Emergency Room Page 2

City Hospital 6:00 p.m.

  THE BLOTCHY PINK VOLUNTEER jackets were so hideous that Diana could only assume the color prevented people from stealing them. It was absolutely impossible to wear anything that would look decent with that shade. Even a plain white turtleneck looked awful, her small head sticking up out of the pink and white as if she really did have the neck of a turtle.

  She attached her photo ID and hiked down long confusing corridors to the Emergency Room. Large when it was built, the hospital had acquired five major additions, connected by ells, above-the-road glass hallways, and underground tunnels. Diana loved thinking about everything that was happening here — every operation, every tragedy, every lab procedure, and every triumph. Most of all she loved knowing that one day she would be a medical student here.

  Okay, so she was only a college freshman now. Just wait. She’d train at this very hospital and have the edge on everybody.

  The ER was built like a letter H, with four treatment halls jutting off the control area: surgical, medical, psychiatric, and pediatric. Special rooms were set aside for eye injuries, broken bones, and police holding. Next to the ambulance arrival pad was the real excitement: the Trauma Room, where the most badly injured patients were rushed.

  Rush was the right word. It gave Diana a rush just to be here. Adrenalin spurted, making her hot and eager to see everything there was to see.

  Of course, the instant she had to check in with the clerk, she would come down off the high. Meggie detested volunteers, especially college volunteers. They were just annoying do-gooders who got lost making pharmacy runs, and had to have their hands held when things got rough.

  Diana turned down the final hall to see Seth standing between her and the desk clerk.

  Wonderful. The humiliation of their only date made her cheeks burn and her temperature rise.

  Seth was a hunk. Hair as black as her own, but longer, thicker, more casual. Eyes that burned blue, like some alien fire. Whenever their paths crossed, Diana found herself studying Seth inch by inch, starting at eye level, which for her, on Seth, was midchest. Seth was very buttoned up, and she imagined unbuttoning him.

  If only he weren’t so arrogant! You couldn’t even apply to their college unless you were pretty full of yourself, but when it came to ego, you could stack Seth’s next to anybody’s. Seth was only a college freshman, but he already considered himself a medical student, a doctor, a Nobel Prize winner, and God.

  Diana never talked to Seth without wanting to put him down.

  Sure enough, she accomplished it first sentence out, which pleased her, and she moved right along to the desk clerk. “Here I am, Meggie,” said Diana cheerfully. “How are you tonight?”

  Poor choice of question. Meggie was never well. Her feet hurt, her head ached, and her fillings fell out. She liked to take these problems out on healthy people, like, for example, this perky, bouncy little rich girl with the glowing cheeks.

  Meggie actually smiled, which meant she had something unpleasant to assign. “Insurance,” said Meggie gloatingly, “needs a volunteer.”

  Diana stared at Meggie. “Insurance? No way! Stuck filling out insurance forms?”

  Who do you think I am? (She just barely kept herself from saying that out loud.) I don’t go to just any college, you know!

  Meggie heard every word even if Diana didn’t say anything. She smirked.

  Seth’s grin remained in place like a computer spreadsheet.

  Perfect for his personality, she thought.

  “What’s my assignment, Meggie?” he said.

  Seth looked terrific even in a salmon-pink jacket that didn’t fit. Possibly why Meggie was shipping Diana off to Insurance. The better to flirt with Seth. Well, Meggie could have him.

  Meggie did not smile, which meant she had good news for Seth. “After you get back from the Blood Lab, Trauma needs a runner.”

  Sexist! thought Diana, absolutely furious at Meggie. You’re giving him the good stuff because he’s cute and male. “I don’t want to do Insurance,” she said. I volunteered to help save the world, she thought, not help insure it.

  Meggie shrugged. “I got no work for you down here.” Her enormous bosom strained against the shiny lime-green blouse she wore every Monday. Why couldn’t the woman expand her wardrobe? She certainly had no trouble expanding her waist.

  Seth was laughing at Diana. “Hey, have fun,” he said. “Fill out an insurance form for me, huh?”

  “How about I just lose you in the computer?” Diana stomped away, even though she was afraid. To reach Insurance, you had to go through the Waiting Room, a frightening hostile place Diana preferred to avoid.

  Inner-city patients were okay when they were confined to stretchers and surrounded by techs and nurses and doctors, stuck with needles and fastened to machines. They weren’t people then, really, but patients, which was something else altogether. Their ages and races, criminal backgrounds or tragedy or confusion blended into the bedsheets and the ward activity. They were so much cleaner, somehow, in the treatment area. Out in the Waiting Room, however, you actually had to be among them; and out there, they were not yet patients.

  Sullen, frightened, pain-ridden people sat tensely in turquoise plastic chairs bolted to the floor. Some would wait ten minutes to be seen and some would wait hours. They suffered every possible woe and wound, and had nothing to do in that Waiting Room but get angry that they had to wait.

  Sick mothers had no baby-sitters and had to bring their small children; a gunfight over a drug sale brought in the families of both the shooter and the shot; babies screamed and children whined and people missed meals and work and appointments.

  Diana passed through a sea of hostile black, Asian, Indian, Hispanic, and white faces. Again tonight there was a yawning policeman sitting next to a man in shackles. The room was so packed that Diana could not make a detour, but had to step over the man’s stretched-out legs. He smelled.

  She reached Insurance alive, however, and tried to calm herself.

  “A volunteer!” said a sexy black woman from behind a glass wall. She had fabulous fingernails and intricate hair. “Great. We’re swamped.” She actually smiled at Diana.

  Diana had learned that her name tag meant nothing. Nobody would ever call her Diana. They would just shout, “Volunteer! Pharmacy!” In spite of past experience, though, Diana attempted conversation. “I’m always surprised that Mondays are so busy,” she confided. “I thought Friday or Saturday would be the night the ER gets swamped.”

  “Nope. Nobody wants to ruin their weekend. People try to stay well or not think about it during the weekend. Monday it hits the fan.” Knika handed her a form covered with a nurse’s scribbles. “I’m Knika, Diana. You’ll help us get paper. We chase after every patient, or else find their family, and get the facts for the computer.”

  Diana felt marginally better. She would at least know how everybody got hurt.

  Knika listed the facts Diana would unearth. “Name, address, phone number, next of kin, and insurance or welfare status.”

  Immediately Diana felt worse again. She could not care less about anybody’s insurance status. At this very moment, Seth was probably assisting on a GSW. (Actually neither Diana nor Seth had ever seen a gunshot wound, but they kept hoping.) “Do they have to have insurance to be treated?” she asked.

  “Nope. This is City Hospital, honey. Everybody gets treated here, which is why it’s so crowded. If they don’t have insurance and they don’t have welfare either, write down ‘self-pay,’ even if you know perfectly well that nobody is ever going to pay the bill.”

  WILLIAMS, said the sheet which Knika thrust at her. MALE. ETOH. FISTFIGHT. BROKEN NOSE. URGENT.

  Knika picked up the phone, having finished with Diana.

  This was not what Diana considered extensive job training and she had no idea what to do next. Diana took her paper to the Admitting Nurse, whose name tag said Barbie. Diana could not imagine anybody who less resembled a Barbie doll. Nor could she imagine a Ken ever sett
ing foot in this Waiting Room to meet her. “What do I do next?” she said to Barbie.

  Barbie was incredulous. A volunteer dared talk to her? “I’m busy,” she said sharply. (Another Seth.)

  “I’ll do the first one with you,” said an insurance clerk, popping out of her cubicle. She was barely five feet tall, slender, blonde, middle-aged. “I’m Mary. It seems a little zoo-y, doesn’t it? That’s because it is. It’s Monday. Mondays are zoos.”

  In spite of the fact that everybody including children in the Waiting Room was bigger than Mary, Mary strode through the place as if it were empty. Diana felt brave enough to inspect the room. She actually focused her eyes. Yes. Everybody there qualified for zoo status. In fact, she would have felt a lot better about one man in the corner if he were in a cage.

  “Urgent means they took him straight to treatment,” Mary said, decoding the scribbles on Diana’s work sheet, “so you won’t find him in the Waiting Room. These numbers here are the ambulance code. They tell you what part of town Mr. Williams was brought from. The W means he’s white. That’ll help us find him; we won’t be looking for anybody black or Hispanic.”

  Help us find him? thought Diana. There weren’t really rooms in the ER — just numbered, curtained partitions — but how could a patient be lost and have to be found?

  Mary kept on. “This little check mark tells you the police are involved. So you don’t want to assume you’re safe around Mr. Williams. Make sure he’s restrained.”

  Diana was not too sure she wanted to associate with somebody who might not be safe and needed to be restrained.

  “There’s only a last name,” Mary said, “so probably he’s too drunk to remember his first name.”

  “How do you know he’s drunk?”

  “That’s what ETOH means. I forget what that stands for. Alcohol, I guess.”

  Down in the treatment area, a washable wall chart was Magic Markered with patients’ last names and room numbers. WILLIAMS had no number, only the letter H. “Hall,” explained Mary. “Drunks just get lined up because we have so many. Look for a broken nose.”

  The inner wall running down the Medical to Surgical wing was lined with stretchers, onto which men were fastened with leather bracelets, ankle grips, or twisted ropes made of bedsheets. Diana usually clung to the opposite wall when she walked here, because these patients were prone to smelling, swearing, and spitting. She had never run an errand involving the hall patients and could not imagine actually having to talk to one of them.

  In the ER, patients were either “attractive” or “not attractive.” It was easier for the staff to be sympathetic to a clean, well-spoken person who’d had an unfortunate accident than to a filthy stinking drunk who got scraped off the sidewalk week in and week out. The people lining these halls were very thoroughly “not attractive.”

  Diana did not think she knew how to look for a broken nose, but when they found Mr. Williams, she did. His nose had been crushed right back into his face. Blood had dried all over his shirt and turned the sheets red around his head. He looked dead to Diana, who wanted to cry.

  Mary displayed no interest in Mr. Williams’s possible pain. “Mr. Williams!” she yelled, grabbing his arm and shaking him.

  Mr. Williams’s eyes opened. “Whuh.”

  “What’s your first name, Mr. Williams?”

  “Whuh.”

  “Where do you live, Mr. Williams?”

  “Whuh.”

  “Mr. Williams!” yelled Mary. “Answer me! What’s your first name?”

  “André.”

  Diana filled in “André.”

  “Now ask him where he lives,” Mary told her.

  “Where do you live, Mr. Williams?” asked Diana politely.

  Two doctors and a nurse walking by laughed at her. She blushed and felt stupid.

  “Yell,” Mary told her.

  Of course Seth had to choose this moment to reappear. He leaned against the far wall, arms crossed in a leisurely superior fashion, laughing at her for the second time in ten minutes. This isn’t fair! thought Diana, cheeks scarlet with confusion and embarrassment. I didn’t volunteer so I could get street addresses from drunks! “Where do you live, Mr. Williams?” she said again, and got no response. Finally she really yelled. “Where do you live, Mr. Williams?”

  Mr. Williams told her where to go.

  Diana turned pale.

  The nurse who had laughed came back, grabbed Mr. Williams’s arm, and shouted, “You tell her where you live or I’ll leave you strapped to this stretcher for the next ten years, buddy!”

  Mr. Williams grinned beneath his crushed nose. To Diana’s surprise it was a friendly grin, and she found herself grinning back at him. “Texas,” he said.

  “Oh, right,” said the nurse sarcastically. “What are you doing two thousand miles away then?”

  “Giving you a hard time.”

  Everybody laughed, even Diana. Mr. Williams told her where he really lived (three blocks away) and to Diana’s surprise, he said, “Hey, honey, I didn’t mean to scare you. I had one too many.”

  “You had ten too many,” said the nurse. “Who hit you, anyway?”

  “My girlfriend’s boyfriend,” said Mr. Williams. He winked at Diana. Diana thought it sounded like the sort of situation where you would get a broken nose even if you hadn’t had ten too many.

  On the way back to Insurance, Diana said to Mary, “Why didn’t we just let him sleep? Why did we put him through that? Shaking him and yelling at him?”

  “We have to know which Mr. Williams this is,” said Mary. “Say we’ve treated fifty men named Williams this year. Say we’re guessing this guy is a drunk with a facial injury. But say what we don’t know is, he’s actually diabetic. He could die from the wrong treatment. So we want the right Patient Record for the doctors to look at before they prescribe. Plus, it’s nice if the Mr. Williams who is actually here is the Mr. Williams who gets billed for being here.”

  At Knika’s desk, Mary grabbed another form and handed it to Diana. “I’ll put Mr. Williams in the computer,” said Mary, “while you do the next one. Don’t screw up.”

  Mary vanished into her cubicle.

  Knika talked fiercely into her telephones.

  Barbie helped a limping old man into a wheelchair.

  Two minutes of training. That was it. A world-famous, world-class hospital, where if Diana got the wrong information, some innocent patient would die.

  The City 6:05 p.m.

  ANNA MARIA REFUSED TO cry. She was too old for that and anyway, she had been in charge plenty of times without tears.

  It was just that without electricity, the tiny apartment was so scary.

  The lights wouldn’t go on, the television wouldn’t work, the radio didn’t play. The stove didn’t heat and the refrigerator didn’t keep things cold.

  It was hard not to cry. Tears filled her up, not behind the eyes, where they belonged, but inside her chest, making a well of hot water that threatened to drown her.

  The streets were dangerous at night. It was not safe to be out there. Night began early in the City. As the sun lowered in the sky, it was hidden quickly by tall buildings. Long shadows darkened the little apartment. Anna Maria wanted to go outside so much it was a cry from her heart. Outside there would be people and talk and laughter.

  Usually, nights, they got that from TV and radio. But not without electricity. Mama said it was her fault they didn’t have electricity, because Mama hadn’t paid the bill. She said in winter they didn’t cut you off, but in summer they did.

  Anna Maria felt so very cut off. As if huge cruel scissors had taken away all sound and light and hope.

  The walls closed in and the heat was suffocating.

  It was still light out and the quiz shows with their laughing emcees, or the reruns with their familiar leads, would be on now if she had a television. But she didn’t. The hours stretched ahead of Anna Maria, black and silent and scary.

  She did not know when Mama would be home. Ma
ma never said. So they had Froot Loops for supper.

  Anna Maria fixed Yasmin’s hair, braiding it carefully. Then she filled a baby bottle with red Kool-Aid and stuck José into the stroller, his little hands wrapped around his bottle. Together she and Yasmin bumped the stroller down four flights of stinking, narrow, unlit stairs.

  The sidewalk was bumpy and Anna Maria kept having to tilt the stroller to keep the wheels going. Yasmin danced the whole way. Yasmin had new shoes from the Salvation Army store and the heels were hard. She had never had hard-soled shoes before, only sneakers, and she loved the taps that the new shoes could make. Yasmin wanted to dance more than anything. A few blocks from their apartment was a dancing school, and Yasmin liked to pretend she went there.

  José sucked on the bottle without tipping the Kool-Aid into his mouth. He would save the liquid for later; now he just wanted the comfort of the nipple in his mouth.

  They walked quite a few blocks. Nothing happened to them. This was partly because Anna Maria was holding very tightly to the gold cross on her necklace, and partly because it was too early for people to be really drunk or really high or really dangerous.

  It wasn’t even dark enough for the streetlights to come on yet. Anna Maria hated streetlights. Most of them didn’t work anyway, and the ones that did cast a sick pool of yellow that turned the faces of strangers into vampires.

  Last year they had spent a lot of evenings at the public library because the children’s room was friendly. But the library had run out of money, too. Anna Maria thought of the books in there, silent and closed like the doors. You never thought a library could close.

  If a library could close, maybe even a hospital could close.

  Anna Maria shivered.

  The flimsy stroller caught on a crack in the sidewalk, and she was horrified for a moment that a wheel had broken. How could they replace the stroller? Yasmin knelt beside the wheel, extricated it, and got it started again. Anna Maria drew a breath of relief.

  Just ahead was the neon sign she wanted:

  EMERGENCY ROOM

  She had been here plenty of times. Never on her own, though. But she knew several things about the Waiting Room at City Hospital.