Had Tran been anesthetized already, she would have certainly died. The overdose I had already given her, combined with her head injury, was potentially lethal as it was. She was quiet as death when she returned to the ward, and I had been at her bedside ever since, watching for some sign of reprieve for both of us.
I couldn’t just blame the doctor and Cindy Lou for the orders. I had to blame myself, too, admit that maybe I was getting rattled, after three long months in what was vulgarly known among staff members as “the vegetable patch.” Maybe it was the Army’s fault for sending a sweet young thing like me to Nam. But one thing for sure: it wasn’t Tran’s fault, and she was the one who was going to die. I tried to explain all of that to God to account for the impure static in my prayers. Unfortunately, there were a lot of distractions that kept me from formulating a really good defense.
“Beaucoup dau!” This time it was bed seven, a fourteen-year-old boy whose Honda motorbike had collided with a tractor-trailer unit. The boy had a broken arm as well as a busted head. Once more George’s jungle boots slapped wearily down the concrete floor.
Somewhere in the distance, mortars crumped. Outgoing. I knew the difference now: what was incoming, what was outgoing. After 124 days in country, I was fairly blasé about anything that wasn’t aimed specifically at me, despite the fact that another nurse had been killed by a piece of a projectile just before I arrived in Nam. Mortars bothered me no more than receding thunder, ordinarily.
But, God, it was hot! This had to be the only country in the world that didn’t cool off at night. I finished Tran’s neuro checks and vital signs again and tried to touch my toes with my fingertips. My uniform was sticking to my skin and my hair stuck out at all angles, I had run my hands through it so much.
Pain boomed through my skull louder than the mortars and probed at the backs of my eyeballs. The odors of the ward were making me faintly nauseous. The smell of disinfectant and an Army bug spray so strong that when I accidentally used it on the telephone it melted the plastic was bad enough.
But the reek of pot drifting in from the Vietnamese visitors’ tent, a shelter set up between the neuro side of ward six and the general-surgery side of ward five for the families of our critical patients, was potent enough to give an elephant a contact high from half a mile away.
At least the disinfectant and the pot smoke covered up the aroma of the scenic beach, which stretched beyond the hospital perimeter, between the barbed wire and the South China Sea. It was off limits to us because it was used as a latrine by the residents of the villages on either side of the compound.
The smells were something everyone complained about a lot. When George had gone on his R&R to Australia, he said he’d felt light-headed getting off the plane and figured out it was because he wasn’t used to clean air anymore. He said he had to poke his nose into a urinal for a while until he could adjust to the change in air quality.
My own headache made me wonder about how Tran’s head felt, with all that pressure in her brain. By now the bone fragment pressing into her head could have been gently lifted, she could have been recovering.
Since they’d brought her back, I’d replayed the scene in my head hundreds, thousands of times, hearing bits of their snippy put-downs. Next time they could write down their goddamned orders as they were supposed to, so a person could read them, or give the medicine themselves, and the hell with Army wrist-slapping and nasty pieces of paper with snotty words like “insubordination.” Better to go head to head with them than this. At the same time, in the back of my mind an accusing voice wondered if I hadn’t overdosed Tran while entertaining some adolescent subconscious desire to “show them”—Chalmers and Cindy Lou—what happened when they didn’t listen to me. The idea scared the hell out of me, and I shoved it away. I was a nurse, a helping person, a healer. The whole thing was a mistake. I hadn’t realized the difference in dosages. I’d never harm a patient out of spite. Gutlessness, maybe, being too chicken to challenge orders until I was sure of what I was doing, but that was different, even if the results were the same. Sure it was.
She had to live. She had to. What in the hell could I do to get some response out of that floppy childish body? The hard thing about somebody you’ve met only after they’ve nearly been brained is that you don’t have any idea what you can promise them to induce them to do what you want. What did this kid like? What was her favorite color, her favorite toy? Did she even have any toys? Was a water buffalo a Vietnamese kid’s teddy-bear substitute? How would she look in a pretty dress? Would she get a kick out of wearing a funny hat while her hair grew back? Would her hair have a chance to grow back?
And why in the hell would she listen to me anyway? I tried to concentrate on my prayers, visualizing not some holy heavenly father in a long white beard but other patients I had been close to, people I had comforted as they died. Nice people. I saw their faces as if they were watching over Tran with me. Mr. Lassiter, a kind man with a daughter a year ahead of me in nurses’ training. When the doctor told him he had lung cancer, I’d held him in my arms while he cried and tried to get used to the idea. Later, when the cancer bit into his brain and he began doing weird, sometimes obscene things, I led him back to his room and talked to him and soothed him while he talked nonsense, and I remembered who he really was while he acted in ways that would have mortified him if he’d known. Mr. Franklin, an incontinent old man who was in a coma with a high fever all the time I cared for him, but who made me wonder, until he died, where he really was, and was he feeling the pain of the hideous bedsores that ate up skin and fat and muscle. And the baby born with its insides so scrambled we couldn’t tell if it was a boy or a girl, but whom I rocked and eventually persuaded its mother to rock before it died. Those people were who I was really asking to help Tran—them and the handful of my own friends and relatives who had died before I came to Nam. I thought about all of those people, visualizing them as a cross between ghosts and angels, relieved to be free of suffering and looking down at us with a sort of benign interest. They wouldn’t be overly anxious to have anyone, especially a child, join them prematurely. “Do me a favor, folks,” I urged them. “Nudge her back this way.”
Old Xe stirred, and I realized I’d been babbling aloud. I stood and stretched, my bones creaking louder than the mortars, and leaned over him. He didn’t seem comatose now so much as dreaming. The fingers of his right hand still gripped the medal thing to his hairless chest. He mumbled a word and groped toward me with his left hand. I thought again of Mr. Lassiter, who mistook me for his daughter in vaguer moments, and gave papasan my hand to hold. He grasped it with a power that was surprising in someone whose bones looked like a bird’s.
Whatever he was dreaming, it must have been intense, because he held on to me as tightly as if it were a matter of life and death that we remain connected. I stayed there as long as I could. It made me feel a little stronger, a little more confident, to provide even such a small measure of comfort. I thought that was what I was doing, at the time.
When I tried to pull away, his hand clenched over mine so tightly his ragged nails bit into my wrist. Well, the beds were on wheels. I tugged them a little closer together and counted Tran’s respirations, then checked her pulses and pain reflexes with one hand. The old man refused to relinquish either my hand or his holy medal. The wrinkles of his forehead and between his eyes deepened, as if he was concentrating. As I knuckled Tran, I thought I felt her stir slightly.
I was reaching for the blood-pressure cuff when the other patients started up again.
“Troi oi! Troi oi! Troi oi!” (Omigod, omigod, omigod!) The old lady from bed fourteen padded toward the desk, holding her head. “Beaucoup dau,” she complained to George, who headed her off halfway down the aisle.
“Mamasan, you just have numbah one pill. No more now.”
“Beaucoup dau,” she insisted, showing her betel-blackened teeth. She was not used to taking no for an answer. The interpreter said she was the scourge of the marketplace in
downtown Da Nang. She’d been clobbered with a rifle by an ARVN guard who wanted some trinket from her shop. She was lucky he’d hit her in the head, where she was well armored by a thick skull. If he’d hit her in the abdomen, he might have killed her.
Leaving George to handle her, I pulled away from the old man to take Tran’s blood pressure. When I pried my hand loose, old Xe’s hand, as if worn out from the exertion of holding on to mine, flopped between the rails and brushed my back.
I dreaded starting the neuro checks again, and my hands fumbled as I lifted Tran’s lids to check her unseeing pupils. If she died, nothing would ever be all right for me again. I wished I could trade places with her. My own skin crawled when I pinched hers, my own lids twitched when I lifted hers, and I felt a knot in my chest when I knuckled her.
I apparently felt more than she did. “For Christ’s sakes, Tran, that must hurt like hell. Snap out of it. Come on, kiddo, wake up.” The breath eked out from between her lips with little sighs. I wanted to smack her awake, anything, just so she’d move. That would be compassionate and helpful, now, wouldn’t it, nurse? Shit. I just wasn’t cut out for this. I was okay with the gallbladders, cancer cases, and geriatric patients I’d cared for while I trained in Kansas City, but we just hadn’t had a lot of skull fractures, traumatic amputations, or people with parts of them shot and melted away. I could take each case individually, but the collective weight was driving me down until I was simply too tired and depressed to try anymore. I was merely going through the motions, reacting automatically, leaving myself and my patients wide open to something like this.
The old man’s hand brushed my hip and I swiveled around and looked at him suspiciously. He seemed the same as before, one hand still clutched at his sternum, the other now curled against my waist. Another mortar crumped and the bedlam in the ward broke loose again.
“Dau quadi!”
“Beaucoup dau, co!”
“Troi oi! Troi oi! Troi oi!”
I tucked the old fellow’s hand against his side and stroked Tran’s arm as if she needed soothing, not I. Through one of the three windows set high in the curve of the corrugated wall of the Quonset hut ward the sky was streaked with lemon, turquoise, and deep purple. Dawn was dawning and everybody on the ward seemed to have something loud to say about it.
“Jesus Christ, George,” I said, stilling Xe’s questing hand by holding it again, “can’t you at least get them to do it in harmony?”
George grunted and rolled his eyes above his Archie comic.
Maybe the noise wasn’t really loud enough to wake the dead, but then again, perhaps all that restless energy was contagious. Because this time, when I knuckled Tran, her mouth twisted and from it came a thin cry, like the kind that comes from a baby doll when you squeeze it.
I mention that incident for several reasons. I guess the first is to get it out of the way and tell it myself before anyone else does. There are those who may use that particular medication error to hint that I was an unstable nurse, which, of course, I was, and that my judgment was faulty, which it also was. However, I think it’s important to note that my initial assessment of how the situation should be handled was rejected, which was also the case later, with Dang Thi Thai. That’s what made me realize how powerless I was to do what I knew was right, and what made me take Ahn’s case into my own hands. Maybe in a war situation there’s no way to avoid tragedy, but I was trying, at least, to do what I thought was right. But most important of all, Tran’s case was the first unknowing link between Xe, the amulet, and me, and what led to my transfer. And that, of course, led to everything else.
Tran’s vital signs had stabilized by the time the day shift came on, and she was reacting to painful stimuli again. She was rescheduled for surgery that afternoon. I was scheduled for a meeting with Lieutenant Colonel Letitia Blaylock, the Chief Nurse of the hospital, that same morning.
I wasn’t afraid of Lieutenant Colonel Blaylock by that time. As long as Tran didn’t die from my carelessness, there wasn’t really very much the Army could do to me that would be as hard to take. And after twenty-four hours of bedside-hovering, I was too drained to take much of anything except sleep seriously, least of all the good colonel.
A couple of weeks after Lieutenant Colonel Blaylock arrived at the 83rd there’d been a mass casualty situation—one of the biggies with chopper after chopper of mutilated people, both Vietnamese and Americans. One corpsman covered all but the most hard-pressed wards while every other available person spent the night in the E.R., cutting bloody clothing off patients, applying pressure bandages, starting I.V.s, giving meds, and going over surgical checklists. By the time I finally returned to neuro, it was almost time for the day shift to come on and I was drinking coffee, catching my breath, and waiting. The new patients were all taken care of, all I.V.s, catheters, and chest tubes were patent, and I felt we’d all done a good night’s work. Lieutenant Colonel Blaylock arrived early for an inspection of the ward, her carefully smoothed, former-model-perfect features contracted in the barest hint of a frown; I was sure I couldn’t be the cause, as hard as I’d been working that night. She toured the ward slowly and stopped several times to look at patients. In the middle of the ward she lifted her arm to summon me to the bedside of an elderly rice farmer who had been hit in the head by a bomb fragment.
“Lieutenant McCulley, I would like to know why this man’s toenails are so filthy,” she said sternly.
“Because he’s worked in the rice paddies all his life, I guess, ma’am,” I said. “He’s been bathed, like everyone else.”
“That is not enough,” she said, her voice soaring above my fifteen new I.V.s. “I want these Vietnamese patients properly cleaned. It is our original mission to take care of these unfortunate war casualties, as you no doubt know, since you have been in country longer than I.”
What do you say to a colonel who insists on a damn-fool thing like that when you come to the end of an awful night? “Yes, ma’am,” I said, but neither I, nor other personnel to whom she had amply demonstrated her deficient grasp of priorities, had much respect for her.
Nevertheless, she was the Chief Nurse. And this time she had something legitimate to yell at me about.
Yelling, however, was too coarse for the colonel. Instead, when she had released me from my stance at attention and bade me be seated in the metal folding chair allotted visitors to her office, she smiled a smile of sweet patient understanding. That made me far more nervous than if she’d yelled. I had learned to beware of smiling colonels at Fitzsimons, where I inadvertently got caught in a political battle between two of them.
I sat. The metal folding chairs used throughout the hospital compound in deference to our unit’s “semimobile” status always reminded me of funeral parlors. When I was little, every time you went to an ice cream social at church or a school assembly, the folding chairs brought in to seat the multitudes were stamped with the name of the Peaceful Passages Funeral Parlor, from which they had been borrowed. They seemed an amenity particularly suited to Nam, where Uncle Sam and Uncle Ho were running such an enormous wholesale client-procurement racket for the funeral business. Although, in country, disposal of the dead was not expedited by agencies like Peaceful Passages with hushed tones speaking of loved ones. Here the departed were shoved into body bags, if there was enough left to bother with.
I suppose sleeplessness and release from tension caused me to drift into such thoughts instead of the trouble at hand. Because when I had composed myself, I saw that the colonel’s smile was wearing pretty thin. She blinked, the dried glue of one of her false eyelashes giving way and detaching itself a teensy bit at the edge. The colonel had been a runway mannequin in New York before going into nursing, as she was fond of saying at parties, little realizing she gave us much fodder for cruel puns back in the barracks. Her modeling experience had to have been fifteen or twenty years ago, though, sometime before her makeup had petrified into varnish. Still, her years of charm school had imbued her with a poise t
hat wasn’t even challenged by dealing with delinquent second lieutenants.
I would have found a firing squad led by General Patton infinitely more reassuring than that Vogueish smile.
“You do realize, do you not, lieutenant, that you are a dangerous nurse?”
“Well, yes, ma’am, but I did ask for a written order—” I began.
“The doctor gave you an order, Lieutenant McCulley. You were supposed to follow it. Instead, you administered ten times the prescribed medication. Didn’t they teach you dosages and solutions in nursing school?”
“Yes, ma’am, but—” But that had nothing to do with it. I was not told to figure the proper dosage from the child’s weight. I had been given a specific order that was incorrectly transmitted or received, I still wasn’t entirely sure which. Had it been written, there would have been no question, and no error. But I was not going to get a chance to make even that meager point.
The colonel overrode my objections. She knew what was needed to mend the situation. Busy work. “Apparently you need a refresher course. You will report to my office during your lunch period until I am satisfied that you know how to properly compute them.”
“Yes, ma’am,” I said.
“Meanwhile, I’m afraid I must agree with Dr. Chalmers that despite your training in advanced medical-surgical nursing, we can’t continue to risk entrusting you with such seriously ill patients.”
“Yes, ma’am.” Well, of course that was right. I was definitely feeling too shaky to work on the neuro ward anymore, particularly with Chalmers and Cindy Lou. But it was stupid of Blaylock to ignore Chalmers’s share of the responsibility for bullying me out of verifying his order. If he could do it to me, he could do it to others, with results just as disastrous. I was not the only insecure, half-baked nurse who would ever work at the 83rd.
On the other hand, she wasn’t in charge of him, she was in charge of me. And he was the doctor. Anything I said would only make it look as if I was being defensive, not taking criticism cheerfully, as they say on evaluation forms. I had only to look at Lieutenant Colonel Blaylock’s face and listen to her voice to know that the arguments clenched behind my teeth would be construed as sniveling and caviling.
The Healer’s War Page 2