Here and Again

by Nicole R Dickson

  “Samuel!” Ginger yelled again to the trees.

  “I am here, Virginia Moon.”

  Startled, she spun around and there he was on the driver’s side of the truck.

  “Wh-what happened to the other one?”

  “He ran when he saw me coming.”

  “I have to get this one to the hospital. You climb in.”

  “I am going home.”

  “Yes, I know, and I have to go to work. Where’s home?”

  “Yet far from here. Laurel Creek. South.”

  “Well, get in and I’ll drive you to Franklin. Can you sit with him? Keep him awake?”

  “I cannot,” was his reply.

  Ginger blinked. She must have heard him wrong.

  “Samuel. It’s freezing out here and this kid has alcohol poisoning or hypothermia or both. I need your help.”

  “I have helped. I stopped you here. Now I must go.” Samuel turned and walked to the edge of the trees.

  “Samuel!”

  “I am sorry. I cannot help more. I would if I could.”

  Then he was off, moving down into the ravine from which Ginger had just pulled the boy and disappearing into the forest beyond.

  “Samuel!” she yelled. But there was no answer. Ginger looked around in the darkness and snow, her jaw moving up and down, saying his name over and over.

  “What the hell?” she whispered and slammed the cab door. She came around the front of the truck and lifted her right foot to climb in. She stopped.

  “Last call, Samuel! I’m leaving!” She waited, but there was no answer.

  Pulling herself into the driver’s seat, Ginger shut her door and shifted the truck into gear. The boy groaned.

  “What’s your name?” she asked.

  “Jacob,” he mumbled.

  “Well, Jacob. We’ve got about fifteen minutes to Franklin. Please don’t throw up in my truck.”

  “Okay.” He moaned, and then he retched.

  Chapter 4

  Sloosh

  Ginger pulled up to the emergency room entrance at one forty-five a.m., climbed out of the truck, and with slippery steps walked to the glass door. She banged three times and as she waited for an answer she gazed at her reflection. Her ginger-colored roots were peeking out of her dark brown hair. She’d need to do something about that soon. A woman in her late fifties with close-cropped gray hair and pink scrubs poked her head out from behind the triage room wall.

  “Morning! I got an inebriated teenage boy I found in a ditch,” she yelled through the glass.

  The woman stepped out from behind the desk, walking to the door. Her name badge read, “Margery T., RN.”

  “His name Jacob?” she asked with a scowl.

  Ginger tilted her head. “Yeah,” she replied.

  Nurse T. unlocked and opened the door. “Let’s bring him in,” she mumbled, setting the door ajar. “I’m Margery Thompson.”

  “Virginia Martin,” Ginger replied. “You know him?”

  “This is only his fifth time here in as many weeks,” she said, following Ginger back to her truck. She opened the back door.

  “Eewwww-wee,” Margery declared. “That’s a mess.”

  “I know. And I gotta drive all the way home after it sits in here for twelve hours during my shift. I’m the new nurse,” Ginger replied with a grimace.

  Margery welcomed her with a wry smile. Together they lifted Jacob out of the backseat and dragged his dead weight through the small waiting room to the closest bed. There, they dumped his body.

  “I’ll call the doctor.”

  “Thanks,” Ginger said and went outside to park her car.

  Franklin District Community Hospital was like most rural ERs—small enough that its weekend and evening staff usually came from medical registries. It was a three-bed emergency room with five acute beds and an attached skilled nursing facility, which was staffed twenty-four hours a day with two LVNs and two nurses’ aides. Major traumas in the area were medevaced to Winchester, Virginia. The usual patients in Franklin were small children with bad flus, broken bones of all ages, abdominal and chest pain of all ages. The care was basic emergency and acute care, and since it was such a small hospital, one nurse was on staff on the night shift to serve as triage, nurse, and even cook, if needed. There was one doctor, who generally slept on a bed in the day clinic across the parking lot until needed. The ambulance owner and driver lived in the house across the street.

  Which was why, as she slipped across the vast patient parking lot, Ginger wondered how it was the medical staff parking lot was so far away to the left. After all, the ER could handle only one-fifth of the parking spaces allotted for patients. Cold and winded, she stepped back into the bright lights of the ER, locking the door behind her. She found the disheveled doctor scratching her head and yawning as she poured herself a cup of coffee. Her badge read, “Anna Maria D., MD.”

  “Nurse says he’s been in here before,” the doctor mumbled.

  “She did say that, Doctor,” Ginger replied, taking off her coat.

  “You been here before?”

  “This is only my third shift here. Last one was three months ago.”

  “So you don’t know him.”

  Ginger shook her head as she stuck her hands beneath the warm water. It burned her frozen skin.

  “You found him?”

  “FFDID,” Ginger said. ER term for “Found Face Down In Ditch.” ER personnel had a very dark and dry wit, usually punctuated by acronyms. ER speak, as Ginger called it, was a language unto itself.

  “YPPA?” the doctor asked. “Young Practicing Professional Alcoholic.”

  “Seems to be,” Ginger said, drying her burning hands.

  “All right.” The doctor yawned, putting down the coffee cup. With Anna Maria D., MD, leading the way, Ginger walked to where she and Nurse Thompson had dropped Jacob on a gurney. He was now without a coat, shirt, boots, or pants, lying beneath a heated blanket with an IV stuck in his arm. Taking the chart, the doctor checked the vitals, after which she handed it to Ginger, walked over to the sink, and washed her hands. Then she put on latex gloves, each one snapping into place. Placing the chart on the end of the bed, Ginger did the same. She always felt her snapping latex gloves had less of a commanding sound than the doctor’s.

  “Not hypothermic. That’s good. Hey, Jacob. Jacob Esch.”

  “Huh,” the kid answered. It was less a word than a grunt.

  “Where you from?”

  “Oak Flat,” he replied. His mouth moved but nothing else did.

  “You don’t sound like you’re from around here,” the doctor replied. “Your chart says you’re from Pennsylvania.”

  “Oh. Yah.” He rolled over and retched. With the skill of a practiced nurse, Ginger grabbed the pink plastic container and caught his vomit in midair.

  Gently the doctor rolled him over on his back, opened one of his eyes, and flicked her little light on his irises. Ginger could see that they were contracting in the light.

  “Did you know, Jacob, that throwing up is the body’s way of getting rid of stuff it cannot process?” The doctor was feeling Jacob’s neck and down his chest to his stomach.

  “Huh,” was all he had as an answer.

  “Did you know that if you drink fast enough, alcohol can depress the throw-up response and force your body to keep inside what it cannot process?”

  He didn’t answer.

  “You’re a very lucky young man that you are throwing up.”

  As she pushed on his stomach, he groaned, at which point the doctor rolled him on his side. Ginger caught the vomit in the dish again.

  “I don’t feel lucky,” he muttered, drool oozing from his lips onto the gurney sheet. Ginger grabbed a paper towel and wiped his mouth.

  “Well, you are. Now, we will just hope that no poli
ce come in here with an emergency tonight because it is also against the law for anyone under the age of twenty-one to drink alcohol.”

  “I’ll pray,” he whispered.

  “You do that.”

  The doctor walked back over to the sink, removed her gloves, and washed her hands again.

  “No need to call lab on the blood. Let him sleep a bit and then see if any one of his contacts can come pick him up. He’ll be a real mess tomorrow.”

  With that, the doctor stepped away, leaving Jacob, Margery, Ginger, and the bowl of vomit alone in the quiet ER.

  “There’ll be no flower sign here,” Margery said, walking toward the nurses’ desk. “Flower sign” referred to patients who have flowers sent to them in the hospital and was ER speak indicating that the patient had someone who cared for them—someone who would come get them. Soon. Nurse T. seemed to feel Jacob was on his own.

  “I guess, unless it gets busy, we’ll just leave him?” Ginger asked, placing the bowl of vomit in the bathroom as she passed.

  “That’s what we’ve done the last five times he’s been in. Real nice kid. Very apologetic. I think he’ll feel bad about your car,” she said, heading toward the acute care section of the hospital. “We’ve only got one other patient tonight. A regular by the name Jack Wolfe. Sixty-six-year-old white male. He’s COPD, CHP, diabetic, noncompliant.”

  Before they entered the room, Ginger could hear him. COPD meant emphysema. His breathing was indeed loud. They opened the door.

  “Hey, you got a dollar, Marg?”

  “Jack here wants a candy bar,” Margery said with a false smile. “He wants to go down the hall and buy himself one.”

  Jack chuckled a little and coughed.

  “But Jack has CHF—congestive heart failure—and cannot have salt and is diabetic. He’s also noncompliant, which means he doesn’t take his medicine and so he cannot have a candy bar.”

  “I’ll get one when I leave,” he said, winking at Ginger.

  Jack was obviously the kind of patient who had lived on his own terms and, as he was coming to the end of his life, wanted to go out the same way. For nurses like Margery, her entire duty was to force compliance to medical orders. If the patient wasn’t going to obey on his own, she would make him while he was in her care. But Ginger was a different kind of nurse. She understood that disregarding orders was a final act of humanity. Sometimes it was a form of dissent. Sometimes it was the right thing to do. For Mr. Wolfe, apparently, it was the right thing to do. Jesse had made the same decision a year earlier, so she winked back now to Mr. Wolfe.

  Jack chuckled a little deeper and coughed harder, which caused Margery to glance over to Ginger. She shied away a little. Margery stared more forcefully at her, which then caused Ginger to smile.

  “Hmm,” Margery said, pursing her lips tightly as she headed out of Jack’s room.

  “The LVNs tonight are Janet and Debbie. Nurses’ aides are Yvette and Brad. If an emergency comes through the door, make sure to get the EMT or police to stay and help until one of those four can come over.”

  “Okay,” Ginger replied, following Margery into the nurses’ station.

  “Doctors switch at six a.m.,” Margery said, reaching down to open a drawer. She lifted her handbag from within it and closed it again with her knee.

  “’Kay.”

  Turning to face Ginger, Margery squinted a little in the ER’s fluorescent lights. “Mr. Wolfe cannot have a candy bar.”

  “I know.” Ginger smiled again.

  Placing her handbag on her shoulder, Margery walked to the ER doors.

  “Has anyone talked to him about his drinking?” Ginger asked as she bent to unlock them.

  “Who?”

  “Jacob Esch.”

  “Oh, sure. But he’s Amish. You know. They reach sixteen and they’re allowed to go all wild. What’s the word?”

  Ginger knew what the nurse was talking about but didn’t know the word. She shook her head and opened the door.

  “Well, he must have lost his way. He’s eighteen and still drinking. Not even close to home. He’s a mess. Good night.”

  “Good night,” Ginger said.

  With the door wide-open and winter crawling in like a lost dog, Ginger watched the woman slip and slide across the empty parking lot until she reached her car. Then, when the headlights flipped on and the car slowly started forward, she shut the glass door against the night and bolted it tight. She shivered.

  “What in the world is Samuel thinking?” she muttered to the black beyond the door. He must have hitched a ride to get so far so fast, but why he wouldn’t get in her truck made no sense. Surely it was darker and colder than it had been when he’d climbed into the car that drove him to Oak Flat.

  Ginger stopped at Jacob’s side and checked his IV. The boy snored softly through his whiskey haze. He didn’t really look eighteen. His whiskers were yet soft as they grew in and his forehead and chin had acne. He had his whole life ahead of him. He could be anything. Yet already there was no flower sign. So young for no flower sign. She brushed the lock of brown hair off his cheek.

  “I’m so tired,” he whispered.

  “Rest,” she replied. As she left the ER, she turned down the lights. Before she saw him, she could hear Jack Wolfe as she made her way back to acute care. He coughed as she came through his open door.

  “You gotta dollar?”

  “You shouldn’t have candy.”

  “I love chocolate.”

  “So do I,” Ginger replied.

  “Haven’t seen you around here before and I’m a regular,” he said with a short laugh.

  “This is only my third shift.”

  “What’s your name?”

  “Virginia Moon Martin.”

  Jack’s eyes widened and he lifted his head off his pillow. Then he smiled the way they all smiled when she said her name. Ginger grinned back.

  “You’re not from around here, are you?”

  “Nope.”

  He nodded and then dropped his head back onto its pillow, closing his eyes as he breathed in heavily. Ginger came into the room, took his wrist, and, looking at her watch, counted—one, two, three. How many times had these little beats coursed through this man’s veins? How many times had someone held his wrist to check them? Ginger sighed and started over—one, two, three.

  “Did you find it, Nurse Moon?”

  Ginger looked up and found Jack Wolfe staring at her with a pop eye. “What?” she asked.

  “My pulse?”

  Ginger nodded and set his wrist back down. She gazed up at his drip.

  “Good. You had me worried.”

  “Why?” she asked, turning the drip nozzle so it fed faster.

  “There’s a tear on your cheek and I thought I passed.”

  Ginger reached up quickly, wiping the tear. The little drop of water glistened in the overhead light. Where did that come from?

  “Can I ask you a question, Mr. Wolfe?” she said, quickly diverting the conversation.

  “Sure. I’m not sleeping anyway.” He sat up a little in bed, his chest rising with the weight in his lungs as he struggled for air.

  “You do know that candy bars are bad for you, don’t you?”

  “Yeah, well, most everything I’ve done in my life has been bad for me. I drank too much. I smoked too much. I had a great time doing both. I’d do both now if I could.” He smiled.

  “No regrets?”

  “I had a good life. I had fun. I worked. I loved. What’s to regret?”

  “So even though you are stuck in this bed with no chocolate, you wouldn’t change a thing.”

  “Not one minute.” He chuckled. “And I only got no chocolate right now.”

  Ginger squinted at him.

  “You gonna give me a dollar?”

  She shook her
head.

  “I’m released tomorrow.”

  She grinned and turned to leave. “Well, Mr. Wolfe,” she said over her shoulder. “Find a candy bar with less salt. At least try to give one of your ailments a break while overloading the other. And before you leave, we’ll make sure your insulin levels are good, ’kay?”

  “I like Snickers.”

  Ginger chuckled and shook her head again.

  “Nurse Moon?”

  Ginger stopped and looked over her shoulder at him.

  “What was the tear?”

  She hadn’t even known she had a tear. She did, however, know why it was there and she also knew that she was a nurse and Mr. Wolfe a patient. She smiled and shook her head.

  “Ah, come on. You can tell me.”

  “No, I really can’t.”

  “Just me.” He looked around the room. “No one will know.”

  She looked into his chocolate brown eyes and thought that, even though he looked tired and drawn, his chest heaving from working so hard to breathe, his gaze was so awake.

  “It was my wrist you were holding, after all. Come on. I shared.”

  Ginger shrugged.

  “Come on,” he whispered. His eyes didn’t move.

  “I was just thinking—I was just hoping someone had hold of my husband’s wrist when his pulse stopped.”

  Jack leaned his head to the left. “I hope whoever held his wrist held it as tenderly as you did mine,” he replied.

  Me, too, she mouthed and, flicking off his light, Ginger shut Jack’s door. Taking a deep breath, she headed back to the ER and slid next to Jacob’s gurney. He was shivering. Pulling out another warmed blanket from the cabinet, she laid it over the boy, tucking it under his legs and shoulders.

  “You need to go home, Jacob Esch,” she said softly.

  “I know, Captain. But I can’t,” he replied.

  July 18, 1861

  Dear Juliette,

  A queersome feeling awoke me at dawn this day. It is July and spring has ridden away; her vibrant colors and new green leaves scattered in her wake. Now the world is turning deep, lush, and thick, as is the nature of summer in Virginia. Do you remember summers here? There were dances lit by a full moon and lightning bugs. I see you still in your pale blue dress as we spun around in a waltz for the first time. Are you remembered of the night we first met? Do summer nights in Sharpsburg hold the ebb of lightning bugs and the memory of our first dance not so long ago?