Saigon, Illinois

by Paul Hoover

  “Nancy,” he said with pride.

  Barbara leaned over to look.

  “Very nice,” I said for his sake, and for hers I added, “His wife, the former Nancy Princetti.”

  “No!” she said with evident sarcasm. “Not one of the Princettis. Really?”

  “That’s right. The ones and onlys.”

  “Let me see that.” She took it out of my hand and held it up to the light. Romona was droning on about Food Service.

  “Well,” said Ed, “what do you think?”

  “She’s very pretty, Ed,” I whispered. But I was thinking, Who shows his wife in a nightgown to people he just met?

  “She’s lovely,” said Barbara, “but she looks like a five-dollar whore. Next time you take a photo, why don’t you have her put some clothes on?” She said it in the sweetest, most disarming way, almost as if she were flirting.

  Ed did a double take. This lady next to him seemed pretty nice, but she didn’t act like the girls back home. Maybe she was kidding him, that’s what it was. She was a kidder.

  “And another thing, Ed,” she continued, “blue is not the color, simply not the color. You tell Nancy to get something else.” She patted the back of his hand and stuck her chin toward the lecture. Her authority was such, Ed felt instructed rather than insulted. He would probably go home that night with a pink nightgown for Nancy. They’d make love, and he’d pose her on the stairs for a new photograph. Barbara had changed Ed’s life for the next three weeks or so.

  But she wasn’t so happy herself. She’d never had the children she wanted, and then her husband left. He fell in love with a woman named Sylvia, who happened to be their milkman. According to Barbara, Sylvia was ugly to the bone, but he fell in love with the uniform. They ran away to Albuquerque and lived in a trailer home, and nothing ever happened to them. That’s why Jack liked Sylvia so much. She made nothing happen, and you can depend on that. Barbara, on the other hand, made everything happen, especially to herself. She said she got a “jackalope” postcard from them now and then, showing a cowboy riding an animal that was half jackrabbit and half antelope; but there was no news to speak of. Once Jack pasted a picture of his face over the cowboy’s face and drew a speech balloon near the mouth that said, “Ha, ha!,” to show how much fun he was having. He’d been a lawyer in Chicago, but all he did in Albuquerque was sit around the trailer home and cook up his special chili.

  “Oh, poo,” she said, “this is boring.” And so it was. Janush was back on the floor, talking about a form the clerks should use for visual acuity tests. I looked around the room: people were half asleep. But I wasn’t. I was having the time of my life.

  The next evening I reported for work. The hours were four until midnight, and when I pulled up near the hospital, parking spaces were easy to get. Everyone else in the world was headed in the other direction, looking tense and driving crazy. They flowed north on Lake Shore Drive, thick as mud, while only a handful of cars headed south toward the Loop. It was like free-falling. The sensation was giddy and happy, but there was also the feeling of everything blowing past your ears at high speed.

  Romona Fisk held forth from an office near the sixth-floor elevator. To my surprise, it had no windows, and the room was intensely hot. A small squat fan sat in the corner making white noise, a dull drone that went on like a headache. She had her elbows on the desk, a cigarette held in both clasped hands. The others in the room were Ed and Barbara. It was Romona’s job to break us in.

  “Hey!” said Ed, giving me the “bang, you’re dead” sign with his thumb and index finger. Barbara said hello with her dimples. Romona opened the palm of one hand by way of greeting. Otherwise, she didn’t move, since her main principle was the conservation of force. After all, this was the evening shift, and things went slower. Let the rest of the world bang into each other. It was those on the evening shift who sanely held it all together.

  Her first task was to check in the clerks, but she did it without moving. They came by the office. If somebody was missing, she’d have the clerk on one unit cover the other one, too. They rightfully hated this practice, and sometimes we would take up the slack ourselves. There was a clerk missing on one of my stations, Six South, but the clerk on Six North said she would handle it, to my great relief.

  Romona took us on the two-dollar tour of the hospital, pointing at things of interest with her lit cigarette. We went past Housekeeping, Maintenance, Transportation, Medical Records, Admitting, and even X-Ray. We saw huge stainless-steel pots of mashed potatoes being churned in Food Service, and got special permission to visit the second floor, where Surgery was located. In a cold blue-tiled hallway, we stood peering through a window at a brain surgery in progress, in spite of the late hour. It was surprisingly informal. The surgeon seemed to be telling jokes, because he waved his instruments around a lot, and the nurses were laughing. At one point, he jumped down from his stool and did a little dance in the middle of the floor. Our view of the brain was obstructed. Ed was disappointed.

  When the tour was over, Romona dropped us each off at our stations and introduced us to some of the staff. Then she went to her office, saying she’d see us in the cafeteria around six P.M.

  My stations were all those on the fifth, sixth, and seventh floors, including Intensive Care, Pediatrics, Orthopedics, and two large general medical and surgical units, one of which was “Social Service.” This meant the people on the unit were all poor, and the state or nobody at all was paying the bill. All the equipment on Social Service, or Six South, was cheap, borrowed, or old. The beds were old wooden ones from the 1930s, with stiff hand cranks. The other units had new electric beds that did everything but the breakfast dishes, but the rooms on Social Service looked like mill-town tenements. They were also very full, six beds to a standard room. Since the sixth floor was also the lowest floor with regular patients, there was some symbolism to where the poorer patients were placed. Wealthy patients were usually given rooms on the top floor of Metropolitan or on the executive diagnostic unit, Fifteen South, where people from the big corporations went for three days of testing each year, mainly for ulcers and heart disease. These rooms were all private and had elegant furnishings. The hallways were kept in semi-darkness after dinner, and the nurses seemed to walk on cushions, noiselessly. But on Six South, there were no easy graces. All was public and loud, with clattering carts, screaming nurses, and nursing aides who could rip off your jaw just for the recreation.

  I walked from one unit to another, trying to look as though I had some role. Finally I headed back to my office, which was smaller than Romona’s and even less well situated. Actually, it was a former storage room, about six by eight, with ceramic tile walls and no windows. I tapped my fingers on top of the desk for a while, looked through the drawers, which were mostly empty, and went back into the hall.

  There stood Robert Sage. He looked like Frankenstein’s monster after three years on a diet. Two purple scars, with marks where stitches had been, ran the length of his scalp, and the hair had not grown in. His color was yellow, and his eyes were dead, but he smoked a cigarette and strolled around in an old woollen robe. As he passed by like a creature from Night of the Living Dead, I saw a note on his back: “My name is Robert Sage. Please return me to Six South”

  “Lobotomy,” said Betty Marder, one of the nurses.

  “They still do them?” I asked.

  “No law against it. In fact,” she said, “the state of Illinois ordered this one. He couldn’t stop beating his wife, he set fire to the house, and the kids are wards of the state. You should see the chart. It’s amazing.”

  She pointed to a rack of metal charts. The patient’s name was taped to the front of each chart, and they were arranged by room number. The station clerk, whose name was Ruth, had a bunch of them piled in front of her, transcribing doctor’s orders. The doctors indicated when this was needed by slipping a pink piece of cardboard into the chart.

  “What’s more,” said the nurse, “they gave his wife one
, too. She’s up on Eight South, in about the same condition.”

  “Why up there? Why not give them a double room?”

  “Insurance, what else? You just take a look at the chart,” she said and walked briskly down the hall, an enema bag held high in her hand.

  For the first time, I entered the nursing station, and Ruth, the black station clerk, gave me an evil look.

  “Whatchu doing in here?” she said.

  “I need the chart of Robert Sage,” I replied. “Do you have it?”

  “You’re not gone be looking in these charts,” she said, giving what I hoped was her sternest look.

  “Oh, yes, I am,” I said, picking up the nearest one. Thank God, at least it was the right one.

  “Romona’s gonna hear ʼbout this,” she said, wagging a finger.

  “Yes,” I said, “but you work for me, and Betty said I could look at the chart.”

  “Well, why didn’t you say so?” she said. “If Betty says so, you can do it. Just make sure you put it back where you got it.”

  The new management program, which hired mostly college kids and other misfits, didn’t sit well with the nurses, especially the supervisors, who saw their own roles threatened. Nurses ran hospitals, by God, nurses and doctors. Ruth thought that way, too: besides, she had been passed over for promotion when they started the program.

  I took the chart to the back of the station and sat on a chair. The history and progress notes, on lined paper, told the story. After several years of odd behavior, including tattooing his penis with the picture of a whale and setting fire to the neighborhood cats, Sage had brought on the slow wrath of the state, which made the lobotomy decision. Drugs and shock treatments hadn’t worked, and he had a green card, so the state would cover his expenses. Since his wife was also crazy (made crazy, perhaps, by him), they’d ordered one for her, too. But her financial situation was different. Through her father, Ellen Sage had insurance, which meant she could stay on the neurological unit. After the Sages recovered, the social worker planned to have them live together again, like Adam and Eve in the garden. The main problem was who would do the cooking.

  “This is a hoot,” I said.

  “Mind your own business,” said Ruth.

  Betty Marder came by and shrugged.

  “I thought lobotomies went out with dungeons,” I told her.

  “Believe me,” she said, “he’s happier now. Just look at the guy.”

  There he was again, leaning on his elbows at the tall nursing station desk.

  “Cigarette,” he said, pointing at his mouth.

  “Not now,” said Betty in a slightly loud voice, as if he couldn’t hear. “You have cigarette later, before you go to bed.”

  “Heap big cigarette, ugh!” said Ruth, which got her a punch in the shoulder from Betty.

  “I keep all his cigarettes here,” she said, taking a set of keys from her pocket and opening a drawer at the back of the station. There were two or three boxes of very small vials, each with a different color-coding, and a pack of Pall Malls.

  “Narcotics. This one here is morphine,” she said, holding up one of the vials and flicking it with her finger. “It’ll cure whatever ails you.”

  “And then some,” said Ruth, as if she knew.

  “Narcotics,” repeated Robert Sage, pronouncing the word perfectly.

  The nurse put the vial on the desk and locked the drawer again. Then she reached onto a shelf and pulled down a disposable syringe and needle, each in its own paper wrapping. After assembling the two, she snapped off the head of the vial, removed the plastic shield from the needle, and sucked the watery liquid into the syringe. All of us watched with fascination.

  “Me,” said the patient from 601, pointing.

  “No, not me,” said Betty, sticking out her chin. “You have a cigarette later.”

  “Later,” he said.

  “You give me now,” said Ruth, holding out her arm and spanking the vein. “Make Ruth feel good.”

  “This is for Mr. Johnson, fool,” said Betty. “Cancer give much pain.”

  There was a light on down the hall where somebody needed help, and the room number on the chart indicated it was William Johnson’s. The Kardex, which listed each patient’s drug and treatment regimen, said he could have morphine every four hours. More often might kill him, and only the disease itself was allowed to do that. A woman stood outside Mr. Johnson’s room, looking down the hall at us. Her arms were folded, and she looked impatient.

  “Pain,” said Robert Sage, pointing at his head.

  “No pain,” said Betty Marder, already halfway down the hall, holding the syringe.

  A failure of technology can result in acts of kindness. Years ago, the hospital had installed an intercom system so the nurses could talk to the patients directly and not have to walk to the room. Being the first of its kind, it didn’t work well, so the nurses forgot about it. A long panel of lights and switches that looked pretty antique rested at the front of the station, between two sections of charts. Everyone ignored them, watching instead for lights above the doors of the rooms. This was nicer for the patient, since it meant more contact with the staff, but it also meant more steps for the nurses and aides. They had to walk to the room, find out what the patient wanted, return to the station to get it, and then go back to the room. On a given evening, a nurse would walk about twenty-five miles. But the sheer exertion of answering all the lights sometimes had the opposite effect: in the absence of the nurse, aides would sit at the station talking while the halls were lit up like Christmas trees. While Betty was taking care of Mr. Johnson, three lights were shining on the other corridor.

  Robert Sage still stood congenially at the desk, a Mona Lisa smile on his face. He reached over, picked up a chart, and opened it, as if to read.

  “Hey,” I said, “you can’t read that.”

  “He shore can’t,” said Ruth, “that’s why we let him do it,” and then, under her breath, she said, “Stupid honky.”

  “Honky!” Robert Sage said brightly.

  “You damn, right!” said Ruth, giving a square-toothed smile.

  Ed and Barbara walked around the corner.

  “How’s it going, my man?” said Ed. “You ready to eat?”

  “I hear the meat loaf is simply divine,” said Barbara.

  “Yum,” I said and joined them.

  We left Robert Sage to his own devices, flipping through the medical chart with the appearance of understanding.

  “Who was that?” asked Barbara.

  “Dr. Robert Sage,” I said, “who sees through stone.”

  “Huh?” said Ed, hitting the down elevator.

  “The wisest of the wise,” I said, “and the happiest man in the world.”

  “Except for you, Ed,” said Barbara, giving him a punch on the shoulder. He blushed, because he didn’t know what else to do.

  Romona joined us in the cafeteria. She was halfway through a story about her son, the real-estate failure, when the gravel voice of a woman came over the loudspeaker system: “Dr. Blue! Room 621, Six South. Dr. Blue, Room 621, Six South.” It was repeated several times, but by the second, half of the medical staff in the cafeteria had jumped to their feet and were running from the room.

  Romona was flushed and excited. “Come on!” she said. “This ought to be good. It’s your unit, Jim.”

  We headed after the fleeing doctors and nurses. Some of them were standing by the second-floor elevator, impatiently staring up at the light; others were clambering up the stair-case. Romona decided on the elevator but pointed toward the stairs for the rest of us. “Not for me,” she said, pointing to her heart. “But the rest of you go that way.”

  “What’s the deal?” said Ed, shrugging his shoulders.

  “Somebody’s having a heart attack,” said Romona. “Hurry up, for Christ’s sake! They might need supplies.”

  Ed and I headed up the stairs as fast as we could go, but Barbara was just behind us. The stairwell was filled with brea
thing and clatter, and we burst through the sixth-floor door dizzy with the exertion. People were streaming down the hall in white coats, interns with their pockets full of notes, residents in longer white coats, stethoscopes bouncing around their necks. We followed timidly, trying to act like we knew what we were doing. Romona wasn’t there yet, so we stood around on the other side of the hall, trying to catch a peek of the action.

  It had to be Mr. Johnson. His wife was standing alone at the deep end of the hall, holding her head with both hands. Barbara walked down to her, and, after a few words, they sat down like they’d known each other for years.

  Romona came lumbering up, swinging her clipboard and half out of breath, even though she’d taken the elevator. “You’re gonna love this,” she said. “Come on.” She led us into the room, where we could see what was going on. The medical personnel had filtered down to about five people called the “arrest team.” Every evening one was assembled: the medical resident on call, in this case a Dr. Rickles; the intern assigned to that unit; the anesthesiologist on duty, a Dr. Ramanujan; an EKG technician; and an inhalation therapist, who hadn’t shown up yet.

  The resident stood at the head of the bed, shouting orders. Beside him, sticking a tube down Mr. Johnson’s throat, was Dr. Ramanujan, but it wasn’t going too well. She maneuvered and pushed, but the tube wouldn’t cooperate. In frustration, she threw it to the floor and reached into the drawer of a large red portable unit, called the crash cart. Every floor was supposed to have one. It was my job, in fact, to stock the thing. On it was everything needed for an emergency like this: saline solutions, various drugs for the heart, IV tubing, a portable EKG machine for monitoring the heart, and a lethal-looking device with two round metal “paddles” called the defibrillator. This was used in case the heart stopped altogether; you placed these paddles on the chest and shot electricity through the body, to shock the heart into action.

  The anesthesiologist had trouble finding a tube the right size. The new one didn’t seem to work either; when she removed it from his mouth there was blood on it. If she kept this up much longer, she was going to dig the guy a new throat. The resident looked pissed.