The Care of Strangers

by Ellen Michaelson

  Sima ran her thumb along the armrest of the chair, feeling for blemishes. If she told Alma Mae, then what? Who else would she have to tell? But was what Dr. Kahn did really such a big deal? Dr. Linton knew, everyone else would too. It was just evidence Dr. Kahn wasn’t cut out to be a medical intern. She was only rotating through Medicine because it was required for Psychiatry. Not so different from having to pass English composition.

  * * *

  —

  AT THE DOUBLE DOOR TO the open ward, the intern team on A71 milled around. Their senior resident was late for work rounds again. Dr. Kahn was juggling three charts. One slammed to the floor. Dr. Kahn bent down to retrieve it.

  As Dr. Kahn stood up, Sima bumped elbows with her. She tapped the top of the chart rack to get the team’s attention. She’d seen Chief Danielson do that. He’d told her she might be Chief material one day.

  “Miss Potter says you guys have to discharge somebody. I just brought up the first hit, and there aren’t any beds,” Sima said. The house staff called new admissions hits. Post-call, they bragged about how many they’d had. Proof they’d been hard hit by enemy fire and survived. Sima liked to use this insider’s word, to use any insider word she understood which was most of them.

  “Why do they send up a patient if we don’t have beds?” Dr. Linton said. “This place is so disorganized.” Dr. Linton, handsome and organized, kept an inventory of mismanaged orders, out-of-stock supplies, under-supported services, and the extra hours of pointless work these deficiencies created for interns.

  “So what does your Chiefness suggest we do about it?” Dr. Long said. The balding ex-surgery intern twisted his thick blond mustache. He was the one dressed in on-call whites.

  “Alma Mae’s been ready to go for days,” Dr. Linton said. He pulled Alma’s chart from the rack and placed it on top. “Dr. Kahn can discharge her before rounds.”

  “I have to clear it with Miguel,” Dr. Kahn said. “He’s the senior.”

  “His judgment’s worse than a medical student’s,” Dr. Linton said.

  “Mindy’s a psych rotator,” Dr. Long said. “Give her a break.”

  “And you’re an ex-surgery intern,” Dr. Linton said. “What do you know?”

  Sima was surprised to hear Dr. Long stand up for Dr. Kahn. And then Steinberg, a head shorter than both Long and Linton, spoke. “Dr. Kahn is better than most medical interns.”

  “You always stick up for your own kind,” Dr. Long said.

  “And what is ‘my own kind’?” Steinberg crossed his arms over his chest. He pushed his horn rims up on his nose, like a college professor. After his year on Medicine, he was headed for Ophthalmology, one of the most competitive specialties.

  “One of the yarmulke boys,” Dr. Long chuckled.

  “Steinberg doesn’t wear a yarmulke,” Dr. Kahn said, one decibel louder than usual.

  Steinberg adjusted his glasses again. “And I don’t worm my way out of call Friday nights and Saturdays to go to synagogue like they do either. I pull my weight around here, and so does Dr. Kahn.”

  Dr. Kahn leaned into Steinberg. “You don’t have to defend me.”

  “No, he doesn’t.” Dr. Linton motioned to Dr. Kahn. “Can I talk with you a minute?” He backed away from the chart rack and put his hands on his hips. Sima didn’t like this male doctor insider stance—I know what’s what, and you better listen up if you know what’s good for you. Dr. Linton might be the best medical intern on the team, but he was still only a few months out of medical school like the rest of them.

  Dr. Kahn armored Alma Mae’s chart tight to her chest and stepped toward Dr. Linton for their private conversation, but everyone was close enough to hear.

  “Just make sure all the IVs are back in by work rounds the next time you’re on,” he said. “Including Miss Osborn’s.”

  Dr. Kahn stretched her long neck out of her blouse like a turtle peeking out to face a predator. “Every patient whose IV was out got antibiotics if they needed them,” she said. “IM and on time.”

  “We all have bad nights.” Dr. Linton faced her directly. “But when Long or Steinberg have one, I don’t have to stay late the next day to finish what they didn’t do.”

  “Half the IVs on the ward were out that night. I was there,” Sima said. It had been a hard call for Dr. Kahn. Sima knew—it had been a horrible double shift for her, too.

  Steinberg clapped, Dr. Long patted her on the back. It wasn’t like Sima to speak up.

  “Thank you, Dr. Sima. But this is not an orderly issue.” Dr. Linton had spoken.

  And so had Sima.

  Part Two

  10

  Train Wrecks

  Mrs. Sampson had been in and out of the hospital every three weeks for breast cancer. Sima had watched from a distance as interns struggled to replace her IVs, no easier than with the addicts. It was clear to her that getting stuck for chemo wasn’t much better for a person’s veins than sticking them for street powder. In the end, shot-up veins were shot-up veins. And what was left of the woman’s hair from chemo jutted straight out the top of her red-and-white bandana.

  “Mrs. Sampson,” she said, “your doctor ordered a chest X-ray for you.”

  The old woman wore glasses attached to a rope that hung from her neck. A small plaid shirt—green, red, and yellow—lay over her white-sheeted knees, a metal thimble covered the end of the middle finger of her sewing hand. Mrs. Sampson tugged at a dark thread, wrapped it around a finger, and yanked until the thread broke off. She pulled a spool out of her bathrobe pocket and unrolled another long piece.

  “You should meet my little grandson, Sammy,” Mrs. Sampson said as if Sima had just joined her sewing circle. She poked the thread into the eye of the needle and pulled it through. “We hardly ever see his mama. My other daughter is raising him. They all live with me.”

  Sima thrummed a wheelchair back. “We don’t have much time to get you downstairs.”

  Mrs. Sampson squinted at Sima over the top of her glasses. “You’re just like Sammy’s mother—and every young person I meet. Always needing to dash.”

  “I’m just doing my job.” Sima folded her arms over her scrubs shirt.

  Mrs. Sampson straightened her bathrobe. One side of her chest was flat; Sima presumed a missing breast. “Bring that wheelchair over here.”

  Sima maneuvered the wheelchair against the side of the bed and set the brake. Mrs. Sampson threw the bed sheet off and swung her naked, bony knees over the side.

  “Hand me them slippers,” she said. “Can’t stand on these floors in my bare feet, Sima.”

  Sima handed Mrs. Sampson her pink fuzzy slippers and clicked her heels. “Orderly Sima,” she said.

  “At ease, private,” Mrs. Sampson said. “This ain’t no army.”

  Mrs. Sampson grabbed onto Sima’s arm with one hand and held the back of her robe against her bottom with the other. She stood facing the wall, her backside to Sima, and then eased herself down into the wheelchair.

  “Please cover my knees,” she said.

  Patients always asked to be covered. Sima dropped a blanket onto the old woman’s lap.

  “And hand me my sewing,” Mrs. Sampson said. “They always keep me an hour or two.” The old woman opened the blanket and smoothed it over her legs. “All those moaning sick folk in X-ray talk you to death about how the neighborhood’s all gangs and hoodlums. The streets never been safe.” She waved at the plaid shirt left crumpled in the middle of the bed, attached to her thread and needle, and as Sima reached for it, she said, “Be careful of the needle.”

  Sima had seen needles all over the County, from her first day there. Doctors got hepatitis from accidental sticks, or when they got too busy or lazy and didn’t bother to put on gloves. It was easier to feel for a vein without the rubber layer between skin. And now there was the new blood-borne illness. Infectious disease specialists
wandered the wards, ordering interns to glove up every at blood draw like never before. And even though they wore masks with TB patients on a closed ward, doctors got sick every year. Orderlies were vulnerable, but no one seemed to worry about orderlies.

  Sima worked at the County because it was only four subway stops from where she lived and she could work nights, and could go another four stops to college during the day. Since there were no private doctors, interns and residents could run the wards and the ER, thrilled to be in charge, while still in training. She wondered why patients came to the County. Patients didn’t know they could go to any hospital with an ER, even a fancy one on the Upper East Side. Sima figured people in Brooklyn stayed with their own when they got sick. She was sure her mother would go to Coney Island Hospital with the Russian Jews.

  Sima watched Mrs. Sampson use her thimble finger carefully to locate the needle wedged in the small plaid shirt.

  “My father was a tailor,” Sima said. “But he had to sweep floors at my school. The Poles didn’t want Jews touching their clothes.”

  Mrs. Sampson wrinkled her forehead. “Too bad. Tailoring is good work.”

  * * *

  —

  THE SOUND OF THE ELEVATOR door closing was followed by a faint, tinny noise. Miss Lawrence leaned over from her chair and picked up Mrs. Sampson’s thimble.

  “My mama had one of these.” Miss Lawrence put it on her index finger.

  “The thimble finger is the middle finger,” Mrs. Sampson said.

  “Can I hold it?” Sima said.

  Miss Lawrence twisted the thimble off her chunky digit. She raised her hand up for Sima to take the tiny silvery cup.

  Sima placed the thimble on.

  “It fits,” Miss Lawrence said.

  “It fits all lady fingers,” Mrs. Sampson said.

  “Maybe you have a calling outside these here walls, Sima,” Miss Lawrence said.

  That wasn’t a thought Sima was ready to consider. She’d been taking pre-med courses for so long now and yet it seemed impossible to think of herself as one of the doctors. She was more comfortable being an orderly.

  Miss Lawrence opened the elevator door on the third floor, and there was Dr. Kahn. Sima hadn’t seen her in a few weeks, not since she’d stood up to Dr. Linton on her behalf. Dr. Kahn stepped inside, her clipboard to her chest. Sima started to smile at her but Dr. Kahn stood stiffly, staring straight ahead, and Sima recalled the intern’s lie.

  Miss Lawrence pushed one of her control buttons and the elevator door closed.

  “They need me upstairs,” Dr. Kahn said.

  “It’s good to be needed,” Mrs. Sampson beamed at Dr. Kahn as she lifted Sammy’s small shirt from her lap. She shook out the wrinkles and then lay the shirt button-side down, with the little short sleeves hanging over the sides of her knees.

  “My mother took in sewing in Poland,” Sima said. She still fingered the thimble, now warm against her skin the way her mother’s thimble had been when she darned socks.

  “Neighborly,” Miss Lawrence said.

  “Poles hated Jewish neighbors,” Sima said. “My mother only sewed for Jews.”

  It wasn’t just that Sima’s father couldn’t work as a tailor because he was a Jew. After a while, he couldn’t work at all. After the doctor told him he shouldn’t shovel snow because of his heart. He lay on the sofa, his swollen feet curled up under the blue blanket her mother knit for him. He spent his days searching the newspaper for the comic strip that still featured Polish police standing over a Jew long after the war, the cartoons he instructed Sima to save for his file.

  “I guess living in New York is better,” Mrs. Sampson said.

  Dr. Kahn looked at Sima now. “In New York, no one ever asks me if I have Jewish hair.”

  Sima kept her gaze on Dr. Kahn. “In New York, no one calls me a brudny zyd.”

  That’s what a girl called her once, only once, in Poland. It was spring, the week before Easter, and the snow was melting. The willow tree in front of her house was sprinkled with green buds. It was the mean girl from the end of the street, the one with curly, dark hair, even though she wasn’t Jewish. Sima knew the girl hated her own hair. She was always trying new ways to tie it back or cover it up. Bows, ribbons, scarves, hats. She was a head shorter than Sima. She was older and wiser, she said, because she was seven. And it didn’t matter that Sima was taller because Sima was a brudny zyd. A dirty Jew. The girl told Sima she could scrub her face, her arms, and her legs all day and night, but she would never be clean. She’d always be brudny. Dirty. Sima’s mother told her words like that could only come from the girl’s father or her mother. No seven-year-old could come up with anything so nasty. Sima should feel sorry for the girl, her mother said. It wasn’t her fault she spoke such horrible words. But Sima didn’t know how to feel sorry for her.

  Sima still wasn’t sure what she should feel about Dr. Kahn’s lie.

  * * *

  —

  AFTER THE X-RAY WAS TAKEN, Sima delivered Mrs. Sampson back to the Nurses’ Station. Another woman patient sat there in a wheelchair. She was big boned and had hair to her shoulders styled in a stiff flip. Fire-engine red lipstick and matching three-inch fingernails. One high, black cheekbone was swollen and bore a bruise the color of an eggplant, and a slash closed with tiny black stitches crossed the laugh lines in her forehead. Her shapely legs were crossed, top foot bouncing off the bottom foot. She strummed her goosey neck with one hand and held her hospital johnny closed at the crotch with the other hand. The crotch hand clutched her admitting papers.

  “Long night,” she said in a throaty voice to Mrs. Sampson.

  Mrs. Sampson snugged her blanket around her legs, the spool of thread and scissors atop the plaid button-down in her lap. “Hmmm.”

  “So how old are you?” Miss Bingham, the night nurse, asked in her cigarette-boozy voice.

  “Only time will tell how old I am. At night, light and time are on my side.”

  Nurse Bingham tapped her purpled pen on her vital-signs chart. “I need to know your age.”

  “Name’s Brandy, hon.” She raised her papers in the air. “Can I go to my room now?”

  “This ain’t no hotel, Brandy, dear. You have to see the doctor first.” Nurse Bingham lifted the papers from Brandy’s hand, ran her pen down the front sheet. “Twenty-one?” she chuckled. “You and me both, sweetheart.”

  “I didn’t come to the hospital to be insulted.” Brandy tightened the cross of her legs, her hand, now without the papers, back in her crotch.

  Dr. Kahn walked toward them.

  “Mrs. Sampson’s back from X-ray,” Sima said to her.

  Dr. Kahn nodded. She took Brandy’s chart from Nurse Bingham and slipped it into the pocket on the back of her wheelchair. She kicked the brake lever and started down the hallway, Sima trailing with Mrs. Sampson in her chair, back to the Female Room, the six-bedded suite for A71 ladies, where Mrs. Sampson would now have one more roommate.

  * * *

  —

  WHEN THE SECOND HALF OF her double shift began, Sima had been up most of the night but hadn’t seen much of Dr. Kahn. Sima had nodded off briefly in a geri chair in the Doctors’ Charting Room. Now she could hear the doctors’ voices outside the room as they huddled around the chart rack to start work rounds. She got up from the chair, peered into a mirror on one of the doctors’ lockers, to settle her hair. She stepped out into the hallway and saw Dr. Kahn holding an X-ray up to the light.

  Just then, a scream issued from the female bathroom a few feet away.

  Dr. Kahn and Sima were closest. Sima pushed on the door, but it would open only a crack. She squeezed through and held the door so Dr. Kahn could follow. Bump-stop to the door, preventing it from fully opening, were pink fuzzy slippers on old lady feet. Stationed over the fallen body was Brandy. She had one foot in the sink and her blue johnny flung behind her
neck like a cape. Two perfect round-as-round-can-be breasts shone watery in the light. And then there was the part that must have been the cause of the screaming and fainting: Brandy had a penis.

  Miss Armstrong, head nurse that day, was trying to see what was going on. Since the door wouldn’t open fully and she was too big to squeeze through, she could only get her face into the room. “Who’s that down on the floor?”

  “Mrs. Sampson,” Sima said. She squatted on the floor by the old lady and found her chin inches from Brandy’s crotch. The penis was wrinkly, soft, the tip hooded—the only uncircumcised one she’d seen other than her baby brother’s before the ritual ceremony. She had a ridiculous urge to reach out and touch it.

  Brandy folded herself deeper into the sink, soaping her legs, right down to the perfect red toenails. She looked like a dancer stretching, in a position no one else in the room could have dreamed of holding. Water trickled from the faucet and mixed with the suds on the smooth, black skin—face, breasts, crotch. It dripped down the tip of the penis onto Mrs. Sampson’s slippers.

  “What are you doing in there?” Miss Armstrong said in her megaphone voice the ward team behind her could hear.

  “A girl’s got to stay clean.” Brandy smiled.

  “First things first,” Miss Armstrong said.

  Sima felt Mrs. Sampson’s wrist, the way she’d seen the doctors do. “I can feel her pulse.”

  Dr. Kahn managed to reach down, confirmed. Sima was pleased with herself.

  “Dr. Kahn, Sima,” Miss Armstrong said, still strong-holding the side of the door open for a bird’s-eye view. “Get Mrs. Sampson out of here.” She squeezed one arm into the room and pointed at Brandy. “And you missy, mister—you’ll finish cleaning up in your room.”

  Sima and Dr. Kahn cradled Mrs. Sampson’s head and back and raised her to sitting. Mrs. Sampson’s pink-slippered feet and bony legs were no longer blocking the entrance. Miss Armstrong removed her head and arm from the room and opened the door to get the full picture. And now standing behind her was the A71 intern team. They were bunched like a bouquet of flowers, bodies pressed together like stems, faces turned toward the open entry as if it were the sun.