“Walker! David Walker!”
I called the name of the next patient as I stood in front of the obnoxiously loud automatic doors that separated the emergency department waiting room from the clinical area. As the doors scraped shut behind me, I realized I’d probably called his name too loudly. The waiting room was dead silent. Only empty chairs on a nauseatingly sticky floor looked back at me as I glanced around the room for Mr. Walker. In the absence of coughing patients and snoring family members, I probably could’ve heard my own echo if I’d listened closely.
A rustling broke the silence. A man stretched out across a row of seats lifted his head slowly and planted his feet firmly on the floor before rising deliberately to face me. I noticed his worn black boots as he rose. He had long, dark hair and piercing blue eyes and he had fading green tattoos all over his face. He was dressed in nothing but black, including a jet-black jacket with a hodgepodge of patches and writing. His outfit reminded me of an old-timey, western cowboy–but his dark leather get-up reminded me of a member of a stereotypical biker gang. If he’d told me that he rode through the blistering cold to the emergency department on a Harley or a quarter horse, I wasn’t sure which I would have believed more. As he walked towards me, I noticed a chain from his jacket pocket that dangled to his hip. It rattled when he moved.
My heart raced and pounded like a drum in my ears. I’d become more discerning about people since working in the emergency department, but I needed little insight to realize I was looking at a verifiable comic book villain. If he’d been an antagonist in a Netflix series, I would have stopped watching because of the heavy-handed cliches.
“Mr. Walker?” I asked, more quietly this time.
“Yes sir, that’s me,” he said, just as quietly.
I turned and waved my badge in front of the automatic doors. The sensor beeped politely as the automatic doors scraped open. We walked slowly across the hall to the triage room and as we crossed the threshold and stepped under the humming fluorescent lights, I gestured for him to take a seat in a sturdy medical chair. He shuffled slowly to the chair and planted himself firmly in the seat. His chain made one last rattle before he went still and looked at me expectantly. Despite his villainous appearance, his posture made him look small and timid. The oversized chair he sat in made him look even smaller.
“Can you slip one arm out of your sleeve? I just need to take your blood pressure.”
“Yes sir, yes sir. Of course,” he whispered, slipping his arm from his thick leather jacket. He nodded his head as he spoke.
I looked at him as the blood pressure cuff inflated.
“What brings you to the emergency department tonight?”
He glanced at me briefly and fixed his eyes firmly on his feet.
“Well, you see sir, I was going to the CVS to get my Haldol shot and they were closed, so I had to come here. I have to get a Haldol shot every month and I always go to the CVS, but they’re closed right now.”
“The CVS just down the road, right?”
“Yes sir, yes sir, that’s right sir,” he said quietly, still staring at the floor.
“Oh ok, no worries,” I said, despite knowing that the 24-hour CVS down the road was certainly still open. It was likely that one of our recently discharged patients was filling a prescription there now.
“Ok, we can get that taken care of for you. Is there anything else you’d like us to take care of
today?”
“No sir, just the Haldol shot sir.”
I looked at the tattoos on his face as he stared at the floor and I examined the creased and weathered skin into which they were drawn. It was impossible for me to guess his age. He could have been anywhere from his mid-thirties to mid-fifties, but I assumed he was younger than he looked.
“Ok Mr. Walker, that’s all I need to know for now. We’ve got a room available and I can go
ahead and take you back.”
I imagined this was probably one of his only lucky breaks in recent memory. Most nights, a room in the emergency department takes hours of waiting to get to, even at this time of night.
“Ok sir, thank you sir.”
He slipped his arm into his sleeve and we walked slowly through the silent hallways to a room where I showed him his bed. He climbed in and tucked his legs beneath the blanket, black boots and all.
“Ok Mr. Walker, the doctor will be with you as soon as possible. Would you like me to turn the
lights off?”
“No sir, that’s ok. I’d like to have the lights on.”
I slipped quietly out of his room and returned to the front of the emergency department. I didn’t see him again the rest of the morning. I only saw that his room was empty when I walked past several hours later and there were patches of dirt from his boots on the disheveled sheets.
That was my first encounter with Mr. Walker. Over the next couple of months, I saw him every two weeks or so, always for the same thing. He’d come in and look at the floor and talk with a quiet reverence about how he needed to get his monthly Haldol shot, but the CVS was closed, so he had to come here. As far as I know, we never gave him a Haldol shot and he always left before being discharged.
Several months after I first met Mr. Walker, I realized he hadn’t come to the emergency department in a couple of weeks, so I asked one of the nurses if they knew what he was up to. Maybe he finally figured out the CVS was open for 24 hours.
“Oh, Mr. Walker,” the nurse said. “He came in a couple of weeks ago with a bad case of
pneumonia and he died upstairs in the ICU.”
“Oh, ok” I said, mostly to myself. I looked at my shoes as I walked away.
I never figured out what Mr. Walker wanted from us. Maybe he really thought he needed to come to us for his Haldol shot. Maybe he just wanted to wrap himself in one of our warm blankets, or it might be that he felt safe beneath the high-pitched hum of our fluorescent lights.
Whatever it was, I didn’t know and I never will.
But I hope he found it.
Image Credit: (“Cowboy mural” (CC BY 2.0) by katalicia1
Contributing Writer
Eastern Virginia Medical School in Norfolk, Virginia
Matthew is a medical student at Eastern Virginia Medical School in Norfolk, Virginia in the class of 2026. He graduated from the College of William and Mary in 2021 with a B.S. in chemistry. He enjoys hiking, running, and reading in his free time. After graduating from medical school, Matthew would like to pursue a career in emergency medicine.