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Banker’s Hill/Mercy ER Patient

The night before I am sitting at the computer, when the giant grips my abdomen, rapping hard knuckles across my limbs. The attack lasts about sixty seconds, here and gone with the severity of a lightning bolt. Once it flows on through my extremities and dies out like a glowing ember, I can think somewhat clearly again, and quietly resume tapping at the keys. Temperature settles back into the usual low-grade, and I attempt to read a thoughtful argument supporting the legalization of marijuana. I can process the information enough only to know that I am relieved to be able to sit in a numbed opioid haze with what legal narcotics the doctor writes. It has not been my pleasure lately to “just say no.”

The next morning I awaken to a shock of yellow fireworks, a Fourth of July special whizzing and searing through my belly and gut, again spreading out in icy sparks through my fingertips and toes. Pressure mounts with the force of last night’s giant fingering me in his palm, deciding whether or not to smash me out of existence. The giant pauses, indecisive. I begin to straighten up, but then stubby fingers close around me again, and vision tunnels, threatening black unconsciousness.

This happens three times before I call out to G., 'we have to go.' He is shaving in the bathroom while the cat sits at the edge of the sink and watches intently. “Cat,” “shave,” and “sink” are words that suddenly, brutally nauseate. G. hastily rinses his face and throws on some jeans and a shirt, grabbing my meds list and insurance card. To avoid the bumps on Fifth, we drive slowly down the promenade of Sixth Avenue, where the silvergreen blur of eucalyptus and lawn translates to a kind of synthaesthetic nightmare of suffocation of taste, texture, sight. Sun through the car window is implacable, burning my retinas and skin. We pull into Mercy’s ER parking lot, but the first two rows of spaces are cordoned off, and the parking attendant stands chatting with someone in what looks like a sports conversation; he glances up only briefly and shrugs at G’s frantic waving. I clasp my guts like a baby as we swerve around, hunting. Frustrated, G. drops me at the entrance and tells me to go on in alone. This means I will have to think of dates, times, names, and events on my own. I lurch out of the mild morning and through the darkened glass entrance.

Hour One:

Mercy’s ER waiting area has stark, apartment-colored walls. Spaced at measured intervals are posterboard photos of “relaxing” scenes, such as an ocean sunset, a closeup of a sipping hummingbird. There are two televisions glaring at one another from wall mounts, trading insults about cleaning products and work-at-home web scams. Shabby waiting room chairs snake across the periphery of the room, pushed closely together in an M-shaped line. Some are covered in dull plastic, some are of a greasy rough weave. I have been here many times, and know the drill. Date, name, address, phone, insurance, policy number, group number, allergies, and finally…the reason you are here.

The first thing an ER patient does is scan the room to evaluate other patients; their levels of discomfort, whether or not they have a right to be here. Newbies sink down into the chairs and try to remain in a bubble of listless privacy, but after a couple of hours, they learn. Wolfish eyes raise and rake over my appearance for signs of whether or not I will jump ahead on the list. Once checked in, one begins to do the same to them. Of eight people, only one appears to be seriously ill, and another appears to be giving the performance of her life.

The latter, a woman with a backlit nimbus of hair like “Buckwheat” huddles in a complimentary Mercy wheelchair, a papery blue trauma blanket over her lap. She searches the faces of her captive audience, chanting a bored litany: Oh god, oh sh—t oh god, oh f—k , oh god, oh sh—t… About every fourth repetition she stands up abruptly to knock on the glass separating us from the triage nursing staff, yelling “I need something for pain!” She picks at her toes, slyly raising the volume whenever staff hurries by. Occasionally a nurse with a hard, bright Aussie accent, or a soft-voiced girl with red braids steps out to tell her that there is a “change of staff,” and that she’ll be seen in turn. Changes of staff are typically lengthy affairs. In this instance, “change of staff” is clear code for 'you are not fooling us.' Wheelchair woman coasts outside, announcing her right and intention to be given a smoke.

A dry desert wind is rushing through me, gathering rocks and sticks and burning sand against my internal organs. A twenty-something too young for dentures, but for whom a heroin habit may soon make necessary, gums her cheeks, and moves in her seat with a low moan. We can’t feel sorry. We can only wonder if she will be seen before us. Between staticky calls of “attention: code trauma” a tinny lullaby wafts out of the ceiling vents. I say that this must be a new code for infant trauma. G. replies softly that it means a baby has just been born. There does not appear to be a musical cue for that other profound human event.

Hour Two:

I am swaying on my metal and plastic conference room chair next to G., inches from the scratched linoleum that the immune-suppressed intuit to be pocked with little soccer fields for bacteria, regardless of how many swipes of Lysol. A tall African American gentleman walks back and forth gesturing expansively, greeting the hapless seated like a generous club promoter. G. whispers that this man’s body odor is like a force of nature, and I feel my gorge rise, a creature whose shell has been pried off, all surfaces permeable. Wheelchair woman’s back, and her litany continues to shoot into my ear canals with a sharp increase in profanity. She looks right into my eyes and before I can stop myself I say “Stop it.” G. tries to shush me, squeezing my shoulder, and I tell the woman “Stop cussing—there are children here.” Wheelchair woman shakes her mane, back to reality long enough to say “What! I’m not cussing!” She does not follow my glance to that of a brown-skinned, rosy-cheeked little girl in Mickey Mouse footed pajamas, mouth open and staring now at both of us.

Triage calls my name, and eyes raise in hard concert, willing me back from the door held open by a familiar nurse. She has forgotten me again, though we have seen her so many times; she taps very slowly at her keyboard, adding cramped characters and lines to long paragraphs of a medical story titled “S Daniels.” A young blonde surfer boy is wheeled past with a sling across his arm and a solemn look. Something momentous is happening to him. We are sent back to sit again. Burning with thirst, I think of Zola’s rackety wooden train cars full of abject sufferers and undesirables heading toward the diseased waters and rabid faith of Lourdes.

Hour 3:

Again, I am called back, with two others. They are opening some unused exam rooms. A large pregnant woman who seems loathe to part with a cop drama on one of the tvs, and and a severely obsese man with the inappropriate grin of the developmentally challenged, are shuttled into exam rooms. In the darkened room directly across from mine, a middle-aged woman with matted hair and puffy face sits wrapped in a blanket with a nurse from the psych ward leaning toward her, inscribing the facts before taking her down to behavioral. Cannot keep food down. Cannot sleep. From up north, waitressing at Denny’s, pregnant, no friends here. A generic ringtone sounds, and the distraught woman interrupts the nurse’s questioning to wail at the presumed “father” who has called to argue on her cell phone.

A jaunty white-haired ER doctor with a lot of hard “Cs” in his name breezes in to inform me in practiced anecdotal tones that my name is the same as his son’s old nemesis of a swim instructor. I wonder if this is the same unsavory character whose unpaid gas and credit card bills prompted collectors to harass me night and day some years ago. I just say, “I swear it’s not me.” The doctor chuckles gently, and palpates my abdomen. The blackness threatens and the giant’s hand raises slowly. "Not a pretty thing to have," he says, now serious. "Not pretty at all. Let’s get you comfortable."

Hour 4:

I hunch shivering on the cold plastic rasp of the gurney, waiting, listening to the phlegmatic voice of the Denny’s waitress swim down the hall, full of talk about dying in a way that feels like luxury. The ‘club promoter’ of the seven olfactory wonders has been asked to take a shower before being examined, to which I hear him reply “Why, of course.” Rush of water and a tinkling drain. “Melody” comes in to prepare my IV. She must get some Benadryl first to prevent itching, before giving me the Dilaudid that makes me scratch my skin raw, and stutter, fluttering my eyes open and shut in a fugue state. It is the only thing that works. I glaze over again, staring at two white styrofoam cups, and crumple back down into fetal position to wait. Muffled show tunes thread in from somewhere behind a curtain at the end of the room, and we realize it must be Mr. Knight’s nine a.m. volunteer gig in the lobby, and that this room must share a wall with the main entrance. I know the tune, but cannot even hum it. The words “piano” and “lobby” share a thick, sickening ping.

There is contrast to drink, but I cannot get it down without pain medicine first, so the cups sit there while Melody navigates labyrinthine halls to the pharmacy. G. remarks that this contrast doesn’t look like the usual, viscous, milky substance I get before a scan, and inquires hopefully as to the taste. It is clear like water, and tastes intimately of the metallic sharpness already pasted over my tongue.

I swirl the contrast in cup no. 1, and make a mental toast to JB’s Mensa joke about Socrates-and-the-hemlock: It’s not great contrast, but it’s good.

Hour 5:

A whiff of alcohol, then the needle sting of Dilaudid shoves the giant down into a subterranean river seeping in more orderly tributaries, tracing deep burning islands in my stomach. Aping the addict’s jerky nod, I am wheeled through mazes of wall-to-wall linoleum, to a darkened cave at the end. A nurse’s hands are cool on my shoulders—my, you are burning—as the hot black scan dye flushes up my veins. Still as a statue, I glide into the wide encircled arms of the MRI scanner. 'Take a deep breath. Hold. Now breathe. Hold—now breathe,' says a digital male voice, with stern importance. The digital voice catches on 'now,' repeating it several times. I have forgotten what 'now' means, as everything rumbles with the intensity of a train into a darkness that does not include me…

Some hours of saline drip and one more pain shot later, the giant brushes me off his palm onto G’s waiting arm, to stumble toward the big double doors. Lined along the hallways, former waiting room sitters now lie abandoned on gurneys, swaddled in white-sheeted cocoons. Fragile pink and brown heads emerge with expressions of bewilderment, anger, and resignation. Some have that chrysalis-squirm; all have a meaty, hungry look.

You have to go past the general area to the exit. It is packed to capacity with new waiting, but full of old, expectant breath. More than two dozen pairs of irises lift and track. Is she leaving? Am I next? Is she coming back, or is this it?

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Two poems by Marvin Bell

“To Dorothy” and “The Self and the Mulberry”

The night before I am sitting at the computer, when the giant grips my abdomen, rapping hard knuckles across my limbs. The attack lasts about sixty seconds, here and gone with the severity of a lightning bolt. Once it flows on through my extremities and dies out like a glowing ember, I can think somewhat clearly again, and quietly resume tapping at the keys. Temperature settles back into the usual low-grade, and I attempt to read a thoughtful argument supporting the legalization of marijuana. I can process the information enough only to know that I am relieved to be able to sit in a numbed opioid haze with what legal narcotics the doctor writes. It has not been my pleasure lately to “just say no.”

The next morning I awaken to a shock of yellow fireworks, a Fourth of July special whizzing and searing through my belly and gut, again spreading out in icy sparks through my fingertips and toes. Pressure mounts with the force of last night’s giant fingering me in his palm, deciding whether or not to smash me out of existence. The giant pauses, indecisive. I begin to straighten up, but then stubby fingers close around me again, and vision tunnels, threatening black unconsciousness.

This happens three times before I call out to G., 'we have to go.' He is shaving in the bathroom while the cat sits at the edge of the sink and watches intently. “Cat,” “shave,” and “sink” are words that suddenly, brutally nauseate. G. hastily rinses his face and throws on some jeans and a shirt, grabbing my meds list and insurance card. To avoid the bumps on Fifth, we drive slowly down the promenade of Sixth Avenue, where the silvergreen blur of eucalyptus and lawn translates to a kind of synthaesthetic nightmare of suffocation of taste, texture, sight. Sun through the car window is implacable, burning my retinas and skin. We pull into Mercy’s ER parking lot, but the first two rows of spaces are cordoned off, and the parking attendant stands chatting with someone in what looks like a sports conversation; he glances up only briefly and shrugs at G’s frantic waving. I clasp my guts like a baby as we swerve around, hunting. Frustrated, G. drops me at the entrance and tells me to go on in alone. This means I will have to think of dates, times, names, and events on my own. I lurch out of the mild morning and through the darkened glass entrance.

Hour One:

Mercy’s ER waiting area has stark, apartment-colored walls. Spaced at measured intervals are posterboard photos of “relaxing” scenes, such as an ocean sunset, a closeup of a sipping hummingbird. There are two televisions glaring at one another from wall mounts, trading insults about cleaning products and work-at-home web scams. Shabby waiting room chairs snake across the periphery of the room, pushed closely together in an M-shaped line. Some are covered in dull plastic, some are of a greasy rough weave. I have been here many times, and know the drill. Date, name, address, phone, insurance, policy number, group number, allergies, and finally…the reason you are here.

The first thing an ER patient does is scan the room to evaluate other patients; their levels of discomfort, whether or not they have a right to be here. Newbies sink down into the chairs and try to remain in a bubble of listless privacy, but after a couple of hours, they learn. Wolfish eyes raise and rake over my appearance for signs of whether or not I will jump ahead on the list. Once checked in, one begins to do the same to them. Of eight people, only one appears to be seriously ill, and another appears to be giving the performance of her life.

The latter, a woman with a backlit nimbus of hair like “Buckwheat” huddles in a complimentary Mercy wheelchair, a papery blue trauma blanket over her lap. She searches the faces of her captive audience, chanting a bored litany: Oh god, oh sh—t oh god, oh f—k , oh god, oh sh—t… About every fourth repetition she stands up abruptly to knock on the glass separating us from the triage nursing staff, yelling “I need something for pain!” She picks at her toes, slyly raising the volume whenever staff hurries by. Occasionally a nurse with a hard, bright Aussie accent, or a soft-voiced girl with red braids steps out to tell her that there is a “change of staff,” and that she’ll be seen in turn. Changes of staff are typically lengthy affairs. In this instance, “change of staff” is clear code for 'you are not fooling us.' Wheelchair woman coasts outside, announcing her right and intention to be given a smoke.

A dry desert wind is rushing through me, gathering rocks and sticks and burning sand against my internal organs. A twenty-something too young for dentures, but for whom a heroin habit may soon make necessary, gums her cheeks, and moves in her seat with a low moan. We can’t feel sorry. We can only wonder if she will be seen before us. Between staticky calls of “attention: code trauma” a tinny lullaby wafts out of the ceiling vents. I say that this must be a new code for infant trauma. G. replies softly that it means a baby has just been born. There does not appear to be a musical cue for that other profound human event.

Hour Two:

I am swaying on my metal and plastic conference room chair next to G., inches from the scratched linoleum that the immune-suppressed intuit to be pocked with little soccer fields for bacteria, regardless of how many swipes of Lysol. A tall African American gentleman walks back and forth gesturing expansively, greeting the hapless seated like a generous club promoter. G. whispers that this man’s body odor is like a force of nature, and I feel my gorge rise, a creature whose shell has been pried off, all surfaces permeable. Wheelchair woman’s back, and her litany continues to shoot into my ear canals with a sharp increase in profanity. She looks right into my eyes and before I can stop myself I say “Stop it.” G. tries to shush me, squeezing my shoulder, and I tell the woman “Stop cussing—there are children here.” Wheelchair woman shakes her mane, back to reality long enough to say “What! I’m not cussing!” She does not follow my glance to that of a brown-skinned, rosy-cheeked little girl in Mickey Mouse footed pajamas, mouth open and staring now at both of us.

Triage calls my name, and eyes raise in hard concert, willing me back from the door held open by a familiar nurse. She has forgotten me again, though we have seen her so many times; she taps very slowly at her keyboard, adding cramped characters and lines to long paragraphs of a medical story titled “S Daniels.” A young blonde surfer boy is wheeled past with a sling across his arm and a solemn look. Something momentous is happening to him. We are sent back to sit again. Burning with thirst, I think of Zola’s rackety wooden train cars full of abject sufferers and undesirables heading toward the diseased waters and rabid faith of Lourdes.

Hour 3:

Again, I am called back, with two others. They are opening some unused exam rooms. A large pregnant woman who seems loathe to part with a cop drama on one of the tvs, and and a severely obsese man with the inappropriate grin of the developmentally challenged, are shuttled into exam rooms. In the darkened room directly across from mine, a middle-aged woman with matted hair and puffy face sits wrapped in a blanket with a nurse from the psych ward leaning toward her, inscribing the facts before taking her down to behavioral. Cannot keep food down. Cannot sleep. From up north, waitressing at Denny’s, pregnant, no friends here. A generic ringtone sounds, and the distraught woman interrupts the nurse’s questioning to wail at the presumed “father” who has called to argue on her cell phone.

A jaunty white-haired ER doctor with a lot of hard “Cs” in his name breezes in to inform me in practiced anecdotal tones that my name is the same as his son’s old nemesis of a swim instructor. I wonder if this is the same unsavory character whose unpaid gas and credit card bills prompted collectors to harass me night and day some years ago. I just say, “I swear it’s not me.” The doctor chuckles gently, and palpates my abdomen. The blackness threatens and the giant’s hand raises slowly. "Not a pretty thing to have," he says, now serious. "Not pretty at all. Let’s get you comfortable."

Hour 4:

I hunch shivering on the cold plastic rasp of the gurney, waiting, listening to the phlegmatic voice of the Denny’s waitress swim down the hall, full of talk about dying in a way that feels like luxury. The ‘club promoter’ of the seven olfactory wonders has been asked to take a shower before being examined, to which I hear him reply “Why, of course.” Rush of water and a tinkling drain. “Melody” comes in to prepare my IV. She must get some Benadryl first to prevent itching, before giving me the Dilaudid that makes me scratch my skin raw, and stutter, fluttering my eyes open and shut in a fugue state. It is the only thing that works. I glaze over again, staring at two white styrofoam cups, and crumple back down into fetal position to wait. Muffled show tunes thread in from somewhere behind a curtain at the end of the room, and we realize it must be Mr. Knight’s nine a.m. volunteer gig in the lobby, and that this room must share a wall with the main entrance. I know the tune, but cannot even hum it. The words “piano” and “lobby” share a thick, sickening ping.

There is contrast to drink, but I cannot get it down without pain medicine first, so the cups sit there while Melody navigates labyrinthine halls to the pharmacy. G. remarks that this contrast doesn’t look like the usual, viscous, milky substance I get before a scan, and inquires hopefully as to the taste. It is clear like water, and tastes intimately of the metallic sharpness already pasted over my tongue.

I swirl the contrast in cup no. 1, and make a mental toast to JB’s Mensa joke about Socrates-and-the-hemlock: It’s not great contrast, but it’s good.

Hour 5:

A whiff of alcohol, then the needle sting of Dilaudid shoves the giant down into a subterranean river seeping in more orderly tributaries, tracing deep burning islands in my stomach. Aping the addict’s jerky nod, I am wheeled through mazes of wall-to-wall linoleum, to a darkened cave at the end. A nurse’s hands are cool on my shoulders—my, you are burning—as the hot black scan dye flushes up my veins. Still as a statue, I glide into the wide encircled arms of the MRI scanner. 'Take a deep breath. Hold. Now breathe. Hold—now breathe,' says a digital male voice, with stern importance. The digital voice catches on 'now,' repeating it several times. I have forgotten what 'now' means, as everything rumbles with the intensity of a train into a darkness that does not include me…

Some hours of saline drip and one more pain shot later, the giant brushes me off his palm onto G’s waiting arm, to stumble toward the big double doors. Lined along the hallways, former waiting room sitters now lie abandoned on gurneys, swaddled in white-sheeted cocoons. Fragile pink and brown heads emerge with expressions of bewilderment, anger, and resignation. Some have that chrysalis-squirm; all have a meaty, hungry look.

You have to go past the general area to the exit. It is packed to capacity with new waiting, but full of old, expectant breath. More than two dozen pairs of irises lift and track. Is she leaving? Am I next? Is she coming back, or is this it?

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