and Libby pressed against the upper part of his body. The house doctor still hadn’t gotten the Blakemore tube in. Blood dotted the doctor’s white coat as well as the bedside table and commode. Harvey jerked his head violently every time the doc tried to get near his nose with the tube. Nobody in the room looked like they were having much fun.
Iris marched up to the bed. The bed was in its highest position, and she could barely peer over the edge of the mattress. She gave Harvey the long hard nurse’s look she’d learned over many years of nursing. Daniel Boone might have used the same look to stare down a grizzly. It caught Harvey’s attention.
“Who the fuck are you?” he snarled. A line of blood bubbled down the corner of his mouth.
Iris smiled sweetly. “I am an angel of mercy, and I want to help you.”
“Then get these people the fuck off me.”
“Harvey, we have to get this tube in your belly to help stop the bleeding.”
“I’m not bleeding.” Harvey was more than a little out of it. He blinked blearily at her.
“Harvey, you are bleeding, and if you don’t let this kind and patient doctor put that tube down your nose and into your belly, you will bleed to death.”
Harvey stared at her a minute, then he mumbled, “Fuck him, and fuck you. I don’t like you. I don’t like your face.”
Libby and Denise tensed and looked away. The house doctor fiddled with the Blakemore tube. Iris moved to the head of the bed. “Excuse me, Harvey?”
Harvey said, “You heard me.”
“I don’t think so. I heard something rude, but I really don’t think that’s what you meant to say.” Her face was inches from his.
Harvey pushed against the pillow. “Stay away from me, you little troll.”
Iris went up on her toes, her mouth almost touching his ear. “I’m only saying this once,” she whispered. “You cut the shit right now and let us put the tube in, or I’ll come in here when no one’s looking and slice off your balls with a dull scalpel.”
Harvey opened his mouth as if to speak, but nothing came out.
Iris looked at the house doctor. “Okay, Doc. Harvey says you can put that Blakemore in now.”
Harvey lay perfectly still as the tube went in. He kept his eyes on Iris the entire time as she stood in the corner of the room smiling at him.
CHAPTER FIVE
OTHER JOBS, thought Iris at about 9 P.M., couldn’t be like this. Other jobs, you get to sit down once in a while, you get to eat your supper, you’re not running your butt off every second, picking patients up off the floor and putting them back to bed, fighting with docs and X-ray techs and Pharmacy and Lab, cleaning up blood and packing wounds, suctioning and turning and injecting and irrigating and draining and bandaging, transferring patients out and getting new ones from the ER, hanging IV meds. And all the rest of it. And that was when things were going normally, thought Iris, downing a warm
Pepsi, her third of the evening—that was before crunch time.
Crunch time had come at 8 P.M. when Dolores’s patient, bed 1, coded. When they saw what bed the code was in, everybody thought: The Terminator strikes again. But it wasn’t her fault, except for the kind of evil magic she seemed to work on her patients. Bed 1 had been the most stable heart patient in the Unit, a resolving myocardial infarction. He was an MI who hadn’t even suffered that much damage to his heart muscle; he was due to go up to the regular floor the next day. Iris was standing beside Dolores, checking a chart, when Dolores said, “That looks funny.”
Dolores had been looking at the central EKG monitor, and since she didn’t know how to read heart rhythms, they all looked funny to her. Iris finished reading her chart, then followed Dolores’s gaze.
Iris swore. The rhythm that had caught Dolores’s eye, that would have caught anyone’s eye, was bed 1’s. The other patients’ rhythms beat with regular electric jiggles. Bed 1’s chaotic jags meant only one thing.
“V-fib,” shouted Iris, already running for the room. “Call a code, Dolores.”
Bed 1, Mr. Beck, sat up in bed, his eyes rolled back in his head. He was making the “gh-ghhh” sound. The gh-ghhh sound was not a good sign, Iris knew. Most of the patients who reached that stage didn’t make it. Libby came in with the emergency cart as Iris put the head of the bed down and started CPR. Short Iris always had difficulty getting a good position for CPR; she had to climb in bed and kneel beside the patient so she could do her chest compressions. This always led to a lot of teasing from the docs about how Iris would use any excuse to get in bed with a man.
The code finally came over the hospital address system: “Code ninety-nine, bed 1, ICU.” It seemed to take forever for help to come, and as always, the nurses were on the front line holding things together until it did. Iris continued compressions, while Libby bagged Mr. Beck with 100 percent oxygen. Denise arrived and charged up the defibrillator. Dolores stood in the doorway, mouth open, doing nothing.
