Neither Here nor There: Part One

Neither Here nor There

or:

where have you been all my life?

"And this is the simple truth - that to live is to feel oneself lost. He who accepts it has already begun to find himself, to be on firm ground. Instinctively, as do the shipwrecked, he will look around for something to which to cling, and that tragic, ruthless glance, absolutely sincere, because it is a question of his salvation, will cause him to bring order into the chaos of his life. These are the only genuine ideas; the ideas of the shipwrecked. All the rest is rhetoric, posturing, farce."

- Soren Kierkegaard.

&&&

The Left Handed Captain, miraculously, comes to town on an Easter Sunday overwhelmed by dying bodies & disordered lives. He brings 18 perfect brown eggs & two bottles of champagne and, while I change out of my scrubs and into a pretty dress, whips up a midnight brunch so sublime, so glorious, I almost cry from disbelief. On the front porch we eat by candlelight, talking about this and that - Flannery O'Connor, giving up the search, lakes in Africa, the queer ability of low-fi audio recordings to pluck at our heart strings like the Holy Spirit. I tell him about my day and he says You are a good woman, Kate. He is handsome & charming, his hollandaise sauce is perfect salt & light. But my faith is so anemic, I tell him. When we talk of the people we've hurt and loved, he says Most days I wonder if I haven't made a huge mistake. We shiver as Easter Sunday fades into the start of another long week, already stacked against us. So incarnate are we -- unable to help ourselves to anything else besides more food - and yet...

(We live in this and yet... This is where we find our home)

...and yet, the early spring dew lands on our heads like a benediction; searching, feasting, together, our communion is blessed.

&&&

I lay awake these nights, deep in the dark, thinking of a man who told me once he loved me, and then told me again, and then again and then, finally, after all was said and done, once more again. In the middle of the night I would wake him, wake him just so he would say Oh Love, it's okay. Go to sleep, Kate, go to sleep. And I would. And just like that, I would.

I lay awake these nights, deep in my own mind, the knowing coursing thru my heart like blood, that love is not enough. Oh Love, it's okay. Oh Love! It's not enough! But love and sleep and passage beyond the bounds of one's own mind - is that enough? A lifetime of sleep, of love. Is that enough? Is okay enough?

&&&

I stop at the corner of 7th Street and Massachusetts Avenue and wait for the light to change. In the basket of my bike I have a bottle of Burgundy, purple grapes, dark chocolate gelato. It is Bastille Day and what I really want to bring with me (Regardez ce que j'ai apporté pour vous, mon amour!) is a gypsy man with an accordion and a wrought iron window basket exploding with red geraniums. But I am 29 now, slightly more practical, slightly less stupid, about these things (Peut-être que ce n'est pas vrai, ma chérie...).

A girl rides up next to me and startles my reverie. She is a little flushed, charmingly disheveled, with short dark hair, pink shoes, a green bike. Am I anywhere near Peregrine coffee shop? she asks and, then, before I can answer, Do I look ok? I'm going to meet a boy! I tell her, truly, that she looks lovely, that she is very close, only a few blocks away. Before she can answer I tell her that I, too, am going to meet someone. Well, you look very pretty, too! Good luck! she says and then pedals off to the place where we left off, il et moi, once upon a time. The light changes and I continue on my way, toward the guillotine, the Hall of Mirrors, an ancient stone wall, a bottle of Burgundy -- qui peut savoir, mon amour?

Zombie Insomniac

A summer of night shifts has left me strung out & wired, exhausted, lonely, slightly paranoid & delusional, with vague pains around my heart. Or: exactly the kind of person who goes to the hospital in the middle of the night.

blueberries

There is something particularly demoralizing about heading into work on a Friday evening, when the rest of the city is checking its lipstick and looking over the happy hour menu, laughing blithely over their beers.

I don't really miss that life most days, but I missed the carefree buoyancy of it all that night; wanted desperately to march right in and sit down at the first table of laughing people, to throw my head back with them and laugh like a drain, the most obnoxious girl in the bar. Instead I splashed cold water on my face, found clean scrubs, tempered my espresso with milk. I drove to the grocery store and wandered the bright, clean aisles, looking for something to ease the way through the long, dark hours. Blueberries were on sale so I grabbed a quart and a pack of chewing gum - bright, sweet antidotes for the handful of bitter pills ahead.

It is a long, shivery walk from the parking lot to the Emergency Room and I fell in step with the silent, single file line of nurses, travel mugs in hands. This winter seems colder than last - or maybe I've made an unknowing bargain in my quest for survival: the thinning of my physical skin as my emotional skin has thickened to a rough, tough hide. As the wordless line snaked deeper into the bowels of the hospital, I thought of all the similarities between my job and a miner. The changing of shifts, time clocks, union dues. We may not have the physical heft of bedrock, boulder, and crag upon us but, believe me, the weight of humanity is a physical pressure only waiting for the invention of an instrument sturdy, subtle, sophisticated enough to measure it.

I will spare you all the details between when I clocked in 7:00 pm and sometime around 2:00 am when I found myself squatting on the ground, reaching under the sterile drape to hold my patient's head steady, while the short, no-nonsense woman from the neuro team drilled through his skull with a hand drill. Right before we'd started, the man's girlfriend had rushed into the bay and thrown her weeping self across his chest. Please baby! Can you hear me! You've got to fight, baby! FIGHT for ME! I bit my tongue to keep from telling her that of course he couldn't hear her, my whole job was to make sure that the propofol was dripping steadily enough into his veins to keep him from hearing her, from fighting the ventilator, from doing anything but lying there, motionless. I regretted these thoughts as soon as I thought them. What do I know anyway about what he could or couldn't hear? There wasn't time to dwell on it, though; the bossy woman was waving the drill around and the cycling blood pressure was going up instead of down. It's now or never, she said. So I said, ok, I'm ready. This is your life now, I thought as I squatted there, my whole body aching with the strain of holding that single head still. But as I watched the blood and spinal fluid pour from above like a waterfall, congealing in a rubbery pool by my foot, I saw very clearly that it was also that man's life now, too.

By 3:30 am I'd transferred my patient to the ICU, giving his new nurse the handful of information that I had. I pushed the empty ER stretched through the quiet halls and parked it in the long line of beds waiting to be cleaned and made for tomorrow's patients. I went into the locker room and splashed water on my face, washed my hands until they were red and raw, grabbed my bag, and went and stood in ambulance bay for a few minutes. The air was cold and clear. I took a few deep breaths. Then I began popping blueberries into my mouth as fast as I could, marveling at the way their thin, taut skin holds everything inside.

blood & marriage

Verbatim conversation with a patient today:

Patient: You got a husband?

Me: No.

Patient: A boyfriend?

Me: No.

Patient: Is that blood on your shoes?

Me: Uh. Yeah. Looks like it.

Patient: No wonder you ain't married yet.

highs & lows of the last 14 hours

Doctor: Hey, you're doing great. I had no idea you are new nurse. Keep up the great work.

Patient #1: Get out of my face, you ugly @#%$*. I'm going to get my people and come back and crush you.

Medical Student: Here. I bought you a diet coke to thank you for helping me so much with that patient earlier.

Patient #2: What do you mean you don't know what's wrong with me. Go tell your boss I want someone taking care of me who's not stupid.

Hospital Police Officer: Girl, you're a hustler. I can tell you're a hard worker. I respect that.

Patient #3. You look like a hunchback.
Me: Excuse Me?
Patient: Bend over so I can look at your back.
Me: I'm not going to bend over. I don't have a hunchback.
Patient: You are a very rude young woman. I'm trying to help you.

Man who delivers clean linens: I been watching you lady and if you take care of your husband half as good as you do your patients, he's a lucky man.

Patient #4 just swung at me.

cash cow

I tell my parents that I have a secret account - a place where I squirrel away a little money here and there so that when the time comes, I'll have the cash I need to buy some cattle. They are not particularly impressed by my foresight. My mom asks when I'm planning to do this exactly. My father suggests I go stick my head in the dairy case at the store and take a few deep breaths -- nothing like the smell of stale milk to snap you back to reality. They laugh, but I'm serious. Few things evoke in me such simultaneous longing and contentment -in perfect harmony- as cows, and every version of the future that I imagine for myself includes cattle.

Grahamcracker told me once that my grandfather loved the sight of cattle grazing on a hillside, that he could watch them for hours. I think of my grandfather, a difficult man, and all his characteristics that my father didn't inherit, didn't pass down to me. When I sift through my memories of my grandfather - of his hollering & cussing - and add it to what I know of my father's childhood, I can not see the line from him to me. My father is nothing like his father and I am like my father, so by the transitive property of inequalities, I am nothing like my grandfather, right? Save this genetic bovine blip, right?

Maybe I should get a milk cow, just to practice, until I get my herd. We could have fresh milk and butter! My mom reminds me that I don't live with them, that I live in the city, and that she is not getting up at 4:30 to milk it. My father says that when he was a child he made butter out of the raw milk from their cow and put it on his popcorn and even the thought of it still makes him want to throw up to this day. Fine. I want beef cattle and not dairy cattle, anyway. Just you wait and see.

Driving home from work tonight through the dark city, I think about all the hours I just worked, about my tiny little fund, and all the hours more I'll have to work to be able to buy even a single Red Angus heifer, never mind a bull. For a few more minutes I worry about my non-existent herd dying of starvation (because I miscalculated the amount of alfalfa hay we'd need to get us through the long winter). What if I ruin my imaginary children's lives by making them mend fences after school? My parents created a childhood for my sister, brothers, and me so vastly different than their own and here I am, trying to go back to where my father came from, to the plains states where many of my mother's father's people still live. I flip on the radio to distract myself and when Diane Rehm's voice fills the car, I almost flip it back off immediately. Her guest is talking about his mother, though, so I wait, my hand hovering over the knob. Family. It is so complicated and yet so simple. We are like them except for all the things we do to not be like them. I turn it off. I don't need to hear another thing.

This [place/job/world] will change you, if you let it.

My very first patient in the ER was a 65 year old woman picked up by the cops after she fell down at the bus stop. She was high. She had no shoes or underwear on, just a big t-shirt with Tweety Bird on the front and a pair of black jeans with a hole in the left knee. Her matted hair was full of leaves and bits of twigs. When she came around, spitting invectives one minute and calling me angel the next, she admitted that she'd shot up with dope every day for as long as she could remember, probably since before you was born. No one saw her fall, so the doctor ordered a head CT to make sure that she wasn't bleeding into her brain. When I told her it was time to go get the test done, she looked at me as though I was out of my mind. You want me to go out of this room looking like this? I can't go out of here looking like this. I need to comb my hair. Hand me my pocketbook.

Like a song or a smell that takes you back to a place you can't quite name, something about the way that woman rifled through her purse - handing me her tattered address book, nubby tissues, a tube of lipstick, demanding a clean blouse before going out in public- reminded me of my grandmother so keenly I felt my throat catch. Oh no you don't. We are not playing this game. You can not see yourself and everyone you know in these patients. TOUGHEN UP NOW. GO ON.

So I have, mostly. I didn't give it a second thought when the principal with chest pain comes in, don't blink when I see the constant stream of patients with the same birthday as my friends & loved ones, don't think twice about the girl my age who was raped a few blocks from where I used to live. I ignore connections and shun similarities. These are other people. What do they have to do with me? Watch me shrug my shoulders as I give them their medications and send them on their way.

And then today the paramedics bring in a patient, another woman in her 60's, my lot in life it seems. She collapsed this morning, they tell us, she didn't have heart beat but we threw some epi at her and now she's got a pulse, they practically grin. She is unconscious, with a tube down her throat, and when I cut off her clothes I see that her emaciated body is literally eaten away by cancer. Her hair is cut stylishly and she is wearing earrings, complete with a tiny diamond in a third hole mid-way up her ear, just like Squirrel. There is no family, someone tells me, and after awhile, a woman with grey hair and a brave smile comes back, looking for my lady. I'm not technically family she tells me, but I might as well be. We've been friends for 44 years and we've been through a hell of a lot together. We met when we were 18 and then moved here. She looks over my shoulder, where her friend is lying on the stretcher, a tangle of wires and sheets. Is she in pain? If she were awake she'd say 'Lou, who cares if it's 10 am, we need a scotch.' Oh God, I hope she fed her cats this morning. She starts sobbing uncontrollably.

After the friend calms down and I walk her over to talk to the doctor, another nurse and I begin the task of making my patient look more like a human and less like a power strip. The smell rising off her body is terrible, and as I work, holding my breath, all my unanswered questions about life and death bubble to the surface. She is covered in drainage from her wounds and her own excrement. We work from head to toe and when I wash the excrement off her feet I notice 1) that her soles are mottled, which any nurse will tell you is a sign of imminent death and 2) her toenails have been freshly painted bright red. My 6 week old resolve cracks and I feel my throat catch once more. It is Sunday morning and everyone I love is at church and I am washing excrement off the feet of woman who is alive but dead and this is Squirrel and me in 40 years and I am not tough and really, does being human meaning living with half broken hearts our whole damn lives?

My patient's best friend of 44 years makes it clear in no uncertain terms that she would not want to live this way and produces the necessary papers to back up her claim. Someone comes over and removes the tube from the lady's mouth. I turn all the alarms on the monitor off, and pull up 2 chairs. As best as I can, I explain what all the lines on the screen mean, that no one can say for sure how long she'll hold on, that the medicine going in her arm keeps her from feeling any pain. She asks if her friend can hear us and I tell her that it's very unlikely, but I could be wrong, so we talk to her and tell old stories about their double dates, their trip to Europe. Before she leaves, the friend clutches my hand and says I could not have done this without you and instead of falling apart, my heart fills -- stronger, fuller.

The rest of my shift passed in the typical blur of people, their need, my ineptitude, cold coffee, paperwork, alarms. At 23:15 I clocked out and walked through the empty halls of the hospital to my lonely car, exhausted but oddly hopeful. It is a strange & abundant grace that allows us to see ourselves so clearly in our neighbors; that erases the line between us & them and bids us wash their feet, go on.