LAURIE HAMPTON, THE NEWEST nurse on the ICU staff, noticed Herb enter the unit. She looked at her watch. Ten minutes, she thought, before he starts rounding with the residents.
Laurie had met Herb in the ER a year ago when a heroin overdose arrived in cardiac arrest. The resuscitation wasn’t going well, and the ICU team had come to assist. Laurie suggested they try a different medication. She had mentioned it earlier to the ER attending who hadn’t bothered to respond. Herb not only agreed, he punctuated his approval with a thumbs-up sign, rare praise coming from a doctor, which was why eleven months later, desperate to leave the ER, she arranged to be transferred to the ICU.
More than a tad overweight, Rubenesque according to her lover Tanya, Laurie was from southern Illinois. She had worked in a Carbondale hospital and lived alone for twenty years before admitting to herself that she wanted to be with a woman. Not possible, she felt, in small-town Illinois, so she moved to San Francisco. Now in her forties and in love for the first time, she had never been happier. Until a recent flail in the ER with an intoxicated, combative patient.
An intern had drawn blood and was holding the uncapped syringe when the man swung at him. The intern jerked back reflexively. The uncapped needle jammed into Laurie’s thigh, an inch deep. There were rumors the patient had the new gay-related disease, that it might be transmitted by infected blood. She had been sent to Employee Health, given vaccines for tetanus and hepatitis, and advised to return if she became sick.
She had to talk to someone soon, she realized. The fear was paralyzing her. She couldn’t keep working in this state. Transferring to the ICU had helped, for a while. Then the nightmares recurred. Fanged maggots invaded her blood stream. They were breeding inside her spleen and preparing attacks on other vital organs. She awoke gasping, her chest pounding.
Herb was alone at the sink, washing his hands. Guessing this would be her best chance, Laurie approached him.
“Can I speak with you—privately?”
“Sure.”
Taking note of her dilated pupils and the droplets of sweat at her temples, Herb led her to an empty room.
“What’s up, Laurie?”
She stammered. Her tongue felt too thick. Averting her eyes, she described the needle-stick incident.
“And all Employee Health told you was to come back if you get sick?” Herb asked, attempting to suppress his outrage. “They gave you no information about the patient, didn’t offer you any counseling?”
“They said I should have my blood checked for hepatitis in a month. That’s all. I’d really appreciate your advice.”
Herb heard no complaint, only apprehension and the desire to preserve her dignity. She clearly didn’t want to be a victim.
“Let me see what I can find out. I’ll talk to our GRID expert, Kevin Bartholomew, and get back to you tomorrow. OK?”
“That would be great, Herb.”
He wanted to give her a sympathetic touch. But concerned she might think it inappropriate, he didn’t act on the impulse. She left to start an intravenous medication.
Herb pretended to skim through a chart. With Laurie’s presence no longer threatening to arouse untamable feelings, he reconsidered that decision. Inappropriate? What a pathetic excuse.
Herb first conceded there was a problem during his residency. He tried psychotherapy but found the mandatory self-revelation humiliating. After seeing how senior physicians at NIH maintained a balanced distance in dealing with young leukemic patients and their distraught families, an era of rationalization began. Despite his incapacity for expressing strong emotions, Herb felt them deeply and was well attuned to how others showed them. He determined by trial and error the minimum amount of emotional juice needed to appear credibly caring to people facing devastating loss. He gave only the minimum, just enough so he wouldn’t be drained and depressed for days afterwards. Damage control, he told himself. When in a charitable mood, he was reassured that he hadn’t completely succumbed to the impediment. At moments like this, however, he couldn’t avoid the truth. He was bottled up inside and making no substantive effort to change.
Once rounds were over, Herb drove to the airport. He reached the gate of an inbound flight from New York City as his mother was walking out the jet way. He hadn’t seen Chen for a year and was delighted to discover her lush white hair and vigorous gait hadn’t changed. In a few days she would turn seventy, he marveled.
“You didn’t need to come, Herb. I could have taken the shuttle. Don’t you have to be at work?”
“I’ve got time to drive you to the house. You can surprise the kids when they get home from school.”
Chen was elated, but only briefly.
“Oh,” she said mournfully, “The happiness those darlings give me makes me sad your father never got to know them.”
He had heard this plaint before and was confident his father, if he were still alive, would pay little, if any, attention to his grandchildren. He didn’t doubt his mother’s unconditional love for Allison and Martin. He felt guilty about how long it had been since Chen last saw them and had to remind himself this was her issue with Cecilia’s family that kept her from visiting more often.
“Any plans for while I’m here?”
He understood her real question.
“Cecilia’s parents are out of town, so it’ll just be Will and Andrea coming for dinner on Saturday night.”
Chen was pleased. She liked these old friends of Herb and Cecilia. Though he was quite sure she had chosen to like them before she ever met them, based solely on his telling her they both had parents who belonged to the elite, educated class in China prior to immigrating. Socializing with Cecilia’s family, on the other hand, had always made her uncomfortable. His wife’s great-great-grandparents had been peasants in China, lucky enough to escape to California when workers were imported to build the transcontinental railroad.
As Herb drove from the airport parking lot to the freeway, he brooded over an incident that happened during his mother’s first trip to San Francisco. Cecilia and he had brought her along to a red egg and ginger banquet in honor of a cousin’s newborn baby. The sheer number of Chang relatives and their raucous chatter made Chen ill at ease. She spoke little until the conversation shifted to the People’s Republic of China. Chen said it was tragic how Mao was destroying the world’s oldest civilization. Another cousin, a radical college student, retorted that Mao’s rule had ended the world’s longest history of state-sanctioned slavery. This interchange quieted all cross-table talk. The young man took the attention as a cue to pull out Mao’s Little Red Book and quote aloud from the Chairman’s sayings. The older Changs quickly tired of his rant and ordered him to shut up. As soon as they moved on to other topics, Chen asked Herb if they could leave. Now he wondered if her discomfort with the Changs was less about class and political differences than about seeing a close-knit, argumentative family in action.
Herb was back in clinic by four to meet Sister Anna. He hid his clenched fists under the desk as he calmly told her about the source of the donated blood she had received. Her equanimity was unshaken by his explanation of GRID, which delicately alluded to its primary mode of transmission and acknowledged the disease might be transmitted by blood as well.
When he was done, she asked, “How likely is this to do me in before the lungs go?”
Herb opened his hands helplessly.
“You’re more worried than me,” Sister Anna scolded. “Are you afraid the bishop will sue you for poisoning a daughter of the church who’s still in her prime?”
He couldn’t smile.
“I’m afraid of losing you,” he confessed.
“That’s most flattering.”
Mired in despair, he couldn’t stop frowning.
“Herb, I know what’s coming. The modus operandi doesn’t matter to me.”
He knew that Sister Anna had worked for years as a pastoral counselor, that she probably had more experience talking with people about dying than he did. She might also be right about the ineluctable obliteration of her airways trumping any complications of GRID. None of this helped him.
“I feel responsible. Hell, I am responsible. I made the decision to give you that transfusion.”
“And it would be a terrible thing for you to bear if I was a young person, not already stricken by an incurable disease. But really, Herb, what difference does this make? I certainly don’t blame you.”
Her eyes sparkled as she added, “If you feel so guilty, perhaps you should talk to someone, a professional, about it.”
Herb managed a weak smile.