I’D JUST FINISHED CHECKING the dinner trays on the seventh floor when news came that Jack Triplett had died on Six North. The nurse had turned his Stryker frame over, and his mouth was hanging open. One of the roommates said he’d been talking just a few minutes before about wanting to be a sports reporter. This had long been one of his goals. He thought he could dictate his stories and reports into a tape recorder and that the newspaper would pay a team of attendants to carry him around. His knowledge of baseball statistics was good, especially the White Sox, but he was barely literate, and it never seemed likely his dream would come true. He’d gotten the idea, he said, from a television report about a blind baseball announcer who would reenact the game from Braille notes and box scores.
We were deeply affected by Jack’s death. He was such a lively character, in some ways the spirit of the unit. Now that spirit was nothing but a bunch of bones and teeth to be wrapped up for the morgue. Yolanda, the LPN who’d been Jack’s lover, was in such bad shape that Dr. Simmons, the resident, injected her with Valium. Even then, you could hear her moans through the closed door of the break room. Emory Ashworth came down from Orthopedics to fill in for her. He rushed here and there, not getting much done, and adding to the feeling of helplessness. His usual campiness and humor were gone. He seemed about twelve years old. For an instant, I imagined my own corpse lying in bed, looking bucktoothed and stupid. I could feel millions of microbes crawling over my skin, incessantly eating each other. Everything in the world is constantly being buried by a fine layer of dust; it even falls on your eyeballs as you lie in bed after sex.
A couple of paraplegics sat in wheelchairs near the nursing station, smoking cigarettes and talking quietly, and one of the nurses yelled at them to do their smoking in the visitors’ lounge. Then she apologized to them. It was a death of enough magnitude that the nursing supervisors came down to express their sympathy to the nurses.
While Jack was special, any death on the spinal cord unit was significant. The patients were so helpless. Their absolute dependence on the nurses and aides was heartbreaking, and made the relationships very strong. When one of these men died, the nurses felt they had failed terribly. If only the kidney infections and bedsores had been caught sooner. If only they had changed the dressings better, and gone to mass more often when they were children.
It was always harder to take the body to the morgue and collect the valuables when I knew the person. Standing next to his body, listing the pairs of socks and searching for the second shoe, I half expected Jack to sit up and talk to me. There weren’t many valuables, just a lot of junk from the gift shop like car magazines, cigarettes, and packages of Twinkies. Nevertheless, everything had to be listed and released to the family.
The paper bag containing the belongings was at the back of the unit when Jack’s father showed up. He wore a brown Shell gasoline uniform with “Rowdy” stitched on the jacket, and his hair, a sleek salt-and-pepper, belonged on a movie star. If his teeth hadn’t been missing, he’d have looked like a business executive or U.S. senator.
The problem was, he was drunk. When I took him to the room to view the body, he claimed it wasn’t Jack lying there. It had to be somebody else, he said, because Jack didn’t look like that the last time he saw him. Jack looked awful thin, and look how his cheeks were sunk. Before the nurse and I could stop him, he touched the face of the corpse, working expressions into it with his fingers. In one drunken blur, he made Jack smile, frown, and doubt. Then he stepped back from the corpse. It might be Jack after all, he said, acting truly surprised. Incensed, the nurse steered him out of the room. When I offered the list of valuables for his signature, he scrawled something illegible, holding the pen as if he were trying to drill it into the desk.
“Shack was a good boy,” he gurgled. “Isha damn shame.”
“We’re very sorry, Mr. Triplett,” I said. “Everybody liked Jack a lot.”
“You better believe it,” he said, jabbing a finger into my chest. “Shack was the besh they ever wash.”
“There’s a gun to claim from the cashier,” I said, “if you haven’t picked it up already.”
“Thash right,” he said, putting an arm around my shoulder and swaying silently back and forth. He was either nodding off or dreaming of better times in Tennessee, when the kids ran around in the yard, among old refrigerators and the remains of a dozen cars. Now he probably lived on Wilson Avenue, where many poor whites resided. He would take the bus home with Jack’s Twinkies and cigarettes, but he was so drunk, he’d probably leave them on the bus. They’d ride around the city until somebody found them and took them home.
I steered him down to the lobby, where the cashier was, and asked for the envelope containing the gun. It made a bulky package. The cashier looked at us skeptically, as if he could sense what was in the package. I took Mr. Triplett around the corner by Outpatient Accounting, opened the envelope, and handed him the weapon. As I did so, the bullets, which had been removed for safety, spilled onto the tile floor. Since we were still in partial sight of the lobby, where people were coming and going, I dropped down in haste and started to gather them up. Rowdy Triplett swayed above me, holding the gun as if he’d staggered out of a gunfight.
“Git ʼem,” he said. “Git them critters.”
I hurriedly shoved the shells into his jacket pocket.
“Don’t put those in the gun until you get home,” I said. He appeared to understand, because his head shook up and down.
I worked the gun loose from his hand and tried to find a place for it. The Shell uniform was tight-fitting. Anywhere I put the weapon, it would make a bulge, and he might get arrested. I decided to put it in the bag containing the valuables. The gun might drop through the bottom onto the sidewalk, but that would be his problem. Then I guided him out the front door and headed him in the direction of State Street. His good-bye handshake was sober and tough, but the rest of his body waved like a flag. He gave me a “Thanks, pardner” and was on his way, weaving through the minimal sidewalk traffic.
Emory and the other aides had Jack wrapped up and ready to go when I returned. They had even put the body onto the cart and closed all the doors in the hall. It wasn’t that necessary—everybody knew he was dead, because news like that soaks through the walls, especially on a unit where patients know each other mainly by rumor.
It was pathetic to see Honest John moping around the unit. While Jack had been in the hospital for months, getting worse and worse, Honest John had been in and out several times. When his family went on vacation, they got the doctor to sign him into the hospital, like putting a dog in a kennel. He knew they were dumping him, but he didn’t mind. He liked the camaraderie of Six North and preferred being there to living at home.
Emory volunteered to help me take the body to the morgue, but when we got Jack into the hall, Honest John wheeled around the corner with authority. He pulled up next to us, and while the humming elevator threw its lights into the hall, Honest John said farewell. Dressed in GI camouflage, with combat boots on his shriveled feet, he touched the body with one hand and put his head down as if praying, crying, or thinking very hard. The elevator operator, who was a grouchy SOB, turned to look at the wall. Under other conditions, he would have told us to hurry the fuck up.
When Honest John was done, he saluted us and headed briskly back toward the station, a look of grim death on his face. Two days later he was released, and I never saw him again. I don’t know if he died, moved away, or spent the rest of his life at the VA Hospital, where most of the veterans went. Louie Bottoms, the roommate Jack thought was trying to kill him, had died months ago. Wilson, the other roommate, married one of the nursing assistants and moved to San Diego. The story came back that he had started a tool-rental business and was making tons of money.
When we put Jack’s body down on the slab, I could feel the difference from a normal corpse. He seemed more like a collection of parts than a whole body, and weighed very little for such a big man. It made me think of high school dances, how some girls seem made of air when you hold them. On the elevator back to the floor, Emory cried and wiped his eyes with a hankie.
Later that night, I was hanging around Orthopedics, talking with the clerk, Mary Patterson, when Dr. Storck went by, guided down the hall by his resident and the intern on call. He was a brilliant surgeon, capable of rebuilding whole hands from a few stray bones and muscles, but he couldn’t find his patients’ rooms if his life depended on it. A staff member always walked with him, to make sure he didn’t walk into a wall or fall down an elevator shaft. He also never remembered a patient’s name, but he knew sinew and bone as a sculptor knows granite.
Mary said the nine-year-old girl in room 711, Storck’s destination, had arrived from Iran the night before. The daughter of a wealthy oil minister, she’d lost her finger in an accident, and Storck was going to build her a new one from bone and muscle in her calf After a period of stiffness and puffiness, it would look and work like a normal finger, unless you looked very close. It would take all day to put the finger together, because the doctor was so meticulous.
Years ago Storck had invented the total hip replacement. This operation was usually performed on older people whose bone structure was weakened by osteoporosis, resulting in a serious hip fracture. Grandmother doesn’t fall down and break her hip; the hip snaps first, causing the fall. Storck would install brand-new hip sockets of plastic and some wonderful new metal, and the patient could think of taking up tennis again.
One morning, however, he absentmindedly put a hip on backward. No one noticed until the next day, when the chief orthopedic resident took students and interns on rounds. When they pulled back the covers, Mrs. Smith’s legs were splayed out sideways, like she wanted to walk both east and west. It was embarrassing for Storck when the case went before the review board, but he was too well respected for anything to come of the hearing. Meanwhile, the patient was taken back into surgery, where things were put right. Now Storck wanted to help little girls pick up pennies, and he was brilliant at it.
A couple of days after Jack Triplett died, Patsy, a nurse in Intensive Care, called up sounding frantic, which was unusual. She was cool and tough, as one had to be in ICU. There had been a shooting, she said, please come right away.
I raced down two flights of stairs and burst onto the unit. Not ten feet away, a middle-aged man stood at the Five South nursing station, a large pistol on the desk beside him. Dr. Raphael, the cardiology resident, was with him.
“Holder,” said Dr. Raphael, “I’d like you to meet Mr. Emmanuel.”
We shook hands and his was surprisingly warm. He had thinning black hair and worry lines on his forehead, and looked a little like Johnny Carson.
“How do you do?” he said politely.
“There has been an unfortunate incident,” said Dr. Raphael. “Mr. Emmanuel’s mother, as you know, has been very ill in ICU.”
I did know. She’d been admitted for the excision of a mole, but suffered a heart attack during surgery and had been comatose for weeks. It was as if she had fallen into an atmosphere, a climate, of illness.
“What’s the problem?” I said, glancing at the gun.
“Mr. Emmanuel has killed his mother,” Dr. Raphael said.
“I’ve only done as she asked,” Emmanuel said. “She always said she wouldn’t live like a vegetable.”
“I understand,” said Raphael, “but there was a small chance of recovery.”
“No chance,” said Emmanuel. “There was no chance.” He shook his head left and right like a confident child, and then he started to cry in a very repressed way, with tight little sobs.
Dr. Raphael put his arm around Emmanuel for a second, then withdrew it, unsure of what to do. Was he supposed to comfort the man who’d killed his patient? With the family’s permission, he had the right to “pull the plug” on the patient, so he was a little peeved that the son had not come to him first.
“I’m afraid we’ll have to call the police,” Raphael said. “You understand, don’t you?”
“Yes, I understand. I fully expected it,” Emmanuel said. He looked down the hall toward the room where his mother lay. Nurses passed back and forth, trying to calm down the three other cardiac patients in the room. Economy required that many beds in ICU, but the practice was self-defeating. When one person went into arrest, it would set off dangerous patterns in the other patients’ EKGs. You could sit at the desk in the middle of the room, where the central monitor was located, and watch the panic set in. The nurses were used to this, so when an arrest occurred, they would hand out tranquilizers to the other patients. One hotshot administrator had the idea of putting carpet on the floors of ICU, in order to maintain quiet. Then it was discovered that the static created by nurses walking back and forth would set off all four monitors at once, scaring the patients half to death.
I called Security from the unit phone, and within a couple of minutes half the force was there, standing around in their blue uniforms. Most of them were in their fifties and overweight, but one was a younger man named Connor who wanted to become a Chicago cop in the worst way. We called him “Cowboy” because of the way he swaggered around the hospital, one hand playing around his holster. Connor grabbed Mr. Emmanuel by the arm and attempted to put him in handcuffs. This was too much for Dr. Raphael, who shoved Connor in the chest, knocking him against the wall.
“Leave him alone!” he yelled, loud enough that the nurses down the hall stopped what they were doing. I thought Connor was going to fight back, but he dusted himself off and walked over to the other officers, who turned their backs on him. They were embarrassed by the guy. A few days later, he pulled his gun on a visitor who was smoking in an elevator. The hospital fired him and took the weapons from all the other officers.
Raphael and I stayed with Mr. Emmanuel in a fifth-floor office until the Chicago cops arrived. He was very quiet at first, but then he began to talk about his mother. She had been an inspiration to him, he said, because she’d raised him and two brothers without the help of his father, who’d run away when he was five. Years ago, he tracked down his father in a small mining town in northern Michigan, where he was in the hospital with Huntington’s chorea.
“When I entered his room,” he said, “he was eating dinner. A spoon was strapped to his hand, and now and then he managed to bring a small amount to his mouth. Most of the time his arm would explode against his will, and food would fly in all directions.”
“Did your father recognize you?” Raphael asked.
“No, how could he? I was only five when he left. I told him I was a volunteer and helped him eat. The next day I drove back to Chicago, and he never did know who I was. A few weeks later, he died from the disease.”
“That’s terrible,” I said.
There was a knock on the door, and two policemen entered. One of the officers put the gun into a plastic bag, and detectives stayed around most of the evening, asking questions of Patsy and the others. The nurses said he would visit every night and stand quietly beside the bed, watching the machine breathe for his mother. Sometimes he would bring candy and flowers for the nurses, and they thought he was the perfect son. Tonight, he had shown how perfect he was, drawing the .38 out of his clothing and putting a single bullet in her chest. It was a famous case, much discussed in the media that summer. A surprising number of people came out in favor of mercy killing, including some noted theologians. Meanwhile, the police discovered a firing range in the basement of the home Emmanuel shared with his mother. He had practiced his shooting there so he wouldn’t miss at point-blank range.
Before he was taken away, Emmanuel asked Raphael to honor his mother’s request that her eyes be donated. Sure enough, there was a permission form at the back of the chart—she had willed away her eyes. The nursing supervisor was in a tizzy because it was a coroner’s case, and she wasn’t sure they would allow it. To settle the issue, I called the coroner’s office, and a guy who sounded more like a Mafia hit man than a doctor said hell yes we could take out the eyes, she wasn’t shot in the face, was she? We should stop calling with these fucking infantile questions.
The Ophthalmology resident on call came to the unit right away, since eyes will spoil if not removed within an hour of death. Under his arm was a Styrofoam container the size of a shoebox. A red label on top of it said EYE BANK in large letters, with the address on LaSalle Street below. The resident asked if I wanted to watch the removal, but I waited outside the room, nervously pacing. Fifteen minutes later, he emerged with the box, handing it over with a smile. Holding it gingerly, I hurried down to the street and hailed a cab. The driver, a handsome black man named Gabriel Swan, didn’t refuse the fare, but he didn’t want the box up front with him, either. I placed it on the backseat, and he headed away, closely watching the object through his rearview mirror.
Romona was sorry she’d missed all the excitement, but she’d been busy dealing with Normal Cane and Desiree Hawkins, a station clerk on the eleventh floor. Everyone knew that drugs had been missing in massive amounts, but they couldn’t figure out where they were going. One theory was that someone on the unit was ordering drugs that weren’t required for the patients’ care and selling them on the street. Now it looked like Desiree, a large white woman with broad teeth and a tough manner, had done just that. Romona said Desiree had been hospitalized with a drug overdose that night. Needle marks were found on her arms, and, of all places, on her vagina. Barbara shuddered when Romona reported this last detail.
“You mean she actually shot it into her, her…?” she asked, unable to say the word.
“That’s right,” Romona said, her red lipstick looking especially lopsided. “She thought no one would look there.”
“Ick!” Barbara said.
“So it was Desiree all along,” Ed exclaimed. He admired Cane’s style, but having accusations aimed at him hadn’t been pleasant. I felt relieved, too.
“Let’s go up to see her,” Ed suggested, and after break we did. Desiree was in a private room on the tenth floor, perhaps to keep her away from other patients. Cane had suggested guards outside her door, but the nursing supervisor said forget it.
The room was dim when Ed and I entered. Head back on the pillow, she appeared to be asleep. The television was on, and its blue light played over the bed. It gave her face a psychedelic look.
“Desiree,” said Ed. “Are you awake?”
She turned her head slowly toward us, and I realized she was still drugged. When she saw us, her smile broadened like a highway.
“Well, I’ll be a son of a bitch,” she said, “come in, you two.”
“Thought we’d come and see how you’re doing,” Ed said.
“I’m doing just fine, and the sight of you two makes me horny.” She turned sideways in bed and leered at us. Desiree often said things like that, and a couple of interns had taken her up on it. There had been some stories about bed use in empty rooms.
“Come closer,” she teased, but when we did, she reached out with a quick hand, cupped Ed’s balls, and gave them a jiggle. The undertaker blushed so hard I thought his ears would blink off and on.
“Hey!” he said. “Let go.”
“Haven’t felt something like this in three days,” she said. “Feels good.”
“Maybe I should leave,” I suggested.
“Stay where you are,” she said. “You’re next!” But she wasn’t serious. Desiree did a lot of things for show, and it was especially funny because Ed had been her supervisor. Here she had been stealing the drugs, selling them on the street for heroin, and Ed was getting the blame. Now she had the nerve to grab him by the balls, and he couldn’t even get mad at her.
What was it about Desiree’s obscene behavior that made me philosophical? On one hand, she was completely vulgar. While on duty, she would step into the back room at every opportunity for a cigarette and a drink from her purse, and orders would pile up on the desk. More than one nurse had asked to be transferred because of her, but somehow she always managed to land on her broad feet, no matter how serious the infraction. Maybe it was the purity of her vulgarity that charmed us, and finally even the nursing supervisors were persuaded. Desiree was an institution. She was a breath of rich summer in a bad alley, but if anybody knew who she was, it was Desiree Hawkins. In a time of anxiety and identity crisis, when every other person you passed on State Street was a psychiatrist, that was worth a lot. That’s why, when she placed her hand on Ed’s crotch, I thought, This is a philosophical issue. This has to do with identity, being and nonbeing, and the will to power. Someday she would drive over a Hollywood cliff in a Cadillac, eyes dilated like skies. Meanwhile, there was something almost normal about her manic behavior, since we both permitted and expected it.
Desiree was telling us what the bastard Cane had said to her, when her eyes went back in her head. Only the white parts flickered below, like night lights on a bumpy road. She threw her head back on the pillow, arched her back as if in orgasm, and made low choking noises in her throat. Ed and I looked at each other oddly, dumbly, for what seemed like seventy-five years before we realized what had happened. A padded tongue depressor was taped to the wall near the bed. These were present when the patient had a history of grand mal seizures.
We leaped into chaotic action. Ed grabbed the tongue depressor and made a poor effort at getting it into her mouth. Desiree thrashed and bucked.
I found myself in the hall calling for a nurse. I must have yelled pretty loud, because everyone at the station looked up in alarm, and in no time at all Gwyneth McCarthy, the charge nurse, was in the room shoving Ed out of the way. No arrest was called, but the intern, Tim Pagel, and resident, Dr. Bernstein, got there fast. Bernstein told us to pull the bed away from the wall and to surround it. This way, we could restrain Desiree from hurting herself on the bed rails, which were already up. Bernstein stationed himself at the head of the bed, where he manipulated the tongue depressor and gave orders. I took charge of one of her powerful legs and Ed took the other, while the intern and Gwyn handled the arms. She was unbelievably strong. We were tossed around like sailors in a storm. Ed took a kick in the chest and bounced off the wall, but gamely he came back for more.
On Bernstein’s orders, the aides brought pillows, which we used to line the sides and head of the bed. Then a nurse entered the room with some Valium in a syringe. The resident shot it into her hip with difficulty. The first ten milligrams didn’t do any good at all. After five minutes, Bernstein gave her another ten, then another. Those didn’t help either, so he gave her even more. The resident was beside himself, and Pagel was no use. This was his first week on the job, and he looked scared.
Bernstein was complaining of the blood on his fingers when Allen Kranz, the hospital’s single hippie resident, came in the door. Desiree wasn’t his case, but he’d been walking down the hall and seen the commotion. He had long curly hair that was held with a rubber band in back, a mystical medallion of some kind around his neck, and a ring on every finger.
He held out his arms in a gesture that looked vaguely prophetic and said with great command, “Stop what you are doing! Stop it right now!”
“What’s the meaning of this, Kranz?” said Bernstein.
“You’re making a mistake. Take your hands off her and she’ll be all right.”
“Look at this blood,” Bernstein said. “If we don’t hold her down, she’ll bite off her tongue.”
“Take the Zen approach,” Kranz said calmly, taking the tongue depressor out of Bernstein’s hand. “Everyone loosen your grip until you’re barely touching her, like fog on a beach.”
He held out a hand to illustrate what he meant, and Gwyn McCarthy turned to me and mouthed the words “fog on a beach.” Everyone thought Kranz was a little strange because of the way he dressed, but he was also incredibly smart, so we did as he said. To our amazement, the less we pressed down on Desiree, the less she resisted. Almost immediately, she began to subside into less serious seizures. Kranz didn’t bother with the tongue depressor. He placed his hands lightly on each side of her face and stared contentedly out of the window, as if he were thinking of going sailing.
Soon Desiree was almost normal. Bernstein left the room, shaking his head. Ed, whose attitude toward hippies was somewhere to the right of Mussolini, had gained real respect for Kranz. What he loved was the spectacle. It was like sitting in mass on Sunday morning, hearing tales of the saints, the grand and theatrical miracles.
It turned out that Desiree had overdosed on purpose. Luckily, just before she fell asleep from the alcohol and heroin, she’d made a call to a staff psychiatrist. Dr. Grabart, an undesirable man with an ill-fitting wig, was known to sleep with his women patients. He had apparently had an affair with Desiree, and she called to tell him what a jerk he was. It was the middle of the night, and more in irritation than in a spirit of mercy, he called the police. When Desiree didn’t answer the bell, the landlady let them in. Desiree was sprawled on the couch, bottles of pills from Metropolitan spread around her, and an empty syringe clutched in her hand. The pills were reported to hospital authorities, and after her recovery she was quietly fired. We all felt sorry for her. There was a little good-bye party with coffee in Styrofoam cups, and a cake one of the aides had made. A few weeks later Desiree showed up on the unit in an Easter ensemble from the fifties. Everything was white, from the skirt and jacket to the pillbox hat with attached veil. It was her way of telling us things were working out for her, but the nylons were torn in back, her fingernails were dirty, and the lipstick was smeared.
Not long after that, she did commit suicide. The coroner found that she had eaten a peanut-butter-and-rat-poison sandwich. This would have killed her within five minutes, but to make sure, she covered her face with a clear plastic bag, tied it shut with a long piece of string, and attached both ends of the strings to her wrists. When she fell unconscious, the weight of her arms pulled the bag even tighter around her face. When the police discovered the body days later, her face was black beneath the plastic, like that of an African god.