Short Story: Patients

After washing my hands with warm water I squirt disinfectant gel on them from the plastic dispenser that hangs on the wall, and stand looking in the mirror while I rub them dry. Looking older? Surely, but it’s so hard to notice, day by day changes, cell by dying cell. Show me a photograph of me from ten years ago and I will jolt with recognition and sadness. Older we go into the unknown, over and older again.

There’s a lot of that here. A mighty sum of accumulated years. I wonder what the average age of the patients is, as I push the bathroom door open with my foot, proud of not touching the handles. My elbows open doors; my feet lift unknown toilet lids.

Simon is sitting where he had been, in the thick green chair next to the bed. He looks noticeably older too. His face is paler; I guess this place adds a few years. He is holding the clipboard that had been hanging at the end of the metal-framed bed, and he is looking at the rise and fall of the numbers on the colour-coded chart.

The old lady in the bed to the right looks up and smiles through her spacious glasses. She is still working on the word-search puzzle. she’s up to page seventy-five now, though she told me she skipped sections when she got bored of them. Earlier I watched her draw surprisingly neat faces on the inside of the cover of the puzzle book then scratch them out. Rosie, the nurses call her, and they all seem to know her name: a friendly name for a friendly face. She talked to me about the kids that sometimes trespass onto her back garden in Athenry to get to the river bank and follow it through the town. She’s like a gentle river herself when she starts chatting, flowing from one topic to the next with an easy but constant rhythm: her son, her neighbours, the tea, the weather, and the changes.

Simon looks worried. I want to tell him that his worrying creases are becoming part of his default face, but it’s the wrong time. He doesn’t appreciate those comments. I don’t believe in Botox but sometimes I try to make my face fully expressionless, even if only for a few minutes. Anyway, I know what he will say. “I have a lot on my plate these days.” I know him well enough to predict full sentences, so they often go unsaid, though I still find it hard to sit still through the longer silences, and my mind keeps proposing phrases or sighs or meaningful long breaths to punctuate the gaps. “Ah well,” I will say, then maybe “It could be worse,” and perhaps I will make the effort of envisioning a potbellied child with flies around its head in a sweltering bone-ash dry desert a thousand miles from a welcoming door, even though I know I shouldn’t do that as it makes me feel too remote. In any case I will invariably fade away with “what can you do?” or “hard to know” or “I dunno”. “I don’t know… don’t know… know… no.” My utterances tend to taper into pregnant pauses that stretch out and taper, maybe like the universe expanding and losing its will to move.

A doctor strides by with stethoscope hanging from his neck. I’ve always been jealous of people who exude calm and stability, whose words seem to be infused with extra gravity, and whose conversation seems loaded with ballast. Even when completely wrong, theirs seems to be the path to follow. I tell Simon that people like this live in action, and not ideas, and that the consistency of their course matters less than what they are currently setting out to believe. Or at least I try to convey the idea, between all of the ahs and ams and inhaling: it’s a wonder we can even speak at all.
Simon smiles and the young worry-lines are redrawn into friendlier folds for a moment. Then he coughs a few times and they come back. He wants to know why the blood pressure is so low, and why the zigzag heart rate measures look like they were scribbled in by a shivering kid.

There’s a TV strung up on the wall behind me. I’m sitting at the outside end of the bed facing Rosie. Simon is watching it, but I can’t see it without straining my neck or moving. I watch his eyes dart up every few moments and force mine not to follow. I scan instead from him to Rosie sitting on her bed bent over her word-search with her feet dangling above the floor, and her thick ankles remind me of my late granny’s thick ankles and I wonder what gathers in them. Words well up: fluid collecting, pus draining, karma coagulating. black bile, yellow bile, phlegm, blood: The four humours sloshing around her swollen feet.

I scan back to Simon. We talk about the empty beds opposite. The Goth teenage girl had been moved from the one on the right to the one on the left because the one on the left is further from the exit. She arrived during the night and by morning there was a group of quiet worried adults holding a hushed vigil around the bed where she was squirming. “You know 20 paracetamol are not for your health?” That’s what Simon said he thought he heard the doctor say while the curtains were fully drawn around the bed. The Goth girl went to the bathroom later and came back bawling crying, then later again she tried to run away, twice, and then they moved her to the other bed and now she is gone altogether. Maybe she just wanted to skip across to SuperMacs? I was there yesterday with Simon, and he just sat and watched me scoff curry chips. I ordered a coke but the guy thought I said coleslaw. He was foreign but I joked about my thick country accent. Easier that way. Imagine if I went over now and the Goth girl was there, standing in the queue, looking up in the harsh white light at the red and brown and golden menus of fats soaked in burgers or chips or chicken nuggets. What would I say to her? What could I say? What could any of them say?

An alarm goes off in the next room. We listen to a rush of feet and voices, then it settles down again, and dinners are wheeled around. Simon looks unimpressed with the chicken and vegetables. “Food’s food!” I exclaim. “It’s ok for you, you can eat anything!” he replies. Visiting is supposed to stop during dinner but nobody says a word. I guess they enforce regulations when they need to, like the guards do with people drinking down by the Spanish Arch. I ask Simon what would happen if everyone tried to enforce every rule and regulation, I mean , really tried. He just shrugs. He’s looking at the pills in the little plastic cup now. He tries to learn their names and look them up on the Internet and worry about them being the wrong ones or about their possible side effects. They all seem to have a pile of side effects, like the same person is writing all of the lists, and wants to cover their ass just in case. I advise that given the situation it is best to gobble pills down without adding the worry of extra knowledge.

The same doctor hurries past in the opposite direction. When I walk down a corridor wearing my thick jacket I imagine myself as a doctor too, resourceful and knowledgeable, being tailed by a gaggle of eager but quiet student doctors, all respectfully admiring my every move. “Constricted left vastricular nerve” I will point out. “Notice the slight indentations above the hibea and the asymmetrical apsis glands? Now, look at the scan again… Gerry what do you think? No Gerry, the lymph node is normal, see? Alice? Good, but notice that the heart rate is elevated. Do a second liver biopsy and you look tired… Huh?” “I just said you look tired,” said Simon. I snap out of the daydream a little disappointedly. Can it still be called a daydream at night? Why not a wakedream instead? “You look tired too,” I say. “From all the hard work.” Simon grins, and I grin back. “It could be worse” I say. “I could use a holiday.” “Me too!” “You could always run away” I add, then we both look over at the bed where the Goth girl had been. They won’t be empty for long. Simon stands up and stretches. “It’s hard to feel healthy in here,” he says. “What’s the opposite to… what do you call it? A placebo?”

The evening has trickled by and we’ve hardly been saying a word. We walk down through and out of St Enda’s ward. The main entrance is closed now so we have to head on up to the A & E entrance. It’s a normal weekday night there. A drunken old man is sleeping across four seats and nobody is asking him to move. A worried couple soothe their child. They stare at the double doors and the blue door next to them with the letterbox. When you come in you fill in the forms and they go in the letterbox in the blue door. The triage nurses prioritize them and you wait until yours gets to the top. When a space is free inside someone will open the blue door and read out a name. While we are there a nurse opens the door and calls out “Samantha Reilly… Samantha Reilly?” I imagine Samantha Reilly sprinting down University road towards the Cathedral, convinced she has been cured, and then wonder if she could be in SuperMacs. But she would be too sick to run: she will have to come back. After the doctor sees you you will probably have to wait again, wait wait wait. A friend of mine reckons that some people exaggerate their symptoms to get to the top. A perfectly rational idea, though I doubt I would have the will to do it: I have a distended superego. I read somewhere that the most bang-for-your-buck easily fakeable symptom is (drum roll) shortness of breath. Wheeze when signing in, pant and pause to catch your breath. Quicker service. Might get a trolley, maybe an oscar.

I squirt some more disinfectant gel on my hands. In the olden days doctors would go from one bloody patient to the next with hardly a wipe of a blade, carrying along whole ecosystems of germs along with them, oblivious. Now they have all these gloves and sterilizers and disinfectant gel dispensers with helpful guides and a huge industry of drug-makers, and play a game of evolutionary chicken with strains of bacteria by filling everyone with antibiotics. “Forget about it!” Simon says. I tell him I’m not interested in conspiracies, but that I am very interested in systems and symptoms and simple incentives. “As a general rule, people, even the wicked, are much more naive and simple-hearted than we suppose. And we ourselves are too” I wish I could remember that quote: I wrote in my notebook. I can’t even spell Fyodor Dostoyevsky’s name without looking it up every time.

We are standing in the exit; close enough to the automatic doors to keep triggering them open and sending draughts of cold December wind in. Someone is probably cursing us from the waiting room. An ambulance pulls up and a man on a stretcher is pushed past with blood on his forehead. A thin woman in a nightgown asks us for a rollie. “We don’t smoke” is all I can say. It is time to leave; we are both almost asleep. I tell Simon that he shouldn’t stay so late and to take care on the drive home and then I head back down towards the ward, allowing myself to be a vigilant passing doctor again, peering into dark rooms lit only by TVs and machine lights to notice the numbers on the little screens and the restless figures curled up in their beds.

Donal Kelly, December 2013.

This is a case of Fragment:consider revising: I guess I will remove or rewrite this comment if I tinker the piece till it finds some better equilibrium. I should go back and hone existing stuff instead of oncemoreing into the breach and filling the world with new fodder. It has fodder enough, fodder aplenty, but the restless seeds must grow as they please. This story is based on some hospital visits: it's a strange place, a world unto itself, with so many personal dramas unfolding all the time. It got me thinking about what it means to be sick and how it can seem so similar to being healthy most of the time. I wanted to create a scene where it is very unclear who is the patient and who is the visitor. I have probably only succeeded in being unclear.

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