Cover and Interior Design by Smoking Gun Publishing, LLC
Copyright © 2015 Claire Applewhite. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior written permission of the copyright holder, except for brief quotations used in a review.
This is a work of fiction, and is produced from the author’s imagination. People, places and things mentioned in this novel are used in a fictional manner.
ISBN: 978-1-940586-24-3
Library of Congress Control Number: 2015905469
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Published by Smoking Gun Publishing, LLC
Printed in the United States of America
ACKNOWLEDGEMENTS
This book is the culmination of years of reading, research and listening to a seemingly endless supply of stories related to St. Louis City Hospital. Where did I find them? It seemed that nearly every St. Louisan had at least one to share with me. I never questioned the credibility of these tales; rather, I wondered how such events managed to occur. It soon became apparent that St. Louis City Hospital owned a unique reputation—specifically, a universal belief that this was a place where anything could and did happen.
I would especially like to thank the St. Louis City Hospital Alumni Association for their enthusiasm in keeping the memory of this St. Louis landmark alive, for their entertaining tales, and their camaraderie.
Thank you to Lois Mans, my graphic artist and friend, for sharing her many talents, friendship and support.
A special thank you to Thomas Applewhite, M.D., without whom this book could not have been written.
Finally, thank you to the St. Louis City Hospital employee “family.” You did your best to make St. Louis a better place for those who could not otherwise afford health care.
Claire Applewhite
April 26, 2015
DEDICATION
This book is dedicated to those men and women who selflessly cared for the patients at St. Louis City Hospital. Often working in substandard conditions, these devoted people confronted the challenges posed by poverty and disease with courage and determination. To this day, a strong camaraderie exists among them.
PROLOGUE
“Okay, listen up!” The young resident grinned at the fresh crop of interns. “Welcome to Orientation.” He pointed at a name embroidered on his long, white lab coat. “I am Dr. R. Franklin Freeman. Call me Dr. Freeman. And remember, this is not a hospital.” He chuckled, and gestured to the thick metal doors behind him. “Follow me, and you’ll see what I mean. We’ll start with the inmates of Division Sixteen.” He winked at a petite brunette. “Later, cutie.”
The metal doors parted. The stale scent of disease filled my nostrils. Rusty fan blades sliced the still air. Mammoth flies circled rows of huddled bodies, trapped in creaky beds.
Dr. Freeman sipped coffee from a dingy foam cup. “Ah! Another day in paradise,” he quipped. “Straight ahead there, folks. Watch your step!”
My colleagues and I gawked at Freeman, and then, at one another. Some advanced with caution, while others hesitated, immobilized by his unabashed scorn for the chronically ill.
I recalled my days in the second grade at St. Ambrose Elementary School, when Sister Loretta asked us to pray for the poor souls who had no one to pray for them. As a child, I didn’t understand how I could pray for people I didn’t know. Back then, I wondered where they lived. Now, I knew.
“Take a good look,” Freeman said. “But, don’t take too long. We’ve still got a lot of looking to do. I promised some sweet young things we’d stop at the nurses’ station. Chat a little, you know. A few words to the wise: it’s smart to stay friendly with the help.” He took another swig from the cup and pressed a large silver button below the EXIT sign. The scratched metal door whined and opened into a wide hallway. “Trust me.” He tossed his half empty cup onto the seat of a dilapidated wooden wheelchair and grinned. “Welcome to City Hospital!”
ONE
My name is Thomas Anthony Spezia. I am a first year intern at University School of Medicine. Besides Mamma, Papa and Grandpa, I have two brothers and four sisters. We live in an Italian-American neighborhood in St. Louis, Missouri, known as “The Hill,” in a house that’s been in our family for, well…just a very long time. Since I’m the first Spezia to graduate from college, the whole family believes I’m a genius, except for my older sister, Rosa. To her, I’m just the little brother who wants to be a doctor.
Sometime around my fifth birthday, I found a robin in our backyard. When I picked it up, it tried to fly, but its wing was broken. I decided to fix it.
Mama was the only person who knew about my “patient.” At first, she wasn’t too enthusiastic, but I was determined to succeed. Finally, she agreed to buy a few supplies. “Just don’t be surprised if this doesn’t end up the way you expected,” she said.
I lined a shoebox with crumpled newspaper, and “set” the wing with a popsicle stick and adhesive tape. Three times a day, I fed the bird some milk and honey from an eyedropper. My “patient” grew stronger. Mama couldn’t believe it. One morning, the robin hopped out of the shoebox, and Mama told me it was time to say goodbye. I felt a little sad, but my curiosity overwhelmed me. When I unwrapped the crude bandage, the bird fluffed its feathers, flapped its wing and soared into the clouds. I felt elated!
That same day, I told Mama I wanted to be a doctor. She said she never considered a choice like that for me, but she thought it was a nice idea. Then, she said what she always said when a decision needed to be made. “Talk to Papa.” When Papa came home from work, I told him about the bird’s broken wing and how I got it to heal. Finally, I told him I wanted to be a doctor.
He listened, and nodded once or twice, but he didn’t say anything. In fact, I thought he forgot what I said until the following day, when the entire Spezia family gathered for Sunday dinner. I will never forget that night.
Papa always sat at the head of the table. We had just finished a meal of Mama’s lasagna, accompanied by her special 10 ingredient salad. Mama placed a large platter of cookies from the Italian bakery in the center of the table. Then, she arranged half a dozen cookies on a smaller plate, and served them to Papa. My sisters, brothers, and Grandpa served themselves.
“I’ll get the coffee,” Mama said.
“Not now, Marie. I want you to sit down,” Papa said.
Mama immediately sat in her chair, beside Papa.
Papa took a deep breath, straightened his shoulders, and faced the members of his family. I didn’t recognize the expression on his face.
“There’s some things I want to ask you tonight,” he said. “Because I have a big question—and no answer.”
Everyone stopped eating. A tense silence filled the room.
“Okay,” Papa said. “I’ll get straight to the point. Does anyone here know what it means to be a Spezia?”
“What’s bothering you, Vinnie?” Grandpa said. “Just tell us already.”
Papa pounded the table with his fist.
“I’ll tell you what’s bothering me! I don’t think this family understands the Spezia tradition, the pride, the…”
“Papa, what do you mean?” Rosa said.
“I mean, Spezias are cops. We have always been cops.” His lower lip started to tremble. He stopped talking, but only for a moment. “We’re the best of the best.”
“Yeah, Vinnie,” Grandpa said. “That’s right. So what’s the big question you got with no answer?”
“Yesterday, I hear my son wants to be a doctor.” Again, he pounded the table. “Not a cop, mind you. Not even a stinkin’ d
etective. No, he wants to be a doctor!”
Grandpa turned to me.
“Tommy, is this true?” he said.
“Yes, Grandpa. But, I don’t want to make Papa angry.”
“Papa isn’t angry,” Mama said.
No one spoke.
“Vinnie,” Mama said, “remember the night your father got shot? The ambulance took him to City Hospital. Remember?”
Papa stared at Mama for a few seconds.
“Of course I remember, Marie. How could I ever forget?”
“Then, you remember how grateful we were to the doctor that took such good care of him.”
Papa studied the platter of cookies. “Yeah.”
“Do you remember the thing your father said on the way home from the hospital?”
“He said a lot of things, Marie. Which thing you talking about?”
Mama smiled at Papa.
“He said if Spezia cops have to take a bullet to make a living, they deserve their own doctor.”
Papa grinned at the memory. “Yeah, now I remember. He did say that. I guess I forgot.” Papa turned to me. “I’m sorry about all the doctor stuff I said to you, son. I just didn’t understand the big fuss about a bird, and all this talk about being a doctor. I still don’t. It’s just that, to me, Spezias are cops. They aren’t doctors.” He sighed and studied his plate of cookies. “You really want to be a doctor?”
“Yes, Papa,” I said. “I really do.”
“Tommy’s a smart boy, Vinnie,” Grandpa said. “Why shouldn’t he be a doctor?” He waved at the air as if he was swatting a fly. “I know, I know. Spezias are cops. But Vinnie, listen to me. Cops need doctors too.”
Papa didn’t say any more, but even at the age of five, I suspected this discussion was not finished. Time would corroborate my suspicion, but it didn’t matter. After that memorable Sunday evening, I knew one thing with utter certainty: I wanted to be a doctor.
For the next sixteen years, I focused on high grades, and my acceptance to medical school. Finally, the day arrived when the mailman handed a letter to Mama from University School of Medicine. She said her hands were shaking too badly, and she wanted me to open it. In truth, I suspected she didn’t want to be the bearer of bad news.
“It might not be what you expect, Tommy,” she said. “That’s okay.”
Grandpa looked at me. “Open it, Tommy. They just want to tell you how much all this is gonna cost, that’s all.” He shrugged and stared at Mama. “Oh, he got in, alright. What’s the matter with you?”
My fingers peeled back the flap of the envelope, and I glimpsed the top of the letter that opened with “Congratulations!” Hot tears welled in my eyes, but I didn’t fight them. I earned every one of them. They belonged to me.
Grandpa was right. I got into medical school.
Mama was right, too. Medical school wasn’t what I expected.
Five years later…
I crossed the street and climbed the massive front steps of City Hospital. While I parked my Pinto on the gravel lot, an orange sun—and its promise of another scorching heat wave—rose in the hazy sky. For those with no air conditioner or fan, that promise could prove fatal. At 7:00 a.m., sweat dripped down my face like I was in a sauna.
The monstrous entrance loomed before me. A security guard stroked his grizzled beard and nodded. Uncertain of a reply, I nodded in return. I tugged on the chrome handle of the door and stepped into the musty foyer. Once inside, my heart sank like a leaky rowboat.
The blades of a rusty ceiling fan twirled in the stale air. A plump rat scurried across the terrazzo floor. In the wide hall outside the Gift Shop, my dress shoe landed in a gob of gooey pink bubble gum, but I knew I had no time to clean it. Today, I would examine my first patient. I had to be prompt.
Despite Dr. Freeman’s Orientation, I got lost on the way to the clinic. Yesterday, he mentioned Dr. Skelton’s notoriously high expectations. Still, I hoped he would understand if I was a bit late on the first day. By the time I finally located his office, tucked away at the end of another long, wide hall, I breathed a sigh of relief. I knocked on the back door and waited.
“Who’s there?” Dr. Skelton said. The door cracked, and he waved at me to enter his office.
“Dr. Skelton,” I said, “I am Thomas Spezia. The new intern? I’m—”
“You’re late,” Dr. Skelton said. “Late is what you are, Thomas Spezia.” He gestured to a metal folding chair in a dark corner of the room. “Now, sit down. Pay attention. Please.” He nodded at the woman beside him. “Dr. Spezia, this is Mrs. Raines. Lori Raines. We were just discussing her latest test results.”
She used to be beautiful, I could tell. The heel of her shoe scraped the dull floor. Tensed on the edge of a wooden chair, Mrs. Raines looked incredulous. A shrill undertone spiked her soft voice. “Are you sure, doctor?”
Dr. Skelton coughed and shuffled a thick sheaf of papers. “Hmm, I’d say so, Mrs. Raines. I won’t lie. You’re a very sick woman.”
For a few moments, the woman sobbed. Her narrow shoulders shuddered with agony.
Dr. Skelton cleared his throat. “Yes, well,” he said, and gazed at a crack in the grey plaster ceiling. Finally, he swiveled in his chair and faced her.
“Mrs. Raines, now there…there now, dear, that’s enough tears,” Dr. Skelton said, “for today, at least.” He yanked a white tissue from a box on his desk and waved it in mid-air. Mrs. Raines’ trembling fingers clawed at the wispy square—much like a drowning person might grope for an inner tube. “Now, as I said earlier, you must fight to remain calm. You must use your time wisely. After a closer look at these scans, I’d say you’ve got about six months.” His hand flipped back and forth. “Give or take.”
Mrs. Raines whisked the tears from her ruddy cheeks with the crumpled tissue. Her gaze drifted to the maze of diplomas, symmetrically arranged on the cracked plaster wall. “But, this just can’t be. I just…” She straightened her shoulders and sniffled. “I don’t feel as sick as you say I am, doctor. Not like that.”
“Well, Mrs. Raines, then why are we here? You must not be feeling like yourself, or you would be, oh, shopping or getting your nails painted. Am I right?”
“Six months?” Outside, a robin perched on the crackled windowsill. The brunette studied her wedding ring and shifted her slender body. The creaky chair whined. “Did you say six months?” Her voice squeaked with a fresh anguish.
“Give or take, Mrs. Raines.” The morning sun sifted through the yellowed blinds. He swiped at flecks of dust in the air. “Blasted things.” Dr. Skelton slid the file across the desk.
“Now I believe we’re finished for today, but we still need a few more tests. The best way for us to get them, Mrs. Raines, is for you to go right back to the hospital and check yourself in, for a just a day or two dear, just like last time. I’ll be by to see you in the morning. My receptionist will help you with your paperwork. Oh, and Mrs. Raines?”
The frenzied woman rushed through the open doorway. “Eddie?” she said. “Eddie, where are you?” The clatter of her high heels echoed in the cavernous hall. “Eddie! I need you!”
Dr. Skelton rose from his chair and closed the door. He turned and studied the young man with the olive skin and kind eyes, clad in a starched white coat. “Well then, Spezia, you have just witnessed the delivery of some bad news. I had hoped that Mrs. Raines’ cancer wouldn’t be quite so advanced. Six months was actually an optimistic prediction on my part. As you can see, this can be a very sad business.”
“I believe the patient understood her predicament,” I said, “but she didn’t seem to accept there wasn’t much that could be done to change the outcome.”
Dr. Skelton almost smiled. “Yes, well.” He shrugged and gazed at the clock. “I’ve never been very good at the bad news thing. No matter how long you practice, Spezia, that part never gets any easier. Mrs. Raines’s case is quite complicated. We reviewed her case in great detail. It’s unfortunate for everyone involved that you missed the first p
art of the interview. You will need to know all of it. This situation must be extraordinarily difficult for a woman like Mrs. Raines to accept, given her professional background. From what I’m told, she used to be quite the entertainer. Exactly what she did on the stage, I really have no idea.” He waved his hand in the air as if he was swatting a fly. “I assume she did some singing, maybe some dancing. I don’t know, something like that. Spezia, are you ready to review the chart?”
I had spent the past twenty years of my life preparing for this moment. “Of course, Dr. Skelton,” I said.
Dr. Skelton cleared his throat. He grabbed the chart labeled Lori M. Raines and placed it in my outstretched hands. “Here you go, Spezia,” he said with a wink, “Here’s a little light reading for you. Look it over and then, why, we can discuss whatever it is that you don’t understand. If your grades are any indication of your ability, our discussion should be quite short.” The doctor yawned and glanced at his wristwatch. “It’s all quite self-explanatory.” He paused and again, cleared his throat. “Is something wrong, Spezia?”
How could I tell him the truth? That I didn’t expect that my first patient would have less than six months to live? Those were the words that I wanted to say. I decided if Dr. Skelton thought I could handle such a case, then, I could, and I would.
“No, Dr. Skelton. No.”
“No, what?”
“No, nothing is wrong. Absolutely nothing.”
“Excellent. As I said, the file speaks for itself. If only it had something better to say, hmm? I’ve admitted Mrs. Raines for more tests. It’s a real opportunity for you to educate yourself about the issues surrounding a terminal illness. Wouldn’t you agree, Dr. Spezia?”
I stared at him. “Opportunity, sir? Did you say opportunity?”
“It is my understanding that you wish to become an oncologist.”
I nodded in agreement. How did Dr. Skelton know that? I didn’t recall sharing information with anyone except my grandmother, on the same night she died of colon cancer. “Yes sir. That is correct.”
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