Code Gray
|
Disjointed shouts and unintelligent grunts rise from the ambulance bay entrance. It breaks through the ding of monitors and unrecognizable chatter of staff members and patients alike. I’m one of the emergency department’s float nurse for the day. They have me bouncing from lane to lane, assisting nurses overwhelmed with their assignments, and responding to the codes and stroke alerts.
Gurneys with patients line the hallways. Six ambulances wait to be off-loaded. The department is short-staffed — four call-outs so far. Patients are more than a little irate when they realize there’s a five-hour wait time before a provider can see them. Fourteen months ago, the pandemic decimated the country. The stress of an already stressful job is making fantastic nurses reevaluate their professional options. Just yesterday, Jack gave his two-week notice, ending a twenty-seven-year career in emergency care. Ronald, a sheriff from the Richmond County Sheriff’s Department, leads a coterie of the hospital’s security guards. One of the guards pushes a slim man in a tattered t-shirt, soot-covered feet, and hair like burnt hay in a wheelchair. Handcuffs keep the man’s arms twisted behind him at an uncomfortable angle. His body leans precariously to one side, almost out of the wheelchair. The front tire is stuck. The wheel rattles and screeches against the frame. The shrill sound silences nearby chatter. It reverberates inside my head; my eardrums vibrate painfully. I try not to bite down. “Get your fuck’n hands — no, stop ’em, they got a knife — I swear they lyin’. Lyin’ all day, all night, all year,” shouts the man in the wheelchair. His eyes roll backward, then dart left and right. He wears a manic, shocked expression that belies any human comprehension. Spittle flies out of his mouth in long strips. Gaping holes where teeth once resided fester black and yellow. I take a deep breath — the familiar and unconscious smell of disinfectant, bodily fluids, and threadbare linen stings my nostrils despite the surgical mask covering my face — and sigh, trying not to roll my eyes. Just once, I wish they’d take the psyches to Saint Martin’s Hospital. Ronald stops in front of the registration desk and says something to Joe, the triage nurse assigning rooms. Joe’s eyes sweep the immediate vicinity and find me tucked in a corner, trying to hide behind my computer. He has always been a large man. Used to be an amateur bodybuilder before herniating several spinal discs while lifting a patient a year ago. Talk about irony. Now he’s assigned the sedentary positions. Joe sits in a chair that narrowly contains his wasting bulk. His arms and chest are no longer toned, but in that awkward stage between muscle and fat that comes from letting fast food compromise a rigorous diet. A shudder goes through me as I imagine grabbing his bicep, my fingers pushing against muscles that give way like play dough. He still wears his scrub tops one size too small. Joe smiles and I can almost hear the condescending chuckle he’s holding in, restrained not by conscious thought, but by the tightness of his scrubs. My right eye twitches seeing the call-to-arms projecting from his beady eyes. I pull my hand sanitizer (a travel-size bottle attached to a pink gel clip) out of my pocket and squirt some on my hand. The coolness of the gel seeps into my palm. The alcohol makes my hands tingle as it evaporates. The sensation soothes me. The same way Mamá slapping Vick’s VapoRub across my chest used to soothe me as a child when I had a cold...or a fever, or a headache, or a stomach bug, or asthma for that matter. It was the miracle drug in our household. I can’t smell the stuff without thinking of congested bed sheets and coagulated pajama tops adhered to my chest. The handcuffed man in the chair spots me approaching the registration desk and starts thrashing in the chair. In the tired fluorescent lighting, he looks enraptured, like a Pentecostal possessed by the Holy Spirit. The sight gives me the chills. My teeth clamp shut with a click and pressure settles at the back of my jaw. Mamá, if she was still alive, would say, “Espíritu no! mi hija. More like, el Diablo,” in that special Spanglish patois common among Puerto Rican immigrants. Ronald shrugs unhelpfully. “You know,” I say with a stiff smile, “we’re going to have to charge you. This is the third one in two hours.” “Must be a full moon,” Ronald says straight-faced. “It’s not.” “Friday the thirteenth?” “It’s Monday...the twentieth,” I say, pointing at the calendar sitting on the desk. “What do you have for me now.” “Pete here’s a regular,” Ronald says over the man’s litany of claptrap. The guards can’t hide the bored and reticent look in their eyes. One even yawns while looking at his cell phone. I stare long enough to catch his attention. He doesn’t even look chagrined. “Picked up last week Meth’d out of his mind. Forty-three years old with a history of schizophrenia, bipolar, drug abuse, and whatever else you can think of. Good Samaritan noticed him behaving erratically before running into oncoming traffic. Now on a 5150 hold.” That means a three-day stay — at least. A headache begins to tap a beat across my forehead. The hospital is seeing an uptick in psychiatric patients. Too much time on their hands with the pandemic insisting people stay home. The inpatient and outpatient facilities are overwhelmed. Emergency rooms across the state and country are becoming dumping grounds; holding patients for days while they wait for a psychiatrist to deem them worthy to repopulate society. Except, most of them end up back in the emergency room days, if not hours later. It’s frustrating. The waste of resources on self-destructive drug addicts and broken-minded patients who refuse to take their medications. These thoughts come unbidden and are far too familiar for me to be shocked by them. It sounds self-righteous ... bitter even. But when compassion is rewarded by ungratefulness, verbal abuse, and demands filled with an entitlement that brokers no argument, what do you expect? When do you draw the line, right? Instead, I’m on a first-name basis with more than a handful of transient patients who frequent the department weekly, sometimes daily, looking for a warm meal and comfortable bed. Listen, it isn’t that I lack all compassion. It’s just that after two decades of working as a trauma nurse, the moral and idealism that once drove me into nursing has degraded into hard-edged cynicism. What did Casey say once? Everyone calls it “burning-out,” but in reality, we’re suffering from moral injury. We start our careers with specific moral beliefs; zealots who want to provide the best, unbiased care possible. We’re taught that, aren’t we? In this she’s right. Nursing school taught me how to be the ideal nurse for an ideal world. But in reality, it’s all about the bottom line. It’s about revenue. And how fast we can move patients. So we adapt and adapt, and we witness the quantification of human suffering into dollar signs. The disparity in our morality takes a beating — fraying and coming undone like these God-awful gowns we give our patients. Until we, SNAP! It’s no different than what soldiers experience after going to war for the first time. I glove up and reach for the portable vitals machine. The hair underneath the dirt is blond. He looks sixty instead of forty-three. “Hi, Pete. My name is Angelica. I’m going to take your vital signs.” My nose prickles reflexively. There’s a not-so-subtle stench of urine and filth wafting from Pete. I grab the blood pressure cuff and attempt to wrap it around his upper arm. “No...leave me...they keep tellin’...no!” Pete kicks out, almost catching me in the knee, and makes a lurching move towards me. His teeth clamp down, making a clicking sound as he tries to bite me in the arm. I stagger backward out of reach. The guards give a startled yelp before springing forward. They grab him roughly by the shoulders and pin him against the wheelchair. There’s a predatory look in their eyes. Their cheeks flush with adrenaline. “Take him to room 33,” says Joe from the safety of his desk. “I’ll have Dr. Richardson put in orders for meds and restraints.” I follow the guards as they race him to the room. Anticipation wafts from them like desert heat, looking forward to the laying of hands. An exorcism of the Meth-god that befuddles this man’s poor soul. Overhead the speakers erupt with the alert that warns the hospital of a combative patient: “CODE GRAY, EMERGENCY ROOM 48. CODE GRAY.” Later, while Pete dreams his Meth-induced dreams, I report to the assigned nurse. Linda is an older nurse with a tired face, lined like a crumpled newspaper. Casey mentioned Linda recently lost her daughter. I can’t recall from what, though. Linda’s hunched shoulders look as if weighed down by memories and responsibilities. There is a brittle quality to her smile that never reaches her eyes. “It’s sad,” Linda says. I ask her what she means. “He’s so young,” she says, reading his chart on the mobile computer stationed outside of the room. We have a clear view of Pete. He looks desolate and forgotten on the unforgiving stretcher. Only a disconnected monitor hangs from a wall. Anything that resembled ligature, or a potential weapon has been removed; cables, chairs, trash bins, linen bins, suction canisters, procedure trays, and nasal cannulas. I rub some sanitizer on my hands from my travel size. “Methamphetamine is an addictive drug,” I reply unmoved. “What if it’s a coping mechanism for something we can’t possibly understand,” Linda says. There’s a quiver in her lips, then the light shifts, and it’s gone. “I read a study that says our senses perceive less than five percent of what we see in our minds. People experiencing psychosis are described as being hyper-focused. And if a mind is ill-equipped to interpret the meanings of events and the intentions of people during one of these episodes, then maybe they can’t translate what it’s seeing, muddling their senses.” “And you think Meth is the answer?” I reply. “Being a drug addict doesn’t make it okay to be an asshole.” Linda flinches and I regret my callous remark. Linda shrugs her fragile shoulders. “All I’m saying is that we shouldn’t judge them when we don’t understand what they’re going through. If you think about it, the study implies we’re all hallucinating. Interpreting massive amounts of input and funneling it into five deteriorating senses. It’s only when we agree about our hallucinations that we call it, Reality — we call it socially acceptable.” Linda moves into the room with the vital signs machine in tow and I remember what killed her daughter. Heroin. |
JACOB PÉREZ
was born in Ponce, Puerto Rico, but spent most of his young adult life in Boston, Massachusetts. After graduating from nursing school, he moved to Loomis, California with his wife, two beautiful kids, and an indifferent cat named, Zelda. Currently, he’s working on expanding his writing portfolio. You can find his contact information on www.jacobperezauthor.com |
***
The rest of the shift passes in a dizzying exercise of frantic prioritization. A transferred heart attack. Abdominal pain after abdominal pain. Kidney stones. Appendicitis. Shortness of breath from asthma, COPD, emphysema, smoking, CHF, obesity... hundreds of sick people. Seeking help, seeking meds, seeking compassion, seeking a solution, seeking a miracle. After sixteen hours at work, the faces blur, and patients become room numbers and diagnoses.
It’s almost the end of my shift, I’m helping Rachel boost a patient on their stretcher when the overhead system interrupts the natural flow of non-emergency sounds. A cardiac arrest. Five minutes out. Doctor, nurses, techs, and respiratory therapists vie for space in a room no bigger than my guest room; waiting for the rat-tat-tat rattle of the EMT’s gurney as they wheel around the corner.
I rub sanitizer vigorously on my hands; the sound is like a wet kiss.
When they finally arrive and round the corner. A boy of about thirteen lies limp and ashen on the gurney. It’s my worst nightmare. Kevin, my son. Fear like I’ve never felt before grips and twist my insides. A grotesque bruise mars his neck and face. A machine in the shape of a shark’s open maw encircles his upper body. A metallic arm with a circular rubber hand attached to the end pumps up and down on his chest.
I rush to the side of the stretcher and realize it isn’t Kevin. The breath I was holding comes out a stuttering rattle. The boy on the EMT gurney is younger, his brown hair a shade lighter. But the delicate features are there. The peppering of freckles that dust his cheeks are almost identical. My hands tremble as we move him onto the stretcher. My muscles twitch with adrenaline. The latex gloves I’ve donned feel constricting and claustrophobic. They squeal with movement. The needle for the IV quivers in my fingers. This never happens to me. I’ve been a trauma nurse for two decades. Traumas are my bailiwick. Other than those first terrifying months as a new nurse, I never hesitate.
Except, that isn’t true, is it? Two years into my career, a family of three arrived at the hospital after a horrific car accident. The father and son survived. The mother arrived pulseless. We worked on her for a long time. It was my first real experience working on a trauma case. That event haunted me for weeks afterward. I brushed it off as a learning experience. And eventually, the sight of blood, death, pain, and suffering became a sort of tinnitus that I learned to ignore.
My tongue flicks out over my lower lip. It’s parched like a horned lizard’s arid skin. Bedlam possesses the room, but to me, it’s my son that governs my thoughts. The muffled voices and sounds of the room are distractions. Every time I look at the boy it’s Kevin that surfaces in my mind. The sound of his laughter, high and pure, rings in my ears. The smell of grass and sand in his hair from playing in the backyard swarms my nose.
I’m still trying to put an IV into his arm when the doctor makes the call. Time of death, 2322. I look up dazed. The other staff members back out of the room, shaking their heads. The boy lies lifeless on the gurney. He stares at me obliquely with opaque eyes. A metallic ding pulls my attention away from the boy. I’ve dropped the needle on the floor.
The hand sanitizer comes out after my third attempt.
It’s almost the end of my shift, I’m helping Rachel boost a patient on their stretcher when the overhead system interrupts the natural flow of non-emergency sounds. A cardiac arrest. Five minutes out. Doctor, nurses, techs, and respiratory therapists vie for space in a room no bigger than my guest room; waiting for the rat-tat-tat rattle of the EMT’s gurney as they wheel around the corner.
I rub sanitizer vigorously on my hands; the sound is like a wet kiss.
When they finally arrive and round the corner. A boy of about thirteen lies limp and ashen on the gurney. It’s my worst nightmare. Kevin, my son. Fear like I’ve never felt before grips and twist my insides. A grotesque bruise mars his neck and face. A machine in the shape of a shark’s open maw encircles his upper body. A metallic arm with a circular rubber hand attached to the end pumps up and down on his chest.
I rush to the side of the stretcher and realize it isn’t Kevin. The breath I was holding comes out a stuttering rattle. The boy on the EMT gurney is younger, his brown hair a shade lighter. But the delicate features are there. The peppering of freckles that dust his cheeks are almost identical. My hands tremble as we move him onto the stretcher. My muscles twitch with adrenaline. The latex gloves I’ve donned feel constricting and claustrophobic. They squeal with movement. The needle for the IV quivers in my fingers. This never happens to me. I’ve been a trauma nurse for two decades. Traumas are my bailiwick. Other than those first terrifying months as a new nurse, I never hesitate.
Except, that isn’t true, is it? Two years into my career, a family of three arrived at the hospital after a horrific car accident. The father and son survived. The mother arrived pulseless. We worked on her for a long time. It was my first real experience working on a trauma case. That event haunted me for weeks afterward. I brushed it off as a learning experience. And eventually, the sight of blood, death, pain, and suffering became a sort of tinnitus that I learned to ignore.
My tongue flicks out over my lower lip. It’s parched like a horned lizard’s arid skin. Bedlam possesses the room, but to me, it’s my son that governs my thoughts. The muffled voices and sounds of the room are distractions. Every time I look at the boy it’s Kevin that surfaces in my mind. The sound of his laughter, high and pure, rings in my ears. The smell of grass and sand in his hair from playing in the backyard swarms my nose.
I’m still trying to put an IV into his arm when the doctor makes the call. Time of death, 2322. I look up dazed. The other staff members back out of the room, shaking their heads. The boy lies lifeless on the gurney. He stares at me obliquely with opaque eyes. A metallic ding pulls my attention away from the boy. I’ve dropped the needle on the floor.
The hand sanitizer comes out after my third attempt.
***
That night, I sneak into Kevin’s room and watch him sleep at his bedside. His snores sound like a kitten’s purr. There’s a smudge of chocolate at the corner of his lips. My hand brushes his hair away before laying a kiss on his forehead.
When I walk into the master bedroom, John grunts and rolls away from the shafts of light spilling from the hallway. After showering, while lying next to him, sleep eludes me. John’s snores are not like a kitten’s purr, but more like a full-grown silverback. I stare at the dark ceiling, unable to close my eyes without seeing the boy’s ashen face and realize I don’t even know his name. Shame warms my cheeks. I should call out tomorrow. I’ve been working non-stop this month. And yet, we’re trying to install a new pool in the backyard, and the overtime money is so readily available.
The dread of going back to work cocoons me. It flares knowing I’ll have to answer my coworker’s questions about the boy’s death. Then something peculiar distracts me. At the center of the ceiling, there’s a small gray dot. In the darkness, it shines almost white. It begins to dart in fast looping circles before it settles above me. Then it expands. The perfect circle loses its form and becomes an amorphous distortion. Subtle curves and new contours of shadows begin to give it definition.
I reach up to it, wanting to touch it, and take it into myself. Warmth radiates from it, assuaging my growing melancholy. Whispers fill the room. The distortion takes dimension and a familiar person gazes down at me. Mamá smiles and it’s like staring directly at the sun.
Mamá died five years ago from complications of AIDS; a parting gift from my father before abandoning us when I was ten years old. I still remember her sobs filtering through the walls at night. When her liver failed, the deterioration became more pronounced, she became a warped version of herself.
Not now.
Mamá is seraphic! Her skin looks untouched by disease; a healthy, sun-kissed brown. It’s strange seeing her without the jaundice coloring her complexion and eyes. Her dark hair spreads out behind her. Her dark eyes twinkle. “¿Mija, what you doing despierta?”
Wonder and awe fill me. “I’ve missed you, Mamá.”
Mamá beams radiantly and reaches out to me. “Necesitas sleep, mija. ¿Cómo crees que you going to function en el trabajo mañana?”
Mamá grabs onto me and lifts me off the bed. John’s snoring fades. When I look down, the house falls away in the distance. The wind tussles my hair and condensation sleek my face as we travel through the clouds, past the troposphere, and past orbit. The lightness of space and the immensity of the celestial bodies beckon me toward the moon. This must be how God speaks to his prophets. And in that realization, I laugh and spread my arms wide. Mamá looks down at me and gives me an avuncular wink.
We reach the moon in the space of a heartbeat. My bare feet touch the surface, and a cloud of powdery dust stirs around my ankles. There’s a loudness to space that I didn’t expect; the pulsing blood in my ears, the gorge of my throat as I swallow, the buzz of cosmic radiation incomprehensibly ancient and alien. Jutting gray rocks and shadowed craters dominate the moonscape. It reminds me of a documentary I once saw on the moon that described how broken and unconsolidated rock material called regolith blanketed its surface.
I lift my foot and see a perfect gray print left on the dust. I look around and see Earth in the distance; an azurite-malachite pearl hanging in the black sky. Space spreads around me like a swath of sequin and lace; galaxies, nebulae, planets, and stars vibrate with interstellar energy.
Mamá wears a shining white dress. “I knew you wouldn’t leave me.”
“Nunca, mija. ¿Did you know que hay un study— ”
Then, John snores, and I look to the right. His back’s turned to me. When I shift my gaze back to the ceiling, Mamá’s gone, taking with her the light, the stars, and the moon. More than a small part of me is sad. But the magnificent feeling of her visit provides a comfort I didn’t know I was missing.
When I walk into the master bedroom, John grunts and rolls away from the shafts of light spilling from the hallway. After showering, while lying next to him, sleep eludes me. John’s snores are not like a kitten’s purr, but more like a full-grown silverback. I stare at the dark ceiling, unable to close my eyes without seeing the boy’s ashen face and realize I don’t even know his name. Shame warms my cheeks. I should call out tomorrow. I’ve been working non-stop this month. And yet, we’re trying to install a new pool in the backyard, and the overtime money is so readily available.
The dread of going back to work cocoons me. It flares knowing I’ll have to answer my coworker’s questions about the boy’s death. Then something peculiar distracts me. At the center of the ceiling, there’s a small gray dot. In the darkness, it shines almost white. It begins to dart in fast looping circles before it settles above me. Then it expands. The perfect circle loses its form and becomes an amorphous distortion. Subtle curves and new contours of shadows begin to give it definition.
I reach up to it, wanting to touch it, and take it into myself. Warmth radiates from it, assuaging my growing melancholy. Whispers fill the room. The distortion takes dimension and a familiar person gazes down at me. Mamá smiles and it’s like staring directly at the sun.
Mamá died five years ago from complications of AIDS; a parting gift from my father before abandoning us when I was ten years old. I still remember her sobs filtering through the walls at night. When her liver failed, the deterioration became more pronounced, she became a warped version of herself.
Not now.
Mamá is seraphic! Her skin looks untouched by disease; a healthy, sun-kissed brown. It’s strange seeing her without the jaundice coloring her complexion and eyes. Her dark hair spreads out behind her. Her dark eyes twinkle. “¿Mija, what you doing despierta?”
Wonder and awe fill me. “I’ve missed you, Mamá.”
Mamá beams radiantly and reaches out to me. “Necesitas sleep, mija. ¿Cómo crees que you going to function en el trabajo mañana?”
Mamá grabs onto me and lifts me off the bed. John’s snoring fades. When I look down, the house falls away in the distance. The wind tussles my hair and condensation sleek my face as we travel through the clouds, past the troposphere, and past orbit. The lightness of space and the immensity of the celestial bodies beckon me toward the moon. This must be how God speaks to his prophets. And in that realization, I laugh and spread my arms wide. Mamá looks down at me and gives me an avuncular wink.
We reach the moon in the space of a heartbeat. My bare feet touch the surface, and a cloud of powdery dust stirs around my ankles. There’s a loudness to space that I didn’t expect; the pulsing blood in my ears, the gorge of my throat as I swallow, the buzz of cosmic radiation incomprehensibly ancient and alien. Jutting gray rocks and shadowed craters dominate the moonscape. It reminds me of a documentary I once saw on the moon that described how broken and unconsolidated rock material called regolith blanketed its surface.
I lift my foot and see a perfect gray print left on the dust. I look around and see Earth in the distance; an azurite-malachite pearl hanging in the black sky. Space spreads around me like a swath of sequin and lace; galaxies, nebulae, planets, and stars vibrate with interstellar energy.
Mamá wears a shining white dress. “I knew you wouldn’t leave me.”
“Nunca, mija. ¿Did you know que hay un study— ”
Then, John snores, and I look to the right. His back’s turned to me. When I shift my gaze back to the ceiling, Mamá’s gone, taking with her the light, the stars, and the moon. More than a small part of me is sad. But the magnificent feeling of her visit provides a comfort I didn’t know I was missing.
***
I’m walking towards the front of the hospital when a mewling sound coming out of room sixteen stops me. It's the last room in hallway C, an offshoot from one of the main lanes in the department. When I pull back the curtain, there’s a person curled up on the stretcher. The bedsheet covers their head.
Usually, I avoid going into patients’ rooms unless the bed alarm is on, or someone calls out for a nurse. So I surprise myself by asking, “Is everything okay?”
The mewling sound stops, and the sheet drops low enough for me to see a face. The woman looks familiar to me, but I can’t place her. She has gleaming black hair cut into an ear-length French bob. Her eyes glisten and are so black they look purple. It reminds me of flying through space and gazing at rotating nebulae.
“I’m waiting for my husband and son,” she says. “They’re supposed to be here.”
“When was the last time you saw them?”
“I-I don’t remember. There was an accident. They wouldn’t let us ride the ambulance together. My son...my son must be so scared.”
Before I can reply, the overhead speakers erupt: CODE GRAY, EMERGENCY ROOM 32. CODE GRAY.
“I’m sorry,” I say, backing out of the room, “but I have to answer that. I promise I’ll check on your family afterward.”
The woman’s eyes widen. There’s more white than black in them now. “CODE GRAYS! are for crazies. There are so many of them here. Send them to Saint Martin’s.”
My hand pauses as I pull the curtain close. The tips of my fingers go numb. The woman pulls the sheet over her head. She says in a muffled tone: “It’s been so long since I’ve seen my son. Please, help me.”
Then, resumes her mewling wail.
After I’ve taken care of the CODE GRAY, I ask Joe about the woman in room sixteen.
“Room sixteen? Not hall sixteen?” asks Joe, while rivulets of sweat glisten on his forehead despite the fan whirling on the desk. “I haven’t assigned a patient to that room.”
“I was just in there,” I say. “Late thirties — Hair in a bob. Her son may have come in on a separate ambulance.”
Joe shrugs and wipes his forehead with the back of a hand the size of a pork roast.
Unable to get rid of this nagging feeling, I walk back to room sixteen. Empty. Clean sheets dress the stretcher, and the monitor cables are curled up neatly on the wall.
Usually, I avoid going into patients’ rooms unless the bed alarm is on, or someone calls out for a nurse. So I surprise myself by asking, “Is everything okay?”
The mewling sound stops, and the sheet drops low enough for me to see a face. The woman looks familiar to me, but I can’t place her. She has gleaming black hair cut into an ear-length French bob. Her eyes glisten and are so black they look purple. It reminds me of flying through space and gazing at rotating nebulae.
“I’m waiting for my husband and son,” she says. “They’re supposed to be here.”
“When was the last time you saw them?”
“I-I don’t remember. There was an accident. They wouldn’t let us ride the ambulance together. My son...my son must be so scared.”
Before I can reply, the overhead speakers erupt: CODE GRAY, EMERGENCY ROOM 32. CODE GRAY.
“I’m sorry,” I say, backing out of the room, “but I have to answer that. I promise I’ll check on your family afterward.”
The woman’s eyes widen. There’s more white than black in them now. “CODE GRAYS! are for crazies. There are so many of them here. Send them to Saint Martin’s.”
My hand pauses as I pull the curtain close. The tips of my fingers go numb. The woman pulls the sheet over her head. She says in a muffled tone: “It’s been so long since I’ve seen my son. Please, help me.”
Then, resumes her mewling wail.
After I’ve taken care of the CODE GRAY, I ask Joe about the woman in room sixteen.
“Room sixteen? Not hall sixteen?” asks Joe, while rivulets of sweat glisten on his forehead despite the fan whirling on the desk. “I haven’t assigned a patient to that room.”
“I was just in there,” I say. “Late thirties — Hair in a bob. Her son may have come in on a separate ambulance.”
Joe shrugs and wipes his forehead with the back of a hand the size of a pork roast.
Unable to get rid of this nagging feeling, I walk back to room sixteen. Empty. Clean sheets dress the stretcher, and the monitor cables are curled up neatly on the wall.
***
“Earth to Angie?”
Casey leans against the counter, and a cascade of red hair frames an oval face. A badge with her face and the letters RN hangs from her scrub pocket. We met three years ago and bonded over our children participating in the same soccer team. We’ve been best friends ever since.
Casey carries a Starbucks cup in her hand. The mandatory surgical mask is down to her chin. One mask per day after all. It’s a counterintuitive and unsafe policy; one unfit for a nation in the throes of a pandemic that has killed millions of people worldwide. How can I keep a single mask clean when every patient needs an assessment, visitors need updates, and interactions between co-workers who may or may not be infected are unavoidable? Am I not contributing to the problem by carrying a potentially soiled mask to every room I visit, risking cross-contamination? Until a month ago, nurses were saving their N-95 masks in brown paper bags for multi-day use for Christ’s sake.
I don’t know how long I’ve been standing there without replying.
“I heard there was a pediatric death yesterday,” continues Casey, “but nobody could tell me any details.” She takes a sip of coffee. “What happened?”
What had happened? Blunt trauma? Assault? Fall? I can’t remember. It seemed inconsequential at the time. Casey notices my hesitation; her eyebrows meet in concern.
“You okay?”
“Yeah, sorry,” I say, making a perfunctory motion with my hands. I clean my hands with sanitizer. “It happened kind of fast. I wasn’t primary. Guess I wasn’t listening to the EMS report.”
Casey relaxes. “I hate pediatric codes. Kids have no business seeing the inside of a trauma room.”
Past Casey and out of earshot Joe’s talking to Vivian, the department manager. She’s rail-thin with a flapping neck that reminds me of a mastiff’s dewlap. Secured to the top of her head is a painful-looking knot. She keeps looking in my direction. Joe nods sagely before giving me a sad, critical smile.
“You sure you’re okay?” Casey asks. “You seem...distracted.”
“Tired. It’s my Friday.” I shrug and gesture behind her. “What’s Vivian talking to Joe about?”
Casey turns around. Vivian and Joe are no longer looking in their direction.
“Not sure,” says Casey, taking another sip of her coffee. “But I heard management is auditing the chart on that code. The parents are looking at the hospital for answers. They think we did something wrong. She’s prob’ly making rounds.”
Wrong? Did I do something wrong?
I try to recall the code, but all I can remember is the unused needle in my hands and the dead boy’s unblinking gaze. I wasted so much time trying to put an IV when EMS likely put an intraosseous needle before arrival. A feeling like creeping spiders walking on bare skin makes its way up my chest. Did my incompetence cost him his life? I needed to be faster, confident, and unperturbed. They know it’s my fault. And if there’s a lawsuit involved; the hospital will be looking for a scapegoat.
From the corner of my eyes, I watch Vivian write something down on a legal pad. Joe’s face is a vulpine mask. All day, it feels like everyone’s talking about me, dissecting my every move, looking away when I catch their attention. Now I know why.
“Angie?” Casey touches my arm and startles me.
“I have to go,” I say. “Rob needed help with a foley cath in room ten.”
I leave Casey before I’m further interrogated and head toward the supply room. Most of the patients lining the hallway have blankets up to their chin; hoping it will help them maintain a modicum of modesty and privacy. Their eyes follow me. I avert my gaze, ignoring their pleas and never-ending questions: When will the doctor be by? What’s taking so long? Where’s my pain medication? Why are you so rude? Where is the manager?
My badge unlocks the supply room. I lean against the wall when the door clicks shut behind me and pull out my sanitizer. The alcohol drying on my skin focuses me. I visualize the pores opening up to expel every disease, germ, and microbe trying to kill me. My hands start to sting. The knuckles are cracked, and an unhealthy shade of red radiates up to my wrist.
The L-shaped supply room is cluttered with every nurse’s arsenal; IV supplies, fluids, bladder scanners, oxygen masks, oxygen tanks, urinals, emesis basins, lumbar puncture kits, IV poles, hospital socks, fall packets, baby diapers, adult diapers, central line kits, ostomy supplies, splints, nasogastric tubes...
The foley catheter kits are around the bend on the bottom shelf. I grab one. There’s a beep before the door clicks open. “Room’s all y — ” The words trail off. Vivian stands in the doorway, legal pad tucked under one arm like a marine bearing his rifle before going out to war.
“Angelica, have a minute?”
She’s here to put me on administrative leave. Everyone named me as the culprit. The one who let the boy die.
“No,” I say in a small gasp. “I — I mean. I’m in the middle of something.”
“It’s a small thing. Won’t take long.”
I side-step Vivian, holding the urinary catheter against my chest. A flash of confusion races across her eyes. Don’t talk to her. Nobody will hire me. With a stay-at-home husband, what will happen to Kevin?
“Can we...talk later?” I ask. My foot catches one of the IV poles and trip over it. Vivian reaches out to me.
“Don’t touch me!” I brandish the foley like a cross and almost shout, Señor repienta, devil.
“I was trying — ”
My hands fumble with the door handle. Nothing happens. My hand slides on the cool metal of the handle. The rattle it makes is deafening in the stillness of the room. Then I remember that the door opens inward. I toss the kit at Vivian and open it. The door bangs against the opposing wall. The shock of the impact jostles the patients near the supply room.
I rip the surgical mask off my face when the carbon dioxide makes me dizzy. The stench of bleach and ammonia from the floor’s disinfectant waters my eyes. I head towards the ambulance bay for fresh air. Faces leer and hungry eyes follow me.
“Don’t look at me like that!” I shout to a woman lying on her side. Humor creases the corners of her eyes. Her chest heaves with chortling laughter.
“No le hagas caso, mija,” says Mamá, who stands at the end of the hallway in a blue and green hospital gown. She lacks last night’s majestic glow. The one that transcended human frailty. Instead, her skin is yellow with excess bilirubin and waste material. Her lined face looks like withered papyrus. Even from where I stand, Mamá’s bloated stomach pulling on her gown stands out. “They don’t appreciate el trabajo you do. They are sanguijuela. Leeches todos.”
More patients turn their heads in my direction. For a split second, the hallway stretches out behind Mamá, angling upward in a slow incline. The moon hangs at the end, giving off a crystalline gray light that reminds me of God speaking and stars forming.
“Angie?”
My head turns. Casey stands next to Vivian. Betrayed!
“Are you okay?”
“You knew all along,” I reply, “didn’t you.”
“Knew what?” Casey asks. Her surgical mask shudders with her words. The mask hides most of her face, making it hard for me to read her.
Vivian, still holding the foley catheter kit, says: “I meant to get a signature from her, and she threw this at me.”
I turn back to the moon, but it’s no longer there. Mamá’s arms spread aside in supplication. “They mienten.”
“Yes, they’re lying.” Laughter rises around me. I pivot toward the patients lining the hallway. My scream is a visceral, ancient emotion. “Stop laughing!” Visitors begin to crowd the doorways of adjacent rooms.
“Angie, please, you have to calm down,” says Casey. She takes two steps toward me with her hands pointed upwards. “Nobody is laughing at you, hon.”
“You think I killed him too, don’t you,” I say. “I can’t lose my job, Casey.”
“Let’s talk in the break room.”
“Mentiras,” hisses Mamá. “Don’t trust esta mentirosa.”
I back away from Casey. “Stay away.”
The overhead system squawks: “CODE GREY, EMERGENCY ROOM. HALLWAY A. CODE GREY.”
I bolt down the hall. Laughter trails me. I run past the first trauma room. Empty. I run past the second one and stop. Kevin stands shirtless in a corner. The skin across his slim stomach is translucent; decaying organs gurgle within. Dead, fisheyes stare unblinkingly at me. A bruise on his neck and face stands in sharp contrast against his bloodless skin. He raises his arm and points an accusatory finger at me.
Impossible. It hadn’t been Kevin in the trauma room. “I would’ve saved you,” I whisper.
Kevin’s lips move and mouths a single word: Liar.
I wheel away from the room, bump against a crash cart, and scream when Kevin begins to walk toward me. Joe at the registration desk lifts his deflating body off the chair and flashes his greedy teeth at me. There’s an obstinate arching of his eyebrows that makes him look like a cooked pig.
“Fuck you, Joe.”
I run past the trauma room and make it to the ambulance bay. The doors swish open and clatter against the wall. Three security guards look up, surprised. One of them has a badge near the door reader.
“Angie?”
Casey and Vivian and Joe and Mamá and Kevin and the woman with the bob and over a dozen patients gawk with delirious curiosity. As if I’m some animal to gape at, to laugh at when I make some blundering misstep, a case study to reference while having a philosophical discussion about the pitfalls of an incompetent nurse.
“They’re out to get me,” I say and back away. “I won’t let them take me. Mamá, don’t let them — It wasn’t me. Can I go back to the moon? To feel the regolith between my toes. Mamá knows. Ask her! It wasn’t my fault. It’s the moral injury talking. We are all morally injured deep down, aren’t — Sacrificing our morality because what else are we going to do? Tell them, Kevin. Kevin, they don’t even care that we have the same mask all day the same mask for days and we give, and we give, and we give until we are empty, empty all the way — We are sponges that suck and absorb the hurt and the sickness until it corrupts our soul until we are just one black, cancerous sponge until we break in two until ... until you make a mistake and lose your livelihood. Your family. Your life.”
“We’re trying to help,” says Casey.
The guards fan out, stalking me as I back into a corner. There’s a gluttonous look in their eyes. They want to hurt me. They like to hurt people. They are going to take me and hide me where nobody can find me. Casey holds a silver object that looks like a scalpel in her left hand. A tech pushes a gurney past Casey and stops behind one of the guards.
“Don’t you dare touch me!”
My back hits the wall. One of the guards lunges at me. His hands grip my right arm. I kick out in panic. A second guard latches onto my leg. The third onto my other arm. I pull, scream, and try to loosen their grip. Voices compete over the commotion. The tech brings the stretcher next to me. The three guards lift me over their heads and dump me unceremoniously on the stretcher.
Above the buzzing sound of issued orders, Mamá says: “Pobrecita, mija. Te van a hurt you.”
I pull myself up. A pair of hands push me back on the stretcher and hold me firmly down. Despite the mattress, the metal frame of the stretcher pokes me, sharp against my lower back. They clamp rubber restraints around my wrists and ankles. One of my arms is stretched over my head, the other beside my hip. They cross the straps of my ankles at the base of the stretcher to limit my range of motion. The security guard next to me mists my face with his halitosis. Sweat shines sickly on his forehead and neck.
CODE GRAY AMBULANCE BAY. CODE GRAY.
My eyes are wide and roaming. Mamá stands over Casey’s left shoulder. Shadows surround her. “Mamá, ayudame. Somebody help me. Pleeeeease...In the name of Jesus, let me go.” Casey looks over her shoulders with a stricken expression, trying to see who I’m talking to.
The stretcher moves and I collapse. The intermittent light fixtures on the ceiling are like flashes from a camera, documenting my state of duress, spectating my unforgiving humiliation and the blatant disregard for my human rights. What happened to innocent until proven guilty? Where is God to pull me away from the hands of demons? I want to hold Kevin. To fly the heavens and feel the glow of the moon on my face.
The flashes of light become pools of renascent daylight. The ten-by-ten windowless room (How many times have I cared for a patient in this particular room?) is a constricting coffin. The walls bulge in, enclosing me into its embrace. I can smell the undertones of human waste waiting under the glossy film of hospital-grade disinfectant...waiting for release.
Casey’s face looms over me. “Angie, we’re going to take care of you. I’m going to give you some medication to calm you down.”
My eyes blur with tears. Mamá looms over me. A bilious hand caresses my cheek. “Don’t cry, mija. Yo estoy contigo, always.” Mamá pulls on my wrist. The restraints fall away and strike the railing of the stretcher, making a clanking sound that reverberates against the walls. The ceiling collapses, leaving Mamma silhouetted against a cloudless night sky. Millions of stars blink their dying light. The moon rises to the left like a searchlight lancing the night. The hospital drops below us, and the sable sky gives way to space.
A familiar voice speaks next. Linda sounds dim as if she’s communicating from a distant planet:
“It’s sad. Do you know that there’s a study...”
Casey leans against the counter, and a cascade of red hair frames an oval face. A badge with her face and the letters RN hangs from her scrub pocket. We met three years ago and bonded over our children participating in the same soccer team. We’ve been best friends ever since.
Casey carries a Starbucks cup in her hand. The mandatory surgical mask is down to her chin. One mask per day after all. It’s a counterintuitive and unsafe policy; one unfit for a nation in the throes of a pandemic that has killed millions of people worldwide. How can I keep a single mask clean when every patient needs an assessment, visitors need updates, and interactions between co-workers who may or may not be infected are unavoidable? Am I not contributing to the problem by carrying a potentially soiled mask to every room I visit, risking cross-contamination? Until a month ago, nurses were saving their N-95 masks in brown paper bags for multi-day use for Christ’s sake.
I don’t know how long I’ve been standing there without replying.
“I heard there was a pediatric death yesterday,” continues Casey, “but nobody could tell me any details.” She takes a sip of coffee. “What happened?”
What had happened? Blunt trauma? Assault? Fall? I can’t remember. It seemed inconsequential at the time. Casey notices my hesitation; her eyebrows meet in concern.
“You okay?”
“Yeah, sorry,” I say, making a perfunctory motion with my hands. I clean my hands with sanitizer. “It happened kind of fast. I wasn’t primary. Guess I wasn’t listening to the EMS report.”
Casey relaxes. “I hate pediatric codes. Kids have no business seeing the inside of a trauma room.”
Past Casey and out of earshot Joe’s talking to Vivian, the department manager. She’s rail-thin with a flapping neck that reminds me of a mastiff’s dewlap. Secured to the top of her head is a painful-looking knot. She keeps looking in my direction. Joe nods sagely before giving me a sad, critical smile.
“You sure you’re okay?” Casey asks. “You seem...distracted.”
“Tired. It’s my Friday.” I shrug and gesture behind her. “What’s Vivian talking to Joe about?”
Casey turns around. Vivian and Joe are no longer looking in their direction.
“Not sure,” says Casey, taking another sip of her coffee. “But I heard management is auditing the chart on that code. The parents are looking at the hospital for answers. They think we did something wrong. She’s prob’ly making rounds.”
Wrong? Did I do something wrong?
I try to recall the code, but all I can remember is the unused needle in my hands and the dead boy’s unblinking gaze. I wasted so much time trying to put an IV when EMS likely put an intraosseous needle before arrival. A feeling like creeping spiders walking on bare skin makes its way up my chest. Did my incompetence cost him his life? I needed to be faster, confident, and unperturbed. They know it’s my fault. And if there’s a lawsuit involved; the hospital will be looking for a scapegoat.
From the corner of my eyes, I watch Vivian write something down on a legal pad. Joe’s face is a vulpine mask. All day, it feels like everyone’s talking about me, dissecting my every move, looking away when I catch their attention. Now I know why.
“Angie?” Casey touches my arm and startles me.
“I have to go,” I say. “Rob needed help with a foley cath in room ten.”
I leave Casey before I’m further interrogated and head toward the supply room. Most of the patients lining the hallway have blankets up to their chin; hoping it will help them maintain a modicum of modesty and privacy. Their eyes follow me. I avert my gaze, ignoring their pleas and never-ending questions: When will the doctor be by? What’s taking so long? Where’s my pain medication? Why are you so rude? Where is the manager?
My badge unlocks the supply room. I lean against the wall when the door clicks shut behind me and pull out my sanitizer. The alcohol drying on my skin focuses me. I visualize the pores opening up to expel every disease, germ, and microbe trying to kill me. My hands start to sting. The knuckles are cracked, and an unhealthy shade of red radiates up to my wrist.
The L-shaped supply room is cluttered with every nurse’s arsenal; IV supplies, fluids, bladder scanners, oxygen masks, oxygen tanks, urinals, emesis basins, lumbar puncture kits, IV poles, hospital socks, fall packets, baby diapers, adult diapers, central line kits, ostomy supplies, splints, nasogastric tubes...
The foley catheter kits are around the bend on the bottom shelf. I grab one. There’s a beep before the door clicks open. “Room’s all y — ” The words trail off. Vivian stands in the doorway, legal pad tucked under one arm like a marine bearing his rifle before going out to war.
“Angelica, have a minute?”
She’s here to put me on administrative leave. Everyone named me as the culprit. The one who let the boy die.
“No,” I say in a small gasp. “I — I mean. I’m in the middle of something.”
“It’s a small thing. Won’t take long.”
I side-step Vivian, holding the urinary catheter against my chest. A flash of confusion races across her eyes. Don’t talk to her. Nobody will hire me. With a stay-at-home husband, what will happen to Kevin?
“Can we...talk later?” I ask. My foot catches one of the IV poles and trip over it. Vivian reaches out to me.
“Don’t touch me!” I brandish the foley like a cross and almost shout, Señor repienta, devil.
“I was trying — ”
My hands fumble with the door handle. Nothing happens. My hand slides on the cool metal of the handle. The rattle it makes is deafening in the stillness of the room. Then I remember that the door opens inward. I toss the kit at Vivian and open it. The door bangs against the opposing wall. The shock of the impact jostles the patients near the supply room.
I rip the surgical mask off my face when the carbon dioxide makes me dizzy. The stench of bleach and ammonia from the floor’s disinfectant waters my eyes. I head towards the ambulance bay for fresh air. Faces leer and hungry eyes follow me.
“Don’t look at me like that!” I shout to a woman lying on her side. Humor creases the corners of her eyes. Her chest heaves with chortling laughter.
“No le hagas caso, mija,” says Mamá, who stands at the end of the hallway in a blue and green hospital gown. She lacks last night’s majestic glow. The one that transcended human frailty. Instead, her skin is yellow with excess bilirubin and waste material. Her lined face looks like withered papyrus. Even from where I stand, Mamá’s bloated stomach pulling on her gown stands out. “They don’t appreciate el trabajo you do. They are sanguijuela. Leeches todos.”
More patients turn their heads in my direction. For a split second, the hallway stretches out behind Mamá, angling upward in a slow incline. The moon hangs at the end, giving off a crystalline gray light that reminds me of God speaking and stars forming.
“Angie?”
My head turns. Casey stands next to Vivian. Betrayed!
“Are you okay?”
“You knew all along,” I reply, “didn’t you.”
“Knew what?” Casey asks. Her surgical mask shudders with her words. The mask hides most of her face, making it hard for me to read her.
Vivian, still holding the foley catheter kit, says: “I meant to get a signature from her, and she threw this at me.”
I turn back to the moon, but it’s no longer there. Mamá’s arms spread aside in supplication. “They mienten.”
“Yes, they’re lying.” Laughter rises around me. I pivot toward the patients lining the hallway. My scream is a visceral, ancient emotion. “Stop laughing!” Visitors begin to crowd the doorways of adjacent rooms.
“Angie, please, you have to calm down,” says Casey. She takes two steps toward me with her hands pointed upwards. “Nobody is laughing at you, hon.”
“You think I killed him too, don’t you,” I say. “I can’t lose my job, Casey.”
“Let’s talk in the break room.”
“Mentiras,” hisses Mamá. “Don’t trust esta mentirosa.”
I back away from Casey. “Stay away.”
The overhead system squawks: “CODE GREY, EMERGENCY ROOM. HALLWAY A. CODE GREY.”
I bolt down the hall. Laughter trails me. I run past the first trauma room. Empty. I run past the second one and stop. Kevin stands shirtless in a corner. The skin across his slim stomach is translucent; decaying organs gurgle within. Dead, fisheyes stare unblinkingly at me. A bruise on his neck and face stands in sharp contrast against his bloodless skin. He raises his arm and points an accusatory finger at me.
Impossible. It hadn’t been Kevin in the trauma room. “I would’ve saved you,” I whisper.
Kevin’s lips move and mouths a single word: Liar.
I wheel away from the room, bump against a crash cart, and scream when Kevin begins to walk toward me. Joe at the registration desk lifts his deflating body off the chair and flashes his greedy teeth at me. There’s an obstinate arching of his eyebrows that makes him look like a cooked pig.
“Fuck you, Joe.”
I run past the trauma room and make it to the ambulance bay. The doors swish open and clatter against the wall. Three security guards look up, surprised. One of them has a badge near the door reader.
“Angie?”
Casey and Vivian and Joe and Mamá and Kevin and the woman with the bob and over a dozen patients gawk with delirious curiosity. As if I’m some animal to gape at, to laugh at when I make some blundering misstep, a case study to reference while having a philosophical discussion about the pitfalls of an incompetent nurse.
“They’re out to get me,” I say and back away. “I won’t let them take me. Mamá, don’t let them — It wasn’t me. Can I go back to the moon? To feel the regolith between my toes. Mamá knows. Ask her! It wasn’t my fault. It’s the moral injury talking. We are all morally injured deep down, aren’t — Sacrificing our morality because what else are we going to do? Tell them, Kevin. Kevin, they don’t even care that we have the same mask all day the same mask for days and we give, and we give, and we give until we are empty, empty all the way — We are sponges that suck and absorb the hurt and the sickness until it corrupts our soul until we are just one black, cancerous sponge until we break in two until ... until you make a mistake and lose your livelihood. Your family. Your life.”
“We’re trying to help,” says Casey.
The guards fan out, stalking me as I back into a corner. There’s a gluttonous look in their eyes. They want to hurt me. They like to hurt people. They are going to take me and hide me where nobody can find me. Casey holds a silver object that looks like a scalpel in her left hand. A tech pushes a gurney past Casey and stops behind one of the guards.
“Don’t you dare touch me!”
My back hits the wall. One of the guards lunges at me. His hands grip my right arm. I kick out in panic. A second guard latches onto my leg. The third onto my other arm. I pull, scream, and try to loosen their grip. Voices compete over the commotion. The tech brings the stretcher next to me. The three guards lift me over their heads and dump me unceremoniously on the stretcher.
Above the buzzing sound of issued orders, Mamá says: “Pobrecita, mija. Te van a hurt you.”
I pull myself up. A pair of hands push me back on the stretcher and hold me firmly down. Despite the mattress, the metal frame of the stretcher pokes me, sharp against my lower back. They clamp rubber restraints around my wrists and ankles. One of my arms is stretched over my head, the other beside my hip. They cross the straps of my ankles at the base of the stretcher to limit my range of motion. The security guard next to me mists my face with his halitosis. Sweat shines sickly on his forehead and neck.
CODE GRAY AMBULANCE BAY. CODE GRAY.
My eyes are wide and roaming. Mamá stands over Casey’s left shoulder. Shadows surround her. “Mamá, ayudame. Somebody help me. Pleeeeease...In the name of Jesus, let me go.” Casey looks over her shoulders with a stricken expression, trying to see who I’m talking to.
The stretcher moves and I collapse. The intermittent light fixtures on the ceiling are like flashes from a camera, documenting my state of duress, spectating my unforgiving humiliation and the blatant disregard for my human rights. What happened to innocent until proven guilty? Where is God to pull me away from the hands of demons? I want to hold Kevin. To fly the heavens and feel the glow of the moon on my face.
The flashes of light become pools of renascent daylight. The ten-by-ten windowless room (How many times have I cared for a patient in this particular room?) is a constricting coffin. The walls bulge in, enclosing me into its embrace. I can smell the undertones of human waste waiting under the glossy film of hospital-grade disinfectant...waiting for release.
Casey’s face looms over me. “Angie, we’re going to take care of you. I’m going to give you some medication to calm you down.”
My eyes blur with tears. Mamá looms over me. A bilious hand caresses my cheek. “Don’t cry, mija. Yo estoy contigo, always.” Mamá pulls on my wrist. The restraints fall away and strike the railing of the stretcher, making a clanking sound that reverberates against the walls. The ceiling collapses, leaving Mamma silhouetted against a cloudless night sky. Millions of stars blink their dying light. The moon rises to the left like a searchlight lancing the night. The hospital drops below us, and the sable sky gives way to space.
A familiar voice speaks next. Linda sounds dim as if she’s communicating from a distant planet:
“It’s sad. Do you know that there’s a study...”
The End