He lounged on a gurney in the dim corridor. He felt cozy, sheltered. One leg draped over the side, propped up on one elbow, he eyed his world. There was just enough light to see, not like days when everything was so lit up. Not a soul. Empty desk, empty schedule board down at the other end. Pity he hadn’t brought some homework. He’d thought it might be too pushy on his first night but it clearly wouldn’t have mattered to anyone. The others were all squirreled away somewhere doing whatever. He’d been right about that anyway, about having time to study. Working full-time days he could only take night classes at the high school. With this gig he could actually attend the university, be a real college student. So that was good. He worried, however, that if something didn’t happen he wouldn’t be able to prove himself and he might not get the shift. Nice, he thought. Wanting some poor soul to have a catastrophe so he could do this thing. Well, shit happens, right? Might as well happen tonight as some other time.
Truth be told, he was a tad concerned about being the only tech in the suite. Sure, he’d done fine days and he wouldn’t be here now if they didn’t think he was up to it. Still, nights were hard-core. Gunshots, stabbings, accidents. Not that he hadn’t seen any of that working days. He’d done a gunshot once. Helped find the holes in a woman whose husband hadn’t liked dinner. 22’s. Little puckered holes going in, little mushroomy holes coming out. Trick was finding which entries went with which exits. Just 22’s though. No 38’s or 45’s. No stabbings either. Not even a gory car crash. He figured he was up for it but you never knew. His very first case a few months back had been dicey. Old lady. Shit herself, blood on the table and floor, died. He had to get the corpse off the table. Nearly barfed.
Funny how different everything was. No one bustling from room to room, no confab down by the desk, the stretchers all neatly lining the walls, empty of patients awaiting D&C’s, tonsillectomies, all the routine stuff. Yeah, this was good, he wanted this.
That’s when the phone rang.
Ring-ring, ring-ring.
It rang in sets of two for some reason. He sat up as Nurse Adams popped out of one of the rooms at that end of the corridor and answered the phone. She didn’t say much, just listened, said “okay” a couple times. He slid off the stretcher when she tapped the shiny little bell on the desk twice with her palm. That meant “nurse to the desk” and brought Tony from the room he’d been hiding in. Nurse Adams held the phone aside to speak to Tony who then turned and headed for the Equipment Room. Nurse Adams hung up the phone and looked up the hallway.
“Ben,” she called. “Go up to room 729 and get us a Mr Fred Pender.”
Ben grabbed his stretcher, rammed it through the swinging doors of the suite and headed for the elevators. Busted stitches, he thought as he pressed the “UP” button. Guy’s an inpatient so he wasn’t shot, stabbed, or run over. Hadn’t fallen off a ladder or had a heart attack, nothing that would have routed him through ER. Unscheduled too. Probably pushed too hard taking a dump and popped his stitches. Just wheel him and sew him back up. Piece of cake.
In room 729 a mousy woman held one of the patient’s hands in both of hers. Ratty coat, battered purse hanging off one arm, one of those pill box hats that looked like she was balancing a small chocolate cake on the top of her head. Sticking out of it on the end of a wire, so that it wobbled with every move, was a fake flower that looked like a dead fake flower. Seeing Ben’s scrubs and the mask hung round his neck, she said, “Here’s the doc now Fred. Everything’s gonna be alright now. Ain’t that right doc?”
Ben smiled and slid the stretcher against the bed.
“Sure,” he said to the patient. “Everything’s gonna be fine.”
The missus looked surprised at this while the patient acted like he wasn’t even there. Shook up, Ben figured. You’d expect that with busted stitches. Folks don’t like for anything to go wrong.
“Nothing to it,” he said.
“There,” the woman said. “Ya see?”
Ben braced the stretcher against the bed with his belly.
“All right now Mr. Pender. Can you slide onto the stretcher for me?”
Mr. Pender flung back his blanket and tried to comply but his left leg had recently been amputated just above the knee and his bandaged stump danced feebly in the air.
“Here,” Ben said. “Let me give you a hand.”
Ben helped the man onto the stretcher, covered him with a sheet, strapped him in and raised the headrest. Then he turned to the woman.
“If you come with us, Mrs. Pender, I can show you the waiting room.”
Not stitches after all, Ben thought as he wheeled his patient down the hall. The stump hadn’t been unwrapped, so no one knew if the stitches were busted or not. At the elevator he pressed the “DOWN” button and thought about the first time he’d seen a boneman sawing off a leg, and how the body under the drapesheet rocked back and forth with the motion of the saw. Bonemen made you think twice about surgery being all fine and delicate, what with their hammering and sawing and banging away with chisels and drills like a bunch of carpenters. He thought too about the arms and legs he’d carted off in heavy paper bags to be burned in the incinerator in the basement. Not like you could take your leg home as a souvenir, like it was a tooth. When the door opened he let Mrs. Pender in first, noticing she now held her purse in both hands, with a grip that made her knuckles white. Her husband, on the other hand, hadn’t once moaned or groaned or even fidgeted. Whatever the problem, it didn’t cause pain. Ben smiled at the missus. How serious could it be?
With the door closed he thought about what he’d do. Apply a tourniquet as far up the leg as he could get it. Make sure the air valve points down. Attach an armboard to the table and tape the patient’s arm to it so they could start the IV. Help drape the sterile sheets over the whole leg, under the stump. Remove the bandage and prep the leg. Hold it up with one hand, scrub with the other. Make himself scarce until it’s over, then get the guy off the table and into Recovery. Nothing he hadn’t done before. Ben looked at Mrs. Pender as the door opened and nodded toward the waiting room.
“You can wait in there Ma’am. And don’t worry, everything’s okay.”
He paused at the threshold of room eight to tie on his mask and let his eyes adjust to the glare of the overhead lamp. A nurse named Margaret stood across the table in the middle of the room. She was privately employed by Doctor Reese, the most finicky orthopedic surgeon in the hospital, so she was top-notch. As usual, she was in full sterile regalia, cap, mask, gown, gloved hands held up near her shoulders.
“Just put him on his back,” she said through her mask.
But when Ben had the stretcher alongside the table he was amazed to see her reach out to help. She actually touched the patient with her gloves and after they had the patient situated she stood with her hands below the level of the table.
Then Dr. Landis wheeled in his clanking cart of oxygen tanks, bottles, hoses and black balloon that expands and contracts with the patient’s breathing. He plopped down on the steel swivel stool at the head of the table and began to tinker with his paraphernalia.
He wasn’t wearing a mask.
Ben reached under the table, got an armboard.
“Which side do you want this on?” he asked.
Dr. Landis looked at Ben a few seconds before saying, “We won’t be needing an armboard this time.”
That’s when Tony rolled in a laundry basket and Ben realized this was a dirty op and there was something inside Fred Pender that was worse than what was outside Fred Pender. Caps, gowns, masks would be thrown into the basket before leaving so as not to let whatever it was out of the room. Tony stepped up to the table and said, “There won’t be any prep, Ben.”
Ben had never heard of an op with no prep, even a dirty one. Unsterile gloves, hands below the table, no mask, no armboard and now no prep. Hey, just do what you’re told, you’ll be fine.
Dr. Landis caught Ben’s eye and, standing up, motioned toward the door. Ben followed him into the hall where he turned and looked at Ben.
“Ben, ” he said. “I can’t give that man any anaesthesia because of what he’s got. You and Tony and I will have to hold him down. Will you be all right?”
Ben had held a man down before. Right across the hall. The man had been gagging and choking and spouting phlegm from the little red hole at the bottom of his neck because Dr. Katzenberry was stuffing a bronchoscope down his throat. It hadn’t been fun but Ben had managed.
“I’ll manage,” he said.
Dr. Landis patted Ben on the shoulder. “Fine,” he said.
Ben followed him back into the room where they found Doctor Reese waiting for them. Ben was one of the few orderlies Doctor Reese would allow in his room. Ben had never contaminated anything or anyone, never washed a patient with benzoin instead of Phisohex, never applied a tourniquet upside down or on the wrong limb. Doctor Reese showed his approval by never looking at Ben much less saying anything to him. Which was fine with Ben. If Doctor Reese talked to you it wasn’t gonna be pleasant.
Like Margaret, the surgeon was gloved and gowned but also had his hands at his sides. His eyes slid over his mask from Dr. Landis to Ben, then back to Dr. Landis.
“Okay Tom?” he said.
Tom Landis sat down and barely nodded.
Fred Pender’s bandage was gone. The skin on the swollen stump shone reddish purple. Doctor Reese glanced over his shoulder at Tony and Margaret, then stepped up to the table right across from Ben.
“Well,” he said. “I guess we better get started.”
Tom Landis stood up at the head of the table and Tony moved around to the foot. The surgeon reached back toward Margaret and when he turned around again there was a gleaming scalpel in his hand.
Fred Pender shuddered, eyes wide on that scalpel.
Tom Landis pinned the patient’s shoulders to the table and Tony grabbed his ankle. Margaret appeared across from Ben as Doctor Reese slid down to the stump. She pinned Fred Pender’s one arm to his side, so Ben pinned the other.
Fred Pender’s body tensed and he moaned deep in his chest. His stump jigged frantically. Doctor Reese tucked it under one arm and cut a deep gash the entire length of it. Fred Pender screamed and fought to get free. Methodically the surgeon made a second gash, then a third and a fourth. Fred Pender shrieked over and over again. Halfway through one shriek he would start another. He bucked and squirmed but it was oh so easy to hold him.
Ben stared at the four parallel streaks in Fred Pender’s jumping thigh. There was no blood, not one drop. Beneath the purple skin was a gray-green ooze that reeked and gurgled contentedly. Ben began to gag. Fred Pender subsided.
“He’s passed out,” said Tom Landis to Doctor Reese.
“For how long?”
“Can’t say.”
“We’re not getting anywhere with this. We’ll have to go higher.”
Tom Landis nodded and Doctor Reese looked at Ben.
“You gonna be okay?” he asked.
“Yeah,” Ben said. “I’m okay.”
“All right then. Let’s go.”
Doctor Reese bent down and slowly slashed Fred Pender from the middle of his groin to his hip. Fred Pender stiffened and arched his back. His stump, no longer held by the surgeon, fluttered impotently. The arm Ben had pinned jerked and twitched. Mr. Pender gasped, four times, staccato, taking in more air each time, air that fuelled a long nails-on-the-chalkboard shriek that knifed into Ben and, like a tolling bell, jangled the silence for several moments after the patient again passed out.
Ben looked up at Doctor Reese who was splashing clear hydrogen peroxide from a brown bottle onto some white lap rags which he then poked into the gashes he’d made in Fred Pender. The corners of the lap rags stuck up out of the slits in Fred Pender’s stump like so many Cary Grant pocket handkerchiefs. Fred Pender groaned and his head rolled from side to side. Doctor Reese stepped back from the table. His shoulders sagged and he glanced at Tom Landis. To Margaret, he said, “Better get us a bed from Recovery.”
Margaret made a “come in” sign at the door behind Ben.
Turning, Ben saw Nurse Adams’ window-framed head nod once and disappear. The door opened and a Recovery Room bed was pushed in. Ben rolled it alongside the table, then watched as Tony and Margaret wrapped Fred Pender’s stump and abdomen with clean white gauze. They didn’t suture his wounds or remove the lap rags. When they had finished, everyone but Doctor Reese helped lay Fred Pender on the bed.
Doctor Reese was gone.
Tony and Margaret wheeled Fred Pender to Recovery and Tom Landis rolled away his cart. Ben tossed his cap and mask into the laundry basket and went into the hall where Nurse Adams was waiting.
“You okay?” she asked.
“Sure,” he said. “What the hell was that anyway?”
“Gas gangrene.”
“Gas gangrene?”
“Yeah. See how it bubbled? Like it was carbonated?”
“Oh”.
Nurse Adams grinned.
“Well, you better go change. That was a dirty op you know.”
Bound for the men’s locker room Ben ran straight into Mrs. Pender who had strayed from the waiting room. Her ratty coat was gone, but she still wore the silly hat. Before Ben could retreat she rushed him.
“Doctor, is he alright?”
Ben started to edge around her.
“Actually,” he said, “I’m not a doctor, just an orderly. Doctor Reese should be out shortly.”
Mrs. Pender grabbed Ben’s arm.
“But he’s okay, right?”
“I’m sorry, ma’am, I couldn’t say. Doctor Reese will be here soon.”
As he ducked into the locker room he looked over his shoulder at Mrs. Pender one last time. She suddenly caught her breath and raised one hand to her mouth.
The dressing room was dark and narrow. Small table flanked by two chairs on one wall, row of lockers on the other. With the overhead off the only light came from the tiny adjoining lavatory. Ben sat in the chair farthest from the door and pondered the situation. What a way to break in. He didn’t suppose ops could get much rougher but he’d handled himself well, and for Doctor Reese no less.
Just then the door opened and Tony stepped into the room. He dropped into the other chair and shoved the door closed with his foot. After a moment he said, “Mind if I turn on the light?”
“Help yourself.”
Ben saw that Tony was worked up, but then Tony was always pissed about something. Tony was not one of Ben’s favorites, too much chip on the shoulder, too much sneering. Tony was trying to get into med school and Ben kind of hoped he wouldn’t make it. Just didn’t seem like he’d be a good doctor.
Tony glanced at Ben. “So, what did you think of that?”
“Of what? The operation?”
“No. The brass band in the hallway.”
“Well, I guess it was pretty rough.”
Tony snorted.
“More like disgusting,” he said, then stood up and dialed the combination on his lock.
Ben stared at Tony’s back. “Yeah,” he said. “Thought I was gonna upchuck for a minute there.”
Tony banged open his locker door, got a new set of scrubs, sat down, pulled off his pants.
“Not talking about the op,” he said. “I’m talking about Reese.”
“Yeah? How come?”
Tony stood, pulling up the new pants.
“Know what that was?”
“Sure, gas gangrene.”
Tony stopped tying the drawstring and looked at Ben.
Got him that time, Ben thought.
“What else do you know about it?”, said Tony.
Ben shrugged.
Tony sat down, thought for a moment then leaned across the table. “Know what anaerobic means?”
Oh boy, Ben thought. Professor Tony. “No,” he said.
“It means without oxygen. Your cells need oxygen and they get it from your blood. When the blood stops flowing, that’s anaerobic.”
“So?”
“So the germ that causes gas gangrene is anaerobic.”
“Ah,” said Ben, starting to get up to leave.
“Blood flow is stopped by a tourniquet.”
Ben sat back down and looked at Tony. After a moment he said, “Are you saying Mr. Pender got gas gangrene in the OR? From the tourniquet?”
“Yep.”
“All limb ops get a tourniquet. How come everybody doesn’t get gangrene?”
“Depends how long the tourniquet is on.”
“And Mr. Pender’s was on too long?”
“Apparently.”
“Why? Something go wrong?”
“Beats me. I wasn’t there.”
“So, what’s the problem? Chances are it wasn’t Doctor Reese’s fault at all.”
“Who said it was? Could have been a lot of things that weren’t Reese’s fault, but that’s not the point.”
“What is the point?”
“The point is, the man’s operation was three days ago. If they got him down here sooner they could have stopped it. Instead…”
Ben looked down, saw a black spot on the floor. Was that gum? Stepped on so many times it turned black? Was it still pink inside? He looked at Tony who was wrestling with his top, trying to get his arms through the sleeves.
“What took so long?”
Tony’s head popped out of his shirt.
“Ah,” he said. “They didn’t get him down here sooner because they didn’t know he had gangrene, and they didn’t know he had gangrene because no one looked.”
Ben said nothing. Tony continued.
“You have to look for it. Only symptom is the skin so someone has to go look. Remove the bandage and look.”
Ben recalled the bandage on Mr. Pender’s leg, the bandage that had not been removed.
“And who’s supposed to do that?” he asked.
Tony shrugged, sat down to tie his shoes. “Someone. Someone’s supposed to do it. The floor nurses, Margaret, maybe even Dr. God himself. Does it matter? Whose patient is it? Where do you figure the buck stops? It was up to Reese to see that it was done and it wasn’t.”
Ben stared at the flattened wad of black gum. After a minute, he said, “And they didn’t find out till tonight.”
Tony straightened up.
“Yeah, when he went into shock.”
Ben remembered how Mr. Pender had looked in Room 729, how he didn’t react to anything, like none of this had anything to do with him. He rubbed the back of his head, glanced at Tony who was now changed and just sitting there.
“So,” Ben said. “What’s next?”
Tony looked at Ben.
“What do you think is next?”
Ben shrugged.
“Next, the guy dies. That’s what’s next.”
Ben stared.
“Then what was this op for? What’s with the peroxide?”
Tony jumped to his feet, started to close his locker, stopped, sat back down.
“What a joke,” he said. “He was trying to oxygenate the stump. Can you believe that? Oxygenate what? There was nothing left, no muscle, no blood vessels, no nothing. Kaput. But that’s just BS anyway. Reese knew the guy was dead long before you wheeled him in.”
“Then why the op?” Ben asked.
Tony looked at Ben a moment. “Where do you think Reese is right now?” But before Ben could answer he said, “I’ll tell you where he is. He’s with the widow, some middle-aged frump with curlers in her hair. A couple hours ago she was home watching soaps, maybe even one of those hospital ones, and now Reese is telling her, hey, these things happen. I’m so sorry. Act of God, one in a thousand, no one knows why. We did everything we could, we fought it to the end.”
Tony stood up, rummaged in his locker. Watching him Ben said, “Hat.”
Tony looked over his shoulder.
“What?”
“Not curlers,” Ben said. “She’s wearing a hat.”
Tony turned back to his locker.
“Well,” he said. “That makes all the difference.”
A few seconds later Ben asked, “Why no anesthesia?”
Tony laughed. “Good question,” he said. “The gas passer didn’t want him to croak from the drugs. He was willing to hold him down, but not to be the COD.”
He slammed his locker shut, making more noise than necessary, spun the lock, took one last look at Ben and left. Ben stared at the closed door and squinted, the light suddenly seemed too bright.
Back in the suite, the hall lights were on and Nurse Adams sat at the desk laboring over a crossword puzzle. Ben looked around. No Tony. Good.
“Say,” he said. “What did you call that stuff again?”
Head down, Nurse Adams said, “Gas gangrene.”
“Nasty stuff.”
“Mmm.”
“How long did he have it, do you know?”
Nurse Adams erased a word, shrugged.
Ben leaned against the desk, shook his head. “Man, the stuff some folks put up with. I saw this woman once, room 12 I think, had this big knob sticking out of her belly, right at the navel. Looked like a shrunken head. The setup nurse told me it was an umbilical hernia and the woman had it since 1948. Eighteen years! Imagine not going to the doctor with something the size of a softball sticking out of your stomach.”
Nurse Adams looked up. It seemed to Ben like she was trying to remember who he was.
“You don’t happen to know a three letter word for ‘Giant of old’, do you?”
“Well. There was a guy used to play for the Giants. Try o-t-t.”
“Hey,” she said. “Looks good!”
“Another time,” Ben said, “I prepped this old guy, real string bean, had a staph infection in his crotch for God knows how long. Ate his business clean away.”
Nurse Adams cocked her head at Ben and waggled her pencil.
“Anyway,” Ben said. “Think how long this guy must have had gangrene for it to creep all the way up his leg like that.”
“Oh no dear,” Nurse Adams said. “Gangrene’s quick. Only takes a few days.”
“Wow, no kidding?”
“No kidding.”
Ben scratched his head.
Nurse Adams bent over her puzzle.
“Hey,” said Ben. “Kinda weird, but the patient didn’t seem in any pain when I brought him down. Doesn’t that stuff hurt? Don’t you have a fever or something?”
Nurse Adams shrugged.
“You’d think so, but no, you don’t feel a thing. Why?”
Ben looked at the clock. “Hey,” he said. “Break time.”
White. They wear white in the cafeteria. Cooks, servers, cashiers, all of them. Even white shoes. 9:15. Empty. Chairs all pushed in. Just the cashier. Granny on her stool gazing at her hands in her lap. Thinking old lady thoughts. Grandkids, birthdays, cookies. Brownies for the kids, Hershey bar on the bottom of the pan. Who wouldn’t like that? Christ, this coffee’s hot. Did she have beaux back in the day? Did she marry the right one? I did okay. Adams smiled, Reese and Landis know me now, daytime classes. Take some French maybe, coeds. But holy shit. Would you look at that water? Really coming down. This whole damn wall is made of glass, tiny streams, all distorted. Barely see out there, dark trees swaying. Wind. What a mess. What a fucking mess. What happens? Shock. Does it show on some monitor at the station? Did the floor nurse see something, hear a beep? Or just making rounds? What did he look like? Blank? No answer? How’s it going Mr Pender? Nothing. She looks closer, uh oh. Or was the Mrs there? No, just threw on something and rushed out, probably was there earlier, when everything was jake. Then home for the night, some TV. Get the resident, resident sees the purple abdomen. Uh oh is right. Bad shit. Who’s the doc? Calls Reese. Ball’s in your court now, big shot. He calls Margaret, bitches at her. Her fault? Was she supposed to check? Landis. They all meet in the room. Missus there yet? Who called her? Floor nurse? Call his wife, the resident said. Did she beat them there? Did she see them sweat? Did she hear Landis say no anesthesia? No, that’s somewhere else, just Reese and Landis, Reese pushing Landis to kill the guy, Landis uh-uh buddy, no can do. Why did Landis bring all his gear? Only used his hands. Why did Margaret scrub in? Patient wasn’t the only one in shock. They went through the motions as long as they could, until they had to drop the pretense and face the music. Shit. What did Mr P know? Did he know what they were going to do? And how? It’s your only chance Fred. It sucks, but if you don’t wanna die… What did Reese tell him? What did he tell her? What words did he use? Did she see they were shitting bricks? And then who shows up? Young Doctor Everything’s Okay. Not to worry. We do this shit all the time. Some fucking doctor. Doctor Head Up His Ass. Gotta stop that doctor shit. I’m just an orderly, ma’am. I don’t know squat. Fuck. Adams doing a fucking crossword puzzle. Crusty bird, seen it all, leave it at work. Tough are the soles that tread the knife’s edge. Margaret, her lord and master. Reese doing her? Could if he wanted. The great Reese, all those patients, all that great surgery. Her job to keep him happy. Whatever it takes. Was it her fault? He gonna can her? Bitch her out big time? But he doesn’t want to replace her, especially if he’s getting benefits. She is a bit of a looker, hard to replace that. Landis, Reese his biggest client? Big enough. Help ya out buddy, but no thanks on the COD. Got something on Reese now, too, locked in client. All good, they’ll live. Tony? Just a little… Wait. That’s her down there. What’s she doing? Soaked. Just standing there get rained on. Staring. There goes the hat! Didn’t even notice. Bouncing in the wind, into a puddle. Dead flower’s really dead now. Drowned. Just standing there. Not even a glance. Ah, here’s the bus. She was waiting. No car? Can’t drive? What is that sound buses make when they stop, metal beast gasping, pneumatic brakes or something? Can’t see her now, just the bus. Driver leaning over. Back again. Getting up. Nothing. Back now. There he goes. Shit. She’s still standing there. She didn’t get on. Just stood there in the rain. Door’s open, she doesn’t get on. Are you okay ma’am? No reaction. That’s when he got up, went to her. Still nothing, finally had to leave, on a schedule after all, can’t be late for a very important date. Tony! He’s wet too. Leading her? Ah, the overhang, the bench. Talking. Staring at him now. He’s got her purse! Up! To the window! The glass cool on my hands and forehead. Rummaging, he’s got her wallet! What the fuck? Ah, just looking. All back together again. Took nothing, not that she would have noticed. I see, a cab. All yellow. How’d he get here? Tony must have called, even before the bus. Now has to know where to. There they go, he’s putting her in, telling the driver where to go. Watching her leave. Me! He’s looking up at me!
He steps back from the window, turns around. The granny in white is gone, and he’s alone.
