Kate McDevitt
I hovered in the doorway to George Washington Hospital room 342 for a moment. The room had seen many changes in the last day. First a miraculous birth given to a family who had lost so many of late. The whole Galich family all piled in to see their new little ray of hope. Then mixed emotions when my own beautiful Natasha announced to her family that she and I were engaged but that I had been called to serve this Friday. Things seemed to only get worse from there when the baby’s health suddenly deteriorated.
It was late in the evening, and visiting hours were just about over. My Natasha stood in a compassionate embrace with her brother Edward, the baby’s father. After blowing a kiss to her new little nephew, she headed out, stopping off with me on the way. “Any news, Lawrence, Sweetie?”
I shook my head. I was in charge of baby Michael’s case for the time being. Nervously, I fingered my stethoscope, a habit of mine. Natasha had given it to me as a present when I first became a doctor, and even had my initials L.A. engraved in the little metal disk. I fidgeted with it many times when I needed emotional support; it would probably be coming with me to Vietnam. “I’ll be working late tonight…”
She, sweet and supportive, gave a nod. “I’ll put the key under the mat when I go to bed.” Her brown eyes twinkled at me. “Unless you wouldn’t care to spend the night—“
“I’ll be there,” I quickly replied, keeping my voice low still so as not to disturb those in the room. “Yours is the only bed I want.” I kissed her cheek, then her lips, my hand running up and down her arm. Then I helped her on with her winter jacket and saw her to the elevator before heading back to the room.
The baby’s mother, Lilly was inside, wearing a hospital gown and awkwardly sleeping in the chair. Edward hovered over the incubator, biting at his fingernails one by one. And little baby Michael lay sleeping to the sound of a beeping heart monitor and a whirring oxygen tank. So tiny, so helpless— so sick. And here I was a doctor who couldn’t do anything for him. But the truth was, I was having trouble concentrating. How would I ever survive the jungles of Vietnam, amputating limbs and picking shrapnel from wounds when I couldn’t even heal my own nephew-to-be?
With a deep breath, I entered, standing beside Edward, beside Michael. How in the world would I start? This was why doctors shouldn’t get involved with their patients. But I was there with Natasha that morning visiting when the baby’s breathing had stopped. Pure, utter terror as I resuscitated and rushed him to critical care. Edward and Lilly pleaded for me to save him; now here he was on machines. And all the while, my mind on the war. Damn the draft. Damn it all.
“The tests came back, Dr. Anderson?” he asked suddenly, nervously, hopefully. When Nat and I ate dinner at his house with Lilly he always called me Lawrence.
“Yes they did. I can’t rule out much from the results. I’m afraid all we can do tonight is wait and watch. Maybe a solution will present itself in the morning.” It was going to be a long night of waiting, though I didn’t intend to sleep at all. How could I sleep when in less than four days I’d be on a plane to Vietnam? How could I sleep when I had less than four days to memorize everything about Natasha? The sound of her breathing, the smell of her hair, the curves of her body.
His rebuttal sounded angry and shot at me like a sniper from the bushes, “But we’ve been waiting all day—“
“Eddy,” I cut him off. Anger would solve nothing. Just what this war was solving: nothing. What we needed was peace, love. What we needed was to be strong for Michael. I put my hand on his shoulder to comfort him, the only thing I could do. But Edward would have none of it and angrily he pulled away from me. I sighed and in vein, I began restating the situation. “He has an irregular heartbeat, his lungs are struggling for air from his congestion, and his fever’s still rising. We gave him some more aspirin but it’s not helping yet—“
“I know!” This time, he cut me off. He certainly had a right to be so scared, so worried. “I know what his symptoms are,” he spat at me, wounding my honor as a doctor. “Now I want him to feel better!” With the desperation and anger behind the words, I knew that in all his worry about his son’s death, he’d forgotten mine.
Fate had picked me up and was whisking me away to serve a government I disagreed with, to save the lives of people I had never known in a country I had never seen for a purpose I could never understand. Fate had brought a beautiful baby to a family that needed hope. Fate had put the baby’s life in danger and I couldn’t save him… all I would be allowed to do was to abandon him. I couldn’t save baby Michael, and I couldn’t save myself.
I put my hand on his shoulder once more, and this time he invited it, covering it up with his own. Softly, I answered, “That is all I would ask for.” I was a doctor above all else. My life was devoted to my patients. My life was devoted to my calling. And that would be my end as well.
* * *
The doctor’s shift had barely begun on the first night of the last decade of the twentieth century when an ambulance pulled up to the ER and unloaded a patient for him. “A John Doe,” the paramedic began as they moved him through the halls on the transport stretcher. “Found freezing on a heating grate a few blocks from here. Someone saw him stumble, fall, hit his head on the ground. Bleeding stopped,” Michael’s hand held a mass of gauze over the wound. “BAC is 0.16, body temp is only ninety point eight.” Exam two was open, and the patient was moved over to the table quickly but gently.
The hypothermia patient’s clothes were filthy and being cut away by two techs as was standard procedure. What was left was a middle-aged, dirty, skin-and-bones man with blue skin, a nasty head laceration, and a strong stench of liquor. Dr.Galich leaned over him, pulling the eyelids up and shining a light into the eyes. “Pupils are dilated.” He felt and found for the man’s pulse, faint but there. He ordered, “Start him on a warm fluids IV, bring the heating packs and a blanket. Then order blood gases and get a hematocrit.” He knew lab tests were misleading with hypothermia patients, but it was standard procedure in any case. Pulling back the gauze, he examined the cut. “Cross-match him, he’ll need blood for that cut once he stabilizes but not until then. Stitch him up carefully, Elizabeth.”
“Yes, Dr.Galich.”
Michael nodded, the comment filtering in through the background in a far second to the beeps and hums of the monitors. He was starting to recover. Breathing was shallow, heartbeat slow, but both were on the rise. Without taking his eyes from the stats he asked, “Any idea who this guy is?”
“No ID on his person,” a tech reported, dropping the torn fatigues into a trash bag. “Just a label on his jacket which reads ‘L.A.’”
“Los Angeles?” Michael asked. The man’s temperature rose a notch on the monitor— was that a sign? What was a homeless bum from Los Angeles doing on the streets of DC in the middle of the winter night? Michael signed a chart and handed it off, muttering, “Keep him monitored and page me the moment he regains consciousness.”
That particular moment did not present itself until the middle of Dr.Galich’s shift. He was working double rotations in the ER, through the night and then into the next day with only a three hour break in between which he planned on spending reading the latest medical journals. It was never a chore to keep up with the disciplines he was interested in, but the medical field was so broad and he knew the board would do their best to make sure he knew everything when they interviewed him for chief resident. And during every break he always paid a visit to a certain little friend in the children’s ward. No matter what his condition, those visits always made him feel better.
He felt the vibe of the pager and headed over to the desk. After checking the board and picking up the appropriate file, he found himself again with the John Doe, this time in curtain four.
“You don’t understand!” the patient protested, not simply alert but now struggling in bed. “There will be more every day the war continues. It’s got to stop!”
Two techs held him down as they fastened on restraints. Young med student Elizabeth did her best to reason with the man. “If you’ll just give us your name we’ll do our best to help. You’re safe here with us at the hospital.”
“Hospitals aren’t safe!” he rambled, his eyes looking past them all. “Guns, blood. So many hurting. Can’t save them all. So many dead. It’s war.” He looked and sounded delirious, but the numbers Michael read off the blood work indicated no such condition.
“Hello, I’m Dr.Galich.” Michael stepped in, clearing his voice, straightening his jacket to look slightly more official. “There is no war right now, Sir.”
Making eye contact for the first time, the man looked right at Michael with concentration. “There is always a war, Son. Remember that.” Then the man’s expression lightened with what could have been mistaken for shock. It was a peculiar look he gave his doctor, the kind of look you give a person who looks terribly familiar though you’re certain you’ve never seen him before.
Uneasy, Michael stepped back. “Just relax, Sir. We’ll take care of you. You’ll be sober and cleaned up and have a warm bed to sleep in tonight, ok?”
The man shook his head. “Snipers get you when you’re asleep. There’s only one warm bed I want to sleep in, Son, and this isn’t it.” He lay still, closing his eyes just the same.
“Is there anyone we can call for you, Sir? Family, loved ones, people who know you?”
He shook his head. “No one is the same now. Nothing is the same, not even the hospital.”
Michael tried again. “Sir, you mentioned a bed. If there’s somewhere you stay—“
Snappishly, “There’s nobody to call, Son. I shouldn’t be here anyway. I was supposed to have died.”
Michael had taken a few psych classes, but certainly wasn’t a psychiatrist and didn’t know what to say. But he was a doctor, above all else. “Well, for right know you’re my patient and I’ll make sure you get warmed and get better.”
The man, eyes closed, made no reply.
Michael stepped out of the area, beckoning, “Beth?” The med student followed him out. “Call psych for a consult. We’ll release him to them as soon as his vitals are stable.” Michael rubbed the back of his neck with a sweaty palm. “He seems to be a Vietnam Veteran. Try calling the VA to see who picks up checks matching his description. And ask if there’s anyone around here originally from Los Angeles.” She nodded. Psych was usually understaffed, especially at the beginning of a new year. This man seemed in need of serious help… but there was something more that Michael just couldn’t quite place.
* * * * *
I was getting nowhere in all of this. For as many books as I poured through, no solution presented itself. And worst of all, my mind kept wandering. To the war, and my service. Then to Natasha and her family. Then back to the baby again, of course. He was my patient and it was up to me to help him get better. But there were no solutions. Only confusion.
“More coffee?”
I looked up to see one of the nurses of the maternity ward. She had a familiar face, and a kind smile, but I didn’t know her. “Yes please.” I was supposed to have gone home hours ago… but Natasha had understood, and encouraged me to stay; it was her nephew after all. So here I sat in the lounge, surrounded by books and journals, a phone by my side in case little Michael’s condition changed. Utter chaos and confusion, and in four days I’d leave all this for more destruction and disorder than I’d ever known.
Closing my eyes with a sigh, I saw the words rush through my head: Reye’s Syndrome. I didn’t want to believe it; there had to be another answer. Worried, I drifted off to sleep before I could stop myself.
I found
myself in a tunnel, long dark, uncomfortably stereotypical. The walls were
slick and damp, dripping, melting. When I cautiously reached out, my fingertips
touched slime and retracted immediately, instinctively. I hurried forward
toward the dim light at the end, pushed by some force. No will, no control.
Simple obedience and the single command to walk toward the light. Soft,
glowing… soothing light. The tunnel led, I found, into a room. The light I had
seen was a single light bulb, suspended from the ceiling on a chain; there
appeared to be no cord to turn it off. The room was sparse, the floor and walls
dark black and green splotches. But the most noticeable features of the room
were its two inhabitants. There was a crib in the center, just below the light
bulb, delicate, beautiful swirls and squiggles etched into the woodwork. Lying among blankets of camouflage pattern
was, of course, baby Michael. The crib stood between me and another man who
stood with his head down toward the crib’s contents, the thinning hair and
small bald spot facing me. I cleared my throat for attention, and the man did
not move. “Hello?” I asked, but it elicited no response from him. I felt the
need to move in, to pick up Michael and carry him away. Out of the room, out of
the tunnel.
Shapes on the walls began to move. Blobs of color became forms, the forms of men. Men bent over, sneaking around with rifles and large backpacks. Forms moving around on the walls, then coming out from the walls. Closing in on me, on the crib. Now more than ever I wanted to run, but I couldn’t leave without the baby. And I couldn’t move in any case. The guns got closer and closer, until the figures reached some invisible boundary and they fell over. But they didn’t just topple over gracefully. No, they fell squirming to the ground, clutching at their green and black heads, moaning. The moaning was soft at first, pained and convincing. It grew in volume as much as in strength, becoming a wretched, formless howling that echoed in the room and the hall behind me. I tried to reach out, I tried to help. But I was frozen, helpless. The man in the center of the room put his hands on the side of the crib, then turned his face to look up at me. It was Edward, tears running down his face. “Do something!” he pleaded, his tears forming a puddle on the floor.
But I could do nothing. I could not move, I could not reach out. No control, and the responsibility of it all. A trying, deadly combination. I could do nothing- I could neither help nor walk away. And I could not even decide which to do. I could only stand helpless in the midst with my feelings, baring the load. Alone and without control.
* * *
With questions about his John Doe patient stuck in the
back of his brain, Michael went about his rounds as usual. There was a man with
an arm broken in three places. There was a woman with appendicitis. Four people
were brought in from a car accident. Seven people came in complaining of the
flu, three of which only had food poisoning. There was a man who accidentally
cut his arm with a knife. There was a man who dropped a bowling ball on his
wife’s foot. And there was the sound of yelling followed by a gunshot.
Reactions were just what might be expected in a place
like D.C. People hit the ground, others screamed and ran from it. Michael,
however, pursued. Quickly, he followed sounds down the hall to the men’s
bathroom. There were several officers, a nurse, and another technician already
there, but that was not what drew Michael’s eye. There was a security guard on
the floor, unconscious but breathing, and his John Doe patient lying dead. The
word ‘dead’ did not convey the situation accurately. The body lay in a pool of
flesh blood on the white tiled floor, a result from a rather explosive shot
straight to the brain. They body had fallen, crumpling to the ground and
folding in on itself in a tangle of limbs. The man who said he should have died
in the war was dead now. There was no hope for Michael’s patient.
As the officers examined the body, Michael bent down and
helped move the unconscious guard to a gurney.
“Hey Michael, take a look at this,” one of the nurses
called attention to a small, empty syringe on the floor. “Looks like he didn’t
use force to knock the officer out.” She handed it over.
It was 5mg of Midazolam, an anesthetic drug. Michael
rolled up the officer’s sleeve, finding the penetration point and looking on in
amazement. The guard was taken out of the bathroom to be treated, vital signs
strong.
The nurse vocalized, “Injected, eased out, cleaned, and
bandaged with gauze. Who does that?”
Biting his lip. “A doctor, Gracie.” A doctor sent to war.
Every doctor’s worst fear came in losing a patient. But here was a man whose
purpose was saving lives, put down in the middle of death itself. No matter how
many he saved, there would always be more deaths. The body was put on a gurney
as well, surrounded by police officers. “Has someone called it?” No one spoke,
so he cleared his throat. “Time of death, twenty forty-three.” His mind was
filling with John Doe’s words, with images he did not want to deal with. “I’m
on a break. Have someone wake me up at 1am.”
“Yes, Doctor.”
With a strange chill, Michael headed to the lounge,
stopping to grab a few volumes of personnel from the medical library. There was
a veritable who’s who of doctors for the last twenty-five years on his lap, but
he didn’t make it past the third page before falling asleep on the couch.
He found himself walking down a short tunnel, the walls padded with thick pillows of velvet. Taking only minutes to reach the end, Michael found himself curiously entering room. Tall, bright lights stood in each of the four corners, and each light was obscured beautifully by falling snowflakes. The snow, as far as Michael could tell, was coming down right out of the ceiling itself. But the very first thing he noticed about the room was not the lights. Instead, it was the soft, squishy feel of the floor. It wasn’t all just snow, either. It was, however, blood. Not just traces or splashes but the whole floor covered in a layer a quarter inch thick. And it was warm, warm seeping through the sides of his soft-soled shoes, warm enough to melt the snow as it touched. Scattered about on the floor were broken pieces of wood, soaked in blood. To Michael, the pattern and pieces looked somewhat, oddly familiar.
He shuffled his feet over to inspect the wood more closely, and found broken glass littered about the floor as well, tiny pieces floating and spreading as they rode on the tiny waves. When he bent to pick a large piece of wood up, such a tiny shard scratched his palm, causing him to drop the wood to the ground with a splash. He recoiled, clutching his hand, applying pressure. But by then it was already too late.
* * * * *
Waking,
I rubbed my face with the flat of a palm, then scrubbed at each of my eyes in
turn with my thumb. With a yawn and a stretch from stiff joints, my eyes fell
again to the books and journals which lay practically uselessly at my disposal.
Nothing fit, nothing matched. And even though the last possible answer was
Reye’s Syndrome, somehow that didn’t seem to fit either. What could I possibly
have overlooked? There just weren’t that many childhood illnesses, and fewer
that could be contracted less than a day after birth. That was practically
unheard of. Tucking a book under my arm, I decided to take a walk and free my
mind so that I might better concentrate.
The hallways of the maternity ward were silent at this
time of night. Doors to rooms which were allowed to be closed were just that,
charts clipped to their fronts. Door-less rooms allowed a brief glance within,
usually giving a passerby a blur of white curtains and sheets, or an
overwhelming eyeful of colors from congratulatory balloons and flowers. The
nursery was eerily quiet as well, just a few fussing babies two nurses were
attending to, and the rest sleeping soundly, bundled in bright white. I paused
there a moment, looking in, the pure whiteness overtaking me. Everything from
the walls to the bassinets themselves were a bright white, from the white tile
floor to the wrist bands. In face, the only colors in the room were the shades
of the babies’ faces and hands. And such bold colors, making themselves noticed
even as they slept. Little lights of hope.
I wondered how many of these little ones would be forced
to die for their country when they grew up. Perhaps the war would be going on
even then, or perhaps its face would be changed over the years. Those fighting
claimed the war would save the children from communism, but they used the same
arguments in the cold war, and that still hasn’t ended. And here was I, being
thrown right into the thick of it. And thrown in before I could finish my job
here.
Little Michael. He belonged in one of those bassinets. He
deserved to be that light of hope the whole family had been counting on since
Lilly announced her pregnancy to us all last Easter during dinner. Janet’s
husband had been cutting the ham and had nearly slipped in astonishment. Mother
Sylva, as Natasha, Janet and Eddy’s mother had told me so often to call her,
had nearly choked on her water at the news. And Eddy and Lilly just sat, chairs
close together, holding each other’s hands so tightly in support and
excitement. The first child of their family, the first of his generation. The
first life in a string of so many deaths. The child named after grandfathers he
would never know. One who slaved for his American-born children to grow up in a
free country, with more than he had had back in Poland. And one who died in the
war so that others in his squadron would survive. Little Michael Jonathan
Galich.
I
turned away from the nursery, looking down the hall. There were two nurses at
the nurse’s station, sitting with their feet up, doing crossword puzzles.
Further on and just around the corner was the hospital chapel. I’ve never been
a religious man, but I felt compelled to make my way there. With each step, my
mind spun, and with each I hoped for inspiration. Just a hint to what was
wrong. I wasn’t asking to walk on the moon,
only to let little Michael live so long as to see someone do so.
As I reached the chapel, I ducked inside, closing the
doors behind. It was silent; when I held my breath, not a single sound could be
heard- not a monitoring machine, not a crying baby, not even a set of
footsteps. The front of the chapel held a simple cross, lit up with a dim
yellow-orange haze, while the rest of the room was rather dark. The perfect
spot for peaceful reflection, and hopefully the perfect spot for thought. I sat
on one of the back benches, emptying my brain of all worries, of all thoughts.
My brain was silenced from hearing sounds of the war. My brain was silenced
from hearing the chants of protests. My brain was silenced from hearing the
comforting words of Nat. My brain was silenced from hearing the cries of
Michael. It was silenced and filled with hope, with faith. But that wasn’t much
of a help. Still nothing came to me. “Stupid brain,” I murmured with a chuckle
and a weary yawn.
And then I froze. Not from fear, not from hesitation, but
from realization. Everything raced to the front in a blur. The brain.
Enkephalos in the Greek. Enkephalos itis. Brain inflammation. Aseptic
encephalitis. I rose, nodding my head in silent thank you, and went straight
back to room 342. He’d need a lumbar puncture, a spinal tap, to be certain but
at least there was hope for my patient.
* * *
A book slid from Michael’s lap, thumping to the floor and
waking him. With a yawn, he checked his watch for the time, checked his pager
for any updates, and stood with a stretch. A disturbing dream which had made no
sense at all, on top of the events of the night… he needed to clear his head.
Putting the book aside, he headed out of the lounge and took the elevator and
bridge over to the children’s ward.
The little boy’s round face became rounder as cheeks puffed up and mouth widened into a smile. “Michael!” he exclaimed, raising his hand, making the IV that ran from his thin arm jiggle on the post.
Tiptoeing across the sterilized ward floor with a matching grin on his face, he held a finger up to his mouth. He whispered back as he perched on the stool by the bed, “Quiet Jamie! You’ll wake…” he looked around to see most of the children of the ward snuggled under their covers with flashlights or hiding top scoring handheld video games under their pillows. As his eyes swept what were too many beds, they rested on the main desk he had snuck past; a middle-aged nurse sat there, her head on a clipboard, arm outstretched and dangling over the side. “You’ll wake the nurse,” he finished, turning back to his young friend. Such enthusiasm for someone in such dire circumstances. Such excitement from someone who was slated to die before the year was out. Such exhilaration and elation that Michael couldn’t help but feel every problem and tragedy of the day simply slip away. “You’re chipper tonight.” Certainly a nice change of pace for Michael. “What’s up?”
The thin little boy sprang to his knees and turned, hand upon his headboard, nose pressed against the windowpane. “It’s snowing! First snow of the year.”
The boy was indeed right, for outside the window fell a heavy stream of snow, which danced in the nearly full moon light. Everything was as still as death itself, but alive from the windblown snow. Michael knew that outside the ER things were moving hurriedly, plows clearing way for emergency vehicles to pull out, staff members pitching in to shovel out the ambulance bay. But on this side of the hospital, everything but the snow was calm and still. Cars were buried. Sidewalks, streets, and grassy commons all blended into snowy ground. Pine trees were covered from above so that the bellies of their branches were still bare. The snow fell most noticeably around the few street lights scattered about a few stories down. They glowed a bright yellow, the only color in the white bath of snow and moonlight that could be seen. Michael, who realized he was leaning so far forward to the window that the wheeled stool could have sprang out from beneath him, held onto the bed railing and straightened himself. “It’s beautiful. So lively,” he said with a smile. Nothing at all like the snow from his dream.
“I wish I could go out and see it. I’ve never been in snow,” James pouted, settling back down in bed. He had been in hospital beds nearly his whole life, he had been in trouble, he had been in critical condition, but had never been in snow.
Michael spoke softly, comfortingly. “I’ll tell you what…” he pulled the sheet and two blankets up over the boy’s drained little legs, up past the tiny waste, the heaving chest, and tucked beneath the smooth chin. “If your t-cell count’s still stable tomorrow morning, I’ll try to sneak you to an open window for a few minutes.”
The boy’s bright round face which already showed happiness filled with such incredible joy that Michael was afraid his young friend might burst.
“And if you promise to paint me something else for my office walls when I’m chief resident.”
The boy, despite himself, bounced in bed, disturbing the covers. “Did you make it then? Did you hear?”
He shook his head. “They make their decision tomorrow.” His nervous uncertainty shown through; he couldn’t help it. After today.. after losing the vet, he wasn’t sure he deserved it. It had been such an open and shut case. Tend to the hypothermia, call psych, call the VA, discharge. But everything had just gone so terribly wrong. From the mysterious anonymity to the gunshot. The loud, startling gunshot which still rang in his ears like the cold porcelain walls of a bathroom. The children’s ward had probably heard the shot it was so loud. To control shaking of his hands, he pulled the covers back up, tucking them around James.
James settled back accordingly. “Don’t you worry. You got it. I know you did,” little James said with such definite assurance that Michael wanted to simply push the window open right then and there and let the snow blow over them both. The lovely snow. So calming. So soothing.
The season of winter was the season of death. But without it, there would be no season of life as the green poked back up through the snow in the spring. That was what he most wanted to have James see. He just hoped the boy would live so long.
“Get some sleep, Bond,” he whispered, getting off the stool to leaned in and kiss James on the forehead.
The boy giggled at Michael’s pet name for him. “G’night Michael.”
“Goodnight my little survivor. Dream of snow.”
Michael did not return to the ER just yet. Instead, he
found himself walking up the stairwell to the roof. It was not much of a climb,
but in his whites and without much sleep, he was a little winded by the time he
emerged. It was certainly snowing all right, and Michael without a jacket. But
the doctor hardly felt the cold as he stood in it a moment, arms outstretched,
face to the black sky and white flakes, to welcome the first snow of the year
to D.C. Then he walked to the edge of the building, leaning with his elbows on
the cold stone barrier between him and the street below. He pulled out his
cellular phone, unable to use it inside the building for fear of interfering
with equipment or pacemakers, and dialed. It rang once, twice, and half of a
third before it was answered. Shivering but smiling, he spoke, “Sorry it’s so
late. I didn’t disturb you, did I?” He paused, nodding at the answer, “Good.
Auntie Nattie,” he took a deep breath and closed his eyes, feeling the snow
calm him as it fell silently about him. “Auntie Nattie, tell me about the man
you were engaged to.”