On Duty
by
Carolin Parnall

Grateful acknowledgment is made to the
following for permission to reprint previously published material:

Henry Holt and Co., Inc.: two lines from Forgive, O Lord from In the
Clearing from THE POETRY OF ROBERT FROST edited by Edward Connery
Lathem. Copyright C) 1962 by Robert Frost.

Copyright (D 1969 by Henry Holt and Co., Inc. Reprinted by permission
of Henry Holt and Co., Inc.

Alfred A. Knopf, Inc.: Excerpt from Sunday Morning from COLLECTED POEMS
by Wallace Stevens. Copyright C) 1923 and renewed 1951 by Wallace
Stevens. Reprinted by permission of Alfred A. Knopf, Inc.

A Fawcett Gold Medal Book Published by Ballantine Books

Copyright (D 1996 by Carolyn Parnall Fink, R.N.

All rights reserved under International and Pan-American Copyright
Conventions. Published in the United States by Ballantine Books, a
division of Random House, Inc., New York, and simultaneously in Canada
by Random House of Canada Limited, Toronto.

ISBN 1-56865-369-7

Manufactured in the United States of America

Dedicated To Nurses Everywhere

Death is the mother of beauty, mystical.

Within whose burning bosom we devise Our earthly mothers waiting
sleeplessly.

-Wallace Stevens, Sunday Morning Forgive, O Lord, my little jokes on
Thee, And I'll forgive Thy great big one on me.

-Robert Frost, In the Clearing ...  in my end is my beginning.

-T. S. Eliot, The Four Quartets

Acknowledgments

I would like to thank all the nurses and friends who helped me with this
book, with their stories, their hope and their encouragement, Mary
Alesch, R. N. Pamela M. Galbraith, R. N. Patricia Hendrickson, C. N. P.
Mary C. Herring, R. N. Angela Luster, L. P. N. Meg O'Keefe, R. N. Marie
A. Olivo, L. P. N. Susan Olivo Rebecca Bobbi Reiter, C. N. P. Domenica
Rush, R. N. Beverly A. Seymour, R. N. Margaret M. M. Trace, R. N.
Patricia Worth, R. N. My thanks to my agent, Lynn Rosen, and my editor,
Susan Randol.

Many thanks also to friends and family, and most of all, to Jack.


Introduction

Once upon a time, I sat at a party and talked to another nurse. I told
her about my patients in a big county hospital and she told me about her
patients in a small private nursing home. We thought we were just two
nurses talking to each other.

When we turned around, half the party was gathered around us, listening.
They wanted to hear more. They wanted to hear more of what we had to say
because it was so real and so funny and so sad. It was all about the
lives and deaths that happened all around us every day.

My nurse friend looked at all these people gathered around us, turned to
me, and said, You know, someone ought to write a book.

I never forgot what she said. For the next ten years I worked with sick,
injured, dying people, and my friend's comment about a book simmered
deep in my mind. It gathered dreams and ideas and it grew.

Soon it had a voice, and it clamored for my attention until I had to
listen to it. It would not go away, it had become too strong and too
loud and too much a part of me, because by then I had met Joe Romero and
Lucy. I had met my friends Marie, Bev, Sharon, and Patty. By then death
had spoken to me and told me about life, beauty, and love. I had learned
that being close to dying people brings you close to life. I had learned
how sharp and bright the light looks next to the darkness, and how sweet
the morning is when you recall a bitter night. By then I had made a
promise. When brave, scared Joe Romero died, I looked in the mirror, and
I told him that someday I would tell his story.

And now, I am doing just that. I have put the voice to paper and set it
free. And I am also telling all of our stories. It's Patty in a little
hospital in Georgia, it's Peg in a cancer center, it's the phantom sheep
on the fifth floor of the hospital. It's Elizabeth and the walker, it's
a patient we called the Witch, it's learning about dying. It's an old
man with a stubby pencil and a lesson about the ends of things. It's
Rose and her memories of Vietnam.

Some of these stories are sad, as life can be. Some of these stories are
funny, as life can also be. Some are for laughing, some are for
thinking, but they are all real. These are the stories of the nurses who
watched and cared and never said much to anyone except other nurses.

Listen to them. Listen to their stories and you will hear voices that
know about miracles and magic. In the nurse's everyday world there are
wonderful moments. In the middle of nursing duties and dirty beds and
bloody bandages, there is magic. Where there is pain and fear and
loneliness, there are miracles. In the small hours of the night when
there is dying and dark things walk, there is light.

And now you can listen to the stories, too, because I have kept my
promises and written down what my friends told me about the patients
they remember. I will tell you a little bit about each nurse at the
beginning of each of their stories, things they may not tell you about
them selves and what they do. I'll describe a little about what their
days look like and how they reached the places they did. And then you
can see their patients through their eyes, as I did. You can hear their
words and listen to their feelings as they tell you what they learned.

These are all real nurses, and real patients. Everything in this book
happened-each problem, each moment of despair, each moment of hope. The
nurses worked with me at the University Hospital in Albuquerque, New
Mexico, and at the cancer center associated with the University of New
Mexico. I worked with all of these patients and nurses, I watched with
them, and laughed with them, and wept with them.

It was in these places that we learned many things about living and
dying. We also learned about Our Lady of Guadalupe, the Mother who
watches over her children on the long roads, as they walk on their
journeys, and shows them the way home.

Chapter 1.

The Shrine on the Road.

Lucy and Mr. Romero were dead. They were dead, and we weren't, and
that's how it all began. They were our patients, and they died. This
first story is mine. It is about the one patient who would not allow me
to forget him, the one who kept me aware and , writing. The writing
wasn't always conscious, it wasn't as if I went in to a patient's room
and said to myself, Remember this, because you'll have to write it down
someday. It was much more subtle, an underground stream that only once
in a while lifted its waters to the sun.

Most of the time I went about my duties at the hospital and the cancer
center learning more about disease, human response to disease, and
available treatments. It never became routine, but it did become home. I
wrestled with the twin demons of fear and inadequacy, wondering how I
dared work in this place among these gallant patients and their
families.

We nurses gave the medications, assisted with the surgeries, helped with
the radiation treatments, ate our lunch in the lounge, and lived. We
remembered our patients birthdays and anniversaries, each small
mile-post was important here. We saved cards and letters and passed them
around, marking the dates and the words of people who knew that there
were not many more dates or mile-posts or words for them. We taught our
patients about their diseases, about nutrition, how cells change, how
treatments work.

We taught them, but they taught us more. They taught us to watch,
listen, and pay attention to the world around us-the way guides who must
leave their tours behind watch and listen. Their teaching gradually
seeped down into my underground stream that had been running silently
for years, it burst into the air, became a torrent, and that is how it
all began.

Mr. Romero had been admitted to the hospital with a stomach problem. He
was having trouble eating and felt sick for no reason. I know green
chili will cure it. He smiled at me, hoping I would believe in green
chili as much as he did.

Mr. Romero was a small man. He had lived in the sun and the weather and
the wind for so long that he had pale smile wrinkles near his eyes.

He came from northern New Mexico, from the old mountains and the old
towns, and he used to tell us that everyone there was old.

I'm old, and the goats are old, and my house is old. All my neighbors
are old. Viejos, all of us. Old men, old goats, old mountains. All the
young people have to leave to find work. He shook his head. But Adelita
is not old.

His wife twinkled and smiled, her dark eyes shining. I was looking at
two people who truly liked each other.

Adelita prays to Our Lady of Guadalupe that we can go back to our
mountains and away from the city. You people are all very nice, but the
mountains are where we belong.

The Virgin of Guadalupe watches over travelers and her shrines are on
the roads, not in the churches. Her people walk, they do not ride horses
or automobiles. They are the poor people, the people of the country. She
loves the poor people and they love her. Adelita had been praying to her
Virgin. Adelita wanted to go back to the old mountains and have
everything be the same again.

Mr. Romero wasn't sure about prayers or shrines. Mr. Romero didn't
believe in anything much except the land. He always talked about the
land as if it were female.

You give to the land and then she gives back. She gives back more than
you give to her. But never try to fool her. She knows garbage. I had a
feeling that Mr. Romero knew garbage, too.

Mr. Joe Romero was in our strange hospital world now, far from his own
world. We nurses wondered how he would adapt to this new scene, with its
rigid rules and rapid pace and strange language. Many of our patients
had a lot of trouble giving up their independence and identity to us,
and I couldn't blame them. We hospital people take patients clothes away
and give them a nightie and an armband and walk in cheerily at 5,00 A.
m. and expect people to like us.

I worried about Joe Romero. He was a little hard of hearing, and came
from a slower, older, more relaxed world. As it turned out, I needn't
have worried. I didn't know Mr. Romero very well then.

So the tests went on. The docs  all said there was something going on and
wrote let's sit tight on the abdomen on their progress notes.

So they sat tight and did their tests, and for several days we waited.

Poor Mr. Romero couldn't eat any chili, of course, or much of anything
else.

He used to say, At least you could give me some oatmeal burritos when he
stared at the tray of Clear Liquid Diet or Soft Bland Diet. And then the
smile wrinkles got deeper.

You know, he said one day, as long as I'm here, you can look at these
funny little marks on my hands. I've had them for a long time. I I He
put out his gnarled brown strong hands and I looked close. I called the
skin docs  and they did a biopsy. Sure enough, they were small skin
cancers. So when the stomach docs  were done, the skin docs  took over and
told Mr. Romero to come down to the clinic when he got out of the
hospital.

The stomach tests were done and they were inconclusive -nothing there,
but nothing not there. Mr. Romero shook our hands, smiled his
sun-wrinkled smile, and said, At least I got those little things on my
hands looked at. Now I can go back to the mountains and eat beans and
real burritos, but don't tell those stomach doctors. It's Fidel's chili,
that's what it is!

The next time we saw Mr. Romero was in the cancer unit attached to the
hospital, in the dermatology clinic. None of those little skin cancers
were very big or very bad, but they needed to come off.

Some skin cancers are small and slow growing and don't spread.

Some are different, they can metastasize and spread through the body.

Until we did a biopsy and took some samples of skin to look at under a
microscope, we wouldn't know which kind of skin cancer Joe Romero had.

So we set about taking them off, one by one. The stomach pain was still
there, though, once in a while. One day Mr. Romero and I were talking
about the pain after we had finished with a small excision of a little
skin cancer, and I asked if there was a pattern to the pain.

No, he said, but it still doesn't like Fidel's green chili. Of course no
one else does, except Fidel. He laughed a loud laugh at his old friend's
cooking. It doesn't like Bud, either, but it can handle the Coors.

1 shook my head. No one was going to give Mr. Romero a diet and have him
stick to it. He had lived in his mountains too long. Mountains,
especially northern New Mexico mountains, make people independent.

When you have heard the flutes of the penitentes or watched los pastores
walk down a dirt road, singing the songs of Christmas, you have been in
another place, and the world of the hospital seems juvenile. When you
have seen the skies blacken in the summer and watched great gray
curtains of rain close over the desert, no other world can speak to you
for very long.

We kept at it and made another appointment and removed another skin
cancer. We had taught Mrs. Romero how to take care of the little wounds,
how to clean them and keep them clean. The healing was rapid, and we
told her she was a good nurse.

She's just good. Mr. Romero grinned.

We told Mrs. Romero if she needed a job we'd hire her, and she told us
that Mr. Romero was a full-time job, thank you. There was a quick wink
between them.

Hey, he told us the next week, I think I saw one of my docs  on TV the
other night. And I saw Annie, too. Mr. Romero had seen a local TV
program about one of our new dermatology clinics, and he had seen a
brief shot of the doctor and one of the aides. From then on he began to
call the doctor Old Famous.

We did the latest biopsy on Joe's temple, on a little area that looked
very much like all the rest of them. None of them had turned out to be
the spreading kind, just local little cancers that grew very slowly.

So we started an excision on the area on the temple, thinking, this
would be another little skin cancer like the others, a little scraping,
some cuts, a little cautery, an electrical heat charge to stop the
bleeding. Then we could check the margins of the skin sample to make
sure there was no more cancer, and that was that.

When the doctor began to scrape on the left temple, we were amazed to
see the probe sink into the wound. Mr. Romero stiffed, awake under the
sterile towel. All our surgeries were done under local anesthetic, and
normally there was no pain. But this was different. This was much
deeper.

The doctor lifted the probe carefully and said, We're going to have
someone else look at this. It's a little more involved than we thought.

We all smiled a little tightly, cleaned up the biopsy site, and took him
from surgery into a private room. All of a sudden our nice little
routine minor surgery had become something else. What else it had
become, we didn't know.

Soon there were other docs  in the clinic, ones we didn't know. There
were muted conversations behind closed doors, reviews of biopsies, plans
being made. I sat in the room with Mr. Romero, whose bandage sat at a
rakish angle, like a little cap on his head. He looked at me with
questions in his kind brown eyes.

What's this? A complication?

That was as good a word as any. I told him that we were going to
schedule him for an evaluation with some of the surgeons.

They'll do some more tests, to see what's going on behind your eye and
what that skin cancer is that we started working on. There's some thing
there, we just have to figure out what it is and how to get it out.

More tests, eh? He sighed. Tell Old Famous I'm tired of tests.

No more oatmeal burritos, either, or green Jell-O. Who invented lime
Jell-O, anyway? Somebody who hates green chili, that's for sure. He
shook his head. He had been able to accept all of our hospital routines
except the green Jell-O.

He tried to sound like our tough, jolly Mr. Romero, but there were
circles under his eyes, and when Mrs. Romero came in, he held her hand
very tightly and did not let go when the docs  came back. He kept holding
her hand, listening to the docs . I left them alone, holding hands.

It was getting harder to smile.

The other doctors scheduled surgery in the hospital, and we waited.

We went through the motions and took care of our other patients, but we
were all waiting to hear the news from the operating room. It came, of
course, late in the afternoon. I still don't like the sound of the term
enucleation. Never will.

Enucleation is easy to pronounce, but hard to think about. It means
removal of the eyeball from the bony orbit. And that's what had happened
to our Mr. Romero. The eye had to be removed from the bony orbit because
of the cancer we had found.

It had grown far into the back of the eye and would have been impossible
to remove by itself. I read the chart and it sounded as if the staff had
done their usual great job up in the operating room, and Mr. Romero was
back in the recovery room. He would be awake soon, and then we all could
go and see him. I knew we would make ourselves go and see him, even if
we felt like clocking out.

I walked up to the recovery room in the main hospital and felt like I
had walked a hundred miles. My feet were stuck in cement and I wasn't
quite ready to deal with Mr. Romero's enucleation. He lay in bed, quiet
and small, smaller than I had remembered him. His one eye was closed,
and the other one just wasn't there. For a minute I asked myself where
the bandages were. He needs bandages, something screamed inside me. And
then the nurse-person inside me took over and said, He doesn't need
bandages, dummy. You need bandages to cover what you don't want to see.

There was my brave old buddy, with a flap of skin over what had been his
eye. The wound was clean and dry, sutures in place, no drainage, not
even much discoloration. But just a flap over the place where his eye
had been. The wound didn't need bandages, but I still wished they had
been there.

I pulled the curtain around the bed, trying to find something to do with
my hands.

Hey there, mi amiga! I knew you would come to see me. Did you bring any
buritos? His one eye was brown and twinkling, but the hand I held was
cold. I guess I'll get a patch, he said, a big black patch like that
pirate fellow in Disneyland.

I nodded, trying to smile. Hey there, you doing okay?

Oh, I'm fine. I expect they'll bring me green Jell-O tomorrow, but I'll
do okay. It doesn't hurt, it never did. He shook his head, marveling at
the body's ways. That stomach pain is still there, so which one do you
want me to worry about more?

There was a pause and he patted my hand and pretended that he didn't see
the tears. He had only the one eye now, but still, Joe Romero didn't
miss much.

I don't want to worry about either one, he said. I'll just go back to my
mountains and let the Virgin of Guadalupe fix it. He nodded, pleased to
have found a solution to the problem of worry. I never did talk much to
Our Lady of Guadalupe, but I think I'll start now. Adelita would like
that.

I knew what the Virgin meant to the old people up north, and I was
afraid he would go back to his mountains and never come back. So the
nurse-person inside dried her tears and said briskly, We'll see you back
here in a couple of weeks for radiation. Did the docs  talk to you about
that yet?

He was silent for a minute, thinking about his great gray mountains
probably, and the Virgin of Guadalupe, and radiation.

Oh yeah, I know all about that. They talked to me about it before the
surgery. Little rays to knock off the cells that may wander around.

Right?

Right on, Joe Romero. You explain it better than I could have done.

You don't sound like you have much faith in our little rays!

Oh, yeah, I have faith in them. He patted my hand again and shrugged. I
just hope Our Lady has faith in them, too.

I sat in the silence with Joe Romero. The recovery room made its quiet
little beeping noises and squeaky nurse shoe noises, and gradually I
calmed down inside. Perhaps the Virgin walked here with me and gave me
peace, because the silence healed. Joe Romero's face was calm and his
hand felt warmer, but I saw that my tough old buddy was getting very
tired. He had closed his eyes. Eye. I promised to come back and kissed
his forehead. He smiled in his sleep.

I walked out of the recovery room into the normal madness of the
hospital floor, and headed straight for the coffeepot. Too bad they had
those silly rules about drinking whiskey in the hospital.

When people have cancer, there are several ways it can be treated.

The doctors either cut it out and then give powerful drugs that kill off
the cells that may wander around like Joe Romero said. Those wandering
cells metastasize or spread the cancer. The doctors may give the drugs
alone or they may also give radiation treatments. Radiation kills off
the cancer cells, and sometimes makes the tumor smaller so the surgeons
can operate later on. The treatment depends on the type of cancer the
patient has, the age and general health of the patient, and the location
of the cancer. Cancer isn't one disease but several, and each one is
treated differently. Each patient is different, too, so the disease
changes.

In Joe Romero's case, the doctors decided to do radiation after the
surgery to keep the wandering down. We would see more of Joe and Adelita
and maybe even Our Lady of Guadalupe.

The waiting room in the clinic radiation area looked like the living
room in a large house. It was designed for the comfort and privacy of
the patients who came for treatment. Some of them came from the hospital
wards as inpatients, some came from home or a motel or nearby apartments
as outpatients. These radiation sessions lasted about three weeks, five
days a week, usually for about an hour at a time. After the decision was
made about where to radiate, the patients had marks put on them, red and
purple marks indicating where to aim the cone of the machine, like an X
ray. The marks had to stay on all during the treatment, even when the
patients went home or out on the street. It was one of the rules, one of
the hospital things that no one ever questioned.

The marks were there and they had to stay.

There's a whole family in there every day! Mr. Romero said. -i guess
there's a lot of us who have to live with this cancer thing. He had been
to the clinic three days in a row and had seen the same people scheduled
at the same time.

They all sat in the radiation waiting room, far away from the rest of
the patients in the clinic. Some were on stretchers, some in
wheelchairs.

They had the same red-and-purple Magic Marker lines on their bodies.

The marks were routine in the clinic, but they were not routine out in
the world.

We all called it war paint and thought nothing of it. It was our world,
and we had different gadgets and language and signs than the outside
world had. We saw it every day, and never really thought about how
people out there felt about it.

I felt like a freak the first time I walked out of here with this war
paint on. One old man sat with Mr. Romero and shook his head. Not too
many people know why it's there or how we can't wash it off.

Mr. Romero aimed a finger at the marks on the old man's head. It looks
like a bull's-eye! That's what it is, a target.

Lucy laughed. Lucy was a tall lady, very thin and drawn and lovely.

She used to wear a wig, but the skin on her scalp was too fragile. She
wore silk scarves on her head so that no one saw that she had no hair
because of the chemotherapy.

You can't see my target, you know, she said, and besides, I've had
chemo, too. They only give that to their special folks. She smiled and
patted Adelita's hand. I used to look like a regular person, but now I
wear scarves like a gypsy.

Mr. Romero and Adelita and the old man sat and watched the comings and
goings of their fellow patients. Some came slowly in wheel chairs, some
who were very sick were wheeled in on stretchers with IVS running into
their veins. They watched a young man limp into the room stiffly,
clumsily, and sit down. He smiled at them and said, I'm still not used
to this, and he patted his artificial leg. Bone cancer, he answered
cheerfully to their unasked question.

Mr. Romero nodded, as if he had been in this place every day of his life
and felt comfortable there. This place was not his mountains, but it was
his place now, and perhaps Our Lady of Guadalupe had a shrine here, too,
on this hard road. Perhaps she was watching all of them.

Perhaps she would smile on all of us.

When I walked back to the clinic radiation area, I saw Adelita sitting
alone, waiting for her husband to finish his treatment.

Are you doing all right in the apartment? I asked her. They were living
in a nearby apartment building where most of our patients stayed during
the time they were being treated. She smiled and said, There are so many
sick people here, and in the apartments. I went shopping and did some
cooking, but my man says everything tastes funny.

I nodded, and pointed to the booklets and papers in her lap.

All those booklets are to help you understand about radiation and what
it does. We have some films, too, every Wednesday morning up stairs.
Would you like to see them?

She shook her head. Not yet, maybe next week. She looked up at me and
her eyes filled, so I just smiled and thought, next week would e just
the. Do you know what the name Romero means in Spanish? she asked me.

I shook my head and sat down next to her.

She looked down at her hands, and then looked around her at the patients
waiting. "It means someone who has gone to Rome, to make a pilgrimage. A
person who has made a trip for religious reasons. She looked around her
again and murmured, Joe has never been away from the mountains to Rome,
or anywhere else, just here. Here to the cancer center.

She said nothing more, just looked around her and shook her head. I sat
and held her hand and waited with her until her man came back.

By Mr. Romero's second week in the clinic, he knew the routine very
well. He always cocked his finger at the old man's head as if to shoot
the target of the red-and-purple marks. He always bowed very deeply to
Lucy and called her the Duchess. He always told the pale old man on the
stretcher that he wanted to ride, too, someday. He asked about Old
Famous and wanted to see Annie and Emily from the dermatology clinic.
He never told us about the vomiting or the insomnia only that tamales
tasted bad.

We went up to the mountains this weekend, he said. Adelita forgot how to
make tamales. I never thought that would happen. I guess she's getting
old.

Mrs. Romero had seen the films and knew the effects of radiation on the
body, so she just laughed.

I always made tamales that tasted like metal. You just had the Coors and
couldn't tell.

Lucy laughed. No Coors now, my friend.

Mr. Romero shook his head. What a life. I can't drink Coors, but tamales
taste like I'm eating the Coors can. What next?

No tamales at all. The old man on the stretcher had been listening.

Three weeks later, on the last day of Mr. Romero's treatment, we had a
party planned for the graduate. We had a cake for Joe and some of his
buddies. The old man who used to ride on the stretcher was back in the
hospital. Lucy had died. The young man who had lost his leg to bone
cancer had been discharged and was doing well at home. But the ones who
were left gave Mr. Romero advice on what to do without them.

Don't let her make you any more metal tamales, they're bad for you. I
Someone else said, How about the Coors? Just drink it, forget the can,
pilgrim.

Did you ever get used to oatmeal burritos and lime Jell-O? Don't forget
the rest of us targets, okay, pal? The old man shook Mr. Romero's hand
and said good-bye. Emily and I walked him out of the clinic into the
sunshine, among the fallen leaves. The sky was the deep dark blue that
fall brings to the high desert. Summer was gone.

We had spent a long time together.

Enjoy your mountains, viejo. Emily's family came from the town of
Villanueva in the mountains where Mr. Romero came from, and she could
call him old man because she understood. She knew the mountains, too,
and Our Lady of Guadalupe. She gave him a hug and a kiss.

We hugged Adelita and she said she would write us, and then they left.

We walked back into the clinic. For a minute we stood in the hall and
looked at each other.

I wonder if she'll let us know?

The letter from Adelita came in April. I could hear her voice in it,
soft and sweet. She told us how much she loved Joe Romero and how
grateful she was to us for taking such good care of him. She told us how
she knew that we cared. This is what I remember of her letter My Jose is
dead now, he is with his Lady. He did not suffer at the end, and he
always smiled. I will miss him very much, but the memories of our life
together will help me to go on. I wanted you to know how much I
appreciate all of you angels who cared for my man. He loved all of you,
and he used to tell me that you all worked too hard.

Tell Emily that he kept the card she sent him by the bed, and he looked
at it every day. May God bless and keep you all, Adelita Romero.

After I read her letter, I kept remembering Mr. Romero and the old man
and beautiful Lucy. There was dignity and elegance in their lives, even
when they wore the red-and-purple stains of the radiation clinic.

As I went about my day I would see them in my mind and hear them in my
head. Tell about us. Tell about the targets.

So I made them a promise, and when I told my nurse friends about them,
my friends helped me keep that promise. Some of them had made promises,
too, to other patients, that they could not forget. Joe Romero and Lucy
are dead and we aren't. And that's where we begin.

Chapter 2.

The Journey Home.

Peg was the first nurse that I interviewed, and was a supportive force
throughout the project. Her insight and probing questions helped me stay
on track and gave me a refreshing perspective. She has worked for nearly
twenty years at the cancer center. Peg's sense of humor has sustained
her and kept her caring and involved. It's hard to believe that working
at a place like a cancer center is rewarding and fulfilling, but it is.
Sometimes the nurses enrich the last few months of a patient's life.
They help the patient come to terms with that life, and perhaps
encourage them to go back to people and say words they haven't said in
years. Some times healing happens at the end, and we can help. Sometimes
the cancer center is a place of miracles. We see a remission that lasts
years instead of months, a cure that no one expected, a bringing
together of the heart and mind and body. Death itself is not always
depressing. Sometimes it's the living that is sad.

According to one of Peg's longtime patients, the center is the happiest
depressing place in the world. The people who work there know that they
need each other. There are lots of plants and pictures around, and Peg
made macrame hangings that give warmth and texture to bare walls. People
may shrink from the cancer center, but it welcomes them anyway.

We filled many tapes in our conversations, but the following stories
were her favorites.

One of my stories is about a survivor, she said, and the other one is
about a teacher.

When I first met Nora, I thought she was deaf. Seriously. She sat in the
chair in the doctor's office, looking lovely and young in her pink suit,
holding one hand over her right breast. She looked at the doctor's mouth
as he spoke quietly about the disease she had and what the options were
for treatment. She didn't say anything, not a thing. Her face was blank
and expressionless, there was no understanding in her face, no emotion,
nothing. She didn't look at me or respond when I offered to go with her
to the hospital, since she had no one with her. She took the forms,
stared blankly at me, and nodded briefly, then went out the door.

The ward clerk looked at her retreating back, ramrod straight, and then
at me.

Yo-you think she knows what you said?

I think she knows, I said, but she's not listening to us. We'll have
work to do with this patient. Lots of work. I didn't take prophecy in
nursing school, I learned it afterward.

Late the next afternoon I helped admit her to the hospital. She didn't
want to be there, and we didn't blame her. She had been diagnosed with
breast cancer and was admitted for surgery the next day. I went up to
the floor that evening, after clinic hours, to do the preoperative paper
business to get ready for her treatment in the cancer clinic after
surgery.

The doctor's preop note in the chart read, Well-nourished thirty-two
year-old female, looking younger than her stated age. I wondered if she
had listened to anything that doctor said, or was she still blank and
silent?

There she sat in the bed, wearing our little hospital nightie and no
makeup, watching us watching her. She looked very young and very scared.
I was sitting in her room, with my clipboard and the clinic's admission
report, when I heard myself ask her a question.

Is there anything else you need?

Nora looked at me with that unblinking steady gaze, and I realized how
silly that sounded. Of course there was something else she needed.

That was dumb. Sorry. I meant, can I do something, get you some thing to
eat, get the TV turned on? You may not be back here in the same room
tomorrow from recovery, so .. . I talked on, trying not to look into my
patient's large gray eyes. Nora shook her head.

Did my husband leave? she asked. Her voice was low and quiet, very calm.

Yes. He'll be back tomorrow, and he said he'd be there when you wake up.

Bitterness destroyed the lovely line of her mouth.

He's been gone for over six months in Saudi Arabia, but oh, yes, he'll
be there, finally, to look at a mutilated wife and hold my hand. He
deserves better.

She turned away and would not talk anymore, and so I sat there, tired.
It had been a very long day in the clinic, and I was ready to go home.
But the paperwork needed to be completed, so I had to continue.

Nora, there are just a few more questions .. .. ..

She turned her face away from me and stared with blank eyes at the wall.
There was nothing for me to do but leave. I went back to the nurses
station and poured a cup of coffee.

It's okay, I told myself. She's having a hard time, and it's easy to
sound silly with someone like that. I had worked for many years trying
to learn what to say to people who were having a very hard time.

Once in a while I found that I was still learning. It's not pleasant to
sound so dumb. Of course she needs something. Her health. Her breast.

When I tell people where I work, everyone always says, It takes a
special person to take care of cancer patients. Sure it does. And it
takes a special kind of person to work in newborn intensive care, too,
and the burn unit. Both of those places tear me apart. I found my niche
with cancer patients, and like one of our friends says, you always end
up where you belong. I found this place early, this cancer center. I
found patients like Nora and, at about the same time, Andy.

Last August Andy Potter was diagnosed with leukemia. He was twenty-five
years old, the same age as my son. Andy was a good-looking young
man-thick blond hair, big grin, nice kind brown eyes. He was a computer
programmer, he worked for Sandia Laboratories in Albuquerque and lived
in a little house near Hyder Park. He was a very logical, calm,
introspective kind of person, the kind who keeps his emotions far below
the surface.

I sat with Andy while the doctor spoke quietly and firmly about the
disease, the upcoming treatment choices, and possible outcomes. Andy sat
quietly, with his hands in his lap, turning the New Mexico Tech class
ring on his finger first one way and then another.

He looked into the doctor's face, asked him to repeat some of the
choices he had, and then said, It used to be a death sentence right off,
I lost a little sister to leukemia when she was four. I wasn't born
then, but now there's about a fifty-fifty chance of surviving. Better
odds than the freeway, don't you think?

He accepted the printed cards we gave him, copies of the diagnosis and
treatment choices so he could go home and review them in private.

Sometimes, when patients hear the word cancer, they seem to be listening
but their ears have turned off in defiance of such news. They need to go
home and relax and gradually the message begins to seep through. They
read the cards and then they deal better with it. Andy looked carefully
at the cards, realized that they said pretty much what he had just
heard, and stood up.

I'll go over this and call you tomorrow or the next day if I have any
questions. We can begin treatment as soon as you say. He shook the
doctor's hand and mine, smiled, put his jacket on, and left. I watched
him walk out to his car and drive away.

He kept his cool through all the early stages of the treatment. He
always smiled and never doubted us or himself It was very unusual to see
such balance, such control.

I'm going to beat this, you know, he said. I've got too much living to
do and too much work to do. Computer programmers don't die, anyway, they
just fade into their monitors. Another big grin, and off he went, back
to work.

He was too balanced, I thought. Too much in control, in charge, not
reacting enough. Patients need to work the problems through on two
levels-the mental, intellectual one, and the deeper, emotional one.

They need to be in touch with the deeper reactions so those emotions
don't take over someday, and are all the more powerful for not being
understood and acknowledged. That is the time when patients fall apart,
or go off their heads, from never having dealt with the inner pain. I
had a patient once who wouldn't deal with his disease emotionally. He
walked out of the hospital in his little blue-and-white pajamas and
stood on the edge of a busy street, unseeing, and was nearly run over.
He was on his way to work, he said, when they retrieved him from the
curb.

He just refused to deal with the disease deep inside and it made him
crazy. I didn't want that to happen to Andy. I guess I just didn't know
Andy very well, then.

It was spring, just after Mr. Romero died. We hurt then, all of us, and
when nurses hurt they sometimes get prim and starched and bossy.

That's the way I felt about Andy, when his leukemia took a turn for the
worse in April.

He's in denial, I told the doctors. He just won't believe it, and he
needs to start handling it. He's living in his head, he's not letting
his emotions get engaged.

He kept coming in for his treatments and I kept doing them, every
Tuesday morning. Every Tuesday morning I was doing what I thought was a
futile exercise, watching him lose his hair, watching his cheeks get
thinner, his hands bonier.

Another week, another step, right?

He lay on the treatment couch, smiling, a peaceful look in his kind
brown eyes. And I was convinced that inside, he was hurting and not
recognizing the hurt, not admitting the fear. During the treatment his
face was calm, his eyes closed. His young face was becoming thinner, his
eyes a little sunken.

Any nausea, Andy? Any vomiting at home after the treatment?

He smiled and opened his eyes. No, nothing. Your cards said to expect
that, but I decided that I wouldn't have any vomiting, and I haven't. I
leave here feeling good, healthier. Stronger. The mirror says I'm losing
weight, but I feel fine. He looked up at me and grinned.

Odd, isn't it?

The week went by, and it was Tuesday again, the day for Andy's
treatment. When I got in the car to go to work that cool spring morning,
Nora and Andy were on my mind. I try to make a habit of leaving work at
work and leaving home at home, which is the only way you can survive in
this business. It seems to work pretty well with my living patients, but
sometimes all of my ghosts, the spirits of patients who have died, crowd
into my mind, clamoring for attention.

There's Nora, she's another target! Joe Romero's spirit said. I told his
ghost that I see her, that he and Adelita would like her. She'll be
fine, once she looks at her wound and begins to accept it. I knew Joe
would understand.

How many more of us are there .. . lots? another old ghost asks.

Yes, lots, I reply. And always more.

I started the car, got on the freeway, thinking about Andy's treatment,
and then, without warning, my right arm went numb. My right arm, my
working arm, went numb, and I felt a terrible crushing pain in my chest.

I was gripping the wheel, fighting the pain, driving down the freeway,
thinking I was having a heart attack. Panic set in, this had never
happened to me. It was pure terror, pure blank freezing terror. This was
my right arm, the arm and hand that gave the chemotherapy, the arm that
today had to treat Andy.

There was the traffic whizzing by, and I was talking to myself, trying
to tell myself to stay calm, all the time my hand was getting more and
more numb. I kept talking to myself, and all the time I was shaking and
trembling all over, feeling this numbness in my ann and the pain in my
chest. Somehow I managed to park the car, got into the clinic, and then
fell apart. I don't remember getting out of the car and into the door,
but I stood in the hallway, crying and shaking.

They tell me that the staff stood there, absolutely shocked. There I
was, this veteran of many years, always full of jokes and stable as a
rock, holding my right arm, makeup running down my face, crying
hysterically. I couldn't stop crying, the stress had just gotten to me.
I couldn't keep the illusion up anymore.

The doctor whom I work with is a very understanding and compassionate
man, and he got me into an exam room and calmed me down.

He talked to me, slowly and carefully.

You aren't ready for Andy to die, Peg. He's your son's age, and that's
very hard. You've tried to push it all down and deal with it only in
your head.

But I know better, I wailed. I've done that for years. I know how to let
my emotions out slowly so they don't all back up! Why won't it work with
Andy?

Your emotions were stuck somewhere inside and they finally blew up and
made your arm numb in order to tell you something. All of us who take
care of people need to deal with that. Sometimes we can't, even when we
know better, even when we've handled it well before.

Andy is a patient that got to you when you weren't looking. His eyes
were kind. I blew my nose and wiped mascara all over his clean hand
kerchief.

He took an EKG, of course, and did some tests to make sure it wasn't
really a heart attack, and everything was fine. With my heart, that is.

Everything was not fine with the rest of me.

Someone else did Andy's treatment that day, and I just carried on,
calmer and more ready to admit my feelings. I made my rounds in the
hospital, looking for Nora after her surgery. She was lying flat on her
back, staring at the ceiling. I told her I would be back to change the
dressings and check the sutures, and she didn't say anything. She was
very pale, and when I took her hand, it was cold. The chart notes said
the surgery went well and she was fine, no problems. No problems with
the surgery, sure. They did their usual magic up in the operating room,
and sent a patient back who would recover physically and do well. But
until she looked at the place where her breast had been, until she ad
m-itted that it was gone and took control of her own recovery, nothing
would go well. I knew, having learned it again, that in order to be
healthy, emotions and mind have to get to know each other very well.

According to the chart notes, the day shift had called the ladies from
Reach for Recovery and they would arrive that afternoon. They were the
women who had undergone operations like Nora's, had mastectomies and
chemotherapy and radiation and fear. They were the women who had learned
how to exercise and reach their aryns to recover the movement that the
operation might impair. But they also reached out to women like
themselves, women who were having the same problems and troubles, and
let them know that there were others who had walked on their road. They
had tried to visit before the surgery, but Nora had not allowed it.

Later, she said. We all knew that earlier was better than later, but she
had been adamant. Later. Well, now it was later. And before it was too
late, we had work to do.

Nora's husband, Ben, had been away for six months in the middle of the
war with Iraq, and that was part of the problem. He was in the army
reserves, and had been called up in August for duty in the Persian Gulf
War.

Nora had felt a lump in her breast about six weeks after Ben left. But
she was too worried about him to do anything. Every day she got up at
five in the morning to watch the news, and heard the commentators talk
about the mother of battles and smart bombs and Scuds and she refused to
think about the lump in her breast.

So it got bigger, and then she went to have her annual checkup, only
because that's what the calendar said to do. She went to her doctor in a
fog, thinking only of Ben. Her doctor found the lump and called my
doctor, and finally Nora was forced to do something. But she still moved
like a person who didn't hear and didn't feel. No expression in her
eyes, lips tight against speaking her fears, afraid that if she spoke
them, they would come true.

When she was diagnosed during the winter, Ben had been in the desert for
five months and she hadn't told him anything about the lump in her
breast, or how she felt, or what was going to happen. She said to
everyone who asked, He's far away in the middle of a war zone, and I
don't want to burden him with this. I can't, it may distract him, and he
may get killed.

So she tried to do it all alone and kept working as a legal secretary
and taking care of her two children, and she buried the fear and the
anger. When he came back in the spring, he was both hurt and sad, hurt
that she hadn't told him, and sad that she had tried to handle it all by
herself.

He was a tall, stooped gentleman, heavy shoulders, big hands. His brown
eyes were deep hollows in his face, full of hurt and sorrow and anger.
He had been called up to go to war, away from his job and his wife and
family. Now a much harder battle was facing him.

We met in the cancer-center lobby, late that spring afternoon after
Nora's surgery.

If I had known, if I had only known.. . he kept saying, over and over.

You were out of the country fighting a war. You couldn't have just quit
the job and come home, could you?

For her, yes. For her, anything.

This was a man who meant it. I had heard other husbands say these words,
but there was something in his face that made me know that he Meant
them.

I'll make it up, somehow, as soon as she begins to talk about it. As
soon as she can look at it and know that it doesn't matter. She's
beautiful and wonderful and she's my best friend and it just doesn't
matter. We've got to get back together like we were before. Six months
was just too long. Too long.

He reached out and hit the wall of the corridor with his fist, and held
on to the railing until his knuckles turned white. All I could do was
get him a cup of coffee, when what I wanted to do was change his life.

We returned to the hospital and Nora was back in her room. She stared at
the ceiling, Ben was quiet, holding her hand in the silence. I wondered
where our Guadalupe was. This was one of her shrines, and she was needed
here.

One of the exercises for surgery like Nora's is called wall-walking.

The patient literally walks her fingers up the wall, to stretch and
exercise the muscles in the arm on the side of the operated breast. It
keeps the muscles toned and the arm flexible, and also involves the
patient in her own recovery, which is absolutely necessary. Cancer
patients who keep control over their own lives as much as possible do
much better than the ones who give up and let other people take care of
them.

The people came from Reach for Recovery and taught her to do the
wall-walking with her fingers, and she did it like a doll, like a
puppet, never saying anything, just going through the motions. The women
took her through the exercises and were very kind, and when they came
out to the nurses station, they shook their heads.

She's got to look at it, to learn to take care of it and help it heal.

Does she watch you when you change the dressings?

The nurses shook their heads and the women left, knowing how hard it
was, knowing what she had to do. They had all been on that road, and
they knew.

Ben came every day, in the morning and at night, and we gave him coffee
and looked into his sad brown eyes and hugged him and prayed.

She'll make it, he said over and over. I know she will. I know she will.
He took out a picture of their two daughters and told me about a
birthday party one of them had, and how he made a cake with the oldest
daughter's help.

They look like Nora, not like me, thank God. He combed his rough brown
hair with a big hand and I saw that his hand was shaking. There was fear
in his kind eyes, and in his voice, just under the surface. He went back
to Nora's bedside, and sat down, leaning his elbows on the bed, held her
hand, and stroked her long fair hair. Nora looked out the window,
unblinking eyes seeing nothing.

And then there was Andy. The next Tuesday morning I walked into the
clinic, took a deep breath, and entered the treatment room where he was
waiting for me.

Hey, where have you been? Someone said you were sick last week. There
was concern in his eyes. He took my hand and his hand was warm and
strong.

I had decided to tell him the whole story, ridiculous as it sounded.

Andy, I wasn't sick. I came apart last week-treating you really got to
me. You're the same age as my son, and I thought it wouldn't matter, and
I've taken care of other guys your age, but you, somehow .. .

Blathering on, I didn't notice the tears in his eyes. His hand tightened
on mine and he looked at the wall.

You and me both, Peg. At first, I had a really hard time dealing with
it. I kept saying, Why me? Why my sister, why my family? After I came
apart, at home, I figured that it was just supposed to happen this way,
and the why just didn't matter. The why met turned into why not met I
decided to keep going. There really wasn't much else to do.

You had talked about some good books to read. I did that, and after a
week or two, with a lot of help and support from my family and my
friends, I accepted it. Just like that, I knew it was a part of me and
something I had to deal with, whatever the result.

He reached over and hugged me. See, he said, patients can be nurses,
too. And nurses can be patients, you know. None of us can do it alone.
Whatever happens, knowing that is the most important thing I've learned
these past few months.

I closed my eyes for a minute and calmed down. His warm hand held my
cold one, and we were quiet together for a minute. When I opened my
eyes, I looked straight at him, picked up the intravenous needle, and
said, Well, buddy, let's see if I remember how to do this.

He laughed and I started his therapy, and I heard all about his latest
computer-program problems, none of which I understood, but we were pals,
in my heart I saw Joe Romero smile.

The day Nora was discharged, I came up to the floor and helped her into
the wheelchair. She sat straight, never said a word, and looked in front
of her with those big gray eyes. One of her nurses looked at me and
shook her head, sadly, as we gathered up the flowers in Nora's room and
packed her bag and pushed her out the big double doors. Ben was waiting
in the car at the entrance to the hospital. He opened the door for Nora,
and helped her with the packages, and kept stroking her arm as she sat
next to him. He looked at us, one mute look, and we watched them drive
away. She looked out the window as he drove. She did not see anything of
the bright spring day and the leafing trees.

The day came a few weeks later when her chemotherapy was to start.

I walked down the hall wanting to see her and not wanting to see her.

All I could remember were those large lovely gray eyes and pale face,
and the blank expression. All I could see were the puppet movements, the
numbness, and the denial. All I could see was the pain in her husband's
eyes.

She was sitting alone in the examining room, and I stood there and
stared at her, stunned. The woman I saw was a different person from the
one I had seen in the hospital. She was the same tall willowy woman,
still pale and fair, but instead of looking drawn, she looked radiant.
Her hair was done, she wore a scarf at her throat, her earrings
shimmered.

You look great! I could not believe it. It was a wonderful
transformation, but I could not believe it.

I feel great. She smiled and hope was shining in her eyes. Things are
going to be what they will be, whatever happens. I feel like I'm
beginning a journey, and the journey itself is more important than the
destination. She and Andy had reached into the same well and found
strength.

What happened? Last time I saw you, you wouldn't look at your chest, or
discuss treatment. It's wonderful, whatever it is.

She removed her blouse and looked down at the scar where her breast had
been. She looked up at me and smiled.

It was Ben. It was all Ben.

Ben, of course, Ben. What did he do?

Her cheeks became a little pink, and the look in her lovely gray eyes
was full of wonderment and awe. And in a voice that was full of pride
and tears, she said, He kissed the scar. He kissed my scar. He made love
to me and he said I was still the most beautiful woman in the world and
he wouldn't let me feel ugly. He said he would miss my breast, but it
wasn't me, and he wouldn't have it back. We're done with the disease, he
said. We're stronger now together, no matter what.

I sat back, busy with my paperwork and her chart, tears pricking in my
eyes, and the nurse-person inside said briskly, Get on with it, you need
to get her weighed and take her blood pressure and get the chemo
started. And the other person swallowed hard and took her hand.

He's quite a guy. And you're quite a couple.

Nora smiled again, and I saw a woman who felt lovely, no matter how old,
wrinkled, bald, scarred, or disfigured she became. Holding her head
high, she said, Let's start this and get on with it. If this treatment
is going to work, we need to start right away. Ben's out in the hall can
he be with me?

I went and got Ben and started the treatment. I watched them together,
how he held her hand and stroked her forehead. We sat there, the three
of us, quiet, and her breathing was regular and strong and there was
healing in that room.

Andy was in remission then, for a few months, and was at home doing
well. I realized how lucky I was. I had known Nora and Andy.

They say that you're never given more than you can bear, but you need an
Andy and a Nora to help you bear it, sometimes.

Chapter 3.

Memory's Exile.

Stephanie works in a nursing home in Albuquerque. She loves old people,
and they love her. She hugs them, listens to them, remembers if they
like apple juice or orange juice for breakfast, and if they take cream
or milk in their coffee. She knows who gets visitors and when and who
needs encouragement to get up and dressed. She knows how important a bed
bath is, soothing and relaxing to the patient, a source of information
for the nurse about skin and mood and balance. She knows how therapeutic
a touch can be, how warmth and comfort can be expressed so simply, so
completely, just by giving a gentle bed bath.

She says, I'm working on the last stop on the road, and it's where I
belong. With all my old folks. She's tall and thin, has gray frizzy
hair, and chews gum since she quit smoking. The patient she remembers
best is Mr. Mcdonald.

I met Mr. Mcdonald ten years ago when his daughter hired me to live in
his house and take care of him. His wife had died six months earlier,
and he needed someone around. He was lonely and wasn't taking care of
himself or eating right. He wanted to live on bean burritos, pickles,
and cornflakes.

I was working days then nearby at the maternity clinic, and I used to
walk to his little house on Columbia Street for lunch and fix him his
meals and make sure he took his medicine. Mr. Mcdonald was pretty alert
then. He used to drive to the grocery store to buy pipe tobacco and
beer, and he washed and waxed his old Chevy every week. He was tan
around his neck and on his arms, from working in the yard. He always
wore a hat, and as he got more and more bald he used to tell me that he
wasn't losing his hair, it just had a wide part. He told another joke,
too. He used to wink and say, Guess who they named all those ham burger
joints after?

When he was young he had lived in southern New Mexico, around Deming,
worked as a hired hand on a ranch, and bummed around during the
Depression. He had gone to the School of Mines in Colorado and had
worked as an engineer in South and Central America, building roads and
bridges on the Pan-American Highway. He worked at White Sands Proving
Grounds near Alamogordo after he came back from Central America. He also
worked as a civil engineer for what turned out to be the Manhattan
Project.

Mr. Mcdonald had all sorts of tools and machines in his shop, all oiled
and kept in covered cases so the dust wouldn't get at them. He had made
furniture, stools, cradles, and benches, years before.

I made things people use, not that fancy Santa Fe stuff. He rubbed a
bench he had made, sort of patted it like you would an old friend. He
put everything away, carefully, peering at each piece of equipment, each
tool, as he wrapped it up. There was a story behind every piece he
had-how a certain friend had given him an adze, another a lathe. The
friends were gone, but their tools were left, with him to look after
them.

Back in the workshop behind his house he had a wall full of photo graphs
from those days, all faded by now. Some of them were signed, some of
them were group pictures, several young men in two rows, all smiling and
tan and handsome and strong. One of the photographs was just of Mr.
Mcdonald and another man taken at the old Owl Cafe in San Antonio, New
Mexico, near Socorro. They were eating green chili cheeseburgers. Mr.
Mcdonald used to look at that old picture and say, He was pretty smart,
that guy, smarter than me. But he was from back east, never could eat
green chili. And after a few minutes of looking, quiet, he would turn
away, and sort of wave to his old friend in the picture at the Owl Cafe.
I kept looking at that picture every time we went into the workshop,
because he looked familiar. I had seen his face before, on a book, but I
never could place him. After the Challenger crash he was on a panel
talking about 0-rings, but I never learned his name.

When we left the workshop he looked back, nodded at the pictures, and
locked the door carefully. He looked up at me and said, Doesn't do to
dwell on the past, but it's there, still. It's there.

He showed me an old black-and-white picture, cracked in the middle, of
him standing by a big tree, wearing a straw hat. He had thick black hair
then and he was taller and strong looking. All that was a long time ago.
Now he was stooped and thin except for a little potbelly, and he wore
round eyeglasses and limped a little. He didn't like getting old, he got
angry sometimes.

You ever see anyone hug an old person? he used to say. People love to
hug kids, or babies, or young folks, but not us old folks. He shook his
head sadly. You'd think old age rubs off, like talcum powder, or body
odor. Nobody hugs us. Of course then I would go up and, hug him, and
he'd say, Cept you. Then he'd chuckle, he didn't make any noise when he
laughed, but his little belly would bounce up and down.

Early one morning I woke up hearing funny sounds coming from the
bathroom, and there he was, holding his penis. He was shaking the hell
out of it, saying, Why do you work when I don't want you to, and then
you don't work when I want you to? He had wet the bed.

There were plenty of people who cared about him-his daughter Jen and her
husband, and a son, Tom. He had friends, too. But as he got older they
all died, He kept a little card in his pocket, with the names and birth
dates of all the friends he had. Each time one would die, he would take
the card out, lick his pencil, and draw a line very carefully through
their name. He wouldn't say much for a few days after that, but then
he'd take the card out and show me, and gradually there were more lines
and more lines until his name was the only one left.

What do you want me to do, I asked him once, draw a line through your
name on that damn little card when you die?

He studied about that for a minute, and then laughed. Put it in my hand,
and bury me with it. Then I can show the Grim Reaper that I been keeping
track of him.

I worked for him in his house for several years, and then they had to
take him into his daughter's home. The thing that really showed us that
something was wrong was when he and I had his family over for Christmas
Eve one year. We had made fire eater's posole, and the luminarias were
lit, glowing along the driveway to light the way to the door. We made
Christmas cookies and biscochitos, and he taught me the words to a
little Spanish song he remembered from his days in Nicaragua.

Right before everyone arrived, he tried to light his pipe, and couldn't.

He sat down heavily in his chair and looked around with an odd
expression, as if he were seeing his house for the first time. I had to
help him with his tie, and he kept spilling things. When his family
came, we were dishing the dinner out in the kitchen, and he turned to
Tom, his oldest son.

Your Jen's brother, aren't you? he asked.

Tom stopped what he was doing, and looked straight at the old man.

Yes, and who is Jen? Tom asked.

Mr. Mcdonald peered up at Tom, and wiped his eyes, and shook his head.
He sat down at the table as if his legs wouldn't hold him up, and he
kept shaking his head.

Tom looked at me, and I looked at Tom.

He couldn't live alone after that Christmas, even with me there in the
evening. He lit the stove and forgot to turn it off and had a kitchen
fire that nearly burned the house down. Once he went outside with no
clothes on and scared some children.

I helped the family pack his things and give some of them away. We boxed
up the dishes, a couple of wine bottles he had saved for some reason,
and books. The workshop was the hardest. I took care of that with Tom.
He and I spent a morning packing it all away, some to go to Jen's house
and some to be given to the local high school in Mr. Mcdonald's name. I
hope those kids learn how to take care of those tools, like he did.

There was furniture, an old chair with wooden armrests that he liked,
and some of Mrs. Mcdonald's old diaries. He sat with the diaries in his
lap for a long time, and stroked the covers that she had held. We put
away some albums of pictures, ones we had looked at over and over again
in the past few years. He looked at them again, over and over, and shook
his head, and couldn't tell me who the people were, or when the pictures
had been taken.

I don't know, he said. I just don't know.

We went to Jen's house with Tom, and moved him into the extra bedroom.
He just stood there, and looked very small in his shiny suit coat with
the wide old-fashioned tie.

His grandson patted his back and said, It's okay, Grandpa, we'll take
care of you. Mr. Mcdonald looked angry, shook the boy's hand off his
shoulder, and limped into the kitchen.

I went to work at the hospital, then, after they sold the house. I was
sad to leave him. I felt like someone had taken a child away from me the
day I left. He stood at the door of Jen's home and waved to me when I
drove away.

I finally got back working in a nursing home after a couple of years in
the hospital. The hospital work is okay, but I always wanted to work
with the old people. When I was in nursing school I took care of kids,
and regular adult sick people, but it was the old people who were
special. They want to share their experiences, and you learn a lot if
you listen. They know who really cares and who doesn't, and they won't
say much if they know you aren't listening. They just stare out the
window and don't talk. They know that just getting old takes all their
energy, and they haven't got much time to waste on people who don't
listen, or who act like they're invisible.

I got a job in a good nursing home, a place with a lot of light, and big
windows and good food. It was a cheerful place, with a good staff and
lots of activities, and it didn't smell of urine when you walked in the
door. There was a minister on staff, a cheerful little lady with short
wavy white hair who gave services every day. Her name was Amanda but
they called her Padre. The old people would come and sit in the room,
and listen to the music, and nod their heads while the minister spoke
quietly from the Bible. She told me once that she wasn't sure how much
the residents understood, but they felt comfortable with the words from
their past, and they felt peaceful when she said them. She called them
her little quiet family of wheelchairs. They gathered around her and
listened, not saying anything, but quiet and still.

Who knows what they understand, and who cares? she said. It helps, and
Our Lady of Guadalupe walks here, too.

They had a preschool children's day-care center associated with the
home, and to watch the old people with the little ones was a treat.
Every time a resident of the home had a birthday, the staff brought the
children in, they helped serve the punch, and cut the cake, and blow out
the candles. The kids accepted the old folks in their wheelchairs, and
didn't avoid them, and there were lots of hugs.

There were all kinds in that home-some residents were bedridden, others
walked, some needed wheelchairs. Some were mentally very alert, others
were a little dim and forgetful, and others had no contact with this
world at all. But they were all interesting, and all of them had come to
this place after long lives. I loved watching them, in the midst of my
duties and chores. One old man used to wheel himself into the dining
room, wearing work gloves on his hands. He took one glove off, very
carefully, and stuck it in his pocket and ate his meal, and then just as
carefully put the glove back on. He had been a carpenter, and his
gloves, all holes and ragged by now, were part of him, part of his work.

There was Dan, who walked all day, up and down the halls of the nursing
home, carrying his newspaper and talking to himself. I think he wanted
it to be his job, because he could no longer do his real job, his adult
money-earning job. Old Mr. Berry wore his army garrison cap and fatigue
shirt with medals, things that signified who he was and what he had
done. There was an old lady upstairs on another floor who would recite
recipes, every kind of recipe, with all the ingredients and
instructions, that she had cooked in her long years of keeping house.
These memories identified them, told what they had done, what their work
had been. I wonder what old nurses do to remember their work? We would
keep the staff very busy, that I knew.

Some days at dinner I took care of Mrs. Eleni Kostakis. She was an old
Greek lady, a beautiful woman whose eyes were large and dark and who
always wore black. One evening she asked me to put two packages of sugar
into her tomato soup and then put the macaroni and cheese into the soup,
too. I fed her sometimes, and she ate real fast, like a hungry little
kid. You couldn't stop filling her spoon, or she would glare and motion
you to feed her faster, as if someone was going to take her food away
from her. If we didn't feed her, she would take one bite and sit and
watch out the window, never talking. I knew that, so I made sure to be
in the dining room as often as I could, to feed her.

She rode a wheelchair around, pushing herself into the day room, into
the lounge, into her room. She moved all the time, never smiling. When
ever she stopped riding in her wheelchair, she would look up at us and
pull on our clothes and say, very softly and slowly, with her Greek
accent, I .. . am .. . innocent.

She was trapped in her mind in Greece, where she had lived until after
World War 11. What terrible things did she remember? What awful life was
she living again, and again? There was no way to get her out of that
mental trap, we had tried everything. She was never violent, very quiet,
but always the same statement, I .. . am .. . innocent.

I would see her down the hall, looking at me with those calm brown eyes.
I would stand by my medicine cart wanting to call out, Don't say it!
Don't say that anymore!

But she would come up closer, moving herself very slowly, never taking
her eyes off me. She would look up at me and pluck my sleeve and again
she would say, I .. . am .. . innocent.

We knew she was innocent, her eyes were so clear and wide, like a
child's. All we could do was hug her, and stroke her lovely face, and
tell her everything was fine. But she was stuck between her world and
ours, and for her, everything was not fine. Her roommate was a little
Italian lady, Mrs. di Giorgio, who had really bad arthritis but mentally
was very sharp. She kept an eye on Mrs. Kostakis and combed and braided
her long white hair, saying it did her twisted hands good to do
something useful.

Then, one day, Mr. Mcdonald was admitted to the nursing home. It nade me
happy, knowing that I could see him every day. We could talk about old
times and I could look after him, like I used to. I didn't bother to
read his chart that first day, which was a mistake. I just went on into
his room.

Hi there, my friend. How are you! It's so great to see you .. .. ..

He looked at me with eyes that were blank and pale. Around the iris of
his eye was a white ring, his skin was spotted, his face was thin, and
his mouth flabby. He used to press his lips together like a stubborn
little kid when I wanted him to do something years ago, but now his lips
were slack. He peered up at me and shook his head, and it bothered him
that he didn't know who I was, and he kept trying to remember.

I had lived in his house for two years, made his meals, talked about the
old days. We had celebrated holidays together, and he had told me about
the customs of South America and taught me how to make the kinds of
cookies that his wife used to make. I knew his children, and had
baby-sat for his grandchildren. And now he stared at me, his eyes blank
and empty. He said my name, once, very softly, and then sat and stared
at the wall, with no reaction.

At first, he knew his way around pretty well. He wanted his pipe, so I
gave it to him with some tobacco in it but no matches, and he stood at
the nurses station and sucked on his unlit pipe, content. Then he
started wandering into other residents rooms and couldn't find his way
back. He would forget where the bathroom was in his own room, and had to
be watched all the time. Then he couldn't walk at all. He had lots of
little strokes, and his legs wouldn't obey him. He spent most of his
time in bed, weak and sometimes angry.

When Jen and Tom came to visit he told them that there were faces in the
pattern of the rug on his floor. He told me that they were experimenting
with him. The chart said paranoid delusions in nice medical terms, but
this was my friend. This man had been strong and able and laughed at
jokes and made cradles for his children. He had taught his grandson how
to tie flies for his fishing rod. He just wasn't my Mr. Mcdonald, with
his memories gone. Like Dan, and the little ladies who sat silent,
staring at the dinner table, and Mr. Berry, his past was locked away
somewhere in his mind, and he couldn't reach it anymore.

It was wintertime, and Mr. Mcdonald had been at the home for about three
months. I came on duty around 2,30 in the afternoon and went to read the
charts to see what had happened to my old people during the night and on
day shift. Mr. Mcdonald had been put in restraints because he kicked the
night charge, the prissy one who put everyone on report.

He had wet the bed, and wouldn't eat, and got wild when they put the
leather straps around his arms. I looked at the latest progress note.
The docs  were concerned that he had another stroke, he could barely
talk, or swallow.

I got to his room and saw that the day shift had taken the straps off,
thank heaven. He lay in the bed, staring wide-eyed at the ceiling,
unseeing. All he did was whisper two words, over and over.

I sat on the edge of the bed and watched him. He was agitated, clutching
the covers, his fingers were thin and white, the nail beds nearly blue.
He was on oxygen, but his breathing was rough and ragged. His blood
pressure was low, his pulse was fast. His eyes were full of unshed tears
and he moaned and muttered. I leaned down close to him, and smelled the
musty smell of old age and waste. The day shift had put a Posey belt on
him, a light restraint to remind him not to try to get out of bed. It
crossed on his chest in front of him, and he kept pulling and jerking at
the cloth. He kept saying the river, the river, over and over again.

What is it, Mr. Mcdonald? What do you want? He shook his head, cross
with me because I didn't understand. He muttered again, and then I
remembered a story he had told me.

A long time ago a good friend of his had been killed on a bridge they
were building in South America. A cable had snapped and wrapped itself
around him like a big snake, and pulled him off far above the river and
slammed him into the bridge. Mr. Mcdonald had told me that story a long
time ago, and now I could see the fear in his eyes. He was remembering
too much.

I took his hands off the Posey belt and said, It's all right, you're not
on the river. There's no bridge, no river. That was a long time ago, and
it's over. Now you're in the nursing home, you're here with us.

You're safe with us.

He looked up at me, his old eyes looking but not seeing. I repeated what
I said, and he looked down at the Posey and stopped pulling at it.

He lay back in the bed and sighed a little and was quieter. I stood
there, watching him twist and turn and mutter to himself, and wondered
what I could do. He was wearing me out.

After dinner the Padre had made us all run to the big west windows to
have a sunset break, and things quieted down like they always do on the
evening shift. Dinner was done, trays put away, everything ordered up
for the night shift, visitors gone, night-lights glowing. It may have
been a time when dark things walked, but here on our hallway it was cozy
and comfortable. We made nurse rounds, made sure everyone was fine, and
finished charting. I wandered down to Mr. Mcdonald's room, and watched
him as he moaned and twisted, and then I had an idea.

It was a crazy idea, but it might work. It couldn't hurt, anyway. I
remembered a young nurse I knew who worked in newborn intensive care,
she used to sing lullabies all the time. Sick little babies quieted
down, listening to her low soft voice. If it worked there, why not here?

I sang a lullaby from my childhood, and as I sang, tears came to Mr.
Mcdonald's eyes and rolled down his thin cheeks, and he slept. I held
his hand, and sang soft and low, low and soft. He grew still and his
breathing slowed down, and he was calm. He couldn't tell us what he
needed, but suddenly I knew how to reach him, to bridge the empty spaces
of lost memories. From then on, we added lullabies to Mr. Mcdonald's
care plan.

The minister stuck her white head in the door, and I motioned for her to
come in. She was out late, looking after her old people, some of them
younger than she was. She wore a bright pink church blouse with a silver
Mexican cross around her neck.

How's Mr. Mcdonald doing? I can see you're a natural, you are.

She had a theory that certain nurses belong in certain places-some in
newborn ICU, some at the cancer center, some in the operating room.

Lucky was the nurse who found her place right away, and lucky her
patients.

Jane died, up on four, the Padre said quietly, matter-of-factly.

The lady who said her son would get her out?

Amanda nodded. She always wanted us to call him and tell him where she
was. She didn't realize that it was her son who had to put her here. He
couldn't take care of her anymore.

How's Dan?

Walking. She smiled, thinking of all our old people doing their work.

I said good night to the Padre and went out to the nurses station, down
the quiet hallway past the quiet dark rooms with their silent old
people. This was the last place for most of them, the last shrine for
Our Guadalupe on this road.

I peeked into Mrs. di Giorgio's room and saw that she was awake,
watching her roommate. The little Greek lady was asleep, her face like a
little child's, the memories wiped away, for a while.

Mrs. di Giorgio stirred, and said, Poverella. The poor little thing.

Her dark eyes were bright, her accent similar to her roommate's. This
little Italian lady walked with a cane, sang little songs to herself,
and hid food in her room. We knew she did it, and we cleaned it out all
the time, and she knew better. She was fine, mentally, she just held to
her frugal habits, learned long ago.

Depression days, she said, Depression days. And then she would pull out
a piece of lace she had knitted, many years ago, when her
not-yet-twisted fingers made miracles with string and thread. She kept
her handwork in the sleeve of her old maroon sweater, with an extra
tissue, and sometimes half a banana.

I left the two little old ladies asleep, each with her memories, each
curled like a tiny thin child in her bed. Their white hair was dry and
wispy, their hands veined and arthritic, their feet swollen. Bless them
both, they had done their work in this life.

I closed the door and went back to the station, and waited for the night
nurse to come in. I gave her my report, told her about the lullaby, and
watched her smile. I signed off on my charts, put my coat on, and walked
down the hall to the elevator. Dan was there, walking, and I said, Time
for bed, Dan.

He nodded. Just a bit more to do. He went walking away, telling himself
some important duty for the next day.

I went past the quiet dark kitchen and said good night to the security
guard at the desk, who was doing crosswords and drinking coffee. Out
side, the clear night air was cold, and the stars were frosty and close.
I looked back up at the floors of the nursing home, with their
night-lights glowing. My feet hurt sometimes and I worried a lot, but I
was blessed.

Chapter 4.

The Coroner's Highway.

Carmen was a head nurse now, she had worked every floor and every shift
in the hospital over the years. She had graduated from a diploma
program, a three-year school that trained young nurses right in the
hospital. They lived in a dormitory across the street from the hospital.
None of them could be married, and many of them were right out of high
school. Diploma programs are obsolete now, because nurses training has
been taken over by universities and colleges. Now student nurses can be
married, they can have children and still go into training. I was glad
for the change, because it means that more women from different walks of
life and different backgrounds can become nurses. But when you talk to a
diploma nurse, they feel a nostalgia for those schools, they were
rigorous training grounds and the nurses that they graduated were some
of the best. Carmen never hesitates to tell us all that, and we really
do believe her. She never suffers fools gladly, and says that she
learned it in school because none of her teachers suffered foolishness.
This is her story, the story of one patient that she remembered from her
years as a young nurse in a rural area of New Mexico, many years ago.

This is the story of one Navajo named Simon Tsosie, and a couple of days
of hell. In one fifty-six-hour span of time, thirty-one patients were
admitted to our thirty-bed hospital, and we had eleven people dead on
arrival in the emergency room. For our little hospital and its staff, it
was a battle and an earthquake and nearly the end of the world thrown in
to get our attention. For Simon Tsosie, it was the end of his world.

It was the summer of 1963, and I was a recent graduate then, out of
nursing school for a couple of years. I started working at a little
hospital in a town west of Albuquerque, near my home. I had been raised
out there, on a small ranch, I knew the area and wanted to go back. It
was a small hospital, only thirty beds, pretty busy with all the usual
trauma where people worked with farm machinery, guns, ranch equipment,
and animals. Our little emergency room served a wide area, and a wide
range of people. The director of nurses put me in that emergency room
to learn all I could. I was green and young, but strong, and we all
worked hard. The staff was small, so we were like a family, we knew each
other well. We also knew our patients well, as regulars, families came
in for childbirth, accidents, car wrecks.

The car wrecks were the worst. At that time the eastwest highway was
four lanes up to our town. Then it narrowed down to two lanes in a
village about twenty miles east of us. It became four lanes again, just
outside of that little village. With all the cross-country traffic, and
the trucks, and the drunks on Saturday, it was a nightmare, especially
in the dark when people missed the slow down signs and the changes to
two lanes signs and ran head-on into each other all the time. It was a
death trap, and the county finally got the state to fix it, then the
interstate went in, so that little emergency room is real quiet now.

Back then, in the late fifties and early sixties, the Native American
population was called Indian, and the big hospital that is now the
University of New Mexico Hospital was called Bemalillo County Indian
Hospital. It's a strong part of the culture of the state, and all of us,
Anglo, Hispanic, and Native American, are rightfully proud of it. But it
was the dark side, the poor side, that our hospital saw as much as the
proud part.

Simon was our first admission that weekend, about eight o'clock on a
Friday night. I was the supervisor in the emergency room when Simon came
in, an old friend, a regular, by then. He was mostly Navajo, part Zuni,
an unemployed uranium miner. He was about forty, but he looked twenty
years older. His skin was wrinkled from the sun and from drinking, his
black hair was thin. He was an alcoholic, a chain smoker, didn't eat
right, slept outside in good weather and wherever he could in the winter
to get out of the cold. Besides the alcohol, who knew what kind of awful
junk had gotten into his system from the uranium tailings all around the
place where he lived? His family had disappeared or avoided him, and he
was typical of some of our weekend regulars. To us, he was just another
Indian, but to him and his people, the fact that he was both Navajo and
Zuni mattered a great deal. The tribes just don't like each other very
much, and have been fighting over the same land for centuries.

I walked into the cubicle where he lay, legs drawn up, holding his
stomach. His eyes were glassy, unfocused. His hair was long and dirty.

I could get real mad at him because I knew him.

You back already? It's only eight o'clock.

He looked at me and tried to smile. His belly was hurting, he had been
throwing up. He closed his eyes and shook his head, and whispered, Only
way to fight the bugs.

He had been in the week before, with DTS, screaming about bugs.

Why bugs? He had been a code talker, as a very young man, in World War
11 in the Pacific. The Navajos talked their language, which the Japanese
never figured out, and their language was the code that kept the
secrets. I saw a picture of him during that time-he was handsome, young,
proud. He kept the picture in his wallet, and by now it was hardly a
picture, more a crumpled-up sign of his purpose in those days.

We had long talks many times when he was admitted, and he told me all
about the Pacific War, how Guam and Saipan looked. How it felt to be
doing such a job, such a vitally important job as keeping secrets. Simon
thought it was so funny that all he and the others had to do was talk
Navajo, their own language, a rapid, everyday sound to them.

We were good. We just talked Navajo, and talked to each other across
miles. We called bombs eggs and grenades were I potatoes.

They never broke the code, but my own little grandmother could have
understood us. I was serving on Guam and Saipan, and the bugs were wild,
big and hungry. Lots of them.

He looked funny when he talked about the bugs, as if they would come
from those jungles to the desert and try to drive him crazy. The
mosquitoes and the ternites, flying in the heat and covering a tree, or
a house, with their millions of bodies whispering together, dry and
brittle. He hated them. His eyes widened and he would shudder, just
talking about them. I felt like scratching all over when he described
these bugs, in the heat and the humidity, and the mud.

Once, while he rolled one of his nasty little cigarettes, he told me
about the caves at Yigo on northern Guam, where the Japanese had dug in
using the natural caves and some fortified bunkers. When the Americans
took the island the Japanese refused to come out, they just would not
surrender. So the Americans put something like napalm or gasoline in the
caves and then used flamethrowers, and bulldozed the entrances to the
caves, burying them all, alive, burned, dead. When Simon told me that
story he was looking straight ahead at nothing, and he told me that the
mosquitoes were terrible in that place, worse than anywhere else. And he
kept saying, I wore the uniform, I was proud of the uniform.

He told me about the cliff called Banzai on Saipan, where thousands of
soldiers and civilians fled the coming of the Americans, and threw
themselves off the cliffs to die. He told me about the stench of all
those bodies, and about the flies. The caves and the cliffs and the bugs
and the death had all melted together in his mind, and crippled him just
as much as if they had blown his feet off, or taken his arms away.

He was a short, slight man, about five-feet-six. He wore clothes that he
found in dumps, or shelters, and his laceless boots clapped when he
walked, and he wore them without socks. He wore an old army fatigue
shirt and pants, with a poncho that smelled like some of those bugs he
talked about. His hands were thin, there was dirt under his fingernails
and caked in the creases, but they were fine and well shaped. His face
was thin, too, cheekbones high under his black eyes. I always wondered
how the proud code talker became this wreck with the DTS, but without
work, without hope, and with too many terrible memories and too much
alcohol, he just started sliding and didn't know how to stop.

We used to let him sleep in the ER, and find him a meal, and send him
out again, knowing we would see him in a week or so, in some bad shape.
We got mad and sent him to the gospel shelters for some help, but he
always came back. We had him talk to the AA guys, and the VA people, and
the counselors, the public-health people. We were all afraid he would
become a Popsicle some winter, one of the drunks that froze to death at
night on the streets of the town and got picked up in daylight by the
police and brought to the morgue.

I asked him once about his religion-maybe a medicine man from his
chapter would do him some good, give him some comfort.

He had looked at me and laughed softly. The medicine only works if you
believe in it. I got too far away, much too far away. I don't belong
anywhere, with the white man or the Zuni or the Navajo. I got stuck
someplace in the middle, smelling bugs and death, in a marine uniform.
He smiled again, but there was no laughter in his eyes.

This particular Friday night was a long weekend, a holiday. I watched
Simon lie quietly on the bed. His breathing was ragged, his face taut
and pale. He was watching me as if he remembered something.

Your brother, he whispered. Your brother is in the jungles.

In Vietnam, yes, in that damn jungle.. .

He looked wild then, and tried to sit up, and grabbed my hands.

Tell him not to look at the bugs, not to listen to the bugs .. .. ..

I'll tell him, Simon, I'll tell him. Now lie down and rest. You need
rest.

He let go of my hand and lay back down, and closed his eyes. But I could
hear him talking softly, as if he were telling my brother about the
bugs.

I was an inexperienced nurse, but I didn't like the way he looked. I
turned around to talk to the doc, and someone burst in the door.

There's a head-on collision, two teenagers.. .

And for the next three days that was our battlefield.

The two teenagers had eloped from a city up north, were driving to
Nevada to get married, and no one knew where their parents were. The
girl was dead on arrival, the boy in critical condition. We got him on
the respirator, and someone from administration began calling phone
numbers we found in his wallet. While we were getting him settled, we
got a woman who had overdosed on something, and Mrs. Harrington, the
head nurse, called in two nurses who were supposed to be off.

Don't argue. I've got a feeling no one's going to get any sleep for a
while. I overheard Mrs. H giving sharp orders over the phone. She looked
at me and shook her head.

Here we go. Full moon, holiday driving, we've got the whole shooting
match.

The ER filled up with another pickup truck of people in another
accident. No one needed to be admitted in that case, just patched up.

But it took a while, there were eight people who needed X rays, casts,
bandages, reassurance. Several children were involved, so that took
time. I was busy with them when I listened to the head nurse on the
phone again.

Albuquerque? You want to send her to Albuquerque?

The overdosed patient's family wanted her in the big city, so they
wanted us to send her in an ambulance, with the respirator, and of
course this meant that a nurse had to go with her. Mrs. Harrington
counted to ten, and telephoned a part-time RN we had on call. By now it
wasn-iidnight, and there was a commotion in the hallway. The parents of
the teenagers had been found, the administrator was going to the bus
station to meet them. They didn't know about the girl and were told only
that the boy was critical. In the mess I was in, helping a little kid
with a bad laceration on his leg, I wondered which lucky administrator
was going to meet the bus. As soon as I got the kid cleaned up and
quiet, we had another admission, a car and a truck had another head on
collision.

Every one on staff was called, the administrators were on the phones
taking calls while the medical people tried to do their best in the
surgical suites upstairs and in the ER. We had Amy, one of our new
administrators, running to find supplies, and she carried dirty bandages
and glop just like the rest of us. She was dressed in her best
management suit, and her champagne-colored stockings were shot. She and
I were on the floor cleaning up one particularly bad mess, me in my
scrubs and her in this really nice outfit.

You're going to ruin that skirt, I said.

So what can I do?

Get a pair of scrubs on, woman! I started being bossy pretty early in my
career.

She did. The scrubs were way too big, but she rolled up the legs and
came back to help. She and I were scrubbing and stocking the cabinets
with fresh bandages when Mrs. Harrington came in and stood quietly
behind us.

I have a job for you, Amy. You'll need to change.

Amy turned around, her curly hair in her eyes, and said, Say, we're
doing a job here. She turned back to her work.

No, there's another job you have to do, as an administrator. Some thing
in her voice made both of us turn around. She spoke quietly, and sadly,
and that head nurse's voice was hardly ever quiet.

Cannen, I need you on duty. Never mind stocking that cabinet.

I hopped up and went to the lobby, and I heard Mrs. H tell Amy, You'll
have to tell her parents.

I found out later that the ambulance with the part time nurse and the
respirator patient had a head-on collision with a car, and both the
nurse and the ambulance driver were dead, and the patient barely alive.
In those days there wasn't any University Hospital helicopter like there
is now, we sure could have used it that night. So Amy had to go home to
change again, and put on a nice skirt and another pair of champagne
colored stockings, and go do an administrator's job to tell a family
about a death. At that point I wanted to hide forever in the supplies
cabinet and never come out.

There was a lull, like that quiet that comes just before you know the
skies will open up and the wind roar. We all sat down and took stock of
where we were, and who needed what. No one had eaten for about eight
hours, so I dug into my stash of peanut-butter crackers and passed them
around. We looked terrible, all of us. Like people must look after a
plane crash, or a tornado. The head nurse was calm, though, and she made
sure we all had something to eat and made some coffee. I took a deep
breath, because I heard the door open and the ward clerk holler out,
Cops coming!

What now? In the police car was Simon, limp and coughing blood.

And here we were, looking almost as bad as Simon, and the police Stared
at us.

You guys look terrible.

And where have you been the past eight hours? On Mars? Three collisions
and a few DOriS and I'm sorry my makeup isn't on! Mrs. Harrington
whipped past them and grabbed Simon.

You screw up! she yelled. What did you do now?

We got him into the last cubicle, and he looked really bad. After the
docs  had stopped the bleeding, he lay there, looking around, dazed.

, .What happened here? Simon asked.

We're a hospital, remember? We got some really sick people in here over
the past few hours.

He nodded and muttered something. I couldn't hear him, so I leaned over
and smelled the bourbon and the vomit.

Sorry, he said. Don't worry with me. But then he grabbed my arm, and I
had to lean over him again to hear what he said.

Don't let the bugs come, not the bugs!

He was terrified, and shaking, and ice-cold. Another attack of the DTS
was coming for him. Another hatch of those big bugs. I shivered, and
covered him with the blanket, and something in his face made me want to
defend him. He's not just another Popsicle. He was more than that, but
he was half-gone already.

I left him there and went to help with the parents of the teenagers.

One of them collapsed, and everyone was crying. I felt odd, like you do
in a bad dream. All this commotion was going on around me, and I felt
like I was moving very slowly, very quietly, hardly moving at all.

We did sleep, some of us, for a few hours, and went home and took
showers, and got called back. It was a nightmare, the worst thing you
could imagine, but it was happening. We had to call for extra supplies
from Albuquerque, and the administrator got in his car to drive the
eighty or so miles to get them. Mrs. Harrington ran out and screamed at
him, Don't die, please! Don't die!

She came back in, acting as if nothing had happened, as if she always
yelled at the administrator not to die when he went to Albuquerque. She
had dark circles under her eyes and kept drinking coffee, cup after cup.

You need to lie down, ma'am. The ward clerk took her hand and led her
over to the couch in the ER, like a child. She lay down. We put a
blanket over her, and she slept, finally.

By now it was late afternoon, on Saturday. We watched the sun set over
the great red cliffs, so silent and strong, and wondered what the night
would bring. It wasn't over, that we knew.

We discharged Simon, and when he left at dawn, he had stopped bleeding
and we had given him something to eat.

Go home and go to bed, and please stay away from the booze.

You're killing yourself.

Simon looked at me, and nodded. I know, he said. I know.

1 couldn't help it. I lost it, and screamed in his face, If you know,
then why are you doing this to yourself? Why can't you stop?

He shook his head, and smiled. There is no place for me. No place.

No job, no family, no home. I can't sleep. When I sleep, I remember the
bugs.

He left, and the day went on, and somehow we got things back to nortnal.
Arrangements were made for the teenagers-the boy had died during the
night. His parents and the girl's parents sat silent in the hallway,
looking at the cracked linoleum. No one spoke to them. It was as if they
had washed up from a flood, and no one knew what to do.

One of the administrators was helping, but he had been up all night,
too, and sounded distracted. In the slow-motion world I lived in at this
point, his mouth was working but no sound was coming out. We all knew
that we were dangerous now, that our thinking was on automatic, but
another head-on collision came in, and that was the last. It was over,
and only a mountain of paperwork remained. Mrs. Harrington came in with
a tray of food scrounged from the kitchen at four in the morning, and we
sat on the floor and fell on it like wolves. The little ER was empty, a
mess, but empty. The work was finally done, the patients were safely up
on the floors, the people cared for, cried over. We all sat there,
looking at each other, silent.

The doors opened, and the cops were back. I closed my eyes and put my
head down on the cool linoleum floor, and wept. One of them was carrying
Simon, and he kept saying, He drowned. He drowned.

Drowned? Where, in the bathtub?

Mrs. Harrington was having none of Simon. She shoved me toward the
policeman and ran out, running to answer the telephone. The ward clerk
had fallen asleep on the desk.

Simon had drowned in his own blood and vomit, choked to death. It was
the last straw for me. How many times had I taken care of him, how many
times had I sent him back, pleading with him to stop drink ing? Now he
was back in the pale predawn light, and I couldn't yell at him anymore.
The policeman carried him carefully to the bed and stood there, holding
his hat and shaking his head. Some of us had a bet, whether he would get
killed by a car, lying in the middle of the street, or if he would
freeze to death.

So no one won, huh? I asked.

He shook his head. Nope. Nobody figured this.

No one ever does.

After I got through crying, out of exhaustion and anger, I cleaned Simon
up and covered him with a sheet. I noticed how his brown thin feet stuck
out of the bottom of the bed. I took the picture out of his wallet and
put it in the pocket of my scrub coat, and went about the motions like
my body was not part of me. It was automatic, and I wasn't thinking. I
couldn't think. I couldn't even think about Simon yet. I would, I would
think about him, and all the rest of them. It was all confused in my
mind at this point, and I was too damn tired to care.

I looked out the window at the cliffs, the red cliffs that were always
there, and I heard a rooster crow, far away. The cliffs were like great
black ships with gray light behind them. Then dawn came, little by
little, lighting up the red cliffs like fire, from the bottoms to the
tops, lit like flames across the top. The rooster crowed and the dawn
came, and I walked out of the ER and into the quiet hallway, and in that
strange place that is beyond exhaustion or explanation, I made a pot of
coffee and sat there with the sleeping ward clerk, watching the dawn
come, listening to the rooster crow.

Chapter 5.

The Pilgrimage of Mabel Potts.

Margaret loves to tell this story because it has so much to teach all of
us-patients, nurses, and doctors alike. It reminds us to keep an open
mind, and not assume too much about people, or illness.

It helps us remember that sometimes the knowledge in our minds needs a
footnote of surprise. It's a good nurse or physician who learns this
lesson early and doesn't forget it, ever, always be prepared to widen
the scope of the mind and bring to it what you don't understand and
cannot predict. Be ready to admit that you don't know-that's the only
way you learn. Especially something that isn't in a medical dictionary.

Margaret keeps her mind open as well as her heart, noticing things that
others don't, hearing things that others can't. And doing things that
few can do.

Mabel Potts didn't like doctors, and she let us know it. She sat on the
edge of her chair, her hands on the chair arms and her feet under neath,
poised for flight. Her expression told it all, her nuckles on the
chair arms were white, her eyes were narrowed, and her foot tapped as if
to say, Hurry up, I haven't got time for this. In a way, she didn't.

She was eighty-nine years old, had never been sick in her life, and
wasn't about to start now. She felt fine, she said, lump and all.

And there was a lump. A big one, under her arm. A primary-care doctor
from the family-medicine clinic had sent her to us at the cancer clinic
for a biopsy and some education as to the nature of such lumps, the
doctor had written. He had tried and gotten nowhere, in other words, so
he sent her to us to see what we could do.

Lump or not I have to see to my old people. I've left Mrs. Franks at the
old folks home alone in the kitchen and she can't see well, and they
need me for the afternoon meal. Her bright blue eyes dared the doctors
to hold up that afternoon meal for those old people. What was old? Not
Mabel Potts, that's for sure.

I've seen them before and I'll see them again, and one day I'll probably
see one in the mirror. Tough and stubborn and a little scared, but not
letting it show too much. Long years of work, longer years of caring for
everybody and everything around them, from children to daffodils to
brussels sprouts. Opinions on everything, too. You didn't need ask her
advice-Mabel would give it to you free. Unless she thought you were dim,
and then she'd give up. And she thought this young doctor was dim.

You just aren't listening to me. I have work to do. She looked straight
in the doctor's face as if he had nothing better to do than badger an
old lady all day. He had a lot of things to do, and one of them was to
get this particular old lady into the hospital to get a biopsy and some
blood. Mabel wasn't making it easy for him.

Our new charge nurse bent down and took Mabel's hand. Do you have
children in Albuquerque, someone you could call?

Of course I have children. I have four daughters and they're all busy,
and I have eight grandchildren and four greatgrandchildren, and calling
them wouldn't do any good because I don't listen to them much, either.

I looked up at the ceiling and said to myself, This isn't working.

Then I thought about my great-aunt Jane, suffragette for the women's
vote, old-style nurse who pretended she knew Florence personally, and
great gingerbread maker. What would I have done if I had been Aunt
Jane's nurse at this particular moment? I was rotating back and forth
from the floor to the cancer clinic, and thought of Aunt Jane a lot down
here.

Mabel, you need to help us out. I took her hand and looked straight into
her face. We have to do this biopsy of that lump and we can get it done
a lot quicker if you let us finish. Then you can walk out of here, and
we'll call you with the results. You owe that to your great
grandchildren, and their medical histories, to do the tests and see
what's going on with that lump under your arm. Right?

She looked at me with a sigh and said softly, I promised my daughters I
would listen for a while, and got out of the chair. Get on with it and
let me get out of here. I'll call the home and have them call Mrs.
Tenorio. She'll help. I'll tell them I'll be back in a couple of days,
right? She looked at me with an Aunt Jane look and I nodded, crossing my
fingers behind my back that the lab would hurry up and get those
biopsies done. I needn't have worried. Mabel had a direct line to the
Almighty. I always had the feeling when we did anything with Mabel that
Someone was watching. Maybe Aunt Jane was watching, too.

She came in with her little suitcase a couple of hours later, resigned
to our biopsy. We admitted her, got her in a room, and took a deep
breath. When I came back about an hour later, Mabel was sitting up in
bed, her white hair like a cloud around her head. She had brought a
Parcheesi board and some cards, and some knitting. The inside of her
elbow was decorated with cotton balls and a Band-Aid where they had
drawn blood, and X ray was busy setting up for a portable chest X ray.

Mabel looked at the X-ray tech as if he came from Mars.

What are you doing with that machine in my room?

He flinched just a bit and then said, They ordered a routine chest X
ray, ma'am, and I have to do it. Could you lie down and let me get it
done? I'll get out of your way as soon as I can.

Brave tech. He understood Mabel better than most of us.

She watched the machine as they took the chest X ray and held her breath
when they told her to, and the tech said, You must remember these tests.
You've had them before.

Not ever, Mabel muttered under her breath. They asked me if I was
allergic to penicillin. She looked at me over her glasses and shook her
head. How do I know? I've never had any before.

The doctors were amazed. What do you mean, she doesn't take medicine?
Nothing but some aspirin once in a while?

She has to take something. Ask her if she takes laxatives or vita mins.
These old people take all kinds of weird stuff. Just ask her. I'll bet
she does, and she won't say. Or she forgot.

It was interesting to me to watch how the middle-aged docs  took care of
this old lady. I had watched them before with other old ladies who were
more docile and agreeable than Mabel Potts. With those old ladies, the
doctors were solicitous, kind, and sweet. Those old ladies seemed to
need that. They seemed to need the take-charge attitude of the doctors,
the just lie there and don't worry, we'll take care of you approach to
medicine. Mabel Potts said, Prove it twice and maybe I'll think about
it. The doctors were not used to someone like Mabel. The nurses were,
they were our grandmothers and aunts and would be our granddaughters and
grand-nieces, too. And us, if we were lucky.

Mabel finished her bland dinner and asked the nurse on duty to go fetch
something with flavor.

corn chips or chocolate ice cream, those are good. How about a green
chili cheeseburger?

We all knew the night charge nurse and wondered if she had found a
convert to cheeseburgers with green chili and fries. Mabel, at eighty
nine, didn't think it mattered.

So what if I've got all that junk in my veins? Who cares? At least my
brain is working. And when will they be done with this testing?

The tests came back and it was confirmed, metastatic adenocarci noma of
unknown origin. In other words, Mabel had a cancer under her arm, maybe
spreading, and no one knew where it came from.

What do you mean, unknown origin.? You don't know what it is or where it
came from, do you? Mabel fixed the resident with her bright eyes, and he
looked at the ceiling.

No, ma'am. We don't know where it came from, and we don't know when or
if it will get bigger, but it is there. It definitely is there, and it
might spread.

So what now? Mabel believed in getting down to the basics.

What now, do I live or not? Do I take medicine or not? What's going on
in my body that I should worry about or take care of?

Right on, Mabel.

We're not sure. It may come back, or it may not. It may be aggressive or
it may disappear. We'll need to do chemotherapy in any case. We've found
that ten treatments over several months will take care of it.

She sighed and looked at the resident. He was new to New Mexico, he came
from Pennsylvania and felt like an alien. We tried to make him
comfortable, but he didn't respond much, just kept talking about The
East. The problem was, he wasn't in The East. He was in New Mexico and
couldn't relax. He stood up, shook her hand, and said, I admire your
spirit, Mrs. Potts. Carry on.

And he walked out, leaving Mabel sitting in the bed, looking at me.

So what does that mean? What about the chemotherapy?

I shrugged. It means he doesn't know what to say but he wishes you
well. He would like to be able to tell you more, but he can't. That
happens, sometimes. We don't have all the answers. I looked straight
into those unblinking blue eyes and tried to sound assured. No one
knows, Mabel. The outcome isn't certain, but there is a cancer there.

They want to try the chemotherapy procedures that have worked before,
with cancers like yours. I took her hand and tried to make her under
stand.

It's not like geraniums, or babies, or old people. There you know what
to do. Here it's different, more stuff going on, and we don't always
know. It's hard, not to know and want to know.

She looked up at me, those china-blue eyes staring me down. You're
supposed to know.

Yep, you're right. We are supposed to know. And when we don't, it's
hard. I refused to be defeated by those eyes.

She looked away and nodded. I felt that there was something going on
behind those eyes, some stiffing of fear, an unasked question.

Mabel, what can we do, if we don't have answers?

Will you come back for chemotherapy?

She looked beyond me as if she were listening to something, and then
said, I'm having my fifth great-grandchild in a month, and my youngest
grandson is graduating from high school about the same time. My
daughters will want me to go through the whole ten treatments. I'll try
one.

I kept my mouth shut. The doctors had told her that she had to go
through all ten or it wouldn't do any good, but I knew better than to
argue with her, because if I did we'd lose her completely. One treatment
might lead to the others. So I patted her hand and told her I would see
her in the clinic for her first chemo.

She came into the clinic with her eldest daughter, Iva, who was tall and
straight and bony. Iva helped her mother into the big recliner and Mabel
stuck her arm out and watched the liquid flow through the tubing into
her arm. She looked around her at the macrame hangings on the walls, the
flowers and plants all around, and said, That philodendron needs water.

Iva looked at the ceiling with a ghost of a smile around her lips. Peg
looked at me with a twinkle in her eyes and said, Could you do that,
Margaret? I've got my hands full.

Clinic nurses love to boss floor. r nurses around, so I grinned back at
her and put the pot in the sink. I was early for my shift, looking in on
Mabel as I had promised.

What do you think, Mabel?

She nodded, and watched another patient sit down in the recliner next to
her. He was one of our oldest cancer patients, a tall, thin old man
whose veins were hard to find. He was a particular pet of ours. Peg
greeted him, and put his hand and lower arm into the paraffin bath near
the chair. Mabel watched as Peg held his waxed arm and wrapped it in a
plastic towel.

What's that for, medicine?

No, Mabel, it's melted wax to warm the arm and bring the veins up where
I can find them. This gentleman here has veins that like to hide from
me. Peg patted the old man's wasted hand and he smiled.

Nothing hides long from this lady, he said. I used to be one of those
targets in the radiation hallway, now they've got me in here.

I'm still a target, but more like a pincushion! He shook his head,
smiling at Peg.

Mabel nodded and watched everything, listened to everything. I had to
leave to get back on duty, so I squatted down and took her hand.

Come and see me on Five West later. She nodded and looked around, with
an odd expression on her face.

Do you work here every day? I heard her ask Peg.

For fifteen years! Peg laughed.

Maybe they'll let you go learn something else soon, Mabel said, watching
the medicine flow into her arm from the bottle hanging over her head.
Iva took out some knitting, the old man lay back in the chair and closed
his eyes, and there was a gentle silence in the room. I went up the
elevator to the fifth floor, thinking, Chemo number one done.

Only nine to go, and wondered if Mabel and Iva would be back.

A few days later Peg called me and asked if we could meet in the coffee
shop at lunch. She sounded tense and frustrated. We sat down with our
soup and sandwich and Peg blurted out what was bothering her.

Iva called and said Mabel won't come back. She twisted her nap kin and
threw it on the table.

She said one treatment, remember? Is she losing her hair? I wondered if
Mabel would balk at that. We find vanity in strange places in this
business.

Of course, but it'll grow back, we told her so. She just won't come
back. She says that the lump is gone and she doesn't need any more
chemo. Peg looked at me. Could you come down if we can get her back in
just for a consult?

Sure. But what can I do? When Mabel makes up her mind.. .

Oh, I know. But maybe .. .

I nodded and finished my soup. I knew it wouldn't do any good, but like
Peg said, maybe .. .

Two days later I was in the office at the cancer center an hour before
my shift began, watching Mabel turn her doctors inside out. She had come
up alone, making Iva stay in the lobby.

I only came to show you that there's no more lump. I don't like this
wig. She twisted the white wig around on her head like a cap. I had to
buy this wig and there's no lump left. You looked at it, you examined me
and saw that it's gone. Gone completely. So why do I have to come back
for more of that medicine that makes my hair fall out? How can medicine
that does that be good for you?

She had us there. It was hard to tell people that the doctors had to
make you sick to make you well. We knew that chemotherapy helped people
and destroyed cancer cells, the side effects were part of the treatment,
and the side effects now are much better than they used to be. Mabel sat
in the chair and Iva waited in the lobby and we weren't getting
anywhere.

What will change your mind, Mabel? Peg asked. What can we say, what can
anyone say, or do, to change your mind?

Or to give you answers that you need? We've given you all the
information on your disease that we have, so what can we do now?

Nothing. Mabel looked straight at Peg without seeing her. She just
nodded her head as if she had found an answer. You can't do anything,
but someone else can. I need to go talk to him to find out. I'll just go
and find out. There was a silence, and she nodded, pressing her lips
together. I'll just go find out.

Iva came to get her. Mabel trundled out in the wheelchair, claiming she
could walk and the wheelchair was only for old folks. They got in the
car, and Iva turned to her mother and said, So we're going for another
train trip, Ma?

Mabel nodded, and began to tell her daughter how to drive home.

Iva, probably exasperated, let the clutch out suddenly and the car
jerked and jolted and came to a stop. When I saw that, I heard Mabel say
mildly, Who taught you to drive?

Iva turned and snapped, You did.

I walked back into the hospital, feeling sorry for Mabel's daughters.

When Mabel said she had to go find out, she meant it. A few days later
Maude, her youngest daughter, came up to the floor and asked to see me.
We sat in the conference room drinking coffee, and I listened.

She's driving us crazy, but that's no surprise. She's been doing it for
years. Maude sighed.

I drank my coffee and listened. Maude took a deep breath.

There are four of us girls. Maude was in her fifties and her oldest
sister was sixty-three, but they were still girls. We're all married and
have children and grandchildren, but with Mother.. . She shook her head.
She had a son, years ago. He died of polio when he was four.

That was back in Michigan, Dexter, Michigan. It was a long time ago.

Right away after he died she had Iva, and then Eunice, and then Erma.

They were born in Michigan. I was born here in Albuquerque. All of us
were girls. No more sons.

She sipped her coffee, and cried a little bit. We always thought she was
having us to have another Christian. That was his name, Christian.

I sat there thinking about the good solid old midwestern names. Maude
was silent, sipping her coffee and dabbing her eyes with the paper nap
kin. I leaned forward and said, When did he die?

In 1928, in the summer. Mother was twenty-one years old. Maude took a
deep breath and told me the rest of the story. She left Michigan in
1939, with the first three daughters. I was born here in 1942 and then
she didn't have any more children.

Maude was the last, the final chance to have another son. It's sad to be
born a girl when you were supposed to be a boy, and sadder still to know
it.

So there we were. Daddy was a machinist during the war at Kirtland Air
Force Base. He was a quiet man, never said much. She looked straight at
me. Her eyes were china blue. Mother didn't give him a chance. She
always just plunged in and did whatever needed doing. He would stand
back and smile and nod and pat us on the head. He knew some good songs,
and he did a lot of cooking while she was off doing things-working,
joining church groups, and looking after everyone.

She ran the PTA. I'm sure the other parents were glad when we all went
on to high school. But Daddy died, in 1973, and she's been a widow for
twenty-two years. Maude sighed, probably wishing her father could come
back and deal with Mabel.

There was a small silence. We listened to the overhead looking for a
doctor and telling us that the gift shop was open. Maude looked up from
the bottom of her coffee cup and told me what she had really come to
tell me in the first place.

So she's going back there to ask Christian what to do, and don't in's
He's crazy because's e one it e I does. She spoke rapidly, looking
straight at me with Mabel's eyes. At first I couldn't imagine what she
meant.

-Where did she go? I asked.

Maude looked at me as if I were slightly dim, like Mabel would have
done, and repeated herself. She's going back to the grave of her first
child, where all of her parents and grandparents and aunts and uncles
are buried, to talk to Christian. Don't ask me how but it works.

I finally got it.

She's gone back to Michigan to Christian's grave, to ask him what to do
about the cancer, and the treatment, I said quietly, testing the words.

Maude smiled triumphantly, as if she had finally made this dim child
understand. She talks to Daddy, too, at his grave here in Albuquerque.

But for really big problems she goes back where she was born, and where
her roots are. There's an old apple farm, old farmhouse, regular
homestead out there. She does it fairly often, and Iva always takes her.

They argue all the way there on the train and all the way back. Maude
sat and patted her lips with the napkin and looked down, blushing.

Iva fights with her. I never do. I can't win, ever, and sometimes Iva
does, but not a lot. So we let Iva fight with her.

I stood up and shook Maude's hand and told her that I wanted to see
Mabel when she came back, whatever she and Christian talked about.

Oh, certainly, she'll let you know. She always does.

Maude left and I went back on the floor, the nice noisy normally crazy
floor, and took care of my patients. I went off duty for a few days and
came back, still thinking about Maude and Mabel. I knew that whenever
Iva got her back off the train, we'd hear about it. I certainly wanted
to be there when Mabel told the doctor about her talk with Christian.

She came back to tell us what they had decided, Mabel and Iva and
Christian. She sat in the conference room in the hospital and announced
her decision.

Whatever that lump was, one treatment made it go away because it was
never really there. Not ever. And I have too much to do with all my old
people and the great-grandchildren, and I'm not coming back. I need to
spend my time living and working, not thinking about being sick or
dying. I didn't like losing my hair. Her hand strayed up to the white
cropped wig she wore. I was never pretty, but my Paul always said I was
a handsome woman. Her bright blue eyes fixed on the resident, daring him
to deny what her husband had said.

And so that's that. I came to tell you not to bother making any more
appointments. And don't charge Medicare for all those chemos, either.

Save the money for our old folks. She stood up, and the doctor from
Pennsylvania sat there with his mouth open.

What do you mean it wasn't there? His voice sounded a little strangled,
as if he were choking on something.

Mabel looked at him as if he had just appeared, in the chair in front of
her. I think she was surprised that he questioned her decision.

It wasn't there. It's not gone because it never was there. She looked
into his face, and he stared back at her. I talked to Christian, and we
decided that I have too much to live for to worry about a silly lump
that wasn't even really there.

The biopsy .. . the lump.. .

Don't care what they said, it just isn't there and never was. Must have
been some funny lump that just came and went, like your throat glands do
when you're sick. They get swollen and go away, don't they?

Now I've got to go back to my old people and get the noon meal on the
table, so good-bye. I'll just live until I die. That's all I can do
anyway.

. Mabel stood up and trotted off down the hall, peering into some rooms
where her buddies from the chemotherapy were. She charged into one room,
and I heard her say, You get up and walk, hear, it'll do you good. You
lie there and you'll just get old and lose your will.

Ask the night charge for a green chili cheeseburger. That'll fix you up
just fine.

And she marched out and headed for the double doors, and I looked up at
the ceiling and tried not to laugh at the expression on that young
doctor's face.

She talked to a dead child and decided not to take any more chemo. His
voice was flat and monotonous as he watched Mabel leave the floor. And
it's gone. The lump is gone after only one chemo treatment. That's not
possible. He looked at the other resident.

What have we got here, some kind of rapid remission? What do we tell the
chief?

Tell him it's a miracle. That'll make his day, I said, only half
kidding. The residents both looked at me as if I was as crazy as Mabel,
and walked off muttering over the chart, trying to figure out what they
would write down for the chief.

I was walking out of the conference room to the nurses station when
Maude came out of the bathroom. I stared at her, wondering what she was
doing there. Iva had driven Mabel to the hospital, and they were gone.

Maude, what do you need? Did you come here alone?

She nodded and twisted her purse in her hands.

I need to talk to you. Is there somewhere we could talk? She looked
around, at the nurses coming and going, at an old man walking slowly
down the hall with the intravenous bottle on a pole like a silent
companion. We went into the lounge and she sat down and looked at her
shoes.

Maude, what's bothering you? I sat down next to her and took her hand.

She looked up, and there were tears in her eyes.

There is cancer somewhere in Ma, isn't there? It didn't really go away?

There are moments when I wish I had taken up another line of work.

Maybe, Maude, I said carefully. We don't know for sure. It was there
when they did the biopsy, and now the lump is gone. Only time will tell.
It depends on how she feels over the next few months.

Maude shook her head. I heard her tell Iva when they got in the car. She
said she would live until she died, whenever that was.

I nodded and took a deep breath. Mabel's done a lot of work and has been
important to a lot of people for many years. That's all we can ask for.
Mabel knows that. She's a wise woman.

Maude stood up and gave me a hug. I know that, I know that. She wiped
her eyes with her knuckles and nodded. I just have to keep remembering
it.

She walked slowly out the double doors, and I went back to the nurses
station. I poured a cup of coffee and thought about patients like Mabel
who teach us all, nurses and doctors alike, and would teach us more,
down the road.

Chapter 6.

The Long Road Begins.

After I interviewed some of the nurses, and wrote the stories they told
me about their patients, we decided to meet in a group. This is what
happened at that meeting. This is the way we gathered together to tell
more stories. I listened and watched, and put the tapes in the recorder,
and wrote it all down.

It was a dark cold winter day when I came to Mama Mia's, around five
o'clock. The wind was blowing cold and hard and once inside, I was
grateful to be able to take my coat off and rub my cold hands together
at the fire. I had come early to get the table ready and set up the tape
recorder. I sat down near the bar and took out the yellow pad and the
pencils and wrote about work and the happenings of the day.

The restaurant is made of adobe and is plastered pink, and looks like
somebody's house in the middle of a big supermarket parking lot in
Albuquerque, near the hospital. In the bar are high wingback chairs and
small round tables, a big wrought-iron chandelier with little lights
winking inside green wine bottles. There is soft music, sometimes the TV
is on, and I can smell the food from the dining room downstairs.

Every afternoon at five o'clock, Harry the bartender puts free green
chili cheese pizza on the big table near the bar. It's made in the
kitchen downstairs. It's warm and crusty, thick, and full of cheese and
chili. It's comfort food.

There were other bartenders working there, I'm sure, but Harry is the
one who often watched me sit in the corner with a legal pad and drink
beer and write when I began this book. Harry is tall and thin and has a
mustache and wears black string ties with a red garter around his arm.

He winks and says, This is a western Italian place.

Harry watched me write while the conversation of strangers flowed
around, nourishing me. He left me alone and smiled at me when I looked
into the middle distance and stared at the mirror over the bar. It
wasn't a sidewalk cafe on the Left Bank in Paris, but I thought it was
better, much closer to home. And they don't have Harry serving green
chili cheese pizza in Paris.

This was the place to which we hospital nurses came to unwind and talk
shop, and to tape these stories. I always brought my big nurse satchel
along, full of tapes and papers and junk, and turned the re corder on
and put it on one of the small tables. We ordered some drinks and I
said, Talk to me. My friends, always interested in a project that
involved their patients, told me many wonderful, sad, funny stories.

You've heard some of them and you'll hear more, but now you need to see
where it all started and how our little comer was a place to recharge
and take a deep breath and then go back to work.

I sat there doodling on my yellow pad, watching Harry and smelling hot
pizza. A few minutes later a woman came into the bar and sat at the
table next to mine, looking around with a sharp, inquisitive look.

She wore horn-rim glasses and a gray suit with a raspberry blouse, she
had lots of rings on her blunt square hands. Her hair was black streaked
with gray and pulled back tight in a bun. There was a square, straight
line to her back, and I thought idly that she looked like a head nurse.

Still doodling and sipping beer, I watched people go to the pizza table.

I debated with myself as usual and as usual lost the debate, and stood
up to get my first piece of melting pizza. The woman with the bun
turned, and in a crisp, no-nonsense voice asked, Are you Carolyn?

I looked at her, sitting quietly with her hands folded and a highball in
front of her. Yes, I said, but how Anne told me to meet her here, she
said there was a great nurse project going on and that it was your idea.

Pleased that Anne thought it was a great idea, I nodded and motioned for
her to come and sit at my table. She shook her head, moved a chair
beside her, and said, This table's bigger. You come over here with all
that stuff. She stuck her hand out and shook mine, and said, I'm
Cartnen.

Yes, ma'am, I murmured, and moved.

Carmen grinned at me. If you're going to get pizza, get two pieces.

You're younger than I am and I've been on my feet all day.

I laughed, and got the pizza. I thought that if she'd been on her feet
all day she looked better than your average tired head nurse. Crisp and
efficient, she probably ran her floor by raising her eyebrows, not her
voice, knowing everything about every patient and rolling her sleeves up
when her nurses needed her. She tapped on her cigarette and sighed.

I'll quit one of these days, but old habits .. . It's a good thing we
can't smoke on the floor anymore. Who has time to go downstairs and
freeze for a cigarette? She shook her head and waved her cigarette at
the tape recorder. I don't like those things.

Pay no attention, I said. It'll just be part of the table in a little
while. I need it to write down what everyone says for my stories.

Well, I've got some to tell you. She looked over her glasses at me.
You'll need more tapes.

I dug into my satchel and showed her all the blank tapes I had brought,
and she nodded. The way nurses talk, you'll use them.

We finished our pizza in companionable silence, and I saw Anne and Patty
and Stella shake their coats out and comb their hair with their fingers
and pull up chairs, all talking at once. We hadn't met in a large group
before, and I was interested to see how everyone would get along.

I needn't have worried. Every one talked at once, everyone had stories
to tell, and it took me three hours to figure out the tapes when I got
home. There were five of us by this time, with a couple more on their
way.

Anne took a bite of pizza, rolled her eyes at the ceiling in gratitude,
and pushed up the sleeves of her black sweater. Every one's going crazy,
we're running a hundred and one percent full. Anne had been a head
nurse, and was one of the administrators in the hospital now.

The executive offices that we called Mahogany Row ran smoother because
she was there.

How can we run over a hundred percent? That's impossible!

Simple. Put beds in the halls.

How about that accident and knifing that came into the ER .. . ?

It was usually this way with us. We all knew each other and had worked
together in pairs, threesomes, in various places in the hospital
complex. It is a big county medical facility, now called University
Hospital. Next door is the cancer center, near the schools of nursing
and pharmacy. The complex is attached to the University of New Mexico
School of Medicine. We train doctors, nurses, lab techs, X-ray techs in
that hospital. We all work very hard, we see a great deal of pain and
heartache every day, but we wouldn't trade our jobs with anyone. Nothing
we do is really exceptional. It's all a part of our job, part of every
one's job. We all know that we need each other, and telling war stories
is our secular confession, a way of putting what was on the inside on
the outside, and letting it go.

I knew this group would start talking all at once, but they needed to
hear one particular story, from one particular blue-eyed nurse.

Stella, tell your story! I said.

Stella was English, and had a lilt in her voice that we could listen to
forever. She was small and had red hair and loved to tell stories about
the emergency room, her favorite place.

This is a story about an ob-gyn doctor, very persnickety he was. He
bought very expensive clothes, the latest thing. He was a very tidy
fellow. One evening he was called to see a lady in the ER, complaining
of a female problem. This lady weighed about three hundred and fifty
pounds, and was not so clean, either. She was on her back on the table,
up in the stirrups, knees in the air, and everything waving in the
breeze, and the doctor kept saying, Down a little further, dearie, down
a little further. Stella smiled, remembering.

So she scooted her butt down more on the table, further toward the
doctor. She came down the table, slowly, further and further, slowly,
toward the doctor's end of the table. And he says, Down a little
further, dear, down a little further.

Then, just as she is sliding down the table toward the doctor, slowly
the other end of the table goes up, ever so slowly up, and all of a
sudden this big heavy lady slides onto the doctor, screaming to beat the
band, and ends up straddled, right there on his chest. And he's
screaming, Get her off me! Get her off me!

We ran in and lifted her off the doctor, and he had to run and take his
wonderful expensive clothes off and put a pair of scrubs on and send
that lovely suit to the cleaners.

There were smiles and chuckles all around, we all knew exactly whom
Stella was talking about.

We had quite a laugh about that-not in front of that doctor, of course.
All I had to do to get a chuckle was to say, very uppity and like an
aristocrat, Down a little further, dear, down a little further.. .. II
Tell us about the sheep, Anne. Peg never tired of hearing that story,
since she had worked with Anne up on the floor when it happened.

She worked as a chemotherapy nurse at the cancer center now, but her
sense of humor never quit.

Anne grinned. Working on Mahogany Row hadn't dulled her memory, and The
Seven West Sheep story was her favorite from those days up on the wards.

There's a room up on Seven West, Anne began, where we admitted a patient
once who was really out of it. He was alcoholic, just out of the DTS,
shaky, really sad and strung out. He kept telling us all night to keep
the sheep out of his room. We figured he was out of it from the booze,
so we pretended to herd the sheep out of his room, all night long, just
to keep him quiet. This happened every night while he was there, for the
next week.

We figured he was just another boozy mental patient. Then he was
discharged, and we admitted someone else to that room, a really together
middle-aged lady, no mental problems, just diagnosed with diabetes.

She was nice and calm and no problem, in the middle of the night she
rang her bell and told us that she didn't understand why but there were
sheep all over the room! Of course we didn't see any sheep in the room,
but she did. No one ever figured it out.

Patty laughed and asked, Did the sheep ever come back?

Anne nodded. All the time. But we never put it in the nurses notes, she
said. That room is just haunted with sheep, that's all.

I held up my hand to get their attention, because it was getting pretty
noisy. There was one story I needed to tell myself, and this was a good
time to tell it.

Okay, listen up. Here's a ghost story you need to hear. This one
happened down south, when Patty and I worked together. I had graduated
from nursing school just after my fortieth birthday, and was working in
the little ICU there, in Alma. The unit only had six beds, but we had
the sickest people in the hospital.

I sat for a minute, remembering, and the table fell quiet. I looked at
Patty and she smiled, remembering, too.

This patient had been in ICU for two months, on a respirator, real bad.
Dying, for all that time. She was calm and enduring, never cross with
anyone, and we all just loved her, Her name was Miss Cherry and she had
been a kindergarten teacher for years in that little town. Every body,
all her old students, came to see her and sent flowers. Her husband was
a nice man, came every day and held her hand and called her Mother.

One evening I went in to say good night like I always did. We couldn't
hear her talk, since she was on the respirator, but she could mouth the
words and make herself understood to me, usually. Some of the other
nurses couldn't understand her. Once I came in on my day off because she
was agitated, unhappy, and no one could figure it out. For some reason,
I could always understand her, I never had a problem.

I looked down at my glass of beer, seeing Miss Cherry's face that day,
pale, drawn, tears in her eyes because of the frustration of not being
understood. I remembered how peaceful she was after we had our talk and
I figured out that all she wanted was to wish her grand daughter a happy
birthday.

So I told her I would be back tomorrow, like I always did, and she
smiled that lovely smile and told me that her mother had come to see her
last night.

Every one at the table nodded. They knew that when patients say that,
they're close to the end somehow.

So I petted her and fussed over her like I had for two months, and told
her I would see her in the morning. She closed her eyes and smiled and
shook her head as if to say, No, I won't be here then.

I went home, got dinner, had the evening with my family, and thought
about Miss Cherry. In the middle of the night I woke all of a sudden out
of a sound sleep, and there she was, standing by my bed.

She looked radiant, smiling, her skin was beautiful, not pale and
blotchy like it was when I saw her last.

41 11 just came to say good-bye, she said. I lay still, amazed at seeing
her when I knew she was back in the unit, in the hospital.

I rolled over and looked at my clock, and it said four-thirty A. M. She
was gone when I looked back. I cried a little, but went back to sleep.
The alarm went off at five-thirty as usual, and I got up and got ready
for work, hugged the kids, thinking about Miss Cherry.

When I walked into the unit, I went to her room, didn't even take my
coat off. Her bed was empty, of course. Housekeeping was there, the bed
was stripped down, all her belongings were gone. I went to the nurses
station and told the night nurse that she had died at four-thirty this
morning. She opened the chart and sure enough, there it was, 0435

Patient expired.

My old patient had come to say good-bye and it felt good to know that. I
was proud that she came to see me, that we had a real bond somehow.

I sat there making round wet places on the napkin with my glass,
remembering her. Patty reached over and gave me a hug. She had been in
the unit that morning and she remembered, too. The same thing had
happened to her, and to other nurses with other patients. There are
bonds that no one can understand and things happen that no one can
explain, sometimes a veil is lifted, to give us hope and comfort about
dying. But those things change us all, as nurses and as people. I can't
walk by a room and hear someone calling, or look at an old unhappy
person with out thinking of my old patient, and doing something to help,
like I did for Miss Cherry, years ago.

How about your new nurse? story, Anne? someone asked.

Anne laughed and nodded her head. As she turned her bright brown eyes on
me, I moved the tape recorder closer to her, not to miss this one.

When I was a brand-new grad, I had an adult male patient who had just
had a circumcision. The bandage was oozing a little, so I called the
doc, he told me to take the bandage off and put a new one on, and call
him in an hour if it was still oozing. So what did I know? I went in
there with a package of Kerlix-you know, that gauze dressing that's
about nine miles long?

By this time several of us bawdy nurses were chuckling, imagining what
was coming.

Well, said Anne, her eyes twinkling, I was young and embarrassed. I
started talking to the patient and wrapping and talking and wrapping.
And when I was done, I pulled the sheet back over him. And there was
this tent pole in the middle of the bed! This poor guy had a damn pole
sticking up in front of him because I had used the whole roll of Kerlix,
wrapping and talking.

Carmen hooted with laughter. I'll bet that new anatomy of his star tied
some people who came to visit!

Anne held her hand up and laughed as she remembered another story.

You have to hear this one, another one when I was young and green, about
a hundred years ago. It was the day after graduation from nursing
school, and we had all partied hearty the night before, believe me. I
got home around one A. M. , and had to be at work at Six A. m. This
patient was admitted during the night, had been drinking a lot, and was
feeling pretty bad. I was trying to give him a bath, and I was feeling
green around the gills, moving slowly, really hungover. All of a sudden
he starts to vomit-you know that boozy-smelling barf that makes even
sober people queasy? So I handed him the emesis basin, and I grabbed the
washbasin, and we threw up together. We were good buddies, after that!

Carmen poked me and said, Remind me to tell you a story about when I was
a student nurse. Interesting patient. She looked into her glass and
said, half to herself, I wonder what ever happened to Elam?

Peg motioned to me and whispered in my ear, Marie told me to tell you
that she needs to tell Marcella's story, so remember when you go see
her.

Patty heard what Peg had said and motioned to me over her Coke.

You've got to go see Rose, she said quietly.

This was usually the way it was, and how this book began. One nurse
would tell me about a patient they remembered, and then someone else
would remember, and so it went.

Rose was an older nurse Patty knew, and I asked Patty why I needed to
see her. Red-haired Patty had been my young supervisor down in Georgia
when I was her forty-year-old student nurse. She gave me a head-nurse
sort of look and shook her head.

You always were stubborn. Just go see her, woman. Don't ask.

I wrote the phone number down and Patty nodded, satisfied. You'll see,
she said. You'll see.

We were talking comfortably when I saw Anne's eyes widen, and she
motioned to me. Look behind you. Isn't that Kim?

I turned around and saw a blond young woman who had been on the staff of
our hospital several years ago, but had left nursing to go to work in a
bank.

Hey, do you remember Kim? I asked. I waved at her and she hesitated,
looking at all of us, then she lifted her chin and came over to me. I
pulled out a chair and she sat down, looking at her hands.

We passed the pizza down and told her about our project, and she looked
at me. So these nurses really open up, huh?

They tell you about their patients, and how they remember the hospital
and the doctors and the other nurses? She looked much older now, and
there was hurt in her eyes. I nodded, and Kim looked at her hands and
was quiet.

I've got one for you, from down south. Patty looked at Kim's face and
nudged me, and I turned the tape recorder over to her. Patty had lived
in south Georgia for twenty years and had remembered every one of those
folks.

Patty began, Y'all know what pulpwooders are?

They're the guys who work for themselves way back in the woods, they dig
up stumps and old wood for pulp, for firewood, and for the paper mills.
Real independent lot they are, too, sort of like moonshiners. One time a
pulpwooder came into the emergency room in our little hospital down
there. This guy was sitting on the examining table, quiet, but sort of
pale, not saying much. He had wrapped his hand in an old dirty ban danna
and the doc was unwrapping it.

It took me a minute to realize that he had lost his thumb, clean lost
it. The doctor asked him what happened, and he said and I'll never forget
the way he said it, Well, I had this big ol chain around this big ol
stump, fixing to tell my buddy in the truck to haul on it, and I got
this here thumb caught in the chain. I guess my buddy never did hear me
holler hey. He pulled that damn stump right out of that hole, and my
thumb, too.

The man shook his head, amazed at the cussedness of buddies who didn't
hear him holler hey!

Patty shook her head, thinking about that old pulpwooder, looking at his
now thumbless hand with grave acceptance.

Kim had listened to the story in silence, and when she started to talk,
everyone was quiet. There is one thing nurses can recognize and that's
paiii.

I was a good nurse, you know. But it was so weird, to walk into a
patient's room and say to a total stranger, Roll over, I'm going to give
you an enema. There are these poor people, with this little ol nightie
thing barely covering their behind, and we walk in, all smart and sassy,
and say rude things.

I didn't know anything, then, about their hurts. They smelled bad, they
smelled old, and I wanted to smell nice. I hated the way my uniform
smelled when I got home from the hospital. I used to run up the last few
steps and rip it off and soak in a hot tub to get rid of the smell of
all those old sick people.

Anne shook her head. She had worked with Kim. She remembered.

Kim started again, as if she had to tell us, had to make us understand.

Once an old man peed in my shoe. I had to go through the whole damn
shift with his pee in my shoe. Brand-new shoes, too, all clean and white
and shiny. I knew it was wrong, but I wouldn't go back into his room
after that. When I was a student, I loved the little cap and the pretty
uniform. I even loved the little pocket thing they gave us for the
scissors. I really tried but I couldn't keep it all clean. Once a little
boy threw up blood .. .. ..

She stopped talking for a minute, and drank her coffee.

Can-Then leaned over to her and asked quietly, The little boy? What
happened?

He died. He had leukemia and he kept throwing up blood, and he was so
little and white, like all the blood had drained out.. .. I guess it
did.

I don't want to remember it. I have a good job now, in a bank, and I can
wear nice clothes and not run up the steps to my apartment and rip them
off and soak in the tub. I can speak nicely to people because they
aren't scared, and they don't make me scared. They speak nicely to me,
too, and they aren't hurting, and they don't smell bad.

She was quiet for a minute and there were tears in her eyes. Then she
told us why she left.

I worked hard at the hospital, you know that, and I never called in
sick. My patients used to write me letters after they left the hospital.

But I remembered them for too long. I remembered all of their fears and
their smells, and then I would see someone old, and think, That's just
like Mr. So-and-So and then that person would multiply until it was more
people than I could take care of. So I left.

She looked at me and asked, Why couldn't I do it?

Why can you people do it and I couldn't? Then she looked around at all
of us and smiled. Maybe I just like to smell nice. Isn't that a weird
reason?

There was silence at the table. We had all smelled bad and hated it.

We had all wanted to run from little patients and old patients who
needed more than we thought we had to give, but somehow, we kept coming
back. Kim couldn't do it, couldn't keep everything clean and tidy, the
touching and the smells and the fear finally made her run away.

We all hugged her and looked at each other in silence for a minute.

When she went back to her table, she was smiling. Someone ordered some
more beer, and Harry made another pizza appear. When he came around to
the end of the table he saw the small tape recorder in the middle of the
glasses and ashtrays and plates.

We're writing a book! one of us said.

Where? he asked, looking at the overflowing table. How do you know what
chapter you're on?

We just talk, and whatever happens, happens.

Harry nodded, understanding. He picked up bottles and glasses and said,
Sounds like tending bar.

Carmen looked around at the group and peered over her glasses at me. How
come Jessica's not here? Or that charge nurse from peds?

Peg sniffed and answered for me. Jessica remembers procedures, not
patients. She uses jawbreaker medical terminology around people just to
show off. She doesn't need to be here. And that charge nurse from peds
hates kids.

Peg with the bright blue eyes may have been critical of others, but she
was also the best critic I had. She had been the very first one I
interviewed, months earlier.

How are you going to tie all these stories together? she had asked, eyes
twinkling. She had hit right on the question that bothered me the most.
I didn't know how I was going to tie all these stories together, and you
can't fool Peg, so I said so.

I'm hoping that as I write, the stories will tell me how to put them
together. I had leaned over the table and tried to look like I knew just
what I was doing. The nurses themselves will tell me their stories, and
the underlying theme will eventually emerge. I just have to keep writing
until I find it.

Peg had nodded, sipped her wine, and looked skeptical. It was the exact
opposite of the kind of thinking she did all day, of course. You don't
mix chemotherapy and let the patient's conversation direct your
treatment. But she trusted that sooner or later I would figure it out.
And I couldn't kill anyone while I was doing that kind of thinking, just
waste a lot of paper.

Peg turned to Carmen. What do you think of our project?

Carmen sniffed, and drained her drink. It's about time someone wrote
down what we do all day long, and wrote it down right. She looked
directly at me, and I sat up a little straighter. People read books or
watch some TV shows and they think all nurses do is chase doctors and
play kissy face in the broom closet. Nobody would last a minute doing
that. It probably happens on some floors, but Not on your floor! Anne
laughed. She and Carmen had worked together for many years.

Move that tape recorder down here, Carmen said. I learned something
today that you guys need to hear.

Call the newspaper, Carmen learned something!

Several voices chimed in unison and laughter. Carmen had a reputation
for being a little bossy, even among head nurses.

Okay, you guys, just listen to this. A couple of days ago I put my
twenty-six-year-old son on an airplane to go to a job in Chicago. He had
been living right up the street from me for a year, getting a master's,
and now he had a great job and he was very excited about it. So on the
outside I was being the great mom, understanding and excited for him and
all that. But on the inside, I was angry and depressed, even though I
knew it was wonderful for him. I was mad that he was leaving. I know
it's dumb, but that's how I felt.

So yesterday I went to work, still feeling sorry for myself. And who do
you think was the very first person I saw up on the floor? A mother
whose twenty-six-year-old son is dying of AIDS. Here is this poor woman,
dealing with life-threatening problems, and I'm depressed about my
healthy wonderful son going off to a job he loves. I felt pretty damn
small, I can tell you. I think somebody was listening and wanted to
teach me a lesson, and it worked. I finally let go of that kid, in my
heart as well as in my head. I called him this noon and told him how
proud I was of him. Carmen shook her head. Mothers! she said.

Stella motioned to me that she wanted the tape recorder down near her. I
fiddled with it, changing the tape.

That thing is only about as complicated as a thermometer, you know. Anne
had no sympathy for me, dealing with technology.

You all know patients like this, and how hard it is to take care of
them. Remember Ellie and Emmy? Stella turned to me and I smiled,
remembering. They were two little ladies with blue hair that were
admitted into the same room at the same time, with the same diagnosis.

They both were under the care of the same doctor, too.

Stella looked around the table at everyone. You know how we hate to say
the gallbladder in 504 or the bleeder in bed two.?

Every one nodded immediately, hating what some hospital people did to
the identities of their patients. But here I had two elderly women with
possible uterine cancer in the same room. Stella giggled.

Every time I walked in with medications I had to close my eyes and
think, Bed one or bed twot I hated to do that, but otherwise I would
have gotten those two cute little ladies all mixed up. They had a buddy
in the next room that we all had to keep an eye on, too, This woman had
a brain tumor and was not right in the head. She used to follow Carolyn
when she did rounds and ended up in someone's room, fiddling with the
IV. Carolyn had to loop this patient's bathrobe tie around her lab-coat
belt and take her with her on rounds. That was a sight, I can tell you.
Emmy and Ellie and Carolyn and I had a time keeping track of that poor
lady. We wouldn't tie her down in her bed with restraints like some
nurses would have done. So we had to tie her to us. But it kept her from
scaring the other patients, and changing IV rates.

Stella and I laughed, thinking about that poor lady trying to imitate
the charge nurse, looped to my belt. That solution was not written down
in anybody's nursing-school protocol book, but we all had to solve
problems on the spur of the moment, in creative and oddball ways some
times. The other patients on the floor thought it was fine as long as
the patient was cared for, and it gave them confidence in us, that we
would solve their problems no matter how odd it looked.

Peg and Anne were talking about the problems downstairs was having with
upstairs at the cancer center, and Patty and Stella traded
emergency-room stories. I smiled at Carmen, and Harry cleared the table,
and no one wanted to leave.

We were quiet then, and sat watching the lights in the green bottles in
the chandelier wink over our heads, listening to the music and the muted
talk around us. We knew we had to leave. It was getting late, but we
wanted to stay just a little while in the companionship of other nurses,
people we could talk to.

Well, guys, it's another day tomorrow. Let's meet soon, okay?

Anne stood up and we gathered our things, I put the little tape recorder
with its treasure of stories back in my big satchel. We all went out
into the dark, cold parking lot.

What would we do without Mama Mia's?

And Harry!

And green chili cheese pizza!

There were hugs all around, and we got into our separate cars and went
off to our separate lives, holding the warmth of the evening inside.

We would come back again, often, whenever we needed to trade war
stories, whenever we had had a hard day. We would remember the promises
we had made to our patients, to tell their stories. And I would bring
my tape recorder and listen and then write our stories down.

Chapter 7.

Travel with Yesterday's Child.

Margaret had worked on many of the floors at the University Hospital, a
veteran of fourteen years. She was unfailingly pleasant to staff and
loved her patients, but she had very few illusions about the state of
health care in this country. We get em in sicker, and send em home
quicker, was her terse evaluation. She knows that there are few
solutions to the incredible problem of looking after all the people in
the country and allocating the resources of the hospital wisely, but she
still wishes that we could take care of everyone in the same way, using
all the technology and all the heart we have. She wishes that all the
Big People-the insurance companies and the corporations-would stop
fighting and just look after people like we do, instead of only looking
after profit.

And she knows that isn't impossible, just hard.

Some of her favorite stories involve old people. She had worked as a
teenage volunteer at the Carmelite Home for the Aged back east many
years ago, and those lessons about the old and the dying never left her,
lessons about reality, and the seasons of life.

This story was her favorite, and I knew why, because I had been there,
too.

When we admitted Elizabeth we knew we were in for some interesting
times. She was a tiny gray-haired woman, very much the lady, the widow
of one of the best-known surgeons in town. She had no use for nonsense
and made tart little comments about her doctors, the state of the world,
politicians, and bigwigs. At eighty-three years of age she had few
illusions about the world. Her daughter was her only visitor.

I've outlived all my friends, and it's mighty boring, I can tell you.

Nobody sings my songs anymore. Once she and I did a rousing rendition of
My Darling Clementine because my grandfather had taught it to me, and
she needed reassurance that somebody remembered. But she was right. No
one sang her songs anymore.

She was in the room right across from the nurses station, because I
wanted to keep an eye on her. I was in charge of the evening shift, and
this independent old lady might just decide to climb over the bed rails
and walk out of the hospital at any time. She also wanted to be around
the hustle and bustle of our busy desk while her doctors were trying to
figure out why she had an irregular heart rhythm.

Hmmph. My heart is eighty-three years old, and so am I, and it can be
just as irregular as it wants. Her self-diagnosis dismissed the
cardiologist, but did not satisfy her daughter.

She's a love, but I'm getting worn out. It was quiet one evening, late,
and Elizabeth's daughter and I were having a cup of coffee with Ruth,
another nurse, in the lounge. We were trying to figure out some activity
that would interest Elizabeth without tiring her.

She was always out doing for people or teaching school or writing.

She was wonderful at figuring people out, why they did what they did, or
didn't do. She'd watch someone for a while and tell you what they would
do, and wham, right on the money. But now she's tired and hates being
old and tries to brush it off, but she can't.

Independent old ladies, you know the type, I said to the other nurse.

Ruth raised an eyebrow at me and grinned. We are the type, you mean.

Elizabeth's daughter laughed. Wait until you have me in here, at her
age. I'll be worse than she is. She finished her coffee, gave us a hug,
and after she looked in on her mother, took some dirty laundry home.
Elizabeth was sleeping like an aged child, one hand tucked undemeath her
cheek.

Ruth and I stood and checked off the preops at the desk for the
following day, and I put the bed list together for the night charge.
Ruth was standing at the desk, staring into Elizabeth's room.

You seeing things or just tired? I asked.

She'll get a roommate tomorrow, probably.

No, I'll empty the floor and we'll all take two weeks off! I laughed,
and sat down for the first time in three hours. Of course she'll get a
roommate. What's your little brain cooking up, my friend?

Her daughter said she liked to figure people out. That's not too tiring,
so maybe we can have Elizabeth do some figuring about all these folks on
the floor. We certainly have enough to think about. Her eyes went right
to room 514, one room down from Elizabeth.

I saw where she was looking and put my head on the desk. In that room
was an eighteen-year-old girl who was paralyzed from the neck down. She
had been hit by a drunk in a truck when she went out in her little car
to buy bread for her mother. Marcella looked like every one's daughter,
and we all had a hard time walking in and smiling.

Ruth looked at the room next to Marcella and we both smiled. In that
room was a biker, a big tall fellow who looked like a Viking, long blond
hair hanging down his back. Luke had a bad infection in his leg and was
scared that the doctors would have to amputate it, He was arrogant,
loud, unsmiling, and uncooperative. He was fighting, he was trying to
deal with his fears in his own way. Independent, tough patients were
sometimes hard to deal with, but they were healthier than the silent,
passive ones. They were the survivors. Elizabeth could do a lot of
thinking and figuring about the folks in this hallway.

Let's see what happens tomorrow. Here comes the Vamp, The tall, thin
night charge nurse walked slowly down the hall, her white cap perched on
her blond pageboy wig, her scarlet fingertipped hand holding a brown bag
with a double-bacon-and-green-chili cheese burger with fries. We never
called her Vamp to her face. She was weird but she liked her patients,
and so we liked her.

What's new? she whispered.

Nothing, I whispered back. I never knew why we played this whisper game,
but it was always the same. I watched her put her coat away, and
wondered where the hell she found white nurse-person stockings with
seams. She always wore skirts, never slacks, and everything was starched
and ironed as if Mother Superior were going to make 2,00 A. M. rounds on
her probies. We checked the narcotics cart, whispering, and I handed
over the keys and we whispered good night. Ruth and I walked out the big
double doors, not looking at each other until we were in the elevator.
The X-ray tech with the portable cart probably wondered why the two
middle-aged nurses from Six South were laughing so hard at midnight, at
the end of shift.

Wow, said Ruth, when she caught her breath. She's a case and a half,
isn't she? But I like her, I really do. She scrabbled in her purse and
pulled out her keys. Well, friend, it's my Friday, so I'll see you on
Thursday.

I nodded and pulled my car keys out of my lab-coat pocket on the way to
the parking lot. It's my Friday, I'll see you on Thursday. The Vamp
wasn't the only one who was weird. On her Friday Ruth always went to an
all-night joint near her house and had tacos, beans, enchiladas, and
beer at I,00 A. M. We all worked five days and then had two off, and so
our Friday fell whenever we had the next two days off. Tomorrows are
always interesting in this job.

1 couldn't make good on my promise to clear the floor and give everyone
a vacation. We got several admissions the next day, and one of them went
into 512. Elizabeth's roommate was Joan Adams, a woman of about
thirty-five, diagnosed with a very early stage of cervical cancer,
caught in its beginning stages by a Pap smear. It had not entered any
deep tissue, and the outcome was going to be very good, all the
statistics were on her side. She was a very lucky woman, in good general
health, good family support, yet for some reason, she was driving all of
us completely crazy.

Nothing we nurses did pleased her, the bed was on the wrong side of the
room, the schedule was all wrong for her, the nightgowns her husband
brought weren't the right color, and her teenage daughter never came
often enough.

When do those doctor gods do rounds, anyway, during that meal you call
lunch? She tore the menu choice in ten pieces and dropped them all on
the floor. She reduced Mary, the day-shift aide, to tears because the
water in her pitcher was too warm and she accused the poor woman of
stealing a lipstick.

I've been a nurse's aide for twenty years and no patient ever talked to
me like that. Why does she treat people so bad? I found the aide huddled
against her locker when I came on duty and gave her a hug.

Maybe she's just scared, they're doing the procedure day after to
morrow, and yelling at us makes her less afraid. Maybe she's just like
Luke.

That wasn't an excuse, but maybe it was a reason.

Mary sniffed. Plenty of people have been through worse, and they never
said I stole anything. She blew her nose and said something that we were
all secretly thinking. Maybe they'll put her over on Seven West, now
that the census is down.

No such luck. The seventh wing had filled up again, faster than our
wing, and the lady we began to call the Witch was with us for the
duration. When Ruth came back on duty from her two days off, she found
Joan in her room, doing her fingernails, frowning at the little old lady
in the next bed. Elizabeth was sitting straight up, wearing her flannel
nightie with the flowers on it and the lace around the neck.

Her face was pink and her hands were shaking, her white hair stood on
end.

You are a rude and pretentious woman, young lady, and your manners
stink! Elizabeth stood up, glared at me, and said, Let's get on with the
walk. I need to leave this room before I punch someone.

I was surprised at her little outburst, but the rude lady in the other
bed, wearing a black lacy billowy negligee, just smiled and continued
with her nails.

Elizabeth and I went out with the walker and began the walk.

, .What was that all about, Elizabeth? I asked.

She's the rudest, nastiest I know, but what happened?

Elizabeth drew herself up to her full five feet one. She told me I
looked like a nun in this nightie. I've had four children and was
married for sixty years, nearly, and there's nothing of the nun about
me, anyway.

What right does she have to swank around in that disgusting outfit and
tell me She's scared, you know. She's scared of dying, and she's scared
of not being a woman anymore, after the surgery, and so she acts like a
jerk. Flannel nighties or black lace don't make a woman, anyway, you and
I know that. So does she, probably, but she's choosing to be nasty
instead of real. I liked flannel, too, without the lace, and I
understood the pain the Witch had caused in this gentle old lady's head
Elizabeth stood in the hall, took the walker, and threw it about two
feet ahead of her, stomped up to it, threw it another two feet, and
walked like this up the hall. We had done this routine before, so I
walked along beside her, resigned.

That's really not the way your doctor wants you to use that walker, you
know. It doesn't do a whole lot of good to throw it around. It's
supposed to help you keep your balance without working too hard, and let
you walk without too much exertion. I kept trying to be a good
nurse-person.

Hmmph. That doctor is only a doctor in training, anyway, and he's
younger than my granddaughter.

With that, Elizabeth continued her walk and I went back to the nurses
station, where Ruth watched the exercise and winked at me.

Doing physical therapy now, are you?

She's going to do it her way, no matter what.

Ruth didn't smile as she watched tiny little Elizabeth march resolutely
down the hall.

Let her do it her way, like that witch and Luke are doing it their way.
Someday you and I will need to do it our way, and hopefully we'll have
someone around who understands.

When I did my evening rounds before the night shift came on, I went into
all the rooms, checked the IVS, made sure everyone was comfort able,
answered questions, and took plenty of notes. My evening rounds were a
great way to solve problems and catch them before they grew bigger. When
I got to Elizabeth's room, I could hear sounds, unfamiliar and sad.
Someone was crying, softly, into a pillow. The Witch? No way. But surely
not Elizabeth?

There Elizabeth was, sitting up hugging her knees with her head down,
the curtain between her bed and her roommate's pulled all the way
across, like a wall. I pushed it aside and sat on the bed, and held
little Elizabeth in my arins.

Ohl Margaret, she sobbed, it's so hard to be old!

I just stroked her hair and rocked her and let her cry. She was right,
it is hard to be old. While I rocked her I felt eyes on my back and
realized that the curtain was open and the Witch was watching.

Oh, go to sleep. I haven't got time or strength for you right now, I
thought. I'll deal with you later.

Elizabeth sighed and patted my shoulder, and I gave her little bony body
a hug. She lay down, and I straightened her covers and gave her a drink
of water. When I stood up and turned to leave, she said quietly, in a
voice with an edge, Margaret, dear, would you please put that damn thing
away?

On my way out the door, I put the walker in the closet.

When I got to the parking lot that night, I stood and looked up at the
stars. Usually I'm just ready to climb in the car and go home to my man,
but that night I felt funny. Maybe I could feel some arthritis in my
hands and feet more, maybe my back hurt a little bit, maybe I was
noticing the increasing gray in my hair. Maybe. But the stars didn't say
anything, they just winked and covered the sky and looked bright and
close in the clear frosty desert air. I got in the car and put my head
against the cold steering wheel. I told myself not to let it get to me,
to look at the stars, to go home and have a hot bath, to stand up
straight.

The next day, as I made rounds early before the shift started, Elizabeth
was waiting for me at the far end of the hall. A white-haired sentinel
in a flannel nightie, she leaned on her walker, her eyes bright.

You've got to talk to the Witch, right now.

The Witch? I tried to look innocent, but she was a wise old bird and
hadn't missed our whispered conversation at the nurses station.

Oh, I know what you call her and you're right. But go talk to her!

She called the night charge nurse a nightingale of the darkness and
asked her where her broom was!

I chuckled, thinking of the tall silent nurse with the cap and the long
red fingernails, riding a broom. But something else was going on in
Elizabeth's mind.

What else is it, you've got a plan or something? I asked.

Something. I know what's wrong.

So do I. She's having surgery for a female problem and it's driving her
crazy.

Elizabeth looked at me as if I were a child.

Margaret, she said, sweetly and patiently, go talk to her.

The door was closed and I walked in, wondering what would meet me. A
flying nail file? Another frilly negligee?

She was sitting up in her bed, wearing the little hospital nightie, no
makeup, no fingernail polish. It had been removed for her surgery in the
morning. She looked very young and very frightened. I checked the IV and
smiled at her and wondered what was up.

I'm being a bitch, she said in a quiet, surprised sort of voice.

I sat on the bed. You've got that fight, but you aren't a bitch, really,
so why are you acting like one?

My mother had cancer. She died when I was nine, and I never cried.
Proudly, she lifted her chin. I never cried. I was very strong and
helped my father and my two younger sisters, and I never cried.

I told that little lady in the nightie, and she said to tell you. Mrs.
Adams looked at me and whispered, She's a wise little old lady, isn't
she?

Then she put her head on my shoulder and she cried. She wept for her
mother, finally, and for herself. The two cancers were too much, the
death and the surgery were too much, but at last the grief erupted and
the healing could start.

As I sat and held her and let her cry, I heard the door close very
quietly, and just before it closed I saw a white head and a wrinkled
little hand and the shiny side of a walker.

We found Joan Adams a counselor as soon as the surgery was over and the
healing began. She talked and talked and began to smile, and three days
later we pushed her in the wheelchair out the door into the cold
sunshine. She looked up at the sky, held a big bouquet of flowers in her
lap, and saw the blue mountains far away to the east. Her husband helped
her into the car, and when I came around to shut the door, she gave me a
hug and almost pulled me into the car with the flowers.

, .Thanks for listening to a nine-year-old!

Oh, the nine-year-old is still there and you must be careful with her.

She's pretty bright, so listen to her. Take care, and come and see us.

She did, several times. She brought us a plate of homemade brownies, and
on the six-month anniversary of her surgery she sent us flowers and a
card that we put on the bulletin board. Sometimes nine-year-olds are
hiding inside everyone, but don't get seen. That was one little girl we
found, thanks to Elizabeth.

When she went home a few days after Mrs. Adams left, Elizabeth hugged
us, too. Her daughter cried, and we all wondered if the walker would
stay in the trunk of the car, or if Elizabeth would use it. Or would
she, someday at some nursing home, ask one of her nurses there to put
the damn thing in the closet?

Chapter 8.

The Ferryman's Landing.

Patty and I worked together a long time ago in a little hospital in
Georgia. She is a tall redhead who drank Cocola at 6,00

A. M. and spent most of her days and nights in the hospital. She was the
young head nurse in ICU and I was a forty-year-old student nurse, a
Yankee to boot. She didn't like me at first, and I was scared to death
of her. Once I was sitting on the floor at the end of my twelve-hour
shift next to the bed of a patient with congestive heart failure,
emptying his urine bag for measurement. They had given him a diuretic to
get rid of fluid in his body, and the bag was very full. I was new and
nervous, and when I opened the bag some of it spilled. I whispered Crap!
or something to that effect, and Patty stuck her red head in the door
and said, That's not crap, Fink, that's pee. Didn't they teach you
anything in nursing school? I laughed and she grinned and we were
friends after that.

It all started quietly enough. We had four patients in the little
six-bed ICU when the shift began. I had been a nurse for about three
months and was still pretty wobbly. Patty put up with a lot from me, and
I was learning, slowly. It was Saturday night, and Patty kept saying,
It's a full moon, Fink. Watch out. I hadn't yet learned about the
full-moon syndrome and told her she was just trying to make this
gray-haired Yankee nervous.

You're already nervous, woman, I'm just trying to warn you.

The unit was dim and quiet in the early-evening light, the monitors at
the desk beeped and murmured. All the equipment was cleaned and put
away. The red crash cart sat quietly, reassuringly in the comer. We sat
at the desk and listened to the report from the day nurses, and it
seemed nice and routine, In room one, we admitted Miss Inez Lott, age
ninety, diabetic with emphysema. One of the day-shift nurses gave us a
report on her patients. Miss Inez's family were longtime residents of
our small town, something like seven generations in the area. Her doctor
had admitted her for a rest.

In room two, Archie Dobbs, a twenty-four-year-old man with a severed
femoral artery who had gotten into a knife fight and tried a karate kick
on his adversary. Unfortunately, this adversary had a big knife and
didn't do karate, just cutting. When our patient lifted his strong right
leg for a kick, his adversary sliced upward with the knife and cut the
large artery in our patient's thigh, causing massive bleeding and shock.
Our patient was in and out of consciousness, fighting us all the way.

In room three, we admitted a thirty-five-year-old male early this
morning, suffering from a concussion and laceration of the scalp. He and
his buddies had been out drinking at the Inn Zone, the local redneck
bar. They had gone joyriding out in the county. His drunken friends
wanted to know what would happen to their buddy if they tossed him out
of the back of the pickup at seventy miles an hour. They found out.

Laughing hysterically, they brought their unconscious buddy to the door
of the ER bleeding profusely from the head. It took fifty stitches to
close the wound, and at present he was resting quietly. Patty kept
looking at the room, dim and quiet, and muttered, He won't be quiet long
when the mortal shakes come on. I was blissfully unaware of the effects
of the mortal shakes, and tried to take good notes during report.

I wrote down ? ? mortal shakes? ? and waited for the report on the next
patient.

In room four there was an elderly man on a respirator who had been in
ICU for a week or two, unable to breathe on his own. He was connected
to the big Blue Bennett respirator, which hissed and wheezed and clanked
and kept oxygen in his tissues and lungs. The family had not yet decided
what to do, so we waited and watched the respirator breathe for Mr.
Jones. I had admitted him, and had watched him slowly deteriorate.

Patty and I gathered our notes, wished a good evening to the two day
nurses, and made a pot of coffee before beginning work. One of the EMTS
from down in the ER wandered in, smelling fresh coffee. He was a retired
army medic, and had seen it all several times, according to him. He
rubbed his bald head, drank our coffee, and shook his head.

Gonna be a wild night, ladies. Full moon.

Do you believe that stuff? I asked, Yankee me, relying heavily on logic
in my life at that time.

He looked at me with an amazed expression and turned to Patty. She new
at this?

Patty nodded, looking darkly at me. It was fine to admit my ignorance of
things medical and southern to her, but not to wandering EMTS. It
reflected badly on all of us. I murmured something about learning fast,
and got ready for rounds. Patty taught me about nursing rounds early,
and it stuck. I learned more that way later on than all the talk and
reports in the world. We went from room to room, three times each shift.
We checked on IVS, noted the fluid left in the bottles, checked on
drains and cathe ers, bandages and vital signs. We talked to the
patients who could talk and those who could not, Patty was a great
believer in talking to people who were unconscious.

Who knows? she said. Hearing is the last thing to go, so maybe it's
still there. She patted their cheeks, and smoothe their hair, and
plumped their pillows, all the time her bright brown eyes taking every
thing in-monitor, respirator, IV, everything.

We got to Miss Inez's room, and she welcomed us as special guests to her
bedroom. She sat up in bed, straight as straight, wearing a lace bed
jacket. She had a pillow at her back, but she would have none of that
pillow.

Miss Patty, you call my son, Horace David Lott, and have him bring over
my own lace pillow. She bowed her head graciously, bestowing favors on
us. He'll know which one I mean.

Yes, ma'am, as soon as we're done here, I'll surely call. Patty
reassured the old lady and looked around the room, frowning as if some
thing was wrong.

Sugar, she said to Miss Lott, where are those things, those wires
attached to your chest? No one had put the EKG leads on this patient
when they admitted her. In any ICU, that was too important to forget.

Miss Lott sat up straighter, if that was possible. Miss Patty, my doctor
said we didn't need such devices. I'm ninety years old, and I don't need
to be attached to that machine. She motioned languidly to the monitor.
I'm not physically strong, but it's nonsense to tie a lady of my many
years to some modern machine. I'll let the Creator decide what my heart
does, and He doesn't need to tell us. Miss Lott said all this in a
lovely soft drawl, patting her snow-white hair and holding Patty's hand
in her delicate long fingers. Now, don't forget my pillow, hear?

Patty nodded and whispered to me as we left, Don't let me forget.

That sweet old lady is worse than ten torments if you don't do what she
asks.

For about an hour we prepared things for the night, drank some coffee,
and enjoyed each other's company. I could learn from Patty just
listening to her talk about her experiences, and we generally agreed on
things. Except grits.

You've just never had grits fixed right. Patty was adamant about the way
to fix grits correctly. None of this quick stuff. Nothing like lem, she
said.

You got that right, I said. Nothing like em except maybe library paste
or wallpaper glue.

Patty shook her head. You eat stuff like those crazy chiladas, and you
put an egg on top. That's not natural. My husband and I had fixed
enchiladas for her one day at our house, introducing her to something
from our part of the world. Maybe you ought to have grits with green
chili.

I thought about that, and admitted that it would probably improve the
grits. Some.

We were sitting by the monitors at the desk when a chilling howl came
from room three, from our head-injured drinking buddy. Jefferson Emory
Beauregard Railiford had woken up. He howled like a cat, began thrashing
around in the bed, and pulled out his intravenous line. We had put soft
restraints on his hands and feet to keep him still when we admitted him.
When he woke up, Jeb ripped them off in about four minutes. Patty ran to
the phone and called the doctor for an order for leather restraints.
Luckily, the doctor was down in the ER. He came up fast and helped us
hold Jeb down. He was better in the restraints, and after a shot of
Valium he quieted down even more. But he kept calling for Annie, over
and over, in a terrified loud voice. I looked at Patty across his
tossing body, and she looked up at the ceiling.

We'll be listening to this poor foot for quite a while, she said.

Sure enough, Patty was right. Everything we did that night was to the
background of Jeb Railiford screaming for Annie.

Who is Annie? I asked Patty.

She shrugged. Mama, probably. That's what drunks with the mortal shakes
always do, scream for Mama. Shut up, Jeb! she hollered.

He murmured, Yes, ma'am, and settled down for a minute. I was to get my
first good look at the mortal shakes, which was Patty's name for the
DTS-delirium tremens, a body's reaction to the with drawal of alcohol. I
wondered why we couldn't just give him a little bourbon once in a while
at least until his head wound healed. At this rate, he was going to open
those stitches. He kept calling our bandage a damn little cap and
ripping it off. Every time we rewrapped it, during those few times when
he was relatively quiet, it took a good twenty minutes. Patty was great
with bandages, and could put a good tight wrap on a wiggling alligator
as she put it. This wiggling alii gator was having none of it, and after
the fifth time he tore it off, we gave up.

He'll just rip all the stitches out, I'll call the doc and tell him.
What we need is a crowbar to put him out, except that we'd just have
another bunch of stitches to put in. Patty walked wearily back to the
desk and let the doctor know. He increased the Valium dose, which now
seemed to have the same effect on Jeb as a vitamin.

Then we got a call from the ER.

Sixty-year-old Jane Doe involved in an MVA, ETOH involved.

Comin up.

We had another patient, a sixty-year-old woman, as yet unidentified, who
had been in a motor-vehicle accident involving alcohol. It was ten
o'clock on Saturday night, for sure.

While Patty and I got this unconscious new patient in bed, put the
little patches on her chest for the heart monitor, and generally
prepared her for ICU, we saw a little black woman dressed in a maid's
uniform come into the unit and walk into Miss Inez's room. She was
carrying a tray, smiling. Patty shook her head and left me to finish
with the patient who was unconscious but rolling and agitated.

I heard Miss Inez say in a quiet gentle voice, But Miss Patty, I always
have a julep about now. I already had my afternoon sip on the other
shift. Surely there's nothing wrong with that?

I heard Patty's voice but I couldn't tell what she said. I wished we
could give a julep to Jeb. It would take the edge off the mortal shakes.

Patty walked back in shaking her head. I'll write the julep on the charl
The day shift already checked with the docs , and they aren't going to
argue with Miss Inez. She knows their mothers and they'd catch it if
they refused her!

We returned to the new accident patient and followed orders that
included restraints. They had put a tube down her throat in the ER and
she was hooked up to the respirator to breath for her, like Mr. Jones.

Two big Blue Bennetts wheezing and clanking in sort of an off rhythm, as
if they were talking to each other. I took a deep breath.

Settle down, Fink, I told myself, you'll get it. Settle down. I kept
talking to myself, silently taking hold and getting a grip, as Patty
would have said. It worked. Even though Jeb was hollering and the two
respirators were clanking, and the Jane Doe in room five was fighting
the respirator and us, and Miss Inez was quietly sipping her julep, I
managed to calm down. For a while.

We got Jeb and his room cleaned up and by then it was midnight and time
for counting the output for Mr. Jones. I went around with my graduated
cylinder and my clipboard, emptying urine bags and chest drains from his
collapsed lung, checking the IV, taking his blood pressure as ordered.
He lay there, still as still, respirator clanking as I emptied the
moisture that collected in the tubes. The monitor was steady, his heart
was beating, but every now and then there would be a little blip and a
bigger curved line would appear. I knew what it was, it was a premature
ventricular contraction and meant that if he had many more in a row he
would begin to fibrillate. His heart would begin beating in a spasmodic
way, not getting blood to the body like the beating of a normal heart.
For now, all was well. His family was waiting outside to see him for the
ten minutes per hour they were allowed. I told him they were outside and
were coming in, but he was too far away to hear me.

As I was leaving the room visitors began to come in, slowly. They looked
around in the dim light and there was sort of a collective sigh.

They went to the bedsides-Mr. Jones's family and Miss Inez's son,
carrying her lace pillow. No one visited the as-yet-unidentified woman in
room five, or Archie, the man in room two, who was finally sleeping
after rolling and tossing for several hours. He had pulled the
nasogastric tube out, the one they fed from his nose into his stomach.
We found it wrapped around his teeth. He had pulled it out simply by
moving and straining and fighting. It took us a half hour to replace it.
Archie was a strong young man, completely unaware of his surroundings,
whose natural instinct when held down was to fight. He wasn't on a
respirator, but he was in restraints, and when he fought, the bed
rocked. He was terrified at some deep level. And there we were, wanting
to help him, unable to communicate. It was frustrating and difficult for
all of us, but most of all for him.

We now had five patients, only room six was empty. It was one o'clock in
the morning, and things were fairly quiet. We did rounds again and Patty
went to her office to do some administrative work for a while, as long
as she wasn't needed on the floor. I was there alone, the unit was
still. I knew what all the noises from beeping monitors and clanking
respirators meant-nothing was out of order. Jeb was screaming again, so
I gave him his medication and he lay quieter, muttering for Annie. I
went into Mr. Jones's room for the output documentation, and when I was
done, I sat watching him. His chest rose and fell with each hiss and
clank of the Blue Bennett, the tubes of the respirator gurgling now and
then.

Words came, phrases came, and I began to write them down. It was
something I did all my life, no matter where I was or what was
happening. As I got older I withdrew into my head and wrote if things
got nasty on the outside. I could handle emotional situations better if
I had a chance to write about them. Nursing school and now work in ICU
had generated a great deal of writing, I can tell you. It was
unfamiliar, exciting, and scary. It was wonderful, all the learning I
was doing was great, but overwhelming at times. And at those times, my
journal grew.

Now, looking at Mr. Jones, thinking about how we were completely unable
to reach Archie or the woman in room five who had been in the auto
accident, I began to think in the dim quiet of this tiny country
intensive care unit about death and myths and humanity. And sitting in
Mr. Jones's room, on the back of the intake and output sheet, I started
to write.

It was a few minutes later when I had some thoughts on paper that I
stood up, turned around, and ran right into Patty. She had been standing
behind me, reading what I was writing.

I wondered what was taking so long, Fink. Are you writing poetry about
our patients?

Surely am. Only way I can put it together in my head. You knit beautiful
afghans, I write bad poetry.

Patty nodded. She understood, and took the clipboard from me and walked
back to the desk, reading.

ICU 2,00 A. M. Blue Bennett breathes watery air Into flaccid lungs Hiss
and clank, Ribs rise Hands cool, twitch.

Green line monitor steady.

Where are you, Mr. Jones?

You are not the gasping respirator (Blue Bennett breathing)

the watery oxygen tube the blinking intravenous light.

You are not here.

Coma state. Blood pressure every ten minutes reads the crisp order.

Are you there, Mr. Jones?

Does the State of Coma Lie across the fenyman's bow?

Your sightless eyes turn Where I cannot see.

Breathe, Blue Bennett Sing to the ferryman For Mr. Jones.

Who's the ferryman? Some kind of story? Patty asked.

It's a myth about dying. People go to the edge of the river Styx, and
the ferryman takes them to the other side, the land of the dead.

This a Yankee myth? Patty asked.

Greek, I said. But it has lots of variations in all countries and
cultures. It's just a way to explain what happens when people die, no
one wants to think there's nothing left, nothing at all. No place to go
but in the ground. So they made up this myth to help them deal with
death.

Sounds sensible to me. Mr. Jones is sure close to that edge, Fink.

She looked at the bed and watched the Bennett breathe. Are we blowing
air into a corpse? Should we let him go?

I shrugged. It's not our decision, but if it were mine to make..

No one wants a full-blown code on Mr. Jones. He's got so many things
wrong with him it would be purely stupid to bring him back to suffer,
Patty agreed.

We charted medications and taped the strips from the EKG monitor in the
charts. Patty pursed her lips at the number of premature contractions on
the strip, but she didn't say anything. One of the docs  made rounds
around 4,00 A. M. in ICU, time enough to show him the strip.

I went to give Jeb his medication and saw the ICU waiting-room door
open. A little man walked in. It was long past visiting hours, but we
watched him walk up to room five and stand at the door. He wore a funny
little Yogi Bear hat and his forehead looked about an inch high.

His eyebrows were thick, and his ears sat funny in his head. He stared
at room five for a minute and then came to the nurses station and stared
unblinking at Patty, over the top of the desk. She looked back at him
and asked, Can I help you, sir?

The funny little man said very quietly, I came to see my aunt.

Your aunt? What's your name?

My family name is Coker. That lady in that room there is my aunt, Annie
Railiford. She heard her son was here hurt, and she came tearing down in
the pickup. Somebody told me she was real bad off hurt, too.

I went back to the desk, I saw Patty staring bleakly into room five, at
the lady fighting the respirator, fighting the restraints.

She's Annie, Patty whispered. Annie Railiford. Patty took a deep breath
and sighed. She's Jeb's mother. She's the one he's been hollering for
all night.

We stood and watched as the little man nodded at his aunt and then went
into room three and stared at Jeb. Jeb didn't know he was there, he just
kept tossing and hollering and screaming for Annie.

The little man came to the desk and stared at Patty and me. I guess he
just don't know she's right down the way there, he whispered. He nodded
his head knowingly and walked back out the waiting-room door.

Patty and I stood and looked at each other and then went to rooms five
and three. There wasn't much to say, so we didn't talk. It seemed darker
in the unit, now.

It was 4,00 A. M. , time for rounds, and we walked to Miss Inez's room
first, quietly. She had been sleeping soundly and breathing normally the
last time we did rounds, so this was just to check and see if all was
well. There were no medications except her insulin, no monitors, no
cathe ers. Patty leaned over her and listened. And then I saw Patty
stiffen and straighten up. She moved one hand to the carotid artery in
Miss Inez's neck to check her pulse, and I knew we had said good-bye to
Miss Inez.

Patty straightened up and wrote on the chart, and covered Miss Inez's
face with the sheet. I wonder what was in that julep? she asked no one
in particular. She stood for a minute and watched the still form in the
bed. She told me once that her daddy was the richest man in Bacon
County. Call the doctor down in the ER. He visits there before he comes
up here.

I did so, and then froze as I watched the monitor for Mr. Jones. Those
large premature contractions were showing up faster and faster, and
Patty grabbed the cart and pulled it into room four just as the doctor
walked into the unit. He nodded as we started the medications on the
standing orders, and watched the monitor closely. It was tense in the
unit. The air felt thick. I was a zombie, doing what I was told to do,
doing what I knew to do, watching Patty and the doctor almost in slow
motion. We worked for about thirty minutes, and the doctor finally shook
his head.

It's over, he said. He walked to the respirator and turned it off. It
hissed and clanked one more time, and then was still. Mr. Jones was far
away, and the three of us stood together, acknowledging death. The
doctor turned and went to the chart rack, wrote his notes, slapped the
chart shut, and said, Now, what's this about Miss Lott?

And who the hell is screaming like that? How do you stand it?

He looked briefly into room three and shook his head.

We followed him into room one, where he stood beside the bed and checked
the patient out completely. He turned to Patty. I'm glad you remembered
her pillow. I'll call Horace.

He walked out of the unit. Patty and I remained, knowing that we had one
room where a code had been conducted, full of mess, and another with a
quiet little old lady whose belongings needed to be packed for the last
time. We also had Jeb, fighting and screaming, and his mother on the one
respirator left going. We both took a deep breath and got to work, first
one room, then the next. We worked well together, quietly, knowing what
the other was thinking. But neither one of us said much. By the time we
were done and all the notes were taken and the funeral homes called and
fan-iilies notified and Housekeeping in fonned, it was 7,00 A. M. Patty
stood up and glared at Jeb, who had slept fitfully but who was now
screaming at full force again. We haven't eaten anything since we came
on, you know that?

My stomach did, and I reached for my purse to go get something to eat
from downstairs, when the phone rang.

That's the ER, I just know it. Patty grabbed the phone and nodded to me.
Here we go again, another Jane Doe, age about twelve. Over dose.

It was time for the day shift, and the sky was lightening, graying from
the coming dawn. The next hour flew by as we struggled with another
patient who didn't know where she was. Althea, one of the day-shift
nurses, arrived, yawning. She put her coat away and looked at the cold
coffeepot, and shrugged. She made another pot and began her day, knowing
that we would give her a report as soon as we could.

For a tiny little thing, she sure is a handful. Patty and one of the
EMTS tried to hold the child -down while I got restraints on her. We
washed her stomach with charcoal and tried to avoid her scratching and
biting. The EMT shook his head.

Had enough of the full moon, young lady? he asked me. I had the doctor's
orders in my teeth, using both hands to keep the child from knocking her
head against the rails of the bed, so I merely nodded.

Surely had enough. But it wasn't over, that I knew. Something in my
bones said we had more to do. Patty and I had long forgotten about
something to eat, and coffee was a distant pleasure. We put this child,
who had overdosed on her mother's Valium, in room six, and did all the
paperwork to finish the job while the EMT sat rocking back on a chair,
picking his teeth.

Where're you sending the karate champ? He looked into room two and Patty
frowned.

Emory. He's on the schedule to be transferred today around eight.

He needs more than we can give him here, and he's young and strong.

He'll survive.

The desk was still full of paper, Jeb had quieted down some, his mother
still breathe with Blue Bennett in room five, our twelve-year old was
quiet. I stared into her room, thinking of my own teenagers.

I wonder why she did it, took those pills? I said.

Patty looked up from her reports and shook her head. No telling.

We'll need to talk to her as soon as she's awake. She probably won't
want to listen, but we'll have to try.

Ten minutes later the doctor and the little fellow with the Yogi Bear
hat came in, looking solemn. The doctor approached the desk and took the
chart, and wrote the order to discontinue the respirator. At the same
time three EMTS pushing a gurney entered and asked where the patient was
they were to transfer to Emory.

We've got the rig downstairs, ma'am. We were told to get a move on it.

Finish that later, Fink. Get Archie ready to go. Patty and the doctor
and the nephew went into Annie's room. I got up, leaving the crash cart
in an unholy mess while Pharmacy went downstairs for more supplies.

Archie was sleeping, finally. I unhooked this and that and got him on
the gurney with the IV pole and the cathe er and all his possessions,
and helped push him out to the ambulance waiting outside in the misty
morning air. I ran back to the unit on the second floor, smelling break
fast from the kitchen, and my stomach reminded me that I hadn't eaten
for fourteen hours. It also reminded me that I needed to sit down and
relax. I had a talk with myself on the way up in the elevator, and took
another deep breath and got a grip. This was becoming a habit.

When I reached the unit, I saw Annie Railiford's nephew standing by her
bed. He was holding his hat and shaking his head. They were both bad to
drink, that's what. Bad to drink. He walked into Jeb's room and smoothe
his cousin's sweaty forehead and tried to talk to him.

She'll be okay, Jeb, don't call for her anymore, he whispered, loud. She
can't hear you. Maybe the Creator will take better care of her than we
all did. He stood for a minute and then left, and didn't look back into
room five. The doctor walked out, nodding to us.

Have a good day, ladies.

Althea and Patty and I stared at Mrs. Railiford's room and listened to
Jeb hollering. I suddenly realized that I had a splitting headache.

Patty sighed and stood up and walked into the room. She turned off the
Blue Bennett and there was silence in the unit. Jeb had worn himself out
for a minute and was quiet. The respirators were still in the rooms but
quiet, waiting for the next patient. I called Respiratory Therapy to
come up and clean them, and take the tubes from Mrs. Railiford. And then
we watched the monitors. Gradually, gradually, the green line showing
her heart rate slowed down. The brain study they had done showed no
brain activity at all, so that's why they decided to let her go.

Exhausted and hungry, we watched the monitor line flatten.

Patty looked around and sighed. Your ferryman was busy tonight.

He got himself a boatful here, Fink.

I was sitting on the floor, still working on the crash cart, and nodded.

When I looked up, Patty was gone. It was almost nine o'clock in the
morning, we had given our report to Althea and the other nurse on duty,
and they had begun their day. I still had some mess and paperwork to
finish up, so I would probably be able to leave by about ten. I kept at
the crash cart, hoping Patty could get some rest. I finished replacing
the last of the equipment in the bottom drawer and stood up. My back
complained, and I poured a cup of coffee and debated about breakfast.

I ought to stay and finish now, and then go home. As I was piling up the
paperwork we had to do at one end of the nurses station, filling the
monitors with more EKG paper and generally getting the day shift ready
to go, I smelled the powerful smell of eggs and bacon and toast. Patty
walked in carrying two trays loaded with breakfast, and put them down in
the little lounge on the table.

Come here, Fink, forget that for a minute.

We sat down and I looked at the most wonderful meal I had ever seen, and
we both devoured it without saying a word. I even ate the grits.

We finished the work, Patty and I, and made sure that none of the night
shift's full-moon doings were left. We walked out of the unit together
around ten in the morning. I was off the next day and so was Patty, and
as we parted I thanked her for the breakfast.

Nothing much, she said, and grinned. You ate all those grits, woman.

I got in my car, knowing that the breakfast was like a badge. I had
earned it that night, and I felt some small measure of confidence. Now I
was a part of the team.

Chapter 9.

Where have all the Children Gone?

Rita is a school nurse now and works in a little town on the river, near
Albuquerque. We knew her when she worked at the university hospital in
labor and delivery, and then pediatrics. She went to work as a school
nurse because she loves beginnings.

The area where she lives is rich in its several cultures-Native
American, Anglo, and Hispanic. The village has four schools and she
works at two of them, the elementary school and the middle school. Rita
sees everything from skinned knees and sunburn to child abuse, hunger,
and neglect. She finds small offerings of damp candies in her desk
drawers, with handmade Valentine's and Halloween cards. She brings three
sandwiches and a yogurt every day, eats the yogurt, and gives the
sandwiches away. She knows the parents, the cousins, the siblings of her
students, and is invited to every wedding and baptism in the village.
She would not trade her job for anyone's. She is everyone's grandmother,
practical and wise. The middle school is her favorite, and this is the
story, Joseph's story, that she remembers best.

Joseph was an eighth grader that year, skinny and short with long blond
hair that he cut himself. He wore strange combinations of clothes, some
too big and some too small. He lived up on the hill in Sand Ridge.

No one at the school had ever seen his parents. He was typical of many
of our kids, growing up without a great deal of supervision, not abused,
but very independent. He always came to see me in the nurses office
before the first bell rang, around 7,30 every morning, and we had a talk
about his day and what he was doing, and he asked me about what I was
doing. He seemed fascinated with the equipment in the office, prowled
around and poked things, and said, What's this for? Do you give shots?
Then the bell rang and he dashed off, jean legs slapping against his
shoes, with a grin and a wave, into the sea of students in the hall
outside my office. It was a nice way to begin the day, with Joseph.

He came into the office just after Christmas and helped me put some new
supplies away, into my old black cabinet.

Glass thermometers again? Why don't you get that new kind we saw in the
catalog? You just stick it in somebody's ear, and presto, there's the
number. Too expensive, huh? Where does this stuff go, this stuff for the
sprains? Cardboard splints are okay, I guess, we can't afford the metal
kind.

I listened and nodded and smiled at his expertise after helping me put
the order together at Thanksgiving. He knew we were on a tight budget,
Joseph knew quite a lot about that.

Here's the Ace bandages, but there's no room, we gotta move some thing.

He stood back, stared at the cabinet, and scratched his head. His gray
eyes were clear and sharp, and I could almost hear him thinking, You
know, you need another shelf here.

He put his hand where a shelf should be, and had been before it was
sheared off in a move from some room to another, before the cabinet came
to me. He was right, there should be a shelf there, and I told him so.

There must have been one once, but this is an old cabinet. We were lucky
to get it, because it has a lock.

He shook his head with a disgusted look on his face.

You work hard, Mrs. Nurse. They should have the money to get you what
you need.

I smiled at him, and gave him a hug across his bony young shoulders.

It's fine, Joseph. It'll do, I'll just stack things here, and maybe next
year we'll ask for a new cabinet.

What if I make a shelf? I could put a wooden one here, right where the
metal shelf used to be. It wouldn't matter if it didn't match. It would
at least be useful.

Someone came in with a bloody nose and I left Joseph to the measurements
and the figuring. He took a chewed-up pencil out of his pocket and
started writing down what he needed to remember to make the shelf in his
woodworking class. He licked the pencil lead, stared intently at the
cabinet, and moved his hands up and down, this way and that. I fixed the
bloody nose, saw three more students, and then realized that his lunch
hour was over.

Joseph, you need to go to class, hurry up.

No answer. He was deep in thought, murmuring to himself, How do I
connect it, once it's cut?

, .Joseph, get going!

Okay, but you'll have a shelf, I promise. He nodded, bit his lip, and
looked very serious, as serious as freckles, long uneven hair, and pug
noses can look. He stuffed the pencil and paper in his jeans, grabbed
his books, and ran out, calling, I'll do it, Mrs. Nurse, I promise.

It was always good to spend some time with Joseph.

One day later that winter, when I unlocked the door about ten minutes
before the first bell, I saw one of my eighth-grade girls in the
hallway.

She was with her little sister, who was a first grader at my elementary
school. They stood there waiting for me, the young lady with dark eyes
and large silver hoops in her ears, hair combed up to a tall sail over
her forehead, with the little girl beside her. She also had large dark
eyes.

Her long hair had been carefully braided, and there were little gold
stars in her small pierced ears.

So what's up, Gloria? I asked the older sister. Why isn't Eloisa at
school?

The little sister whispered in a very grown-up important voice, I have a
stretched throat.

I put my lunch bag down, picked up a thermometer and a tongue depressor,
and tried not to smile. Sure enough, she had big juicy tonsils with
little white specks on them, sure signs of stretched throat. I squatted
down and looked directly into her large, aware eyes.

You probably do have strep throat, little one, and you have a fever.

You need to go to the doctor. I looked up at Gloria. Is there anyone who
can take her to the clinic?

Gloria sighed and shook her head. No, Mom is working and she has the
truck. Can I use the phone? I'll take her to the clinic with my uncle.

They walked out, and I heard little Eloisa say, See, I told you I had
stretched throat.

She and Gloria would miss a day of school because at the clinic, the
folks with no health insurance waited a good part of the day. Her uncle
had to go to work at noon and Eloisa could not be left alone. It was
common and no one said much about it. Getting angry didn't help, writing
letters to congressmen got nice replies, but children still missed
school, looking after their sick little brothers or sisters or sick old
grand parents. Their parents both worked, and there was no other child
care available. It was a fact of life, here by the river, as it is in
other places, ignored by everyone.

A couple of weeks or so went by, and I had forgotten all about Joseph's
shelf. It was February, and my office was warm, the radiators were
clanking, and kids were lined up with flu, strep throat, and colds.

They met me in the morning, they were waiting for me when I came in the
door. On this particular day I saw about forty students, some with
bruises from gymnastics class, one or two of my kids with diabetes who
had run too hard during gym class and needed a snack with some sugar.

A few of my young friends had a Mr. Jaramillo headache, they wanted to
get out of English because he was giving a test. One young lady was
having a fight with her boyfriend and wanted time out in my office. And
one wild young one who punched walls when he got mad had hurt his hand
again.

Lorenzo was tall for his age, he had been kept back in the fourth grade
because he missed too much school looking after his little brother, like
Gloria and many more of his friends. He was a year or so older than the
other students, taller and heavier, and his long dark hair flowed down
his shoulders. Wherever he went in school, a crowd formed around him. He
led them with a scowl, a smile, a wave of his hand.

They were stung by his quick angers, but warmed by his regard, and boys
and girls alike followed his lead.

We had talked about his anger, he and I, and how to control it, but when
things got too much for him, he punched the wall. Today he probably
cracked a knuckle, and I wrapped it and gave him some ice, and sat him
down in the chair.

You need to get an X ray of your hand. It may be broken, Lorenzo.

Silence. Black eyes, glittering. Young face trying to look old, and
looking used and blank. Black hair, long and straight, hung over his
shoulders, and I imagined that he wanted to be a tall chief, Cochise or
Crazy Horse, free and in control.

Lorenzo, is your mother home?

His mother worked nights as a cocktail waitress, his father was absent,
and lots of aunts and uncles wandered in and out of the house at all
hours. He had no medical insurance.

Don't call her, it's too early. She was on last night.

We sat there, Lorenzo and I, in the quiet room, listening to the noise
of students in the halls. The bell rang, and there was an announcement
over the loudspeaker. We both knew that there was trouble in his life
that neither one of us could solve, and time would at least make him
bigger, able to drive, able to get out of the house and on his own. He
was waiting for that time, but I was afraid for him, afraid for that
time, Lorenzo on his own and lonely, still punching walls in his anger.

It'll be okay. I'll be back sixth period for more ice.

He swaggered out, wearing my bandage like a boxer, his long dark
warrior's hair swinging free.

A few minutes later Lorenzo and Joseph came back. There was a big tear
in Joseph's shirt.

What have you been into now, my friend? I asked, trying to look stem.

Joseph grinned, eyes dancing. Lorenzo tore it. I called him a name and
he grabbed me, but I got away.

Why don't you beat up on somebody your own size?

I asked, hunting for a pin.

There isn't anybody my size! Joseph laughed, skipping around the room,
shadowboxing around Lorenzo, who looked at him like a father with a
favorite child.

I heard their conversation from the door, as Lorenzo said, You did good
with Dale, man.

Of course I did good. Joseph stood up proudly. Nobody's gonna beat up on
a retarded dude when I'm around!

I couldn't help it and I called out, Joseph! Dale is not retarded!

The student Joseph and Lorenzo were talking about was one of our
medically fragile children, with cerebral palsy. He limped and didn't
talk quite right, but he was as intelligent as anyone. Joseph shadow
boxed back into my office and said, Yes, he is! One eye goes this way
and the other one this way"-Joseph pointed his arms in opposite
directions--and he talks to himself!

The tardy bell rang, and Joseph asked me for a pass.

No pass, Joseph. You aren't sick, just visiting. Get to class!

Suddenly Joseph grabbed his chest and sank to the floor.

Oh, I'm having a heart attack! Just the idea of going to Mr. Jar
amillo's class gave me a heart attack! Call an ambulance. .. . he
murmured, and closed his eyes.

I returned to the log sheet on my desk, paying no attention, and he
opened one eye and looked at me. Don't believe me, huh?

Nope.

He jumped up and ran after Lorenzo, calling out, Okay, Mrs. Nurse, see
you after fifth period! I finished your shelf and it looks neat!

Sure enough, Joseph brought his shelf and had figured out how to connect
it to the metal sides of the cabinet. He worked and turned screws and
had seventeen tools scattered on the floor, and frowned as he got it
into place. I wasn't watching the whole procedure because I had too many
sick visitors, but when they were gone I heard him say, There!

It's done! Come and look, Mrs. Nurse.

There it was, a sturdy wooden shelf exactly where it was needed. He had
rearranged the stacked-up supplies on the bottom of the cabinet, and
everything was neat and tidy. I was amazed, and so was he.

It really worked, didn't it! I wasn't sure if I could get it in, or if
the measurements were right, but it works, and now you have room for
everything, it's just as tall as these bottles of hydrogen peroxide.

He stood proudly back, moving the brown bottles, pleased that he
remembered the name of the solution inside. He was pretty amazing all
right, and I said so.

That's the nicest thing anyone did for me ever, and you're great!

We'll call this the Joseph Moffett Memorial Shelf! What a great idea.

Did you tell your woodshop teacher?

Joseph grinned. Yeah, he said he wants to see it when it's in. I think
he wasn't sure I could do it.

I didn't add that I hadn't been sure either, but we were both wrong.

Joseph was full of surprises, for all his scattered, careless look.

Have you got an old school picture, Joseph? I'd like to tape a picture
of you on the inside of this cabinet. An official cabinet needs a
picture, you know.

Joseph's ears got red, and he fished his wallet out of his pocket and
found a seventh-grade photo, taken a year ago.

That was last year, but I'll bring you a new one when they come out.

I got some tape and he held the little picture while I fixed it to the
inside door. We both stood back and surveyed our handiwork, and shook
hands solemnly.

Good job, my friend, I said.

Glad you like it, ma'am. He bowed.

Now you need to go get your teacher and show him.

Joseph spun around and did a jig, and his eyes sparkled with pride.

Old Mr. Johnson won't believe it, he thought I was just full of it when
I told him .. .. .. and off he went, bouncing down the hall, waving to
me as he went. I watched him go, and thought how many times I had been
pleasantly surprised by students. But Joseph was the most surprising,
and the most pleasant.

Sixth period, Lorenzo was back, frowning, a black cloud around his head.
He simmered, the anger just below the surface. I rewrapped his hand,
dark and bruised by now. More ice won't help in another few hours, I
told him, but you can hot-soak it and that might make it feel better.
Come back Monday before school starts, and I'll wrap it again.

Today is Friday. I'm gonna get wasted. Got an uncle who buys us beer,
whenever we want. Gonna take Joseph with me, too.

His flint-black eyes had no expression, his bragging was almost
automatic. He would get wasted on something and probably would be out of
school on Monday, recovering. He would brag about it on Tuesday, with
his friends, all huddling together because no one else gave a damn.

The afternoon went quickly. When the bell rang, I heard a howl and a
racket of feet crashing down the stairs, and out the door they went,
eddies and flurries of children, mixing and weaving, weekend promises
ahead, roaming the malls, idleness. Lorenzo walked by, his arms around
two seventh-grade girls. He winked at me with a lift of his chin as he
walked out the door, into the sun.

The evening went by, peacefully quiet. I did a house call on one of my
students and finished reports. I went from being Mrs. Nurse to Rita, at
home, looking forward to my weekend.

Up on the desert hilltop from our house I could see the whole valley and
part of the brown river, slanting away in the sunlight. The fiver
flowed, green and lush with cottonwoods against the dusty flanks of the
dry desert on both its sides. In the valley were alfalfa, corn, chili,
tomatoes, animals, life, activity, and people. In the desert were
sagebrush and gray-green chaniisa, small scrabbling things, and silence.
We pre feffed the silence, and our place grew yucca, hardy herbs, and
ever greens.

In the fall, there was always a ristra of red chili hanging against our
adobe house, and on Christmas Eve the lights of the luminiarias lined
the wall. It was a peaceful kind of life, a quiet kind of life,
predictable in its traditions and customs.

When the phone rang in the middle of that Friday night, I was jolted out
of bed. The voice on the other end was crisp and capable, telling me
about an accident and a death, and could I go to the emergency clinic at
once. Behind the voice on the phone, I could hear another voice, a young
man's, calling out to me, hopeless and helpless. I pulled on the uniform
pants I had left on the floor to wash, grabbed a T-shirt, and flew out
the door.

I drove the twelve miles to the urgent care center in the next village
in about ten minutes, still wearing my slippers. Instead of the quiet
orderly little surgery room there was chaos. I ran in the door and saw
something that I never want to see again. My students, my eighth
graders, in terror and anger and fear, were trashing the place.

There were only five of them, but it seemed like fifty. Joseph took the
contents of the little sterilizer and threw it on the floor. His eyes
were open and unseeing, his arm moved and glassware tinkled to the
floor. Chris and Gloria threw bandages and rolls of tape in the air,
crying. The other two had ripped the sheets apart and overturned the EKG
machine. On the exam table under a sheet lay Lorenzo, his long dark hair
matted with blood, his eyes closed, his battered, bloody face like clay
I called out to them to stop, over and over, to leave the nurses alone,
to be calm and quiet. Stop it! All of you, stop it! I shrieked as the
two nurses stood huddled in the comer, watching my students tear their
world apart.

Joseph stopped suddenly when he saw my leg, where a jagged piece of
glass had struck my thigh. I never felt it. Blood spread slowly across
my uniform, a wine stain on a white tablecloth. The students stopped and
looked at me, and then with a roar, Joseph ripped the sheet from Lorenzo
and screamed into my face, He's dead, Lorenzo is dead! The truck rolled
and I saw it, and he's dead!

And wrecking this place won't bring him back! Stop it, right now!

Joseph stopped shaking, and I put my arms around him. He stood, still
and silent, like a young tree. The girls sat on the floor, crying. The
other two boys turned a metal table over in their anger, and Joseph
closed his eyes and took a deep breath.

Cool it, you guys. They called the cops, he said quietly.

Every one was still, one of the nurses sobbed quietly, as around the
comer, two squad cars came whistling, lights blazing.

I held Joseph's arms and made him look at me. He's dead, but you aren't,
Joseph. You're still alive, and so are Gilbert and Mindy and Gloria and
Chris. But you need to listen to me, now. Sit down and listen. You don't
like it when people your age die, but they do. They drink and act crazy
and somebody pays. You're all hurtyou've got a cut on your face that
will need stitches, and Gloria's arm is cut-but Lorenzo is dead. Look at
him.

Joseph stared at the cold, gray face of his friend, who slept, silent,
far away from us. Joseph looked around him, at the wreckage of the room,
at the glass on the floor and the instruments and medicine scattered all
around.

He took a deep breath and began to cry. He bent his head and wept.

His sobs shook him, his voice was harsh and grating in his chest, his
tears scalded his face. Joseph was no longer a child, he knew it, and so
did I. Death had brushed him with dark wings.

You know anything about this, Mrs. Olivas? It was Officer Chavez, with
his notebook and his gun and his crisply creased shirt, and his sharp
brown eyes.

Oh, yes, I do. Let me help take care of these people, and fix myself up,
then we'll talk about what I know.

We got them cleaned up and stitched and I bandaged my leg, we got the
room picked up as well as we could. The girls cried as they put the
dirty sheets in the hamper, and Joseph scowled while he put brown
bottles of hydrogen peroxide away, carefully lined up against each
other.

By now it was long after midnight, and everyone was shaken and exhausted
and sad. They would find Lorenzo's mother soon, and she would come in
and weep over her son, weeping for all the missed days and nights and
years. She would weep because she couldn't go back to the days when he
was small and easy to leave with a neighbor when she went to work. She
would weep because Lorenzo and the problems all got too big too fast and
there was only her to fight them. She would weep because now there was
lots of time and quiet, Lorenzo and his angers were gone.

Joseph and I walked in silence out of the building, and I drove him
home, to a little trailer on the hill. We explained to his parents,
those anxious little people, we told them what had happened, how Lorenzo
had been drinking and had driven the truck into the gravel pit off the
Mission Road. We told them how Joseph was driving the car behind him and
pulled Lorenzo out of his truck and ran to the neighbor to call the
ambulance and made them call me at home.

We explained it quietly. We didn't talk about all the broken glass in
the urgent care center or why Joseph and Lorenzo were driving without
licenses. I held his hand while he showed them the stitches on his face.

I didn't say anything about the stinging bandaged wound under my torn
pant leg.

I left them in their trailer, up on the hill, and drove back to my
house, where the lights were bright and my husband was waiting. Here
there was peace and no anger and few problems that two people couldn't
solve. But could we have faced what Lorenzo and Joseph faced every day
with any strength? Or would our anger have destroyed us, as well?

We all went to the funeral, all of us, teachers and staff from the
middle school. The church was packed-there were more people than there
had ever been for a funeral. Middle- and high school students, teachers,
administrators, all of us. All of us came to say good-bye to Lorenzo.

He lay in the casket, handsome still, taking his anger and his silences
with him. We filed past, and we hugged his mother and we hugged each
other. Lorenzo's friends looked at him, lying there, willing him to get
up and get mad and punch the wall again. They were the same age, they
were alive, and people their age don't die. He's sleeping, he's fooling
us, he'll get up in a minute and laugh and say it was all a joke, and
then we won't be afraid anymore.

But Lorenzo did not move and did not wake.

How did we all get through the next few months? I don't know, and no one
else does, either. We all walked around doing our jobs, numb.

Our counselors were wonderful. They knew that our grief had to be
expressed, and they helped us in bereavement sessions, alone and in
groups, and with students. We began to heal each other, and as the
spring came we planned more picnics and field days than usual, and
hugged each other more. Lorenzo's death forced us all to look at the
work of our lives.

One day late in April, Joseph came in, with a picture in his hand. He
didn't smile, he just stood quietly and said, I promised you a picture
from this year, for the cabinet.. ..

We opened the cabinet. I got the tape, and in silence we put the picture
of Joseph next to the one from last year. We both saw that the second
picture was a different Joseph.

That first one was when I was just a kid, he said, frowning.

Yes, that was last year. That was a long time ago.

He nodded. His gray eyes were clear and sharp, but there was an edge to
his voice and a sharpness to his face that hadn't been there before. He
walked slowly out of the office, straight and tall, and I noticed how he
had let his hair grow. It swung down his shoulders like a warrior.

And then suddenly it was the last day of school, and the halls echoed
with see you next year! and see you in high school! Students wrote in
each other's yearbooks, hugged each other and cried, and gave flowers
and balloons to favorite teachers. I locked up my cupboards and
cabinets, cleaned up the supplies and my desk, and felt very tired. This
year had been longer than other years.

Joseph stood quietly at the door, looking around as if to memorize the
nurses office. He did not come in, he just stood at the door, looking
around. He would go to the high school in the fall, and this room would
no longer be a place to visit, or take a break from the rest of the
world.

I came to say good-bye, Mrs. Nurse, he said quietly. He didn't look at
the cabinet.

I went up to him and noticed for the first time how tall he had grown.

I hugged him, and through his torn shirt he felt thin and hard. He stood
there letting me hug him, both arms hanging down. I took his face in my
hand and looked up at him.

Listen to me. Listen carefully, Joseph. You can do anything you want to
do, anything. Don't ever let anyone tell you different.

He looked at me, gray eyes unsmiling. Maybe. Maybe so.

And then he was gone.

There is no place more silent than an empty school.

Chapter 10.

Ladybug, Ladybug, Fly Away Home.

You met Marie at Mama Mia's. She worked with Margaret and me on the
neurology floor. She was an old navy nurse, and she covered up a tender
heart with a no-nonsense, prickly exterior.

She'd been an emergency transport nurse, and her calm steadiness
supported her well during those years. She's smart and observant, and
keeps her mouth shut, her eyes open, and backs up her charge nurses,
which is something rare. Marie draws from her great experience, and is
always learning, when changes happen on the floor, she is aware and
watchful. She also figures patients out fast, and has taught the docs  a
thing or three. If they are smart, they listen to her and the patient
benefits from both their medical expertise and Marie's plain old
uncommon common sense.

If I were sick, I'd want Marie right there, looking after things.

When we met at Mama Mia's, I told Carolyn that I needed to tell her some
stories. I've worked for about a hundred years on the floors in the
hospital, as an aide and then a nurse. I worked mostly in the unit that
had all the head injuries and neurosurgey problems, people in Stryker
frames, paralyzed, lots of motorcycle accidents, no helmets. It's a sad
place, so we laugh a lot.

There are some patients I can't forget.

Marcella was a teenage girl who was struck by a drunk in a truck when
she went out to buy some groceries for her mother. She was driving a
little Chevy, and when they pulled her out, alive, she had a broken neck
and was paralyzed from the neck down. Eighteen years old, she was.

I was on the night she came in, and she was our fourth admission, so I
took her. We admitted directly from the ER after eight o'clock at night
on weekends when it was busy down there, and I saw the big double doors
burst open and in came the stretcher. She had barely been cleaned up and
all the information we had was an eighteen-year-old Jane Doe, no name,
nothing. We didn't need to know her name to take good care of her, so I
walked over with my clipboard and the admit papers and looked at her
face and nearly fainted, I thought I was looking at my daughter.

There was my Jennifer, dark curly hair, brown eyes, wide forehead, nice
mouth, and all I could think was, What did they do with your dimples? I
stood there with my clipboard like a statue, until another nurse
realized what was going on and shoved me aside and admitted the patient,
telling me to go get some coffee. I needed more than coffee, I don't
mind telling you. It took an hour and twenty minutes to find out our new
patient's name and get her family over there, and it was an hour and a
half I never want to see again. My daughter was home from college,
working evenings, and I was convinced that she had been hit, and was
lying there with that collar on, covered with scratches and bruises and
not saying anything, just looking at us with her big wide frightened
eyes, afraid and in shock. We got Marcella in the room and on the
Stryker frame, and everything happened just as it should, the orders
were written, and the family was found, and there were tears all around.
They came into the hospital frightened and bewildered, with her big
husky boyfriend named Jerry, and they stood at the door and looked at
Marcella on the frame.

Let me tell you about Stryker frames. They come apart in two pieces,
like the bread in a sandwich. The patient is the ham and cheese in the
middle. You strap the patient in on his belly, facing the floor, and let
him lie there, and bathe his back or treat his burns, whatever. Then you
put the top layer of the sandwich on him, strap him in good, and with
one nurse at one end and another nurse at the other, you turn him on his
back, and remove the top layer of the frame. This device makes it easier
to turn patients, and it's good for taking pressure off the back or the
front of the patient. Some old orthopedic doc invented it and it's
simple, but it works. It's light, made of metal with canvas straps. We
get used to it, it's one of our tools, like the Hoyer lift that we use
to move paralyzed patients into and out of bed. But if you're strapped
into a Stryker frame, helpless, frightened, unable to move anything,
it's not so simple.

Here was Marcella on the frame, eighteen years old, paralyzed from the
neck down. She would never walk, would never dance again, would never
have children, would never have anything resembling a normal life. A
drunk in a truck had robbed her of all that. They treated the drunk down
in the ER for a broken hand. One ruined young life, one broken hand.
Some trade. I told you we laugh a lot on this floor. We have to.

I worked my shift until around eleven, and kept fussing around, doing
stuff that didn't need to be done, until finally I figured out what I
was doing. I had to go back into the room where the paralyzed teenager
was, and it was just too hard. I closed my eyes and thought, Tonight I
only have to see her. Tomorrow, I have to deal with her mother. How can
I deal with the mother when I'm glad it's her daughter and not mine?

How the hell can I do that? Or even think it?

I went in, of course, and smiled, and checked her IV and made sure
everything was okay for the night shift. Margaret and I turned her on
the frame so she was on her back, looking up at the ceiling with those
beautiful big brown eyes. She looked at me, and didn't say anything, but
the tears trickled down her cheeks. I leaned over and gave her a kiss
and wiped her tears and mine, and said, See you tomorrow, ladybug.

She smiled. She didn't know that ladybug was my name for my daughter. I
didn't think Jenny would mind.

The next day we admitted a guy who was also paralyzed. He came into the
ER in a wheelchair, complaining of pain in his lower back, pain he
wasn't supposed to be able to feel. He said he'd been paralyzed from the
waist down since an accident two years ago, and the records were in
another state and unavailable for some reason. So they sent him up to
our floor, and we put him next to Marcella's room. I didn't like him.

For some reason, I just didn't like him.

His name was Jim. He wheeled around, a small, slight man, with a blanket
over his legs. It was winter and cold and the blanket was appropriate.
He had a reddish untrimmed beard and wore a blue baseball cap on his
thinning hair. We got him in a room, and fussed over him like nurses do,
and since it was about four o'clock we asked him about dinner. Right
away he said, Make it doubles!

There was something about him, something in the way he said, Could I get
you to do this, or that? Something in the way he smiled all the time,
something in the way he ate double portions at every meal.

I watched him and kept wondering why I didn't like him.

He had visitors, sometimes, and I didn't like them either. I've seen a
lot and met some pretty funny people and never worried much about how
they dressed or what they looked like. But these people were some thing
else again. One woman came in and right away started to tell us how
wonderful we were for her Jim, and how we were some kind of saints, and
how hard our work was, and on and on. She had a pasted on mole on her
cheek and her mascara kind of caked on her eyelashes.

That would have been fine, but she kept putting her hands on my arm and
patting Margaret and touching us. We had work to do, we couldn't be
talking all the time, and what did she know about our work, any'a'ay?

She and Jim were always whispering together and watching us, and it was
enough to give you goose bumps. Margaret gave me the eye every time that
woman came sashaying into the unit, always late in the evening just
before the end of shift, our busiest time. But it wasn't just that.

I would have had goose bumps if she had walked in when there wasn't
anything going on, it was just her. Sometimes she came in with another
friend, a skinny little guy with a baseball cap like Jim's. He wore
jeans, holes in the knees, and a black T-shirt with the name of some
band on it. He didn't look sick exactly, just unhealthy. Like he hadn't
been outside in a long time, and was awake only during the night.

Once, this little guy came over to Margaret and said, Can I get you to
go buy me a Coke? and pulled out a wallet with a wad of money in it.
Margaret told him to go down to the cafeteria. We both wondered how a
skinny, pale little guy dressed like a burn could have so much money in
his wallet. Whenever those two left the unit I felt like spraying with
the bug killer.

If some patients can give their nurses goose bumps and make them run for
the bug spray, it's amazing how some patients help their nurses.

Marcella had asked for pictures in her room, and her parents brought the
pretty static pictures of a graduating senior, the hand on the chin, the
hair all arranged pretty. But she said, No, I want the cheerleader
pictures.

So they came back with the cheerleader pictures, the ones with Marcella
jumping and doing all kinds of calisthenics and holding flowers and
kissing the ballplayers. These were the pictures she wanted in her room.
Even though she would never jump or run or leap into someone's arms, she
wanted to see the pictures.

So we fussed over the pictures while we fussed over her, and we tried
not to cry. All I could think of was my Jenny, my ladybug, lying in that
Stryker frame with the orders turn every two hours on her care plan,
looking at herself moving in the pictures as she would never move again.
Her steady brown eyes kept looking at the pictures as if to memorize
them, the movements of that other life. There were no tears, only a firm
chin that said to us and to her parents, I will live and do and be.
Somehow.

The days went by, and Jim went to PT and every time he came back I read
the therapist's report. On the third day it read, This is a very
unconvincing paraplegic. And then I realized why I didn't like him. I
didn't trust him. He was faking his paralysis. His legs were fine under
that blanket, the pain in his back was a fiction, and I had known it all
along. With my sixth sense, that gut-level intuition that nurses bring
to their care of people, I knew it. It hadn't reached my brain yet, but
the same thing was obviously bothering the physical therapist
downstairs.

The docs  watched him, too. They read the progress notes very carefully,
but no one could catch him at anything. He just wheeled himself around
and complimented us in that nicey-nice way he had that made my skin
prickle and ate double meals and played cards with the old man down the
hall. He never went near Marcella or her family, though.

Our ladybug was doing pretty well, considering. She had talked to the
docs  about getting a typewriter or some kind of computer that would
allow her to tap out letters so she could continue with her schooling.

She had a brave idea that she could help other people like her, and the
plan gave her strength through those first few weeks. She had a long way
to go, a long painful rehabilitation to complete, but maybe that idea
could bring her the will and the strength to keep going. Her boyfriend,
Jerry, came to visit her and they cried and he held her hand. He never
looked at the picture of Marcella jumping up to hug him at a football
game. He was very quiet and polite and didn't seem to know what to do
with himself. He would back out of the room, looking at Marcella, and
run his hands through his dark hair and walk very fast to the double
doors without looking at anyone.

One evening Marcella's mother and I were having a cup of coffee
together, going over the discharge plans for Marcella when she went out
of state to the rehabilitation place in Denver.

I finally told her the truth. She looks so much like my daughter .. ..
..

Mrs. Rodriguez looked away, tears in her eyes. That's what the doctor
said the day after she came in. She's like a lot of daughters, but she's
my brave little treasure.

We stood together and I cried with her, and in some way, it healed a
little bit. It made it easier for me to talk to Marcella's mother,
anyway.

Talking to Marcella's father was harder. He was very angry and wanted to
do something about that drunk who had broken his family and his life.

He was a short man, strong, hard brown arms under a white T-shirt and
gray suit jacket. He had a little black mustache, brown eyes that were
angry and sad all at the same time.

Why can he get away with this? Mr. Rodriguez paced the floor, not
looking at Marcella. Why can he walk out, and go get drunk again, and my
little one is here .. . ? He looked around with a sort of wild look in
his eyes, at the Stryker frame and the bare floor and the hospital walls
and the bare hospital furniture and me. He stood there for a minute and
I saw the tears in his eyes. I heard his boots hit the floor as he
walked very fast away from us. Mrs. Rodriguez took my hand and said,
It's not you people. He's just so very angry that this happened to his
little one .. .. ..

What about Jerry? Marcella said suddenly.

Mrs. Rodriguez looked startled at the question, and turned to her
daughter. What do you mean, what about Jerry?

He's your boyfriend, what about him?

Marcella lifted her chin and looked at her mother. I think that she had
been thinking about Jerry for a long time.

I cannot be a woman anymore with Jerry. I talked to the doctor, the nice
one with the beard. He told me what I can and cannot do.

No, it can't be that way, not the way a wife can be.

Then Jerry must find someone else. He can always be my friend, but he
must find someone else to be that for him.

Marcella looked at me and at her mother. Mrs. Rodriguez was crying,
probably for the grandchildren she would not have from Marcella, and she
put her head on Marcella's pillow. I left them alone then because I
needed to go find Jenny and talk and have dinner and watch my own
ladybug walk and dance.

Jim was to be discharged before Marcella, and he was complaining more
and more of pain in his back which the docs  couldn't figure out,
naturally. We went along with him because you can't exactly call a
patient a liar, but we kept a careful eye on him. The night before he
was to leave, Margaret and I stood at the nurses station and watched him
across the hall, lying quietly in bed.

He'll probably pull something, this shift or on the night shift, to
delay his discharge. It's still cold outside, and he knows we're having
chicken tomorrow night.

Margaret was a sarcastic type when she was tired, and she hated the time
we were wasting with this lowlife when there were so many really sick
people on the floor. We looked at Marcella's room and then back at
Jim's. She gave me a nudge and said, Watch him. He's your patient, keep
an eye on him.

All evening he lay in bed, real quiet. That sixth sense kept telling me
he was planning something. But what? I gave him his medication at ten
and cleared up his room and settled him in bed and said good night.

The floor was dark, the light was funny, but I thought I saw him
wiggling his toes when I went out the door.

We left his door open, and I kept making excuses to walk past his room.
Then, after we finished our charting and taped report for the night
shift, I heard it.

Nurse! Nurse! Jim was calling from his room, and he sounded odd. I went
in, expecting just about anything, and found him lying on the floor,
legs straight out, not a rumple in his hospital pajamas. He was just
lying between the beds, and I said, real concerned like, Well, my
goodness! What on earth happened here?

I fell out of bed, and my legs and my back hurts now, real bad.

He said it like he was talking about the weather, no pain in his face,
hardly any movement of his upper body, not at all like a really
paralyzed person would fall, all crumpled up and scared and helpless. I
felt like laughing and saying, Come off it, you creep. You arranged
yourself on the floor and then called out. You want to be paralyzed? Ask
Mar cella about that. But I didn't. I just said to Margaret, who had
walked in when she saw me go into Jim's room, Go call the docs  and
we'll see about this.

The doctor on call was one of the smartest young neurosurgery guys we
knew, he was the nice one with the beard and he hadn't believed Jim for
a minute. But he came up to the floor and gave him a complete check, did
everything that he would have done for any patient. It took about an
hour and believe me, it was well documented. When he was done, he gave
Jim a big smile and said, Well, fella, you're pretty lucky.

No problems, and you can go home on schedule.

Jim started to whine about his pain, but the doc patted his legs and
said, With an appetite like yours, that pain will just fade away. We'll
give you something to take home, anyway. He winked at me and gave me a
prescription for aspirin to include in the discharge papers.

I left that night around midnight, after Margaret gave her report to the
night charge. When I left, Jim was in bed, and when I came back the next
afternoon, he was gone. The day nurses said that he claimed he was being
treated wrong and would let the lawyers know, but I can't see that. We
took care of him and fed him double meals for two weeks, and it was all
free, on Medicaid. His legs were probably fine, but there was something
wrong between his ears. Maybe he figured we owed him something. Who
knows? We work too hard to try to figure out people like that. There are
too many Marcellas to take care of to waste time worrying over the Jims.

Marcella left, too, about two weeks later. She went to Denver and it was
a three-hanky afternoon, believe me. She had so many cards and flowers
and boxes of candy that her mother left it all with us. We all couldn't
leave the floor to take her to the ambulance. Margaret got to do that,
but we watched from the windows. We all stood by the big windows and
watched the family around her with Jerry. When we saw the ambulance
leave, we hugged each other and cried.

Marcella still looked like my daughter, and for a long time, when the
big double doors opened and a Jane Doe came in on a stretcher, I did
some praying. I didn't need any more ladybugs who couldn't move.

I like my ladybugs dancing.

Chapter 11.

Far from the Pennsylvania Turnpike.

Sometimes nurses have to be many different people for many different
patients. We get used to being firm with stroke patients, encouraging
them to get up and move so their recovery will be more complete, we are
used to being quiet, moving smoothly around children or the dying. We
are used to watching monitors and intravenous lines and chest tubes with
a practiced eye for technology, but also being attuned to patient moods
and subtle changes in behavior. Sometimes the behavior isn't so subtle
and we have to deal with abuse or worse because patients or their
families are afraid and we are all that stand between them and the dark.

It's not easy to be all these things, and some nurses and doctors
retreat into themselves and show only one face to the world because
their other faces are exhausted and they don't realize it.

They've gone past the moment when the inner self is sensitive, so it
closes off and goes blank and becomes technical, because machines are
easier to deal with than people who are hurting. That's why Margaret is
so valuable, she knows about the ebbs and flows of the spirit, and knows
when to go dig in her garden to relieve the pain and anxiety of her job,
she knows when to go deep into a good book to find perspective. And she
also knows that nurses and care-givers don't always wear badges and name
tags, some times they wear short cotton gowns and paper slippers and
have a plastic name band on their wrists.

Lucy Moore was one of the best nurses I ever met, and she wasn't even a
nurse, she was a patient. We had just been through the business with the
phony in the wheelchair, and some new folks had been admitted to us.
Since our floor has five major services, we see everything from head
injuries to female cancers and quite a lot of stuff in between. We also
board people from other floors when they're full, which is how we got
Luke. He came in about three days before Lucy was admitted.

He had to wait a few days to meet his nurse.

He was a tall, lean, long-haired young man who had been in a motorcycle
accident, and had a minor injury on his leg that he had not washed or
taken care of, and it got infected. When he was admitted he had a very
high temperature. His leg was swollen to twice its size, and was red and
hot to the touch. If the infection didn't heal, he could lose his leg or
possibly his life.

He was on bed rest, which he ignored, and intravenous fluids, fed
through lines that he yanked out all the time. He terrorized the student
nurses I sent in to start his IVS and threw his medication at them. He
was frightened because deep down he was mortally afraid of becoming a
one-legged biker. He would rather have died than lose his leg. He was
nasty, uncooperative, and gave us a headache.

You ought to work in a prison. You're so bossy, you'd fit right in.

He was growling at me again when I took the food tray in.

What do you know about prisons? I put the tray down on the bedside table
and watched him lift the brown plastic cover.

Lots. Been in some prisons that were nicer than this hellhole.

We were having meat loaf, mashed potatoes, and gravy, and a mixture of
peas and corn. One of our better meals, actually. He made a vomiting
sound and threw the tray on the floor.

I haven't eaten a mess like that since the third grade in the school
cafeteria.

Did you throw it on the floor then, too?

I bent and cleaned up the squashed mess of meat loaf covered with gravy
and peas mixed with the apple crumble they always served with that meal.

Sure did. Got in trouble then, but you won't give me any trouble.

You're too nice.

He leered at the word nice and made it sound like a long hiss.

But you're bossy, too, so maybe I will get into trouble. Huh, bossy
lady?

I stood up with the garbage of his dinner on the tray. I wanted to dump
it in his lap, and he knew it.

If you get hungry, tell the night shift. I've got work to do, Luke.

I wanted to add, with people who are nice to me and behave them selves,
but I didn't. Somehow that act never sounds real with me. And it
certainly wouldn't work with Luke. Whining women were red meat to this
guy, but something about him was appealing, nasty as he was.

Maybe it was the way his long hair made him look like some kind of
Viking, maybe it was his green eyes, trying to look mean and sometimes
showing the pain, the lines around his mouth that grew deeper as his leg
got worse. Maybe this was his only way to fight off the black uglies
whose quiet footfalls in the hallways make people afraid in a hospital
at night. Maybe it was all those things, and the fact that Luke was
young, very young, and very vulnerable. He knew we knew it, and he hated
us for knowing.

That night, very late, five of his biker buddies came to visit and
walked into the unit drinking beer. They were wearing leather and metal
all over them, some kind of spikes sticking out of their belts and on
their wristbands. They all wore long braided hair, and they had chains
around their necks. They were laughing and talking loud, even though it
was late and the hall was dim and quiet.

They walked down the hall looking big and strong and healthy and scary.
I knew that calling security wasn't the answer, so I took the tallest,
oldest biker by the ann and turned him around toward the big double
doors. I walked him out, and the other four followed, meek as lambs. I
waited with them at the elevator and told them nicely to please come
back without the brews at regular visiting hours.

We've got sick people here, guys. People who need to sleep. Come back
when everyone's awake, please. I patted the leader on his tattooed ann
and came back shaking my head. Patients like Luke are interesting, but
their friends I can do without.

I always give thanks for a good staff of nurses-male or female who can
juggle many different types of patients without turning a hair, I am
always thankful for hard workers who smile. But tonight I was glad that
Loretta Yazzie was on duty.

Loretta is a Navajo nurse from Tuba City, Arizona. She's bright,
compassionate, and flexible. She went to school with Anglos, so she
understands us, but she never lost her roots. So when we admitted our
next patient, I looked up and said thank you for Loretta.

The rules of the hospital were pretty strict about admissions, but this
little old Navajo lady wasn't having any of them. When I got to her room
to admit her, the little grandmother was sitting on the floor, smiling
at everyone, but she wouldn't get in the bed. She preferred the floor,
because the high white bed with the cold metal rails was scary and
unfamiliar, and the floor with her little pile of belongings was safer.
I had to admit her, get her into a hospital gown, into the bed, and do
some important paperwork, but neither one of us understood the other
one. There she sat, on the floor, smiling at me.

Patients in the emergency room used to be confused when the nurses said
they were going to put them on the floor. I remember one old man said,
Don't you have a bed? In our language, the floor was up on one of the
hospital wards as opposed to the emergency room. It was not the real
floor on the linoleum. But Mrs. Joe was on the floor, all right.
Literally.

So I called Loretta, and she squatted down near the little grandmother,
and looked into her wrinkled face, a toothless map of years of life and
many, many grandchildren, and spoke to her in their own language.

They spoke quickly and Mrs. Joe sighed and nodded. Loretta and I helped
her up and she climbed into the bed, smoothing the cold white sheets
with her brown little hand.

She said something softly in Navajo, and Loretta spoke to her. I asked
Loretta what the old lady had said.

Loretta smiled and replied, Mrs. Joe just said, This bed is cold, like
them. So I told her, Hush, little grandma, they want to help you.

I will stay here with you and explain. Try to understand them, and try
to help them understand you. Mrs. Joe hid her toothless grin behind her
little hand and giggled. I laughed, too, at the idea of this ninety-four
year-old Native American woman helping the white nurses and doctors
understand her ways. Even Loretta was going to have a hard time
understanding, because her ways were the young-people ways, not the old
folks ways. But we would shake our heads and try harder, and somehow, we
would understand.

Somehow.

Her name was Mrs. Betty Joe. She was the only one in the room, and that
bothered her. Loretta told her not to worry, that the other bed wouldn't
stay empty for long. It wasn't. That night we admitted Lucy Moore, an
elderly cancer patient. She had been recently diagnosed, and was in the
hospital for tests, surgery, and scheduling for radiation treatments.
Her hair was red, her eyes were blue, and she and Mrs. Joe smiled at
each other and looked at pictures of each other's grandchildren. They
found a common language without any trouble.

Miss Lucy patted her red hair and whispered to me that it was gray
underneath but it wouldn't matter, because soon it would fall out, and
then she could quit coloring it. I do it for my daughters, but it's
pretty silly. They can't stand gray, but now they have to get used to
bald.

The next morning Mrs. Joe asked Loretta for her medicine man.

They have their own kind of doctors, those folks who live on the res. It
would give Mrs. Joe great peace and security knowing that she could have
her own kind of healer as well as the white man's. Here at this hospital
it wasn't unusual, we had a medicine man who visited every few months
when any patient asked for him.

But the young resident doctor on Mrs. Joe's case was the doctor from
Pennsylvania who took care of Mabel and when I told him what she wanted,
he got red in the face and said, No Indian's coming in on my case.

There's already an Indian on your case, I said, and she's your patient.
Mrs. Joe needs her own doctor as well as you, and it will make her feel
better. If you focus on the patient, you'll see that.

He slammed into the nurses lounge to write the order to bring in the
medicine man and gave up after three tries. He came out to the station,
threw the chart down, and said in a nasty voice, How do I write this
damn order? Call off the cavalry, we need Sitting Bull'? I looked at him
over my glasses and picked up the chart. I had been opening packages of
IV tubing and had my scissors in my hand. Loretta said later that she
wondered if the scissors would end up back in my pocket or in the
resident.

I tried to remember that this young doctor was from the east and had
lived in New Mexico for only a few months. I tried, but I had to grit my
teeth. He had already been through a character building experience with
Mabel, but he needed more lessons.

It's not difficult, I said sweetly. Just write something like Patient
requests medicine man from home, family will make arrangements.

Something really quick and professional will do it. I looked at the
resident, and he looked at me. We had our differences, we two, but he
sighed and sat down heavily at the station.

No one in medical school ever said I'd have to do this, you know.

This is weird. Weirder than that miraculous remission.

No, not weird. Different. Just think how much more you're learning than
if you stayed back east. You'll be in the room with the medicine man, of
course, when he comes. It's required.

The resident dropped his jaw and started to say something, but the took
on my face kept him quiet. I knew it wasn't required for him to be
present, but he was beginning to learn that there were other truths than
his, thanks to Mabel. One more lesson was on the way. We were a teaching
hospital, after all.

We finished our charting, yawned, stretched, and gave report to the
night shift. When I started to leave, I stopped in to see if Mrs. Joe
and Lucy were asleep. Mrs. Joe was a small figure huddled in the white
man's bed, but Lucy was gone. I spotted her down at the end of the hall,
sitting alone by the big windows, looking out into the darkness.

Hey, lady, time for bed. You've got a big day tomorrow.

I sat down beside her. She looked down at her hands, her nail polish
removed for surgery. When I looked closer, I could see the tears.

Is it okay to be scared? she whispered.

I didn't say anything because right then there was something in my
throat and I couldn't talk.

My daughters came, but they didn't stay long. They're scared, too, but
won't admit it. They brought me a novel that weighs nine pounds, two
boxes of chocolate, and a long ice-blue silk robe that I'll probably
bleed all over. She sighed. Girls.

Those girls are trying to help, so let them, I said. You'll wear the
robe, and the novel will help pass the time. If you don't want the
chocolates, we'll eat them.

Lucy took my hand and held on. Mrs. Joe has the same thing I do, the
same damn thing growing in her where babies used to grow. She told me
today.

Told you?

Oh, you know. Pointed to her stomach and mine and then nodded, and put
her hand over her mouth and giggled, as if it was some enormous joke.
But she had the medicine man, and she felt better. Now she's asleep. You
should have seen that young doctor from Pennsylvania. He actually paid
attention and didn't make a fool of himself.

He'll be fine, when he grows up.

Lucy looked at me and brushed my hair back from my face, and sighed.
Here I am, keeping you up. You go home, and say a prayer.

I'll see you when they're done cutting me up.

I hugged her and walked out the double doors, but before I left I looked
down the hall and watched her watch the darkness.

The next day she was in recovery when I came on, and when she came back
to the floor she was groggy and sleepy, but she held my hand tightly
when I did her vital signs.

Her daughters had been waiting all day, and were in the room when Lucy
came back. Once she looked up at them and said, very clearly, You must
get used to my hair now, it's white. And pretty soon it won't be there
at all. And then she went back to sleep and didn't see her daughters
cry. I walked back to the nurses station to hear Luke hollering at the
aide as he threw his dinner on the floor.

I had two days off then, and tried to put Lucy and Luke out of my mind
and let someone else take care of them. It worked, sometimes.

When it was time to come back to work I arrived on the floor early and
found Lucy walking down the hall, slowly, trying not to stoop. She was
wearing her ice-blue robe, stains and all. She was pale and tired, but
she was standing up and she looked wonderful.

You're up! Congratulations! I gave her a quick hug.

She was pushing the wheeled IV pole beside her. A heavy plastic Foley
bag that collected her urine was hooked to the pole. A tube took the
urine from her bladder to the bag. She glanced down at this contraption
and smiled.

This thing slows me down a bit, but it helps me stand up straight.

I call it my pee cup. Do you think I can make two more rooms? Her face
was pale, but her blue eyes were calm and steady.

I looked down the hall and saw that journey would take her past her room
and then past Luke's.

Sure, I'll join you. I don't have a pee cup, but I'll keep an eye on
yours.

We walked slowly, one step at a time, Lucy breathing heavily. There were
some lines on her face that were deeper than before, but her red hair
hung down her back, and her thin veined hands held the IV pole firmly,
steadying her. She made her queenly way past her room and I saw Mrs. Joe
sitting on the floor, smiling and nodding at Lucy's progress.

When we reached Luke's door, he watched us silently. He was sitting in
bed, bare from the waist up, his long blond hair wild and tangled.

His face was flushed and handsome. He was still fighting, and still
angry.

Lucy turned to me and whispered, What's wrong with that young man?

I told her that Luke's leg was infected and she said, Can I go visit
him?

If he'll let you. He throws things at people, and he's very angry about
having to stay in bed. The attending doctor caught him standing up, and
just about had a heart attack.

She nodded. I've seen his biker friends visiting. They seem like nice
young men, trying to look tough.

We walked slowly into Luke's room. He sat silently, watching us.

His eyes narrowed when I listened to his rapid, harsh breathing. He
needed a pain pill but he wouldn't ask for one. He never did.

Can you keep an eye on Lucy while I get something? I asked.

I'll be right back.

Yeah, right back. You always say that, but you guys find ten things to
do on the way. Go ahead, go. I can watch the old lady. Watch her do
what? He laughed, making a pained grin with his dry lips.

Lucy sighed, sat down on his chair, and looked at Luke's leg. It was
angry and swollen and he moved it very carefully.

You have yours on the outside. Mine is on the inside, I heard Lucy say
cheerfully as I went out.

III I ran to the medication room to get Luke's painkiller. It had been
ordered PRN, which means as needed, and he needed. When I got back, Lucy
was standing with her back straight and her chin up, smiling at Luke.

I'll have to go downstairs to the cancer place for radiation and
chemotherapy, they tell me. What happens after your leg heals? Will you
take care of it? You don't want to have to come into the hospital again,
do you?

Luke didn't say anything, but he took the pill without an argument.

He looked at the Foley bag on the pole and asked Lucy what it was.

It's my pee cup, the doctors collect it and add it up. They say I'm too
skinny, and things inside aren't working right. There's something inside
here that's going to kill me. Lucy looked calmly at Luke.

You're okay, Miss Lucy. I like you. There aren't enough tough old ladies
in this world. Luke grinned his wolf grin, and Miss Lucy raised an
eyebrow at him.

There are more of us than you think, young man. More than you think. She
pulled her long silk robe around her, turned, and walked slowly out the
door, pulling her pee cup regally beside her. At the door she stopped
and turned back to Luke.

You stay angry, and live. Don't suffer quietly. Make them notice you.
She smiled. I'll come back and see that you do.

Luke lay back in his bed, muscles tense. How long does that damn pill
take to work?

When you fight it, it takes a long time, I said. Relax, and think about
something else. Think about Miss Lucy, as you call her. Or Mar cella, or
that guy who used to wheel around here and eat six meals a day.

Luke looked at me sideways and frowned. That guy was a phony.

You all fell for it, but he was a fake.

Not all of us fell for it. Some of us, including this bossylady charge
nurse, saw through him. We aren't all fools.

I straightened his covers and left him lying quietly, trying to relax.
It wouldn't come easily to him, but he might learn.

And he didn't have to ask for pain medicine anymore. I got the order
changed to every three hours regularly, not as needed. He would never
say that he needed, so we would just give it to him. Maybe then he could
relax and heal. Lucy would check on him, to see that he did.

Four days later, the day she was discharged, she went in and sat by his
bed and held his hand. She looked at him with those bright blue eyes and
he did not look away from her.

I'm going to have cancer treatments next week and I'm scared. It will
probably make me throw up.

Luke grunted. Everything in this damn place makes me want to throw up.
Your leg looks better. Walk out of here and don't come back.

He looked at her in silence for a minute and then said, Will you come
back here?

Probably, she answered lightly. What Mrs. Joe and I have will kill us.
She held her head up and smiled. But we're old. You're not.

So you go live.

He watched her as she walked out with her head up, tall and thin and
straight. I was fiddling with his IV bottle, wondering when I would see
my Miss Lucy again, and he scowled fiercely at the window. Life's a
bitch, and it's not fair, he growled.

Sure it is, she knows that. But who ever said it had to be fair?

He continued to scowl, looking handsome and scruffy as usual. I finished
my job, and suddenly he grabbed my hand.

Why do you work here? Why do you do this?

It was something I had thought about, but never said. It was good to
have him grab my hand and make me say it to him, straight in his face.

Because here it matters, I do this because it's important. I need to be
in a place that's real, where there's no small talk, no time for games.

It's as real as it ever gets, here in this place. Besides, who would
harass you into taking your medicine, or get Mrs. Joe up off the floor,
or get the medicine man in here?

I shook his hand off, and stood up. Very few people are nuts enough to
do this, you know. When I walked out, he was still scowling at the
window, watching the darkness.

Chapter 12.

Going My Way?

Marie has taken care of many different kinds of patients in her long
career, and usually can handle everyone. But there is one kind of
patient that she can do without, the overbearing self important big
shot. This patient carries the office and the board room into the
hospital with him. He can't be bothered with anyone, his problems and
his needs are far more important than anyone else's, and he has demands
that tax the considerable abil ities of the hospital staff. What's
worse, he takes valuable time away from other patients, and that's when
Marie has enough. She knows that these big shots are afraid, that they
have little identity a

w f ay from their work, they need the supports and scaffolding around
them to stay sane in the hospital. Marie knows all that, and probably
wouldn't have minded that much, if it hadn't been for Andy Potter. It
was Andy, who was very sick, who taught a few people about what was
important.

We've all had patients like the big shot. They think they're more
important, busier, and grander than the rest of us. Some learn, others
don't. This big shot didn't. He came on the unit like some kind of
hurricane, blowing people all around him like scraps of paper. I was
used to seeing patients come in through the double doors on a gurney,
maybe coming from the emergency room or X ray, or in a wheelchair from
Admitting. People like that were patients. They couldn't walk well, or
they'd had surgery, or were too sick to move fast like the rest of us.

Not the big shot. He came walking in with his tie flying and his eyes
narrowed with concentration, avoiding us. He wasn't a tall man, he was
stocky and red-faced. His tailor had worked very hard to make him look
slimmer than he was. If you looked close, you could see the tiny broken
veins in his cheeks, a little map of indulgence. His meaty hands kept
working, clenching and unclenching as he walked fast past the rooms full
of sick people, away from the sights and sounds of illness and pain.

As he steamed past me I smelled stale cigarette smoke on his clothes,
and saw the nicotine stains on his fingers. He looked like a powerhouse,
huffing and chugging to be away from all of us, walking with his heels
hitting the floor hard, giving orders to his poor little secretary, who
was carrying briefcases and folders and a ton of long yellow pads of
paper.

All the big shot was carrying was fear.

You get so you can watch it, you see it the way a patient's eyes sort of
slide away from the truth, from the diagnosis or the lab result. They
don't look straight at the nurses, they sort of look sideways at us and
at the nurses station and the charts. You can smell it, the way a
patient sweats and his palms are wet when you take his hand to take a
pulse, or help him into or out of bed. You can feel it like a presence
in the room, like there's someone else there besides you and the patient
and the roommate. With the big shot we saw it first and felt it later. I
don't know when he felt it himself, because he never did tell us. He was
too busy being important.

He was a lawyer, an attorney in a well-known and respected firm in
Albuquerque with offices in Santa Fe, close to the state capitol and the
legislature. He was a business lawyer with lots of big clients, like
utility companies and important families with hotel and restaurant
interests. He was used to being in charge.

Carmen, our head nurse, was also used to being in charge, and she
watched this gentleman breeze onto her floor and she said, Excuse me?

Most people stopped when she said excuse me in that tone of voice, sort
of stopped to explain what they were doing. Not the big shot.

He brushed her aside and told his secretary that the other bed in the
room had to go, and a desk put in and that the phone for that other bed
was going to be for the modern.

What the big shot didn't know was that Carmen and I had just settled
Andy Potter in his room for what was probably the last time. Peg was in
the conference room waiting with the clinic charts, and 148 other things
were going on with the other forty-five patients on this wing.

And Carmen was in charge, not the big shot.

We can't make this into a private room, sir. We have another patient
coming up from Admitting and we need the space, and I need it worse,
young lady. My medics and my wife are being hysterical about a little
chest pain, and if they expect me to stop working they're nuts. If I
have to be in this place--he looked around at the plain hospital room
with a sneer--then I'll work in this place until they do their damn
tests and then I'll go back to the office.

It didn't look like he had to go back to the office, he had just brought
his office with him. I watched Carmen's eyes narrow, and her back
stiffened when he called her young lady. She turned on her heel and
walked into her office. I stood there with the admitting papers,
wondering how much of our routine was going to be destroyed, and asked
the secretary, Do you think he'll have time to answer some questions so
I can admit him to the floor? It's important, and I need to get it done
soon.

I tried to sound reasonable, but the secretary looked around at the big
shot and whispered, Oh, no, he's expecting a call from the coast. Let me
do that.

I gave her the papers on the clipboard and went to find my head nurse.
Since when were patients admitting themselves?

Cannen was on the phone, standing by her desk tapping her teeth with her
pencil at top speed. We could usually tell what mood she was in by the
rate of the pencil taps. This was maximum speed. Carinen never raised
her voice with her staff, but she could be pretty loud with
administration when she had to be. And this was going to be one of those
times. I watched her for a minute talking to the administrator's
secretary and the admissions chief. She looked at me during a lull in
one of those conversations and twirled her finger around and around near
her temple as if to say that everyone was crazy. I nodded, figuring we
were in for a rough time. Administrators listen to people like the big
shot, not Andy Potter. And when Carmen slammed the phone down, I knew
what the answer was.

He's a friend of the governor. A VIP. At least our administrator in
Admissions is thinking. He routed our new admission into the wing
downstairs.

I went to the lounge for a cup of coffee and ran into two other floor
nurses and Peg, the nurse from the cancer clinic who had taken care of
Andy for so long.

Who is that guy?

Somebody important, that's for sure.

Not as important as our other patients.

Tell him that.

Peg shook her head. He should go see Andy. Maybe he'd learn something.

I nodded, but I was older than Peg. His kind never do.

We walked down the hall with Andy's chart and his medications. Peg would
add the clinic notes to the hospital chart, and we would all watch and
wonder when the end would come. Andy had been in and out of the hospital
several times, and he was one of our favorites. Never demanding, always
smiling, accepting what life was handing him with grace and gentleness.

He lay in the bed, pale and thin, his breathing was shallow and sounded
as if it hurt. His eyes were closed for a minute and he looked very
young. The chemo had thinned his hair, but he still looked very young.
When he heard us close the door, he opened his eyes and smiled and put
his hand out.

I knew you would come, I told Cannen you would come, he said to Peg, and
then to me, How's Marie? We gave him a hug and settled him back down in
bed, and gave him his medication. Peg sat on the chair and I changed the
IV bottle and marked it. I took his vital signs, which were not too
good, and stroked his hand. His skin felt clammy and cold, but his
temperature was higher than normal. I wrote all this down on the patient
record form and watched Peg talk softly to him. I told him I'd be back
soon and to have a good visit with Peg. When I closed the door behind me
I sort of leaned on it and watched the hustle and bustle up the hall
around the big shot's room. I closed my eyes for a minute and prayed for
patience. I have some good traits, I've been told, but patience isn't
one of them. I have to keep asking for it, and this time I asked for a
double dose.

There was another gentleman standing near the door of the big shot's
room, talking to the secretary. He carried a briefcase, too, and I
thought, Oh no, another one. He looked a little disturbed, and he
frowned when he saw me.

Can I help you? Some little bit of patience was given to me.

Are you the nurse for this patient? he asked me directly, looking
straight into my face. I saw kindness and a man who had been stooped by
the weight of something. He was a big man, shoulders bent a little, his
face broad and lined, his big hands like the hands of a workman, or a
farmer.

Yes, I have to get the admission papers from his secretary and make sure
they're okay. He knew I thought that something awful would go wrong if a
secretary filled them out instead of me and the patient, and he smiled.

When you do that, I need to talk to you.

I rescued my clipboard and asked a few more questions while two men set
up a computer and printer and what looked like ten miles of cables. I
told the secretary I would be back with the admissions kit and a menu,
when the big shot glared at me.

No hospital food, ma'am, no thank you. My people are bringing my meals
in.

I nodded and felt like asking him where he had purchased his people, and
motioned to the big gentleman to follow me. We stood by the nurses
station, far enough away from the room not to be overheard.

Can you tell me what this is all about? I asked.

He nodded, eyes closed. I had a feeling he had explained this before.

I'm Ike, one of Mr. Waters's partners. He's in for tests because. he had
an episode of chest pain, and his wife was concerned, so she called his
doctor and they admitted him. He's a very busy man, very busy.

He turned around at the chaos in the room and sighed. He tends to get
his own way, usually. People don't like to cross him. But he's a good
fellow, underneath. Ike turned to me and I didn't say that I had no time
to dig that far.

I'm sure he's a prince of a man, but he's making things difficult for
us. We have a lot of very sick people to take care of. He's going to
need a full-time crew just to get blood drawn and X rays done. Can you
talk to him, tell him to at least go along with our routines a little
bit?

It'll be easier for all of us and he'll get out sooner. I hoped all that
chest pain was only indigestion, but we probably wouldn't be that lucky.

Ike nodded, and looked down the hall to room 504. That was the room they
promised him. It's a private room and out of the way so he could work in
peace, not in a room right across from the nurses station.

There's a dying patient in room 504, 1 told him, in what Carolyn would
call my best brisk nurse voice. He needs privacy, and he needs not to be
disturbed. I eyed the printer as it began rattling and the phone rang
and the big shot shouted some order to the secretary.

Please do something. We have to keep the noise down.

Ike nodded and went into the room and tried to close the door against
the cables on the floor. I looked up at the ceiling and wished we could
have Luke back, with his biker buddies drinking beer while they walked
down the hall. They were lambs compared with this guy.

The floor quieted down around dinnertime, as usual, and the lights were
lower. The big shot's people had brought in a meal with two trays, and
we bet how many people ate off those trays. The staff who bet on one
person were right, all the rest of his people had to troop down to the
cafeteria. The noise from the room was more subdued, and when I went in
to check his vital signs, the big shot was staring out the window,
looking at the dark night and the lights across the street.

He turned to me as I wheeled the blood-pressure machine up and stuck a
thermometer in his mouth. He started to talk and I gestured to him to
keep his mouth closed. It was the only time I ever saw him silent.

Can't get the coast now, it's too damn late. He muttered to himself and
snatched his arm away when I moved to take his blood pressure.

No need for that, it's too high and to hell with it.

I put his ann down firmly, strapped the cuff on again, and said, Maybe
so, but we need to see if there's a change.

He quieted down, grunting. I looked in his eyes and I could tell this
guy was scared. All the fax machines and computers and cables couldn't
keep that fear away. I took the cuff off and noted his blood pressure on
my patient record sheet. He didn't ask what it was. I asked if there was
anything else I could do.

When will those damn results be in? They took enough blood for twenty
tests. How long does it take the medics to figure out what's wrong? If
there is anything wrong, of course.

I Well, the doctors will let you know, I'm sure. They should know
something in twenty-four to forty-eight hours.

Too damn long. If I ran things like that I'd be broke in a week.

It's the way it is, that's all. I looked at him again. Is there some
thing wrong?

Hell, no, just give me that briefcase when you leave. He growled and
motioned to a fat briefcase full of forms.

You need sleep more than you need this, I said, heaving the case onto
the bed.

I know what I need. Just close the door behind you. Leave a message to
your people on the night shift that I'm expecting a call and I told them
to ring the desk.

Now we're his people answering phones. I wrote in the progress notes in
the chart that he was using the station phone for his personal calls,
but I doubted if anyone but Cannen cared. There had been too many blue
suits from downtown visiting him for anyone in Administration to do
much. Hopefully the lab would work overtime.

I finished my charting and waited for the night shift to finish
listening to the report, so I could answer questions. The charge nurse
on nights came out to the desk, with her bag of bacon burgers and fries,
wearing her cap and whispering. Who is that guy?

I shrugged and went to say good night to Andy.

He was asleep, barely breathing. His feet were cold under the sheet, and
I covered them with another blanket. His hands moved restlessly on the
bedspread, and he muttered in his sleep. I stroked his head for a while
and he quieted down. It was late, and I had to get home, but I sat there
for a minute, talking to Andy while he slept. I felt peaceful somehow,
knowing that someone so near death was listening. When I got my coat and
walked past the big shot's door, I heard him talking on the phone. Maybe
not everyone on the coast was asleep, he had found some fool awake.

When I came on at three the next day, the tension among the day shift
nurses was thick. Normally friendly people weren't talking or even
looking at each other, and the charge nurse was tightlipped and wouldn't
look at me. We listened to the report and learned that the big shot had
thrown a fit in the middle of the night because he had missed that call
to the nurses station. He made an official written complaint about the
whole night shift and called the hospital administrator at home at flour
in the morning. We learned that Andy and his family had decided that we
were not to do anything heroic, no codes, nothing to bring him back when
he died. Enough was enough. I was sure that it never occurred to Andy to
call anyone at four in the morning to complain. Some of the big shot's
test were back, inconclusive. That really made him mad.

What do they mean, inconclusive? He spat the word out as if it tasted
bad. Tests are tests, and they should show something. One more day .. .
He motioned ominously to the big watch he wore. One more day and I'm
leaving this incompetent.. . He had more choice words to say, but I
left. I had work to do.

Andy was sleeping deeper and deeper, slipping faster and faster. I
looked around his room, where a friend of his sat in the chair and held
his hand. The room was bare, very few belongings, a nice plant, some
cards. The only things in the room were quiet and peace. It was hard to
watch, this gradual quiet dying, but if you sat by the bed and held
Andy's hand, something odd happened. It wasn't hard anymore, it didn't
hurt. It just was.

Ike came in toward dinnertime with a couple of letters for his partner
to sign, and smiled at me. He came up to the station and asked, How's
the young man in 504?

Dying. I Ike looked at me, and turned away. I felt bad, and walked
around the station to stand beside him.

Sorry. We get starched and bossy when we hurt. Andy's one of our pets.

He nodded, and turned toward room 504. Do you think he would mind if I
went in and sat with him?

Of course not. He'll make you feel peaceful, I do know that.

A little while later I went in and saw Ike, his big frame hunched over,
holding Andy's thin wasted hand in his big one. I changed the IV and
made some notes. Andy's vital signs were failing fast, and it wouldn't
be long.

When my wife died, she was quiet and peaceful like him. I wonder why
that is?

I vowed to be nicer to this man, this patient man.

How long ago did your wife die? I asked.

Twelve years. I still miss her as much as ever. He was quiet then,
holding Andy's hand and watching his face. Just like her.. . he murmured
as I left.

It was after dinner that it happened. Things had been very busy with a
new admission and the nurses were trying to get something to eat and
finish clearing things up before the ten o'clock medications were due,
when Ike emerged from Andy's room. I heard him call for help, and two of
us ran.

I think it's over, isn't there something we can do, he looks so cold ..
.. .. Ike was talking fast and rubbing his hands together, wanting to do
something.

No, we'll call his parents, they just left for the night. Don't worry,
just sit by him.

Some nurses have a theory that patients can still hear us talking to
them after they've died, and I'm one of them. I covered Andy up, making
sure his feet were wann, and talked to him while I removed the IV and
noted down the time and did all the good nurse things we do to keep from
running away. The docs  had left specific orders, so we followed
protocol and called the family, and made some arrangements. Ike sat in
the midst of the comings and goings, and then he stood up and patted
Andy's hand.

Say hello to her when you see her.

One nurse looked at him oddly and then at me, and I shook my head.

She would understand, once I told her.

On the way out the door, Ike looked at the plant on the table. He turned
to me and asked if he could bring it to his partner's room.

He has a lot of machinery, but no plants, nothing growing.

I said I would ask the family but I was sure it was okay, and Ike walked
out. He went into his partner's room, and I heard the big shot yelling,
Where the hell is everyone? I need some more fax paper and my people
haven't come back from dinner. And that call is going to come in soon,
and if I miss it again, there'll be hell to pay, you tell them that!

I walked to the station to make some more calls for Andy, and Ike came
up to me. He had Andy's plant and put it on the station desk.

He says he doesn't want a damn plant, he needs paper for the fax, he
said.

I don't care what he needs, a patient has just died and we have work to
do. Real work to do, not bothering with machines.

Ike put his big hand over mine and looked sad. That's not nice.

He's scared, and- I don't feel nice, I hissed at him. We've just lost a
good friend and I feel awful and I don't have time to worry with his
nonsense.

Doesn't he get it? People are more important than machines, Ike, you
know that. You're not like him. You're human. What is his problem?

Ike thought about that for a minute, and his homely, kind face grew
sadder. Everybody needs him but nobody likes him, he said. He's lonely.
That's why he calls people on the coast all night long. He can't sleep
because he's scared. And he doesn't even know it.

I took a deep breath and patted Ike's hand.

Okay, tell him I'll call about the fax but it's not for him, it's for
you and it's to get things done so we can discharge him and send him
home. Or to his office, whichever. Does he have a home? Or does he live
inside that fax machine?

Ike laughed. No, he has a nice wife, he doesn't deserve her. His face
got more lined and sad when he remembered twelve years ago, and his own
wife. He walked into the room, and listened to the big shot holler about
the tests that didn't show anything, and how he was going to leave in
the morning with or without the doctor's approval. And where the hell
were the men to fix the printer and where was his damn paper?

I heard Ike say quietly, T. E. , they just had a death on the floor, and
they're busy. Marie will get to it soon, she said she would.

A death, of course there's a death. People are always dying in
hospitals, that's what hospitals are for.

Mr. T. E. Big Shot Waters started packing, and making phone calls to his
people to come and get the computer and the fax and the printer, to hell
with the paper, get me out of here, and make it fast. It was late at
night, but he wouldn't listen. He called his doctor at home and said he
was leaving and called his wife to come and pick him up and bring the
Caddy because he had a lot of equipment to move. It was a circus, him
getting ready to leave with all his stuff, making more noise than anyone
ever heard on a hospital floor. Ike walked out quietly, carrying Andy's
plant back to his room from the nurses station.

A few minutes later Andy and the big shot left at once. The gurney with
Andy's body was quietly moving down the hall, Andy's father and mother
following in silence. There were tears all around, and Peg made another
pot of coffee to keep her hands busy. Then the big shot's wife appeared,
a small bird of a woman with a worried frown on her face and lots of
fine rings on her veined, thin hands.

, , Is he okay, is everything all right with the tests?

They didn't show much of anything, but you can check with the doctor in
the morning. I'm sure he'll want to hear from you. Cannen smiled sweetly
and called Housekeeping to clean two rooms.

The big shot left, his wife and his people behind him trailing computer
paper and cables and briefcases, he walked fast, hands jammed in his
pockets, fear still riding his back. The gurney with the red body bag
ended up right behind the big shot because he shoved his way past it to
get to the door. But the gurney kept following him, and he kept looking
behind, walking faster to get away from it. He looked at it, then looked
away real fast, and kept edging away, poking the elevator buttons to
hurry it up to our floor. The big shot's face was red, and his heels
kept marking time on the floor. The red body bag on the gurney stayed
behind him, with the undertaker's men on both sides, silent. All the
time the big shot was glaring behind him, but no one noticed. The
elevator took a long time, but it came to our floor, quietly opening its
doors.

The big shot ran into it, held the door for his people and then closed
it before the undertaker and the gurney and the red body bag could get
inside. The big shot didn't want to ride down with Andy. So the gurney
waited silently, patiently, for the next elevator. No one was in any
hurty.

Carmen watched them go, watching this little charade through the door,
and whispered to herself, Don't look back, big boy, something is gaining
on you. And then she sighed, and ran her hands through her graying hair.
It had been a very long two days, it seemed more like two weeks.

He never did get it, did he? she asked.

I shook my head. Ike did, though, and maybe he can help. Maybe.

We cleaned up the mess and got ready for the night shift, and watched
the charge nurse walk slowly down the hall, carrying her double cheese
burger with bacon and a bag of fries.

What's new? she whispered. She looked around her at the big shot's room,
all pulled apart. Did he leave?

Carmen nodded and handed her the patient list for her shift so she could
make her assignments. Night charge looked it over and then saw that
Andy's room was empty, too. She closed her eyes for a minute, took a
deep breath, and said, Looks like we'll have more admissions.

She went to put her coat away, and her shift gathered around the
station, and another day was over. Carmen and I walked to the elevator,
rode down, and walked outside, into the early-spring night.

I'll miss Andy, Carmen said, but not that other guy. I wonder what the
chest pain was all about, anyway?

Does loneliness cause chest pain? I asked her, and she laughed.

Maybe. He'll be back with more chest pain, that's for sure, and we'll
ask him.

Chapter 13.

Wayfaring Stranger.

This is the other story Carmen mentioned at Mama Mia's, it happened when
she was a student in the diploma program at St. Joseph's Hospital. It
was 1959, and she was in her third and last year of nursing school. She
lived at Regina Hall across the street from the hospital during those
rigorous years as a student. This happened long before the University of
New Mexico Hospital or the medical school was built, and there were no
resident physicians in the house to see to patients. In those days St.
Joseph's had about 150 beds, it was a dark red-brick building on Grand
Street, surrounded by grass and trees, and had a big open portico at the
front door. The school and the hospital were run by the Sisters of
Charity. These nuns were women of an uncompromising sort of spirit, and
Carmen learned much more than good nursing from them. She learned to
observe without judgments, to watch and learn from experience. She
listened to their tart and brisk appraisals of life, caring but
unpitying. They knew that people needed care, but they also knew that
pity saps the spirit. They had a brisk, no-nonsense approach to things
like death and illness, and, with prayer, could look reality square in
the face. It was the nuns and Elam as well as Simon Tsosie who tested
Carmen's new nursing skills and lived in her memories.

He came by ambulance from Chama, a small town up in the mountains three
hours north of Albuquerque. When I saw him on the stretcher I thought,
How handsome he is! He had large dark eyes and very dark hair, which he
wore longer than the current fashion of nearly shaved young male heads.
He had a little mustache, too, which gave him a foreign sort of look,
along with the white shirt with the wide soft collar.

I had just started a month-long rotation on the emergency service. It
was the middle of the afternoon on a bright Sunday in October when the
ambulance pulled in under the portico. The young man with the mustache
had been a guest at Corkin's Lodge and had fallen off his horse and
probably broken his left leg. They had put a good splint on it in the
ambulance and tried to keep him comfortable, but he was pale and quiet.
He was trying to be brave, lying there on the stretcher, saying just
like John Wayne with a southern accent, It's nothing, ma'am, just a
knock on the head and another twist in a game leg.

When we got him into a bed and I closed the curtain around him, Sister
Ann Margaret was with me, of course. No Sister of Charity would have
left a young lady alone with a young man, even if he couldn't walk and
had a lump on his head. Sister Ann Margaret was our head nurse. We
called her Sam, behind her back. She was a wonderful tall sharp-eyed
eagle of a nurse who could hear sin being committed even when she
couldn't see it.

Wash that head so I can see what's going on. And cut that filthy pant
leg off. Her quick hands poked and prodded as she examined him while her
eyes darted around, taking in everything.

Born with this, young man? She was examining his left foot, which was
twisted slightly inward, lacking the last three toes.

Yes, ma'am. I am my mother's imperfect child.

Nonsense. A little physical therapy would help, get it stronger so you'd
never notice. Should have started right after you were born. No
imperfection would last long around Sam.

The patient, Elam, leaned back on the bed and tried to hide his foot by
sliding it under the covers, but the pain in his leg made him gasp.

Sam looked quickly at him, pursed her lips as if to speak, and turned to
me with a look.

Get the admissions sheet, Carmen. We need to get a history.

Ask me no histories and I'll tell you no lies, he whispered, eyes
closed.

Sam sniffed, and I left the cubicle and went to the chart rack, where
the ward clerk was making up new charts. The chiefs of two services,
orthopedics and neurosurgery, wrote orders for our new patient, Elam
Jefferson from Richmond, Virginia.

He lay quietly in the bed, his left foot covered with the sheet. He was
pale, the lump on his head was reddening, but both pupils in his eyes
were equal, and he didn't seem dizzy or disoriented.

I had found a little flute in the pocket of his coat, and he smiled.

A pennywhistle, for this little lame balloon man.

What happened, young man? Sam held the ambulance notes and looked at him
over her glasses. All it says here is that you fell from a horse during
a fast run. You were warned by the head wrangler at the lodge not to
ride this horse fast, that he tended to bolt. Why, with a game leg, did
you do such a thing?

Elam winked. We knew he was in pain, but he wouldn't admit it.

Had to prove I could do it, show Father.. .

Sam frowned, and brushed his comment aside. Come now, we have X rays to
take so the doctors will know what's what when they get here. Sam and I
wheeled Elam toward the X-ray department, and he was quiet, lying back
on the gurney with his eyes closed.

If he was in pain, he never said. I watched his hands clench several
times, and his mouth turned down. His fine dark eyes never showed
anything, and when they got him back on the gurney, he winked at me.

Sam clucked and told me to find the admission orders and come to the
floor and assist Mr. Jefferson into bed. They would immobilize his leg
and put a cast on the next day.

X ray wasn't too far from the emergency room, and both Sam and I heard
the scream at the same time. Elam turned his head and his eyes narrowed.

What was that? Is someone hurt? he asked, frowning.

Someone is having a hard time in the ER. Sam motioned to me to go see
what was needed. I left her with Elam and ran down the hall.

There were several patients waiting, all listening to the screams coming
from one of the cubicles, curtain drawn tight around it.

No, no, no! It was hardly a human sound, agonized. I went toward the
curtain and drew it aside to see if I was needed. There on the bed lay a
child of about six or seven, covered in bruises and blood, great
abrasions on his little legs and body, hair matted, and eyes closed.
Next to him stood his mother, now silent, great eyes fixed on her child,
mouth covered with her fist. Every one seemed to hold their breath while
two doctors worked quickly. One of the doctors looked at me and then at
the mother, and motioned with his head.

Please come with me, ma'am. It will help your child to give the doctors
room to work. I drew her aside and she came with me, not seeing. She
kept shaking her head, whispering Tommy over and over. I pressed my lips
together and looked to the ceiling for the guidance that Sam said was
always there. We stood to the side of the cubicle, and she began to
shake with sobs. I put my arm around her, and held her, and let her cry.
There wasn't much else I could do, except make soothing sounds and pray.
I felt pretty useless, until an older woman came running into the
hospital straight toward us.

I'm her mother. Where's Tommy?

1 motioned to the cubicle. They're in there with him, the doctors and
all the emergency team. We need to let them work. A call went over the
loudspeaker for another doctor, and I could feel the intense silent
activity behind that curtain, around Tommy.

Thank you for being with her. I'll stay now. Tommy was on his bicycle,
right in front of their house, when the car hit him. Right in front of
their house. She rocked her daughter and wept, repeating, Right in
front, right in front. Then she brought her head up and looked at me
with a plea in her eyes. Please let us know what's happening, will you?

She walked, holding her daughter's shoulders, to a bench and helped her
sit. I followed them with the woman's blue sweater, which had fallen off
when she stood by her son's bed, and put it over the younger woman's
shoulders. It was missing a button. I stood quietly for a minute,
wishing there were more I could do, more I could say. I nodded at the
boy's grandmother and went back toward X ray. Sam and Elam were making
their way slowly down the hall. Sam looked straight at me with a
question in her eyes.

Sister, they'll need you in cubicle two. Automobile accident. I must
have looked pretty stricken, because Sam let go of the gurney and ran. I
took a deep breath and asked Elam how he felt.

Not too bad. Pretty numb, actually. My head hurts, my leg hurts, and I'm
not sure where I am. But you, angel of mercy, look terrible.

He looked up at me with concern in his large dark eyes, and I started to
cry.

There's a child in there, unconscious, all cut up .. . his mother..

Elam took my hand and reached up and put his finger across my lips.

Don't, don't. Please don't. I want to see you smile, not cry. Can you
take me to a room, and a real bed?

I made myself stop crying and looked at his chart. He would be admitted
to orthopedics on the fourth floor, and would be observed for head
injury. All precautions and orders were clear. We made our way to the
elevator, and the ER orderly came with me to help move Elam to his
hospital bed. As the door opened Elam turned and looked down the hall.
There was the young mother, standing in front of the doctor, who kept
shaking his head and shrugging. She bend her head and took her mother's
arm as if she would fall. The door closed quietly behind us, and we rode
up the elevator in silence. Elam held tight to the side rails of the
gurney and I heard him whisper to himself, Hospitals. Why hospitals? I
came to find the west and all I see is a hospital.

Orthopedics came early in the morning and put the cast on, frowning at
the left foot. No reason for that in this day and age, should have been
looked after long ago. He spoke gruffly, as he wound strips of wet
plaster of paris around the leg. Elam never winced during the whole
procedure, I was there, holding the basin of hot water and watching
plaster drip on Orthopedic's boots.

Too busy, they were. Too busy worrying over Aaron. You see, he was
perfect, and I was the darkling child. Always the broken butterfly, the
wounded bird.. . Elam sounded confused. He lay back, pale and exhausted
until the cast was done. The doctor wiped his hands, looked at his
plaster-covered boots, and nodded to me and the nun who was assisting.

Keep him quiet, Sisters, and feed him. I'll look in on him tomorrow.

Orders are on the chart. He looked around the room. Family here?

No, sir, they're.. .

Not here yet. Went to visit the senator in Santa Fe. Putting their faith
in princes, Elam murmured, feeling the effects of some painkillers we
had given him. Orthopedics grunted and walked out of the ER, muttering
something about politicians.

Neurosurgery came, too, did the full exam, and frowned. He had recently
come from Germany, and his assessment was, Also? There is going on
something. What the something was we didn't see, Elam was alert and
complained only fitfully about a mild headache. He asked me several
times if I had any news of the injured child and all I could tell him
was that Tommy was on the pediatric ward, still unconscious, his mother
always in the room.

The next day we got him a wheelchair. Elam wanted to see everything in
the hospital, and prowled around in his wheelchair with his left leg in
the cast sticking out in front of him. He wandered in and out of the
cafeteria, the gift shop, the emergency room, all over the first floor.
I was with him when he saw Tommy's mother sitting in the pediatrics
waiting room. He stopped and looked at her. They were about the same
age, and he wheeled slowly over to the door and sat there, looking in.

She's so young. He said it in a whisper. What's going on with her son?

I shook my head. Elam, I have to go on duty. I'll find you in your room
at lunchtime. I gave him a pat and he smiled up at me.

Go on, I'll be fine. He looked back at Tommy's mother, who sat with her
head in her hands. The last I saw, he was moving slowly into the waiting
room, drawn to that still, tense woman.

When I got up to his room at noon, he was sitting up in bed, his lunch
tray in front of him, staring out the window. He hadn't eaten anything.

Elam, aren't you hungry? You need to eat.. .

She's a widow. He looked up at me and there was pain in his face. She's
only a few years older than I am. Her husband was a firefighter and was
killed in a forest fire in the mountains when Tommy was two years old.
Her son is still unconscious .. .. .. He grabbed my hand and held it
tight. We sat there, him staring out the window at the golden trees and
me looking at him, listening to him. Why is there such pain, why does
everything turn out so very badly?

He spoke more to himself than to me, and that was fine because I
certainly didn't have any answers to that question. Neither did anyone
else I knew. We sat quietly, then he took the fork and began to eat.
There was a little smile on his face, and he patted my cheek.

It's good to have you here, Cannen.

He closed his eyes and frowned, and rubbed his head. It was then that I
noticed the second bruise, behind his left ear, a small bluish mark,
hardly a lump, but he winced when I touched it lightly. I added a
sentence to the physical findings on the chart, signing my name as usual
with SN after it, for student nurse. By now it was afternoon, and unless
Sam found me, I would be back during his supper to visit him again. The
afternoon flew by, and I walked into his room just as the sun was going
down, but Elam wasn't there. His bed was empty, the wheelchair gone. For
a minute I felt a hammering in my chest and wondered what had happened
to him, then told myself to calm down.

He's off wandering again, I'll bet. Down the hall, into all the waiting
rooms, down to the ER, in the gift shop. No Elam. Finally I heard a
sound, a soft sound, a soft, terrible sound coming from the pediatrics
waiting room. Tommy's mother was there, on the couch. Elam held her hand
and looked intently into her face. She held his hand tight, her other
hand over her eyes, weeping. He stroked her hand and didn't say
anything, but when he saw me, he closed his eyes and shook his head. I
saw the doctor go around the comer in his white coat. He was a tall man.
He walked with his shoulders stooped, moving slowly. He had not brought
good news to this room tonight.

We sat with her until her mother came, and we saw fresh pain. I found a
box of tissues and left a message for Sam at the desk. I left them
sitting there, Elam in his wheelchair, head down, holding his fore head.
I had heard that working in the emergency room was difficult, but not
impossible. As I left to go to Regina Hall, impossible was the only word
that fit.

I returned after dinner. I wasn't on duty, but there was duty to be
done. I found Elam alone in the same waiting room, sitting in the dark,
tears pouring down his face.

She's all alone. Her mother is with her, but she's really all alone.

All by herself. He wiped his eyes almost angrily. I know all about that,
you know. It's a familiar feeling, never out of sight for long. He put
his head in his hands and murmured, So alone. We're all, so alone.

I remembered that Elam's parents hadn't appeared yet. They had sent word
from Santa Fe that they would be coming to the hospital soon, but it had
already been three days. I stroked his head and wondered, Is he weeping
for the young mother, or himself? Or both? Or all of us?

Two days later Elam's leg was doing fine, the X ray showed good
alignment, but I sensed something else. He seemed smaller, quieter,
after Tommy's death, as if there had been another wound. Neurosurgery
kept coming in and testing him, having him make faces and tell if things
felt sharp or dull on his skin. After the tests Neurosurgery would put
his long finger on the side of his nose, shake his head, and mutter. We
were finishing with the noon meal, and suddenly the cubicle curtain was
flung aside and a tall, thin man with a thundercloud of a face stood by
the bed, hands clenched and jaw working.

So here you are, after your little stunt on that horse. The voice was
low, southern, and angry. I've had to interrupt my meetings with Senator
Anderson, thanks to your foolishness.

Elam saluted feebly and tried to smile. Did Miz Blanche come with you?

Her name is Lydia, you imbecile. Why do you call her that ridiculous
name from that ridiculous play?

Mr. Tennessee Williams would disagree, sir. She's a perfect Blanche.
Perfect. Elam turned to me and Sam and bowed his head.

Meet the Master, ladies.

Let me apologize for this young man's behavior, ma'am. The tall
gentleman turned to Sam and bowed. Next, a woman's voice came clear as a
bell across the hall, Where is my baby? Where is my poor wounded bird? I
demand to see him.. ..

And here comes Blanche, right on cue. Elam smiled, but his eyes were
full of pain. I couldn't tell what caused the most pain, his leg or his
family. Mrs. Jefferson appeared beside the tall gentleman, all flounces
and silk bows and perfume.

Oh, my poor baby! What did that horrible horse do to my poor child?

It wasn't the horse's fault, Lydia. Mr. Jefferson held her hands away
from Elam. Do be quiet. Elam brought this on himself. He never should
have ridden at all, with his foot in that condition. Now it's worse, his
leg is broken and the foot will be worse than ever.

Worse, how worse? It was terrible to begin with, my poor I must insist
that you wait in the lobby, please. Your son will be fine. He has two
fine doctors and his leg will be well looked after. You can speak to
them presently.

Sam bustled out, taking Mr. and Mrs. Jefferson by the hands and broke
one of her rules again. She left me alone with Elam, probably figuring
that he was the lesser of the two evils. He was in no shape to sin.

He laughed, a bitter sort of sound. Massa and Miz Blanche make a fine
pair, worrying about their poor crippled child. What will they tell
their friends back home?

They sounded worried, that's all.

Oh, yes, they worry. They worry that I won't finish my master's degree,
and then I'll have failed them again. Since the perfect son is dead, I'm
all they have to carry any fading dreams of social ascen dance. He drew
out the last few words in a mockery of a southern accent.

Perfect son? Who is that? I asked. You mentioned him before, as if you
were less than he was, ugly. But you aren't ugly, Elam.

Elam closed his eyes and shook his head. His name was Aaron. He was born
in 1932, four years before me. From the beginning he was perfect. Tall,
strong, handsome, great athlete. From the beginning I was not perfect, I
was crippled. He was blond and smiling, I was dark, perhaps a little
grim. Elam looked into middle distance, remembering.

I sat quiet, waiting and watching the bleakness in his face.

Grim because I knew that my parents would rather look at him.

They were charmed by him, everyone was. There wasn't anything he
couldn't do. But evil times came to paradise, and when he was at VMI, he
flunked calculus. He decided to enlist in the army and not wait for his
commission. He went to Korea and was killed in 1951. He was perfect,
then, perfectly dead. Elam started to laugh and then he cried.

And the poor, poor Jeffersons were left with their little lame man.

He sighed and looked up at the ceiling. Hard times, little one. Hard
times.

We sat for a moment in silence, thinking hard thoughts.

Do you ever talk to your parents about it, how you feel? Have they ever
shared how they felt, how much they must miss him?

Elam looked at me, and leaned over and stroked my cheek, watching his
finger trace my face. Never, wise one. Never.

But why? It would have done you all good, to talk about it, comfort each
other.

He nodded. In a real, imperfect world, yes. But not in my father's
perfect universe. Never admit defeat, never say you hurt. It just isn't
done. He gave me a rueful comic look, and crossed his eyes. I laughed,
wanting to cry. So we soldier on. Lousy choice of words, my dear.

We soldier on and try to live and pretend that all is well. The three of
us, unable to talk, unable to walk, limping into the future. He lay back
and sighed. It does me good to tell you. It warms this old heart.. .

He put his hand on his chest and I laughed.

Elam, you're only three years older than I am. What do you mean , old
heart.?

Old, old. He tried to look serious. Old in pain, not in years.

I shook my head at him and stood up to get back to my work, but he took
my hand and held it. Lovely lady, what are you doing in this place of
these putrid smells and blood and dirty bandages? You should be dancing
and wearing pretty clothes and perfume, with seventeen gentlemen callers
all begging for your attention.

I laughed, and thought of his mother. No silks and bows and pretty
things for me. I'm a student, just like you, but nothing as grand as a
master's degree, just this. This I love .. .. .. I looked around the
ward, at all the familiar instruments in the white wood cabinets behind
their glass, all the familiar noises and equipment. I belong here. And
I'll graduate in the spring!

Elam smiled and I thought again how handsome he was. Then I heard the
heels of Sam's black shoes hitting the floor like pistol shots and tried
to snatch my hand away. Elam held it tight, put it on his forehead, and
looked mournful.

Elam's parents are going off to the coast on the Super Chief, Car men,
and the doctors are here. You have other patients and duties to attend
to .. .. ..

Yes, Sister. I smiled at Elam and left, walking past Elam's parents in
the lobby. Elam's father looked bored, his mother was still fluttering.

My poor little boy, my broken butterfly .. .

Mr. Jefferson closed his eyes and probably his ears, and they walked out
the door. His back was straight as a post, but there were deep lines
around his mouth. I wanted to tell him to go talk to his son, but some
thing in the way he held himself kept me away.

Elam lay in the bed, casted leg elevated, playing solitaire and reading.

I sat with him sometimes. Actually, I was with him every chance I got.

He told me about his reading, and why he liked plays.

You see, Laura, in a play I can be someone else, someone finer and
taller, possessing direction and a reason to be. He looked away, at the
wall. I do not have to be crippled, or the second son.

Why do you call me Laura and not Carmen?

He looked straight into my face and took my hand. Because as Laura, you
can leave here and come limping with me into a stage land, a
make-believe, a perfect place. Carmen has to stay here and wash my dirty
feet. He laughed then, a strange laugh that made me shiver. He looked
down at his toes sticking out of the cast, and wiggled them.

I thought Elam was the most wonderful young man I'd ever seen, of those
few I knew. He was handsome and he paid close attention to me, something
no young man had ever done. But there was something about his need for
make-believe and acting that made me uncomfortable. I understood it-he
didn't like where he had been put in this life, plays and dramatics
could make that different, for a while. But I knew that he would have to
return to his real life, he would have to live his life, and make the
best of where he was. I didn't really like his avoiding it all the time,
and giving his parents different names. They were who they were, and
that was that.

Elam could read my mind sometimes. He looked seriously at me and said,
Carmen child, you think I'm trying to escape, don't you? You love this
reality, so you can't imagine anyone wanting to playact all the time. He
stroked my cheek and smiled. You should have seen the fish I caught in
Chama. It looked like a rainbow in the morning light, and they cooked it
for my breakfast. I'd like to go back there.. .. And then he closed his
eyes and said, I'm tired, Cannen. Very tired. And I have a headache.

I left him to sleep and went to tell Sam. We watched him for several
hours and Sam called Neurosurgery back in. This was not sleep, it was
like death. The doctor agreed, and we waited for another hour. And then
Elam woke up, after his ten-hour nap. He looked around, frightened, as
if he didn't know where he was or who he was. He cried out, and grabbed
the bedclothes and held up his arms as if to protect himself from
something. Sam was sitting by the bed and soothe him, and called for the
chart. Elam didn't struggle, but he seemed to be tense and upset.

Sam called me into the room. He keeps asking for Laura. Do you know what
he means?

I put my chin up and said, Yes, Sister. He calls me that sometimes, when
I'm sitting with him. It's a name from a play he likes. It seems to
quiet him and he doesn't fidget so much when he calls me that.

Sam looked at Elam and back at me. She was more nurse than nun
sometimes, and this was one of those times.

Sit with him, Carmen. Keep him quiet. I don't like what I see.

So I sat, and Elam woke up again and smiled, and went back to sleep.

He slept more and more now, agitated unless I was at his bedside. I
learned to notice little things. I noticed the way his hands clenched
and his closed eyes moved under the eyelids when I moved away from him,
I noticed how sometimes he seemed cold, and we covered him with
blankets, and then an hour later he would sweat and throw the blankets
off. His blood pressure was a constant worry, never stable. He would
mutter and frown, irritable and agitated. Sometimes he lay like a corpse
three days dead, and other times he was never still. Sometimes he was
awake for hours and hours, unable to sleep.

And then after a couple of weeks, he didn't wake up at all. He kept
sleeping, sleeping, as if to say, Your world is too sad and bitter, so I
will sleep now. The doctors came, went, did their tests, and shook their
heads.

Then Elam started to have seizures. Neurosurgery came in and told all of
us that Elam had a blood clot in his brain. It had to be removed, and no
one could predict the outcome. We all knew that, but it was hard to
listen to the doctor saying it. We got him ready for surgery, as he
slept we prayed and talked to him, and told him that we would be waiting
when he got out. We were, and all the student nurses went to mass
several times the day he was in the operating theater, and we were
quieter than usual. No one suggested hiding pizzas in the dorm from Sam.

When he came back to us from the recovery room he lay in a coma, still
sleeping. We cleaned him, bathe him, and kept him nourished with the
intravenous line. But he got thinner, a little gaunt. We read to him,
and sang little songs. And we prayed, boy, did we pray. Prayers like
white light surrounded him. His parents, back from the coast, came and
went from Santa Fe, staying only a minute or two. Mr. Jefferson stood by
Elam's bed, jaw working, never saying anything. His hands were clenched
on the bed rail as he stared in silence at his sleeping son. Mrs.
Jefferson cried all the time, and watched us bathe and care for her son.

She never offered to do anything, but kept saying, I'm not strong, I'm
not strong enough. Then one day they stopped coming.

Had to leave. Had to go back home to tend to business. Both of them,
gone without a fare-the -well, Sam said crisply one morning near
Thanksgiving. It had been about six weeks since Elam's admission, and
the world was bare and cold. No more yellow leaves on the trees outside,
the lawn had turned brown, and we could see the bright blue sky through
the bare branches of the trees.

Are they coming back, Sister? I could not imagine them leaving him here,
with us, complete strangers.

They've arranged for a family in North Carolina to take care of him, if
he wakes up or not. It's theirs to decide. We will do as they wish.
Crisp, blunt, realistic, that was Sam. She bustled about, as I stood
silent at the foot of his bed, tears running down my cheeks.

Here now, missy, we'll have none of that. Sam shoved a tissue in my hand
and gave me a push. Out, do your work. That's the best antidote to pain
that there is. Besides, she said tartly, you can't read a thermometer
with tears in your eyes. Remember, you have evening duty in the ward,
Carmen. Get back to work.

I said, Yes, Sister Ann Margaret. I knew I didn't have ward duty, but
Sam knew that work was what I needed. And I was beginning to learn.
Slowly.

Elam woke up about ten days after his parents left. I was sitting by the
bed, reading David Copperfield to him. The nuns believed that an
unconscious patient could still hear, so we talked to Elam, read to him,
and generally behaved as if he could hear while we bathe him and
performed our nursing duties around him. We had gotten quite a bit of
the way through the book while he was asleep. When he opened his eyes I
was so startled I couldn't move. He looked puzzled at first, not afraid.
He looked up at the ceiling and then moved his head a little to the side
and saw me. He couldn't move his head much because of the bulky
bandages, but he put his hand out and took mine.

Put the book down, he whispered. I've had enough Dickens.

I've got to go tell Sister, I whispered back, but he wouldn't let go of
my hand. I punched the call button and Sam came into the room, crucifix
and beads rattling all the way down the hall.

He woke up, Sister! He woke up and he heard all of the book I've been
reading!

Of course he did, and it's about time.

Is it a miracle, Sister?

Hnimph, said Sam. It's his own strength and some good nursing, that's
all. But she made the sign of the cross anyway, thinking I didn't see.
She also checked his toes sticking out of the long cast, and covered his
foot with a blanket.

Bring the chart, Carmen. I'll note the change and you make sure his
parents are notified by the doctor. They'll want to know their son is
awake. Sam spoke firmly, hoping that saying it would make it true.

Elam smiled.

Awake and still imperfect, unfortunately. No miracles there.

Perfect is as perfect does, young man. Don't dwell on your foot, just do
your work and use your brains to look after other people. She looked
over her rimless glasses at him and I went for the chart, knowing how
important looking after people was for Sam. It had rubbed off on me and
all my classmates, it was that important. Elam would do well to listen.

He stayed with us, his leg healing well, his head perhaps not so well.

Orthopedics was satisfied, but Neurosurgery frowned. Elam would laugh at
odd moments for no reason, and say things that made us students blush. I
knew that head-injured patients acted like that, but I didn't want Elam
to be like all the others. He still called me Laura, and sometimes he
even called Sam Big Mama. He called Orthopedics Big Daddy all the time,
which made the doctor frown.

He would get restless, and as soon as he could, he got back into a
wheelchair with his left leg sticking out straight. He cruised up and
down the halls. He looked like a wounded soldier, with his leg in a cast
and his head wrapped in bulky bandages. He wore a silk robe, and
sometimes put a flower in the head bandage so that it stuck up like a
talisman on a helmet. His eyes, those fine dark eyes with the long
lashes, were restless, too, and he looked everywhere, at everything. He
watched the nuns as they glided by with their long skirts. He wondered
about the high crown of the habit, the veil flowing behind. He said it
looked medieval. He watched the lay nurses, and of course the students.
He whistled at us, and made us blush, and the nuns had a hard time
making him behave.

Life is to be enjoyed, not hidden, not despised, he would say, and they
clucked over him, poor young lad so badly hurt. They clucked and shook
their heads, and warned us to stay away from his wheelchair.

He grabs, was all Sam would tell us, and shooed us away. They all do,
poor lambs with their inhibitions destroyed by the blow to the head. Of
course what he was grabbing was the anatomy of the students, anything he
could reach.

He never grabbed me. He was gentle and kind, and liked to sit in his
room, or out in the solarium in the sun and have me read to him. He got
a headache if he read to himself too long, so he found books for me to
read. He liked the plays of Mr. Williams, and never tired of listening
to The Glass Menagerie. I caught him often saying, Things have a way of
turning out so badly.

One day we got a call from pediatrics. The nun in that unit was small
and blue-eyed and breathless, and she said to Sam, Oh, thank you for
sending Mr. Jefferson down to entertain the children!

Sam looked at me and I looked at her and we ran to the elevators and
went down to pediatrics. There was Elam, in his wheelchair, playing his
pennywhistle and rolling along like the Pied Piper, singing songs for
the children, who followed in a ragged line, laughing and singing.

Elam had played Cat's in the Cradle for them, and began a long talk
about holidays. The nuns had put some charts and pictures about the
different foods that people ate on the bulletin board. They used it to
teach the children nutrition, and Elam was teasing them.

Thanksgiving! Oh, yes, that's when you eat lots of colored eggs and have
chocolate bunnies and jelly beans! he announced triumphantly. All the
children laughed and booed and said, No, no, that's Easter! So he looked
comical and put his finger on his nose, and replied, Easter is when a
big fat man in a red suit and white beard comes and brings you lots of
valentines and chocolate hearts! And he laughed and laughed as the
children hollered, No, no!

Don't you know anything? One little tiny girl with great brown eyes came
shyly up to Elam's chair and handed him a small white feather. He took
it with a bow, and said, Ah, my small Roxanne, the white plume of honor!

and he stuck it in his bandage.

Sam watched Elam with the children and they with him, and said
sorrowfully, We lost a fine teacher when Elam Jefferson was thrown from
that horse, Elam walked out of the hospital ten weeks after he had come
in on the ambulance from Chama. He had come in the bright golden days of
mid-October, with the trees turning and warmth still in the air. He
would leave in bleak January. He stood at the entrance to the hospital
in the cold winter sunshine, blinking and looking around him.

It's no longer warm, Laura. It's cold. He looked at the bare trees and
felt the cold wind. He held a cane in his left hand, a strange sort of
twisted cane with a big knob for a handle. One of his friends had
brought it to him from Taos.

The yellow cab was there on the street, waiting to take him to the train
station. He turned to me and took my hand. He wore a tweed hat with the
little white feather in the brim. It was curved on his forehead, hiding
most of the bandage wrapped around his head. He wore his coat like a
cape around his shoulders, and the white shirt with the flowing sleeves
that reminded me of pirate movies. He leaned heavily on the cane and
shrugged his coat closer around him as a gust of wind whistled through
the front portico of the hospital.

He bowed over my hand and kissed the tips of my fingers as he looked
straight into my face with those wild dark eyes.

I won't come back, Carmen. And if I do come back, it won't be me. He
looked frightened, despairing. I'm not the same anymore.

I'm less and more and who knows who I am? I don't belong to myself
anymore.

I looked into his dark eyes. They showed the strain of keeping a tight
hold on himself, and the fear of the unknown road ahead of him.

Carmen, be kind and take good care of other poor souls like me, lost and
alone. But keep care of yourself, and guard the sweetness in side.

He kissed my fingers again and brushed my cheek with the back of his
hand. I'm just a lonely sojourner now, a wayfarer dependent on the
kindness of strangers.

He walked to the car and stopped, looking around him at the hospital,
and the bare trees. He looked for a long moment at the wide empty blue
sky. He turned and saluted me, and then opened the door of the cab and
got inside, in the backseat. The driver put his bag in the trunk, and
got behind the wheel, and they pulled away from the curb. I watched
until I couldn't see them anymore, and then walked back to the hall,
feeling cold wind around me all the way.

Chapter 14.

The Moving Circle Closes.

This is one of my stories, too. I told the first one, and I'll tell the
last one. We are coming to the end of this road, but there are other
highways that we all must walk. On each of those roads there are
friends, wise people like Mr. Wheelwright.

There was something about this patient, something about his strength,
his wisdom, and his stability that lingers with me. There was something
about how he explained life to Al Rocco that made me feel that I was a
Part of his center, his solid ground. I have to tell his story and
Reben's. I can't leave them out. Nurses always learn from their
patients, and I was luckier than most. I was given Joe Romero to take
care of, as well as this old man. I was also given Ruben and I found
mystery as well as grace. I learned that sometimes you can't ask for
answers, you just listen to the questions.

Let me tell you a story about an old man and a young man, and what I
learned from them. it's funny how you learn about life from taking care
of the dying. Sounds odd, but it's simple really.

The old man's name was Robert Edward Wheelwright. He came into the
hospital diagnosed with emphysema and heart complications. I was on duty
then, three-to-eleven shift, and I figured he'd be just another lunger,
old, skinny, skin the color of tobacco, and lungs all shot to hell.

I must have been tired that night because I don't really remember
admitting him. It was late and he was my fourth admission, and my back
hurt, and we were two nurses short as usual.

All I remember was a tall old man, skinny, just like I thought. He was
thin and his skin was papery dry, his fingers clubbed and wide at the
ends. When I listened to his chest I wrote on the admit chart, wheezing
on expiration, but that didn't tell the story. He sounded terrible,
noisy and wet, and the wheeze at the end of each breath sounded like
pain. I finished the admission, noted how late it was, and asked him if
he would like to have the TV turned on, I gave him the regular hospital
drill about meals, and no electric shavers and visiting hours, and he
listened quietly, and then he said, I've been here before, missy. I know
the rules.

Tired as I was, I missed the smile and the twinkle. All I wanted to do
then was finish my charting and leave. I put Mr. Wheelwright's chart in
the rack and stretched.

Done with your report? Margaret was as tired as I was. I had made the
coffee for the night shift, made sure that all my patients were tucked
in and settled, and turned in the key to the narcotics cabinet. It was
time to leave. The hall was dark and quiet, the only noises were the
little beepings from the IV machines, the voices on a television program
down the hall, and the squeak of night-shift nurse's shoes on the floor.

I collected my coat from the locker and walked out the big double doors
to the elevator.

There would be time to get to know Mr. Wheelwright.

Nice day off, not long enough. When I went back on duty at three in the
afternoon, things were pretty much the same. Mr. Wheelwright was there,
reading his paper, watching everything that went on around him. He had
bright blue eyes, the kind that looked like cracked glass.

He never asked for anything, his light never went on, and he took care
of himself pretty much. The docs  did their tests, and it seemed that he
had some kind of blood problem as well as the emphysema and heart
difficulties. In between tests and breathing exercises, he told us a
little about himself and how he felt about things. When he talked it was
slow and quiet because he didn't have the energy to talk fast or get
excited.

I had the feeling that he would have talked the same way, though, even
without the labored breathing. When he talked, you listened carefully,
not only because it took a long time for him to explain things, but also
because he was so interesting. Talking to him while we were cleaning
around in his room or bathing him sort of quieted us down, too. We felt
calmer after spending time with Mr. Wheelwright. He told us that when he
was a young man he had worked on the railroads. He would tell us those
old stories and his eyes would get brighter, and we tried to imagine him
as a young man with black hair and strong muscles, working on the
railroads in Chicago, where all the trains met.

He lived in Albuquerque, over on Durango Drive across the river. He had
come from the midwest in 1944 because he had gotten tuberculosis and the
doctors removed a lung, which is why his breathing was so bad.

He had never smoked, just got TB when he was about thirty and nearly
died. Lots of people came to Albuquerque then for TB, expecting to die
but getting better in the bright high desert sunshine. He and his wife
built a house on the bluff overlooking the valley on the west side of
town. He liked to watch the city grow and told us about watching the
lights at night from his back porch. His wife had died years before, and
he didn't talk much about her. He had no pictures in his room, no
reminders of anyone. We never asked about children, and he never said.

One day he got a roommate, a twenty-five-year-old man whose name was
Ruben. He was admitted with a tentative diagnosis of liver cancer, which
is really rare and strange in a person his age. When we admitted Ruben,
I nearly blew it by assuming that the docs  had told him what was wrong.

So what's a big tough guy like you doing here?

Then I saw written on the doctor's admission notes the words patient is
not yet aware of possible diagnosis. Why hadn't they told him?

Ruben was a handsome young man, his face was long and lean like the
paintings of the old Spanish conquistadores. His eyes were wide and
clear and full of laughter.

I've been really weak, he said, and I fainted on the job a few days ago,
and they're doing tests. Nothing wrong with my appetite, though!

Ruben was sitting up in bed, eating a regular meal, double portions.

He was on bed rest, no walking, no activity, but everything else was
fine. No intravenous lines, no meal restrictions, just fine.

Mr. Wheelwright laughed. You're about as well as anybody in the world.
Maybe those docs  are testing your appetite?

He and Ruben played cards, and the old man shared his newspaper and
visited with Rubeii's parents. Ruben's mother used to make us cookies
and call us the angels who are taking care of my boy. They were little
people, very proud of this tall handsome son. And if they knew something
was wrong, they never said. Mrs. Baca hugged Mr. Wheel wright every time
they came, and once they brought him a pair of slippers. Ruben was a
wonderful patient, just like his old roommate, never asked for much and
only put his light on when it was necessary, and then he apologized.
Ruben's parents had told Mr. Wheelwright what the doctors had told them
about the diagnosis. He didn't like the fiction we were all carrying on
any more than we did.

It's not fair not to tell him. The sparkle was gone and his eyes were
sad. He needs to deal with that. I can remember how it was when I got
the tuberculosis, but I had to know. So does he.

Ruben's tests were finally done and the diagnosis was certain. He had
cancer of the liver and probably had about six months to live. The
doctors were going to discuss it with him on morning rounds and let him
know that even though he felt fine now, the cancer would start to show
fairly soon, and he needed to make some decisions about treatment. His
parents had talked to the doctors, and we saw them the evening before
they were going to tell Ruben.

Mr. Baca never said anything-he didn't speak much English-but Ruben's
mother was trembling.

What will he do? she kept asking over and over. What will Ruben do?

We all knew that he had some good quality time left, if he could handle
it. He seemed to be a strong, thoughtful young man, and we all waited to
see what Ruben would do.

That night I left at midnight, after saying good night to both Ruben and
Mr. Wheelwright. Ruben was fine, as always, playing cards with Mr.
Wheelwright, who seemed a little quieter than usual.

See you guys tomorrow afternoon. Don't give the day shift too hard a
time.

Ruben laughed. Maybe they'll let me out tomorrow, if they can't find out
what's wrong with me. Besides, I've had enough hospital food.

I want some beans and burritos.

I went out the double doors and down the elevator, trying to think about
something else, and hearing Joe Romero tell me how much he had wanted
real burritos, too.

The next day was grocery shopping, so I managed to keep busy until it
was time to go to work. I almost called the floor at noon, but didn't.

At 2,30 I was in the front door, up the elevator, through the double
doors, and everything seemed normal. End-of-shift stuff, busy, phones
ringing, a new admit down the hall. The big wagon with the dirty lunch
trays was in the hall, X ray was doing a portable in one of the rooms,
Phannacy went clicking by with a carl Nothing different.

On the wall next to the nurses station the ward clerk had put the log
sheet for our shift, showing where each patient was. The charge nurse
used that sheet to make her assignments, so I took a peek. My eye ran
down the log. Every one was where we had left them the day before,
except for Ruben. The space for bed two in room 516, Ruben's bed, was
empty. Mr. Wheelwright was in bed one, so that was still the same.

Had they moved Ruben off the floor?

Where's Ruben? Discharged?

The ward clerk was trying to answer two phones and had a pencil in her
teeth and a wad of new orders in her hand. I waited while she untangled
herself and whispered to me, He died.

For a minute I thought she was kidding. Died? Sure, he had a very
serious disease, but it was early yet and there had been no signs of any
obstruction or other problems. Died?

Died? What do you mean, died?

Susie looked at me like I was crazy. A nurse for about a hundred years
didn't know what died meant?

They did rounds this morning and told him what he had. He said he'd be
dead by noon, and he was. Just like that. Marcy went to bring him his
tray at noon, and he was dead in the bed.

Mr. Wheelwright. What a day he must have had. I went down to his room.
The door was closed, so I opened it and walked in.

He was lying there, looking out the window. They had put him on oxygen
and the tube was twisted around his head, making his white hair stick up
like a halo. He lay very quietly, his hands on the coverlet, his bony
feet sticking out at the end of the bed.

I went around and sat on the edge of the bed, and took his hand. He
looked up at me and closed his eyes, holding tightly to my hand.

He said he would do it, and he did. He told them he would do it.

They didn't believe him, he said softly.

Mr. Wheelwright looked at me with something very like anger in his eyes.
They didn't believe him. But I did. They just smiled when he told them
that he wouldn't go through all the pain and dying, that he wouldn't put
his parents through that. They patted him on the head and went to finish
their rounds, and they didn't believe him.

The talking tired him, but the anger was keeping him alert. I smoothe
his hair back and fixed the oxygen tube.

Listen, I said, you know there are strange things that happen in this
world. Don't tell me you don't. We've talked about some of them.

How you felt in the sanitarium with TB and some odd things that happened
to you. Maybe that's one of them, just one for the books.

He nodded, finally. But he wouldn't let go of my hand. There was
something else bothering him. I just sat with him, stroking his hand,
and then he told me what it was.

Why didn't he teach me how to die like that? I wanted to know. It would
be so easy, so nice and easy. No fuss, just turn around and die.

But he left me, and he never told me how to do it.

There was nothing to say to that, so I stayed with him for a while and
then went to the desk and started my shift. Nobody said much about
Ruben. We didn't put anyone in Mr. Wheelwright's room that night.

We got three admissions, but we did a nurse-person magic act and made
sure that he could be alone, at least for tonight. He came out on the
floor after dinner. He walked slowly to the window, bent over, and sat
down on the bench and watched the night come. It was fall now and the
nights were cooler, and the stars were bright. He walked back, breathing
a little better with the oxygen, and I walked him back to his room.

Ruben's parents said they would come and take me home when I get out of
here, he said.

You'll be discharged soon, I think. There are some new orders on the
chart for oxygen at home and Meals on Wheels and a visiting nurse twice
a week. You'll do fine.

He patted my hand and sighed. Oh, I expect I'll be back someday.

You be here, missy.

I was.

It was the day after Thanksgiving, and he was admitted on the day shift,
weaker, less able to breathe, dehydrated. He hadn't been eating well at
home, cooking for himself. The visiting nurse had found him, disoriented
and ill.

How about Meals on Wheels? Did you try that?

He shrugged and twinkled at me with those bright blue eyes. I don't like
meat loaf, he whispered.

It was hard to be impatient with him, he was so calm. I would rather
have him throwing things and being mean and impossible, wanting to die.
But here he sat, even thinner than before, bonier than before, looking
at me with those twinkly blue eyes and knowing that I understood.

Who wants it? Who wants life like this? Since I can't die quick, I'll
die slow, but it'll happen. Sure as taxes, it'll happen.

The doctors had ordered a special treatment for him, TPN, a liquid
intravenous infusion that gives a patient lots of protein and
carbohydrates and vitamins when they are too weak or too ill to eat
much. They were hoping to build him up, but he knew better. He watched
me hook it up to the intravenous line in his neck and shook his head.

Look at that bag. Looks just like cat barf, but they say it'll do me
good. That's meat and potatoes, eh?

I laughed. It was a plastic bag full of a brownish liquid and didn't
look appetizing, but it gave him the nutrition he needed. It dripped in
slowly and he watched, shaking his head at how plastic bags that looked
like cat barf would make him better. I cleaned up in his room and put
things away and looked at the empty bed next to him.

You'll probably get a roommate this shift or later on tonight. How do
you feel about it? I wanted him to talk to me, I needed for him to talk
to me.

He looked at the bed and nodded.

I expect so. No bed stays empty for long around here. Wonder who it'll
be? Not someone too young, okay? I know I'm two years older than God,
but you could find somebody closer to my age this time, couldn't you?

I nodded, crossing my fingers. We couldn't plan on what came in those
double doors.

What came in was Al Rocco, a sixty-five-year-old man being worked up for
cancer of the colon. He was from Las Vegas, Nevada, and was living here
with his daughter. He was tough and strong and told jokes and played
cards and called everyone kid. He told the docs  that nothing they did
to him could scare Al Rocco. He had been through Korea and had been a
prisoner of war there for two years, he had seen it all.

Hey, kid, you've got to go to Vegas. He found out I had never been
there, and while he sat up in bed playing solitaire, he told me about
it.

Everything's for sale. They got breakfast a mile long for a couple of
bucks and change.

Mr. Wheelwright was sitting up in bed and watched Al put the black ten
on the black jack and he winked at me. I was interested in why Al was
cheating at solitaire, but Mr. Wheelwright was interested in Al, whose
brown eyes kept shifting to the door, watching for the docs .

The next day I came in and checked my patients, and Al Rocco was very
quiet. Mr. Wheelwright was watching him, and looked at me with a
question in his eyes. I nodded. The tests had been positive, and the
docs  had told Al what he had and scheduled him for radiation and then
surgery. Al was lying in bed, not eating, not cheating at solitaire any
more, just lying there, staring at the ceiling. He wouldn't talk to
anyone, not even his daughter. This went on all day, and that evening I
was in Mr. Wheelwright's room, unhooking the TPN and fixing the
dressing, when he turned to Al.

Hey, fella. Are you scared?

Al turned and looked at Mr. Wheelwright and didn't say anything.

It's okay to be scared, you know. Most of us in here are pretty scared,
them giving us cat barf and all. He looked up at me and winked and
slowly, carefully, turned in the bed and sat up, his long bony legs
dangling to the floor. He sat there for several minutes, breathing
slowly, gathering his strength. He stood up and sat down on the edge of
Al's bed.

I need to tell you something, something that someone told me when I
first started coming in here. He took the menu from the bedside table
and groped for something in the pocket of his dressing gown. He found a
small stubby pencil, and with his gnarled bony hand he began to draw.

You see, you start here, when you're born. Mr. Wheelwright drew the
start of a wobbly circle on the back of the menu with that short stubby
pencil and then he said, And then you grow up and you get married and
you have kids and then you get older and you retire. And then your wife
dies. He closed his eyes, the shaky circle stopped for a minute, and
then he continued. And then you get a lot older and then.. . The circle
had almost come to an end.

And then, he said, you die. And it's done. The circle is done.

He finished the circle carefully with his stubby pencil and put the menu
in Al's hand. And then it's finished, like it should be.

Al traced the circle with his own finger and looked up at Mr. Wheel
wright. I remembered Joe Romero. He would have laughed and said, There's
another target, like all of us with the war paint in radiation!

And Ruben would have smiled.

I cleaned up the TPN and went out to do report for the night shift,
thinking how I would tell them about Mr. Wheelwright's circle.

Then Mr. Wheelwright went home again. It was Christmas and the New Year,
and we had Al Rocco admitted several times, sick from the treatments.
But he did fine and still cheated at solitaire and laughed a lot.

What else, doll, he said, what else can you do?

And then one day when spring came to the desert and the wind blew and
the trees were green again, Mr. Wheelwright was readmitted. He looked
older, a hundred years older. He was so thin his bones felt like brittle
sticks under his clothes. His face was gaunt and his cheekbones and
forehead looked shiny in the harsh hospital light. His breathing was
shallow and his one lung sounded full of something.

But he winked at me. I still don't like meat loaf, he whispered.

I laughed. I knew a patient once who hated lime Jell-O.

Mr. Wheelwright approved. Good man. You shouldn't give a sick person
lime Jell-O. Hospitals are no place for sick people.

But he was sick, very sick. We gave him TPN again, but even our favorite
cat barf wasn't going to help him.

He lay in the bed, breathing hard, his hands plucking at the bed
clothes, his bright eyes closed. Only when he opened his eyes could we
see that the fighter was still there. Without those bright blue eyes
open, it was as if Mr. Wheelwright was gone. His energy, his power, his
strength were going. His eyes were closed, and tears made tracks down
his thin cheeks. He whispered a name again, and finally I understood.

He was talking to Ruben.

It was springtime, a time for flowers. For growing flowers and giving
flowers. No one brought flowers to Mr. Wheelwright, but when he died Al
Rocco called the floor and told me that he would send flowers to the
funeral home.

He was a good old guy, a good buddy, you know?

Now his circle is closed, I guess. Al was not a man comfortable with
philosophy, but he had learned something from Mr. Wheelwright. Maybe
someday he would tell someone else about the circle.

Chapter 15.

The Long Road Continues.

Several months later we gathered around the small tables at Mama Mia's
again to talk, to tell more stories and recharge. Some of us had changed
jobs, but basically it was the same group, same kinds of ideas and
memories. Margaret, who was now a hospice nurse, joined us, and so did
Rose, who had arthritis and bunions and her back hurt, but she still
wished she could go back to work. The conversation started out the same
way, telling how it was on the floors, in the ER, what was happening to
our people. Patty was now the charge nurse on nights in the intensive
care unit, and was telling about a full moon three months earlier.

Had eleven codes in seventy-two hours, thanks to that damn moon.

Used up every crash cart in the hospital. Never saw anything like it,
even full moons on Labor and Delivery. She turned to Carmen and asked
her if there had been a full moon many years before during that
three-day disaster near Albuquerque. Carmen laughed and shook her head.
We all knew that Patty loved to tell full-moon disaster stories, and
knew plenty. Then Patty grinned at me and I knew what was coming. She
also liked to tell stories about her old student nurse.

Let me tell them about the first patient you had, woman. Remember that
guy with the heart attack? Patty had some hard times with me, this
gray-haired graduate nurse, but she did some teaching and I did some
learning and somehow we made it. The patient she was talking about was
my first real patient back in Georgia.

This guy came into the unit on July seventh that year. Carolyn had just
graduated and taken the nursing-board exams, and came to work with me in
ICU. This patient had been diagnosed with a heart attack, and she
studied his chart like her supervisor said. Patty winked at me.

In the chart was a note from the year before. He had been admitted then
on July eighth for a heart attack, too. The doctor had written that the
patient needed to quit smoking and lose weight or he was going to have
another heart attack in a year.

I looked around the table, and there were some nods from all those
experienced people.

Patty continued, speaking slowly, with her soft Georgia drawl. So he did
exactly what his doctor told himm. He didn't lose the weight, he didn't
quit smoking, and he came in exactly a year later, and died on July
eighth. Programmed himself, that's what he did.

Patty shook her head. Got this young'un's attention, I can tell you.

She was right. This young'un never forgot it. I was forty years old, and
it was my first glimpse in the hospital of how the mind and the body
work together in odd ways sometimes.

Let me tell one more. I promised this patient that I would tell it, to
teach people something, Patty said. I was working in that same little C,
ICU before Carolyn came, and the unit was quiet, only three patients.

I was working with a nurse's aide that night, sitting at the desk
working on charts. All of a sudden I stopped what I was doing and
watched the heart monitor on the patient in room six. Annie, the aide,
had gotten the patient up on the side of the bed and the monitor showed
some really wild heartbeats. I jumped up just as Annie started hollering
and dragged the emergency cart into the room. The patient was
unconscious, turning blue, we got her back in the bed, on the board, and
Annie started CPR. I turned on the machines and brought her back. We
felt really good, Annie and I, and then the patient looked at me and
said, Why did you do that? Why didn't you just leave me alone? I was in
a better place, and you brought me back to this.

There was silence at the table.

I couldn't say anything, Patty said. I just walked out of her room and
cried. I never felt so bad and so joyous at the same time. I had saved
my patient's life, but she didn't want to be saved. She wanted me to
leave her in that better place. She looked around the table a little
defiantly. How was I to know she didn't want to be saved? I don't know
about any other places, just this one.

There was silence after that, while we all thought about some bitter
places. Rose and Margaret looked at me, as if deciding something. Mar
garet worked in hospice home health and sometimes her road was bitter
indeed. Rose had worked in many places for years and years, and had been
in Vietnam. She seemed to be sitting there looking into space, listening
to something. Margaret looked down at her hands, and waited.

We would hear from Margaret and Rose when they were ready.

Stella looked sort of sad, and quiet. After a few minutes she said,
Something happened yesterday that I need to talk about. She looked
around, shy, and added, I know I'm usually the one with the funny
stories, but this one isn't funny, and it needs telling. She sat there
for a minute, and we all waited, while she made wet circles with the
bottom of her glass on the tabletop.

We got a patient two days ago in the ER, a young man who died suddenly,
a work-related accident on a construction site. A foundation trench
caved in on him, killed him immediately. He was cleaned up and put in
the morgue, and then his wife came running into the emergency room,
screaming. She was young, they had only been married a few years. Stella
looked down and made more wet circles with her glass.

I followed her into the morgue with the attendant, I felt someone who
had been with her husband when they brought him in should be with her,
to explain, sort of. She was going to have to identify him, and when
they pulled that big drawer out and she saw him lying there, cold, she
screamed again, and started to yell, Get out of there, you can't be
dead.

We had breakfast this morning, we made love last night, you can't be
dead .. .. . and she tried to climb into the drawer with him, calling
his name over and over.

Peg was sitting beside Stella and leaned over and gave her a hug.

Funny what people do when they get a diagnosis of death, like that young
woman. Peg had been at the cancer center for many years through many
stories. I had a patient once who had just been told by the doctors that
he had lung cancer. He was an older guy, thin, chain smoker for forty
years, started smoking in the army at seventeen. He and I talked for a
while, and then he asked me if I would be there when his wife came, he
wanted to tell her himself. So I said yes, of course, and then the wife
showed up, this little plump lady with a big purse.

His call light went on, so I went into the room, and put my ann around
his wife, and looked at him. This patient looked at his wife, and then
he looked at me, and then he said, Tell her.

Patty whistled. Hey, that's not fair! That wasn't the deal!

I know, Peg said, but he just couldn't do it. So I looked at her and
him, and told the truth about what was going on, and how she could speak
to the doctors later, and we all cried and I walked out and left them
alone and sort of leaned against the wall for a minute before I could go
take care of anybody. I felt like a wet noodle.

Patty shook her head. Nuts, that's what we are, nuts. Things like that
happen all the time, but we just carry on Peg interrupted. You know what
was really nice, though? When that patient died a few months later, his
wife came to the floor and looked for me, and told me how much she
appreciated what I had said to her months ago. She told me that her
husband was a very shy man, never comfortable with feelings or emotions
or what he called mushy stuff, so he had to look to me to help him out.
I didn't remember anything I said, but it must have been okay, and it
comforted her.

People don't realize how important their words are, Peg added.

We can have an impact that we don't even know about. Think about how
some people use terminology.

Stella snorted. Like a weapon, not like teaching. I had a patient once
with Lou Gehrig's disease, and the resident doc went in to tell him what
he had and what would happen, how his muscles would weaken and his
nervous system would deteriorate, until he died. When the doc left I
went in and the patient still had no idea what was going on. So I went
after the doc and called him back to the station, and asked if he had
explained the patient's disease to him. This young doc said, Sure, I
told him he had amyotrophic lateral sclerosis and his prognosis was
typical. He actually said that to this poor patient. So I dragged him
back into the patient's room again and told him to explain the disease
in words this person could understand. The doctor learned, finally, that
patients aren't dumb, they just don't know what we know.

We have a language and a system and a whole world that most people don't
know about. And why should they? Stella sat up straight with her curly
red hair and her blue eyes and looked around at each of US.

That's what makes it so important that we talk to each other like this,
because we understand, most of us, we understand each other and the work
we do.

That's one reason why I'm doing this, I said. One very good reason.

Peg asked her question again, as I knew she would. Have you figured out
what this book is about yet, and how you're going to do it?

Peg always wanted to know what the land looked like, bless her. I
couldn't see an inch in front of me when I started this project, or
later when she first asked me that question. Now, after writing for
several months, and talking to my friends, and thinking about Peg's
question, I was listening to what this book was telling me.

I nodded and took a deep breath. It's about death, all kinds of death,
and how people deal with it, Like Miss Cherry in ICU, and Patty's
patient who didn't want to be brought back. Like Joe Romero and Lucy.

They all had to face it, somehow.

There was a thinking sort of silence at the table.

Peg leaned over and looked directly at me with her bright blue eyes,
serious now. You're saying we have to laugh because what we do is so sad
sometimes, right? And how taking care of the dying makes you learn more
about life.

I nodded. And if there was no winter, no one would love the spring.

Margaret had been listening and stared into her glass. We're always
learning. Anybody who thinks they've seen everything is fixing to get
surprised. She looked up at me and I pushed the tape recorder down to
her, and wondered what this tall, thin hospice nurse would tell us.

I see patients in their homes a lot, it's amazing how a visiting nurse
can become part of the furniture. Margaret seemed shy, and when she did
a job it was in the background, no fuss, no bother, just good nursing.

I knew-I had worked with her on the wards, before she went into the
hospice service.

There was this old lady that I got to know really well, bossy little
thing she was, figured she had been put in charge of the world and she
wasn't about to give it up, even at ninety-one. I went with an aide once
a week for about six months to assist her, and she wanted everything
just so. When you put a pan away in her kitchen, it had to be in one
special place. Her whole apartment was like that, cluttered and full of
stuff, but every little thing had a place. Margaret sighed, remembering
this difficult old lady. Patty and Carmen and Rose looked at each other
and then looked away, and I smiled. They were like that, too.

One day I went to fix her Medicare claims. She had just gotten out of
the hospital and was having a hard time walking with the oxygen carrier
behind her, and had lost weight. She looked little and much older, her
bones were like a little bird, and she tired easily. She had this chair
she sat in, right near the TV, and on this chair she had shawls, and
sweaters, and long pieces of plastic from the dry cleaners. I kept
moving that damn plastic out of the way, figuring it was a real hazard,
with her bad balance. She always wore hand-knitted slippers that would
slide on the plastic and I knew that she would fall and break a hip
someday. But every time I moved the plastic, she would give me a black
look and put it back, just like before.

It keeps me warm, nothing else works. Wait until you're old and you get
cold all the time'-you know the type. Margaret grinned at all of us and
didn't say that we were probably all the type, like Ruth would have
done.

So this particular day, the old lady was feeling old, or maybe thinking
about how she was going to die soon. So she had me sit down and get a
pad of paper, she was going to make me write a list of all her
belongings and who she wanted to give everything to. Now this was really
unusual, because this old lady didn't give anything away, ever.

Her daughters were always asking her for certain dishes or pots or cups,
things she hadn't used for twenty-five years, and she always refused,
giving them that look. None of her daughters could do the look like she
could, so they just shut up.

I sat down with a pad of paper, wondering how this was going to work.
She started with her coffee set. Margaret imitated the old lady's shaky
voice. That's my mother's coffee set, she died in 1917, and I'll bet it
hadn't been used since then. She shook her head.

So I wrote coffee set on the pad and waited. The old lady looked up at
the ceiling and sucked her false teeth, then said, I can't give it to
Mary, she'd just give it to that no-good son of hers. I can't give it to
Jennie, she hasn't got married yet. And I can't give it to Constancia,
she has everything.

I sat there waiting, and when I asked her if she could give it to her
other granddaughter, she gave me a look. She's married, yes, but she
hasn't got children. And I can't give it to Louis, I don't like his
wife.. .. So in the end the pad of paper just had coffee set on it, with
no names, and we didn't talk about giving things away anymore.

Margaret shook her head again, remembering that tough old lady.

She got sicker and older, and about a month later she told me a wicked
little story. She had these three daughters, all nice ladies, all afraid
of their mother. She never approved of anything they did, and they
waited for her approval for years, waiting for something she held back
from all of them.

She asked me to bring three dresses from her closet, and lay them on the
couch. One was gray, one was black, and one was dark blue, all pretty
much the same style, with little differences like silver buttons or a
pink rayon flower on the neck. The old lady looked up at me with that
tight little smile of hers, and said, I told each of my daughters that I
wanted to be buried in a different dress. I told Mary that one,
Constancia that one, and Jennie that one, and she pointed to all three
dresses one at a time with her cane. After I'm dead, they'll all have an
argument, each one thinking I want to be buried in a different dress,
and that wicked old lady threw her head back and laughed at her fine
joke.

Margaret was sn-ffling now, and we all were laughing at the thought of
that old lady and her joke on three poor women who tried to please her
and never could.

Patty choked on her coffee, she was laughing so hard. That's terrible!
What happened, at the end?

She died, finally, her heart just gave out. Margaret looked into her
glass.

She lay on the undertaker's stretcher under the coverlet like a small
pile of sticks. Her hands, thin as leaves, were crossed over her heart.

Her eyes were closed, unable to check on the rest of us who were left.

All the daughters were weeping, holding the old lady's hand as she had
never allowed them to do in life.

She's at peace, at last, said the oldest one. No more suffering ..

You know, the things relatives say when someone dies, Margaret said
briskly.

I was waiting for what I knew was corning, and sure enough, one of them
said, We need to get Mama's things ready to take down to the funeral
home. One of the daughters bustled into the old lady's bedroom and took
the blue dress off the hanger and began to fold it. Immediately her
sister said, Oh, that's not the one she wanted. She picked out the gray
dress. Here, put that away. I know exactly what she wanted, you don't.
Never did.

And then I told the sisters what their mother had done.

Margaret thought about that little family, about the last day of her
assignment with them, and laughed again.

They stopped talking at last, each with a dress in her hands. They told
me to pick out the one I thought was best, and I found another dress in
the closet, not one of those they were holding. I'll bet that somewhere
that old lady was laughing, buried in the dress I picked out.

Then Margaret was silent.

You must have more stories, I said. You've worked in hospice nursing for
quite a while.

Margaret looked up and thought for a minute. I'll tell one more, and
then I'm done, for now. I had a patient I went to see when he was
admitted to the hospital. I had been seeing him at home for a long time.

He was in his late seventies, had been sick for years, long-term
congestive lung and heart problems from having TB years ago. His
circulation was bad, his legs were swollen and black almost to his
knees.

He could hardly take a breath-he sat on the edge of the bed, hanging on,
hunched over, his eyes closed, just trying to breathe. Listening to him
breathe was hard. It was a rasping, harsh sound.

I was in the bathroom when I heard a nurse come into the room with his
dinner tray. She didn't know I was there. She just danced in like Nancy
Nurse and put the tray down and said, Have a nice dinner!

and danced out.

When I opened the door of the bathroom and walked into the room, he was
sitting there, on the edge of the bed, looking at his tray. The nurse
had not taken the plastic cover off the soup, or taken his fork and
spoon out of the cellophane. So he just sat there, hanging on to the
edge of the bed, trying to breathe, staring at his tray.

I got all the utensils out of the plastic and fed him some soup, and he
was hungry, poor guy hadn't been able to eat much because no one thought
to open his spoon and fork, or take the cover off the soup. I read the
chart on the door that said he had not been eating well. Of course not!
How could he eat? Just breathing was difficult. He didn't have enough
energy to unwrap plastic dishes and utensils and feed him self.

I went out to the nurses station after he had eaten what he could, and
I'm afraid I was not too polite. Nancy Nurse was there, doing something
with some paper. I didn't care about the damn paper. Pay attention to
your patients, I said. And then I left.

He died two days later. I wonder if that young nurse fed her patients
after that, or asked them if they wanted some help. It's a simple thing,
doesn't take much time, but sometimes, to some nurses, paper seems more
important than people.

Carmen snorted. I'd love to have that young lady on my floor! Poor old
man.

I changed the tapes, labeled all the ones that we had filled that
evening, and put them carefully away. Margaret and Peg and Carmen and
Stella watched me quietly, thinking about those tapes, and the lives of
the patients they represented. Anne was watching me, too.

You finally learned how to run that thing.

We'll come back, won't we? Stella asked, and there was anxiety in her
voice. Even when the book is done? There are always more stories to
tell.

Rose stirred in her chair, and we turned and knew that this veteran of
almost forty years was going to tell us something that we needed to
hear.

They need us old ones back, you know. We could teach them a lot, she
said. Carmen grinned, and did an okay sign to Rose.

Sure you could, but would they listen? she asked.

Good question. Rose nodded. She poured a cup of tea and thought about
it.

Probably not. We wouldn't have, either. I guess we each have to learn it
by ourselves. But isn't that a helluva waste of time?

Oh, sure, Carmen said. But that's what human beings are all about. Doing
it the hard way.

Rose stirred her tea, moved a napkin around on the table, sighed, and
began.

I'll tell you the best story I can remember out of all those years.

This is one I have never told anyone, but you can put it in the book
because someone needs to hear it. It was during Vietnam and I was doing
nursing on a base in Japan. I was a civilian but attached to the air
force. My son was in the jungle then .. .. ..

She stopped and closed her eyes. I looked a quick look at Peg and
thought, Oh God, I knew I had made a mistake inviting her. Peg looked
back at me with those bright blue eyes and whispered to Rose, It's okay.
You don't have to tell us, you know. You can keep the story and- No, no.
I need to tell it. I was stationed at this little air force hospital in
Japan-Camp Drake it was called-and Vietnam was really heating up. This
was in 1970. I was about forty-five, and my son was twenty.

He was everywhere in that damn jungle. Half the time I had no idea where
he was, or whether he was dead or alive.

So here I was, taking care of some wounded, they came in from Vietnam by
plane to a base in Japan and from there into Drake in these big
helicopters. I never knew a copter could be so big. They just kept
coming and coming, off the copters and into the hospital.

I was in the ward, helping out with this kid, about nineteen, who had
been blinded. After ten hours working on the floors some of us would go
back in after dinner and do volunteer work, like writing letters,
reading to the patients, just looking after stuff.

She stopped and looked off into a distance we could not see, as if she
were listening for something.

I came back after dinner, off shift, to check on this kid, and he asked
me if I would write a letter to his mother. Sure, I said, all bossy and
ready to do my nursy thing.

I picked up the pen and looked at this kid, redhaired he was, and got
ready to write to Mom. So he says, Dear Mom, I am fine .. .. . and I
thought, What the hell, you are not fine! You're blind, dammit.

But I just went on, and wrote his letter to his mom and mailed it.

I walked out then, went back to the dorm. I didn't do much volunteering
for a while.

Was it that one kid that got to you? Anne asked.

She turned and looked at Anne, with eyes that still looked into a long
distance.

Oh, no, Rose said. It was just after that my Joey was killed.

They said he died a hero. I didn't care. I just wished it had been him
in that bed writing to me about being fine, even if he was blind. At
least he would have been alive. But no, they took my Joey and I can't..
.

The years had gone by, but the pain was still there. Her hand shook when
she sipped the tea.

I can't go to the memorial, that wall in Washington. I don't know why.
Every time I get enough money together to go, I just can't. My daughter
wanted me to go with her, but she had to go alone. I just couldn't do
it. I want to see the statue they finally built for us, the nurses that
were there, too. She shook her head and turned to me and poured another
cup of tea.

Do you think I'll be able to go, someday? I've seen a lot of pain and
suffering and dying and birthing in all the years I've been nursing.

Why can't I go see that wall?

There was no answer to that. We all sat and looked at each other.

Carmen blew her nose and Anne dabbed her eyes with a napkin.

So these nurses tell you stories, and you're going to write them down
and let other nurses and regular people read them?

Is that what you're doing? Rose asked.

Peg grinned at me when I said, That's what I'm doing.

Are you learning anything?

She got to the point, Rose did. Right to the point.

Oh, yes. I'm learning. Every day.. .

She patted my hand and we sat in silence. She sipped her tea. Some where
we heard the whistle of a train, faint and far away.

The voices around us were muted, and it was quieter at our table than it
had been for a long while. Harry noticed it and came over to us.

Is everything okay? he asked.

I looked up at him, and Peg said, Oh, yes, everything's fine. We figured
out what we were doing. We thought we were just telling stories, but it
turns out we were doing a lot more.

It was winter the first time we came to Mama Mia's. It had been cold and
windy outside, and we welcomed warmth and winking lights. Now it was
spring, and the air outside was cool and smelled of growing things, of
promise. The dark streets of Albuquerque were busy, people were going
home, busy doing and living. We stood in the parking lot for a minute,
watching the lights of cars, thinking about patients, and winter, and
spring, about the ends of things and the beginnings of things, about
writing and listening and caring.

We'll be back. I'll call you.

Take care, see you soon.

Rose came over and gave me a hard hug.

Thanks for inviting me. She looked brightly into my face, and hugged me
again and walked slowly to her car.

Again, we went our separate ways, for a while. We went back to hospitals
and homes, cancer patients and old folks, people sick or injured or
dying. It was what we did, after all, every day. I would buy more tapes
and write about those days.

Ruben and Joe Romero and Lucy and Mr. Wheeiwfight are dead.

Nora and Joseph learned about death and circles, and Al Rocco travels
down his road. They all walk past shrines on their journeys, and Our
Lady of Guadalupe walks with them. We began with their stories. We have
walked down their long roads. Our friends and our teachers are dead, and
we aren't. Now we can close the circle and begin again. the end.