“Three, two, one … lift,” the circulating nurse directs as I raise the patient’s feet from the trauma table onto the recovery bed, gushing with the giddiness of getting to use my hands in a medical setting for the first time. Using my hands with purpose, intent and precision to touch, transfer and care is always an honor. Using my hands doesn’t feel like work to me.
The emergency department is conducive to quick, action-oriented, tactile work — stitches, a chest tube, cardiopulmonary resuscitation. I watch as the staff run about the emergency department, carrying themselves with sunken eyes, worn surgical masks and fingers ready to heal or type into a computer. They’re running for seven-plus hour shifts, some twenty-four. As they go about their day, patients come and go, and beds are shifted around like parking jam puzzles.
“Excuse me!” I often hear with a gurney pushing behind my knees. I’m distracted, enchanted by the bustle of the floor. As I awake from my daze and take a step out of the way, the gurney swooshes past. I bump into another. Then, the triage nurse stares at her computer for a moment, yells out a few numbers and the patients are carted off. I take one gurney, the mechanics of which is like a game of Mario Kart with latex gloves for banana peels. In the middle of the hallway, I throw my weight in the opposite direction, and the bed skids to a stop. I lock the wheels and leave the patient to wait.
Walking around the floor, I watch as most people sleep away the hours of waiting. Others smile and give me a wave; some are chatting it up with their nurses, others are calling their Aunt Jessicas to come keep them company and a majority sit face up in the bed, stone-faced, staring out upon the wing, likely attempting to abridge their state of loneliness.
I approach one undemonstrative lady. Her eyebrows immediately lift, revealing the intricate channels of wrinkles that adorn her forehead. Using my high school Spanish, I am able to pick out that the lady doesn’t want to be a bother. “No, no. Dime. Estoy aquí para ayudar.” ‘No, no. Tell me. I am here for you,’ I say. I pull back her blanket to find the sheets, gauze pads and her gown all soaked. “Mojado como la lluvia.” Wet like rain. Too scared to communicate her need for the bathroom, and with no one coming over to help, this beautiful, sentient, yet reticent lady had been sitting in her own urine for at least 10 hours.
After I successfully persuade a nurse to come over, she tosses her on her side and removes the garments, as I plug my olfactory system off from any odor molecules that might penetrate through my mask. Then the nurse walks off to attend to something else. My lady is left out butt-naked, raw, shaking and exposed in the open air of the emergency department. “Eres el único agradable aquí,” or ‘You’re the only nice one here,’ she says to me. Of course I know that’s not true. It’s only because I am able to hear her say that. Once all cleaned up, she purrs, “gracias mi dulce querida,” ‘thank you my sweet dear,’ with a parting kiss on my hand.
Cleaned up but still icked by the residue of uric acid, indignity, saliva and appreciation on my hands, I head into a room of the emergency department full of critically ill patients, only described by the loud and unabating sounds of different tones and decibels.
Behind one curtain is an old lady, frail and jaundiced, whose alarm will not stay quiet. She’s laying, eyes closed, somehow sleeping through the unrelenting sound. After three trials of silencing the alarm and flicking at the central line to clear it of air bubbles, the daughter of the woman dying from stage IV liver cancer asks when a bed in the main hospital will be free.
The hospital has a 24-bed waiting list. I apologize for the wait, though I keep how long it’ll be to myself. I pull up a seat beside the daughter, an immigrant from Ukraine, a lover of her mom’s cooking. Cabbage rolls were her specialty. My own grandmother died — frail and jaundiced — from pancreatic cancer when I was ten. She made a killer chocolate chip cake, featuring Duncan Hines boxed yellow cake, vanilla Jell-O pudding and a bar of hand-shaved Baker’s German chocolate.
A stretcher surrounded by six-plus people bursts through the doors of the wing. One man, elevated over the group, undulates his body in a shucking motion. His two hands, placed firmly together, hurry into view, tenaciously impelling into the body of a lady laying on a stretcher below, trying desperately to resuscitate her heart. At a slower pace, someone squeezes a blue, oval-shaped bag until it fills up with air and they squeeze again. Out of the trauma room echoes one unbroken note. A B-flat in the key of Queen’s Bohemian Rhapsody… “Goodbye everybody … I’ve got to go.”
The note abruptly ceases while gloves are tossed and foreheads are wiped, people in scrubs leave the room chatting, laughing and gossiping. Left in the room are vital machines showing nothing but a blacked-out screen, and, in the middle, a woman, tinted-blue, sprawled out, mouth open, eyes half-shut, naked. Gathering my bearings, I process out to the linen closet. The beeping sounds obnoxiously loud, cutting sharply through the chatter among the floor.
I bring a plain, white, cotton sheet into the room. The pall isn’t embroidered nor is it thick enough to prevent molecules from falling into the chalice. It’s just enough to save other patients from observing the horrors of their own creeping mortality. And when the soul of the woman underneath the sheath looks down, she may only be reminded of her bright and pure legacy, able to paint in colors and designs of life flashing before her eyes.
I take a step back toward the door and look out over the wing. The image of the lady under the cover is burned into my mind. I don’t know what she sounds like. I don’t know her name. Putting my hand to my neck, I feel my pulse. Amidst the equipment that continues to cry out beeps, I feel the quiet, consistent “lub … dub” beat against the tips of my fingers.
In the emergency department, I must savor the senses of my healthy human body to balance light with dark, noise with silence, life with death. Only then can I appreciate both the art of medicine and the brevity of a life surrounded by death.