The Pain Nurse

by Jon Talton

  Now he said nothing. The speakers called trauma team one to the emergency room, and then trauma team two. His mouth was too dry to speak, his lungs too tired to force out any words.

  “I’ll help you with money, Will. You won’t have to worry.”

  “Just go.”

  “I’ve talked to your brother,” she said.

  He waved it away. “I asked you to bring me something else. Did you?”

  “Damn you, Will.” She reached into her purse and handed him the black leather case. Inside was his badge and identification card. “I shouldn’t have done this. Julius will be…”

  “Thanks.” He spoke in a rough monotone. Then he violently wheeled around to face the city, provoking his back to spasm with pain, the one reliable in his new life. Night poured down on the city and lights pierced the puffy blackness. She spoke to his back. She had made plans for him. She was always good at planning. But Will wasn’t really listening. For a long time after she left he just sat there, watching the city lights, knowing he was past due for his pain meds, not moving. He slid his wedding band off for the last time—Cindy had kept it during his surgery—and dropped it into his fanny pack. He thought about pawning it, or just walking out on the Roebling Bridge and letting the river take it away.

  Chapter Ten

  Cheryl Beth stood in the wide doorway into the solarium, watching the man. His back to her, he was framed by the darkness of the lonely broad windows, his posture rigid with pain. His shoulders heaved slightly. She knew he was crying and thought about checking on him. This was in character for her, checking on strangers, with or without a referral. She had the run of the hospital, something she thrived on. She loved to help people. Andy had said it was actually a character flaw, a selfish compulsion to be needed—those had been his words—not so much to help anyone as to feel secure herself. But he had only said that toward the end, as they were spiraling into the place where every sentence was an accusation, every phrase the quicksand of further estrangement. It was odd that the words still stung her, so many years later.

  She watched the man in the wheelchair and almost went to him. He seemed too young and vital to be here, to be in that chair. But something in her hesitated. She hated that it was getting dark so early, that her home seemed almost violated by the footprints she had seen. She felt off her stride, Christine’s bloody face and mutilated hand still hovering in her thoughts, deep footprints in her flower beds—she looked down at her own shoes as if to reassure herself that she wasn’t standing in Christine’s blood…Ah!

  “I’m sorry. Everybody’s jumpy right now, and you have the most right to be.” The hand on her shoulder and the voice in her ear belonged to Dr. Jay Carpenter, the chief of general surgery. He was tall and rumpled, as usual the only neat thing on his body seemed to be the expertly knotted bowtie he wore. It was amazing how many docs still didn’t realize their conventional ties could fall on a patient or a surface, picking up bacteria to be deposited elsewhere. Dr. Carpenter always wore a bowtie. Above it was a goatee of gray and brown, setting off a creased, craggy face, all topped by thinning white hair. His voice was always ready to assume its distinctive thundering tone. He was a notorious and highly successful ladies’ man.

  “Any Christmas plans?”

  “I guess I’ll go see my brothers in Kentucky.”

  “Walk with me, Cheryl Beth.”

  Visiting hours were coming to an end, so the halls were emptying out.

  “Were you in the ER for the shooting du jour?”

  She had been called in. The aftermath of gunshot wounds could be especially painful. The patient was a fifteen-year-old with a stomach wound. As usual, poor and black. As usual, from the violent ghettoes that separated downtown from the hospital district on Pill Hill.

  “It’s going to be a pain grenade,” she said. “You know he’s probably not opiate naïve.”

  “Not with all the addicts in that neighborhood.” They knew the drill: a patient with a history of addiction didn’t respond to doses of painkillers that would work in a normal, or “naïve,” patient.

  “So there’s a good chance he won’t be adequately medicated,” she said. “I’m going to go back and check on him, post-surgery.”

  “That’s good,” he said, pausing to lean against a wall, his voice assuming its full freight-train tone. “If his doc isn’t doing the right thing, you do what you need, and you have my verbal orders.” He looked around and spoke more quietly. “The last thing we want is to have another African American kid screaming in pain in this hospital. Lord, this city is so tense. They won’t admit it, of course. Everybody is so nice in Cincinnati.” He paused. “They could have used you in peds today.”

  “I can’t do peds.” She spoke quickly.

  “I know.” He gave a gentle smile. “I’ve been worried about you.”

  “Me? I’m all right.”

  “I know, you’re the tough one. But your job can get pretty lonely. Why don’t you come up with me to the stroke floor? They’re having their Christmas party tonight.”

  “Maybe I will, if I’m not persona non grata. Stephanie Ott is out to get me.” Cheryl Beth said it lightly but the words still sounded dark. She sighed. “Things aren’t right.”

  “With Stephanie?” He gave his trademark rumbling laugh. “Nothing is ever right with Stephanie. Don’t worry about her. I’ve got your back.”

  “It’s not just that. Someone was digging through my desk. The whole vibe here seems different. And I found footprints in my flower bed, right by my window.”

  “Maybe it was the meter reader?”

  “No, the meter is in back. And they only appeared in the last couple of days.”

  “It wasn’t me.” He winked. “It’s probably nothing, Cheryl Beth. Still, you ought to talk to the police.”

  “It was the first thing I did!” She heard her voice rising and slowed herself down. “They blew me off. They wouldn’t even come out, just said call if I see a prowler. Damn it, they think I killed Christine.”

  “No.”

  “Pretty damned close.” She slumped against the wall, suddenly exhausted. “They say I could be ‘a person of interest.’ Isn’t that what it means? I always hear that on TV and those are the people who end up being the killers.”

  He patted her shoulder and spoke quietly. “Nobody thinks you would hurt Christine.” He paused. “I do have to say, jeez, baby, Gary Nagle? If you were going to do that, I should have been hitting on you harder all these years.”

  “Yeah, yeah. Hell, does everybody in the hospital know about this?”

  “Of course not.” He waited a beat. “Of course.”

  She laughed with him but felt the rough stone of exposure pulling her down. What an insane thing, getting together with Gary, going for a drink with him that windy spring night, letting him kiss her underneath the streetlight. She tried to push the memory away.

  “Maybe you need a vacation,” he said. “I can’t afford you to burn out.”

  Her immediate reaction was defensive, but she knew he meant her well. “Oh, Dr. Carpenter, you know how it is. Sometimes it’s so sad. Sometimes something wonderful happens. A patient gets good news or makes you laugh. I always think, no matter how bad the news, at least I can control their pain.”

  They walked again, in the direction of the cafeteria, moving to the edge of the hallway as five people walked past, closely bunched together. It was obviously a family, three generations of women, the oldest looking a little older than Cheryl Beth. Eyes red with tears and faces stretched with fatigue, they bunched together in their thick winter coats as if any straggler would be pulled irretrievably into the deep space.

  “Dr. Carpenter, who would want to hurt Christine?”

  “Want me to make a list?”

  “I’m serious.”

  He said nothing until they were in an empty hallway again. “Christine was a big personality, as you know. People loved her or hated her. Well, no, that’s not true. People tolerated her or hated h
er. She didn’t have many friends. You tangled with her, remember? When you were trying to get us away from using so much Demerol, using all your charm and all your data, she went ballistic. That was classic Christine.”

  “I’d actually forgotten that. There was another time, too. She told me her patient was being a problem, and I said, ‘Dr. Lustig, the problem is how you’re writing the orders.’ She was way under-prescribing for this particular patient, who was just moaning, really hurting. The nurses were afraid to cross her. I wanted to say, ‘You’re killing people with these PCAs,’ but I didn’t. Great. These will be more reasons for the cops to suspect me.”

  He chuckled. “If arguing with Christine Lustig was a crime, I’d be under the jail. I knew her for fifteen years, and I can’t think of one day when she wasn’t after somebody. The truth is, she was brisk…well, beyond brisk, because usually she was right. I saw her stand toe-to-toe with the big guys many times, and that wasn’t easy for a female doc of her generation. On top of all that, she was gorgeous and knew it. My God, those cheekbones…”

  He stared wistfully. “She felt entitled and she was incredibly competitive. She and Gary were both that way. It’s amazing they didn’t kill each other. Guess I shouldn’t say that. I thought she was a gifted surgeon, especially on gall bladders and GI stuff. But she was kind of a technician, if you know what I mean. Her people skills with patients sometimes left a lot to be desired. Let’s just say she didn’t have your emotional IQ. Not to speak ill of the dead.”

  “Is that why she was put on the computer project?”

  “You mean to get away from patients for awhile? Maybe. She actually asked for the assignment, and she became a real advocate. I called her Tech Head, she became such a geek. She traveled to other hospitals and studied their systems. SoftChartZ is pioneering electronic patient records. Digital medicine. Christine was a believer. Don’t kid yourself. This is what’s got Stephanie’s panties twisted, that the project might be delayed now. Not that she gives a damn about how much paperwork you do. But the docs in the neurosurgery practice are screaming for computerized records, and they’re the ones who still bring real money into this benighted place.”

  “So who in this long list of enemies was capable of killing Christine?”

  “Oh, Cheryl Beth. How would I know that?”

  “Because you know everything, Dr. Carpenter.”

  “What, you’re a detective now?”

  “Someone has to be. This cop, Dodds—I have a really bad feeling about him. He just looks at me like he thinks I did it, like I’m hiding something.”

  “Are you?”

  A shot of defensiveness stiffened her before he laughed.

  “I’m serious, doctor. I feel like I need to do something, get him some information. And Stephanie, too. You should have seen how she went off on me.”

  “The detective talked to me. I told him you couldn’t have done it.”

  “See! He has it in his head that I killed her!”

  “Cheryl Beth, this is a big old urban hospital. And we have all the problems of an urban hospital. Yesterday, I saw a guy in a stairwell, dressed in rags, just walking up and down the stairs. He said his dead mother was chasing him, and didn’t I see her? He was shaking and bawling. Scared the hell out of me. I called security, and it turned out he was just another street person who wandered in here for warmth. He was diagnosed paranoid schizophrenic, off his meds, hearing voices. Good Lord.”

  He stopped. Then, “Do you know how much of this hospital has been closed down the past decade? There are old, abandoned parts of this place that I’ve never even been to, that the security guards don’t even know about.”

  “They’re probably all my old shortcuts,” she said.

  “You know I studied here when I was a medical student? This was back in the Stone Age, when they had real wards, just long rows of beds separated by curtains. But it was great training. Young docs today, most of them don’t really know how to listen to heart sounds. They don’t get a chance. Hearts get fixed. People don’t get rheumatic fever. Back then, we’d get lots of public health cases, lots of people with heart murmurs. It was great to be a student. The old basement, that’s where the morgue was. It’s so isolated. Why they would put offices down there, much less even put a woman alone in an office there…?” He shook his head. “It was just a horrible, random act.”

  That didn’t make her feel better. She said, “So what about the footprints in my flower bed?”

  He smiled, half to himself, staring at the floor. At first Cheryl Beth thought he was patronizing her and she grew angry. Then he spoke in a different voice. “The irony of the whole thing is that Christine was quite the sexual predator. She had cheated on Gary for years, and not with just one person. She was hardly the victim, however much I am baffled by your taste in men. I’ll just leave it at that.”

  For a moment, Cheryl Beth was conscious of her every swallow and breath. She made herself smile and gently punch Dr. Carpenter in the arm. She said, “Don’t tell me you and Christine…?”

  “Not my taste,” he said. “And my conquests are vastly over-imagined by some of my coworkers, not that I’m complaining… Cheryl Beth?”

  She realized she had just been standing there silently staring at the wall.

  “I was just thinking,” she said. “The way Christine was cut. It was done with such rage. I’ve never seen anything…not in the ER…not anywhere. It could have been…”

  He spoke quickly. “I probably said too much.”

  “It could have been a spurned lover.”

  “Cheryl Beth…”

  “It could. My God, it could have been a lover’s angry wife. A woman could be strong enough to do that…”

  She stopped instinctively when his name came over the paging system.

  “You.” He put his arm around her. She didn’t feel intimidated. It felt good, just to be touched. “You, my intense friend, need to go home and get some rest. But first, come with me to the party, get something in your stomach.”

  “Doctor’s orders?”

  “Absolutely.” He took her arm and they walked.

  Chapter Eleven

  Gravity was his enemy. Anything dropped to the floor was lost. A pen, a book, a pill. A towel, a water cup, a dollar bill. He couldn’t pick it up because he couldn’t stand, much less bend down. His only recourse was to ask a nurse to retrieve it, or ask Cindy. But she wouldn’t be coming back. He had lost her just as surely as if she had fallen out of his hands to earth, his useless legs unable to let him follow her. The morning had been slow and difficult, as he had pulled on his T-shirt and sweatpants, then, in greater agony, socks and shoes. Cindy had bought him workout shoes with Velcro snaps, to avoid the near impossibility of holding his legs in place long enough to tie shoes. Then he had angled the wheelchair close to the bed and locked each wheel in place, while he carefully pushed himself into a sitting position and maneuvered to the edge of the mattress.

  Like so much, getting up had gone from an unthinking move of a normal human being to an act of significant physical effort. Using one hand to grip the bed railing, he would roll to his side. Then he could rise to his elbow and, again grabbing the bed, swing his body into a sitting position. He used his strong right leg, hooking his right foot into his left ankle to pull the weak leg along. It all took planning and care. He couldn’t feel his bottom, so he had to be sure that he was actually sitting on the bed and not sliding to the floor. Then, relying on upper-body strength, he would lift himself across to the chair. It wasn’t exactly kosher: he was supposed to wait for a nurse, but they were always busy. And no one seemed to notice or care when he just wheeled himself out of the room and down to the nurses’ station.

  There he would be given a multivitamin, stool softener, Vicodin for pain control. He was profoundly aware of the med times. He didn’t need a watch. His body had betrayed him with the tumor, but its clockworks for pain were precise and as unforgiving as the enemy gravity. If he missed the pills by even
a few minutes, the pain would break through again. It was a creature living inside him, pinned up in the fragile pharmaceutical cage. The pain frightened him.

  After the morning physical therapy and lunch, he was on his own. No one told him how long he might be in the rehab unit. It was the way he imagined jail time. If he hadn’t been free to roam the hospital he was sure he would go mad. But he could come and go as he pleased from the neuro-rehab ward and now, after so many days, had just become part of the landscape. Some people said hello. Most ignored him. So he wheeled himself through the halls, watching people, trying to keep dark thoughts outside. He ended up in the corridor leading to the old entrance to the hospital. It was a quiet place because the outside doors were sealed now, the main entrance moved. But the grand arched ceiling remained, along with a display of historic photographs from the hospital’s history. The entrance to the hospital chapel was nearby, the chapel itself empty. Outside, the light was somber and wintry. A woman walked by, her hair bouncing on her shoulders at every step, reminding him of Cindy when he had first met her. He put the thought in a box, put the box on an imaginary shelf holding thoughts about his wife. He wouldn’t be the first cop with a busted marriage.

  He played a game of thinking about all the women he had crushes on or had lusted after while he had been married. One was a pretty young yellow-haired cadet with flawless fair skin. She had followed him around with a doe-eyed interest that was both innocent and knowing, and once, when he had seen her in a skirt, he had realized how attracted he was to her. Karen was his partner before Dodds, a woman going through a divorce, who said Will was her best friend. One night in the car they had started kissing, until he had stopped it. There was the assistant DA with the violet eyes, the writer who was working on a profile of the homicide detectives—in all those cases, he had felt the attraction, known it was mutual, and each time he had pushed it away. Only once did he slip, nothing compared with Cindy’s serial infidelities. He pushed that thought away. He thought of the others. Maybe now he would look up one of those women. And do what? He hadn’t had an erection since the surgery.