I MANAGED to work my next few shifts without killing anyone, but every decision seemed to vibrate with danger. Each time I signed my name at the bottom of a chart to discharge a patient, I had a superstitious fear that, like Mr. Kelly, he’d be rushed back to the ER in an ambulance, with a burly paramedic doing chest compressions.
Even the simple cases became tricky. A guy who’d twisted his ankle playing basketball had minimal tenderness and no swelling. The X-ray was normal, but I couldn’t be 100 percent positive there wasn’t a subtle fracture I was missing, so I splinted his ankle in plaster. My indecision meant he’d be hobbling around on crutches until he saw the orthopedist in a couple of weeks. At best he’d be taking all his baths with his foot wrapped up in a plastic bag and his lower leg dangling outside of the tub—at worst, he could fall after getting tangled up in his crutches as he lurched down the stairs of his apartment. I hated to think of that, but I really hated the idea of missing something.
A patient with a simple chest cold insisted on an X-ray to make sure she didn’t have pneumonia. The film didn’t show anything, but what if I was missing a subtle infiltrate? Probably best just to put her on antibiotics. But what if she had an allergic reaction to the unnecessary antibiotics, and rushed back in with her eyes puffy, making tight squeaky noises through her airway that was swelling shut? Every patient offered an infinite regression of second-guesses, and I felt more like a third-year medical student than an experienced attending physician in an ER. Of course, a patient with chest pain was the worst. I was afraid I’d telegraph my insecurity, so I tried to modulate my voice to a calm and confident register.
It took a month or so, but eventually I could introduce myself without the hollow, queasy fear that I might fail a person who trusted me. I could do it, but as I finished each shift, I was anxious and jittery.
At home I tried not to think about Mr. Kelly, or to wonder about the other mistakes I might have made but hadn’t yet heard about. One weekday morning I slept late, then padded downstairs to the kitchen, grateful for a few days off to recuperate after working four late evening shifts in a row. It’s hard to work in an urban ER for more than three or four days in a row because the pace is so intense. You can get overloaded to the point that you’re caring less, which makes you more likely to make a mistake. For the previous four nights the paramedics had been banging away at us non-stop, bringing in patient after patient. Our waiting room and hallways had remained full of bored, tired, angry people.
I needed a break.
Sally sat at the table, leafing through the newspaper. She leaned forward to give me a hug around the hips. “Coffee?” she asked, as she got a mug from the cabinet.
“Yes, please.” I was glad to have four days off coming up, and hoped to let the tension drain out of my system so I could enjoy them.
“Where are the kids?” I asked.
“Watching Sesame Street.” Sally set a steaming mug of coffee in front of me. “I’m glad you could sleep late.” She added a small dollop of milk.
I took a sip. “Me too.” I yawned, and looked at the clock radio on the kitchen counter—10:17. I’d left work about midnight and had finally gotten to sleep by two. I counted on my fingers—I’d gotten eight solid hours of sleep. I yawned again, looking forward to a day of hanging around the house without anything pressing to do. No one calling my name on the squawking overhead speakers, or having a seizure in room 6. No impatient family members standing in the hallway glaring at me.
I could read, doze off, wake up, then read some more. Or I could stretch out in bed for a real nap, or maybe fish on the banks of the Eno River with a cane pole and a bunch of worms. I’d been holding the stress in tightly, careful not to blow up at anyone. Now I could let the sun bake it out of me, and let the tension slowly release into the warm spring air.
“Cereal?” Sally asked.
“I’ll get some in a minute,” I said. I read Doonesbury, Blondie, and Peanuts, mindfully skipping Garfield and the other comics that irritated me. After working in ERs for several years, I was finally getting the hang of dealing with stress. All I had to do was keep my guard up and clamp down on my emotions until I got the chance to decompress. Then I could let the pressure out slowly, like easing open a bleed-off valve on an air compressor. That morning was a perfect example.
I took the editorial page to the bathroom and gave myself a little diagnostic test. Could I read the letters to the editor without getting irritated? I scanned the hostile letters from my fellow Durham citizens without a single beat of vexation.
After washing my hands, I started back to the kitchen for a bowl of cereal, enjoying the coolness of the linoleum floor on my bare feet. The door to the kitchen was closed. I turned the doorknob, expecting to walk right through. Instead, I stubbed my toe against the door because it wouldn’t open. Damn. Previous owners had attached a barrel bolt to the door leading from our kitchen to the mudroom, half-bath, and laundry room. They’d also drilled a quarter-inch hole into the trim of the doorframe, into which the barrel bolt could slide. The barrel bolt must’ve been engaged. Must’ve been Sarah, playing during a break from her TV show. I let go of my foot and knocked on the door. “Sally?”
No answer.
I knocked again. “Sally?” A little louder.
I considered going out the back door and coming back in the front door, but I didn’t feel like hopping barefoot through the dew-soaked grass. “Sally?” Why had she just wandered off after letting Sarah lock the door?
I grabbed the doorknob and rattled the door.
I felt a hot flush of anger. I shook the door harder. Fuck this. I smacked my shoulder against the door and popped it open. A chunk of doorframe as long as my hand went spinning into the kitchen, torn loose by the engaged barrel bolt. There. Door open, problem solved.
My heart was beating hard. My vision was clearer, sharper than before. The kids’ cereal bowls stacked next to the sink, the morning sun’s shadows in the folds of the curtains, the fine shards of wood scattered around the larger piece on the floor, all stood out in clear and sharp relief.
I listened for Sally, but heard nothing. Must’ve gone upstairs. I bent over to examine the damage to the doorframe, feeling a flush of shame. Flecks of white paint had splintered off, revealing the barn red enamel I’d painted over when we moved in. I picked up the long, jagged piece of wood and placed it on the kitchen counter.
My hand shook as I poured my cereal and milk. I leafed through the grocery store ads. I turned and looked at the doorframe, then back to my cereal.
Sally walked through the kitchen with a laundry basket of whites. She stopped at the splintered jamb. “What happened?” Her voice sounded concerned, the way it did when John had limped into the house with a skinned knee, or Sarah ran toward her after a bee sting. She set the laundry basket on the floor and leaned over, lightly running her fingers across the doorframe.
“Door was locked.”
She stared at me, then at the splinters at her feet, then back at me.
“I must be feeling more stress than I thought.” I looked down at my toe. “Sorry.”
“Paul,” she said. “You need to do something.”
“Soon as I finish breakfast.” I looked up. “A little wood glue, a few brads…” I knew she wasn’t talking about the doorframe. She wanted me to get therapy. She was a psychiatric nurse, and her father had been a psychiatrist. She thought everyone needed therapy.
She paused.
“Some sandpaper, a little paint.”
“Okay.” Her tone said she knew I’d purposefully misunderstood her, but she wasn’t going to argue about it again. Sally carried a basketful of dirty clothes into the laundry room.
The initial step of patching the door took twenty minutes. The splintered ends of the large piece meshed perfectly with the broken edges of the doorframe. I was afraid that the wood might split along the grain, so I drilled tiny little holes for each skinny little brad, before I tapped each one gently home. The smaller splinters held with wood glue alone.
As soon as the glue dried, I sanded the patch job, and puttied the remaining cracks smooth. That afternoon I sat in the sun, reading Wallace Stegner’s The Angle of Repose. Midafternoon, I sanded again, and brushed on some thirty-minute primer, then painted over it.
As soon as the paint was dry, the damage was almost invisible under the doorframe’s smooth and shiny surface.