“Come on, Etienne,” Sima said. “Let’s go back to the ward. Venez avec moi.”
She lifted Skinny’s hand in her own, his brown-tan skin against the white-pink of hers. He felt soft and warm, just like anyone.
Skinny held Sima’s hand against her knee, and stood, all six feet and more of him, their two hands dangling somewhere between his hospital johnny and her scrubs, and headed back to the ward.
Part Three
17
Finding the Pain
Mindy stood by the Nurses Station with a radiology request in hand. Chief Danielson had asked her to come back early from the leave he’d recommended because another intern had suddenly taken sick. Sima was pleased to see her mentor and friend still in the program. She hoped they were still friends. They hadn’t spoken since the day by the laundry. She didn’t have Mindy’s telephone number, she didn’t know where she lived.
“I paged you several times while you were gone,” Sima said.
“My pager was turned off,” Mindy said. She reached for a chart.
“Of course. You weren’t working,” Sima said. “I didn’t think of that.” She had but she didn’t think anyone would tell her how to find Mindy. She wasn’t sure she should even ask.
Mindy opened the chart, pried apart the page binders, and inserted the radiology request.
“I’m glad you’re back.”
“Mrs. Sampson needs a CT.”
Business as usual.
* * *
—
THE PROBLEM THIS TIME WAS pain. Mrs. Sampson bit at her bottom lip. She stood from her perch on the side of the bed and slipped down into the wheelchair. She let her breath out, pursed her lips, and then closed her eyes.
“Sammy wants to know if I’m going to die out like the dinosaurs at the Natural History Museum. Six years old and he knows more than your doctors,” she said to Sima.
Mindy stood bedside with the CT request, chart in hand. The X-ray tech had driven in from Staten Island on a Sunday night. He refused to do the CT unless Mindy’s senior resident told him it was necessary.
Back pain in a cancer patient. There was no time to waste. If the pain was due to the spread of the breast cancer, it could be a few hours from pain to paralysis. It was one of those moments Sima had witnessed more and more during that year when Mindy lost her Boston cool and acted as if she’d grown up on the streets of New York City. Mindy had learned after so many months at the County that the only way to get urgent things done urgently was to be there with the patient. That’s what it took. And Sima wanted again to be there, alongside her friend.
The three ladies left the ward on the long trek through the dank corridors of the tunnel to C-building where CT was. Wisps of baby-fine hair stuck out from beneath the blue bandana on Mrs. Sampson’s head. Mindy’s hair, like Sima’s own, curled in the humidity of the wet steam from the mummy pipes, winter or summer.
Mrs. Sampson wheezed. “Hold up a minute,” she said. “Hard to ride and rest at the same time.”
Mindy tapped her watch. “They’re waiting for us,” she said. Sima elbowed her, and Mindy lowered her watch arm to her side.
The steam hissed from the mummy pipes, the water dripping from the rusted-out valves making orange stains on the floor. The air was heavy, hard to breathe in even if you were healthy, smelling of mold and damp concrete. Two flies bumped against the ceiling bulb, buzzing the way light-crazed bugs do.
Mrs. Sampson hitched up one hip, trying to find a more comfortable spot in her chair.
“Smells like my mother’s cedar closet down here,” Mindy said. “Her fur coat in mothballs. That’s what she wanted—that and a diamond.”
“Furs and diamonds don’t make a woman happy,” Mrs. Sampson said.
“I have a pearl,” Sima said.
Mindy said, “A pearl—both my grandmothers gave me a string of them.”
“Aunt Miriam gave me the pearl.” Sima had never met either of her grandmothers; Mindy had two.
“It’s the ’80s,” Mindy said. “Women join protests against killing animals for fur. And they want more than a fancy stone to pawn off to feed their fatherless kids.”
Mrs. Sampson leaned into the wheelchair arm, hitched up off the other hip. “What’s a girl like you know about fatherless kids?”
Mindy’s arms dropped by her side. She faced the long hallway and walked off ahead.
“Her father just died,” Sima said.
Mindy moved further away, her shoulders rolled in, head down.
Sima turned Mrs. Sampson’s wheelchair and pushed it down the hallway. They slowed where Mindy stopped, leaning against the wall under a broken lightbulb. Mindy slumped down onto the floor, her back against a spot of dry wall where there were no mummy pipes.
Sima took a seat next to her, leg to leg, hip to hip, on the grimy, cold cement. She could feel Mindy trembling with the effort of trying not to cry. Sima reached around Mindy’s shoulder, her hand on the back of her neck, under her hair. She put her other arm around Mindy, holding her up. And then Mindy started to cry. Sima held her, and Mindy cried and cried, her whole body shaking.
“You can’t cry enough when you’ve lost someone you love,” Mrs. Sampson said from her wheelchair. And the three of them sat with Mindy’s tears, just tears.
There was a rumble overhead.
Mindy sniffled. “The giants are bowling,” she said. “My father used to say that whenever there was a thunderstorm.”
Mrs. Sampson smiled, her wrinkles deepening. “Girls believe anything their daddy tells them.”
* * *
—
IT WAS MIDNIGHT BY THE time the CT was completed and the radiologist had arrived. Mindy stood at his elbow as he reviewed the scan. Sima stood by Mindy’s other elbow, looking on.
“What do you see?” Mindy said. “Is it her spine?”
The radiologist put his face up close to the screen, and then he leaned back. “The spine is OK,” he said. “No cord compression. Just a broken rib, alongside one of the vertebrae.” He fingered the spot. Mindy and Sima both leaned in to see it. “A pathological fracture. Talk to Radiation in the morning. They’ll give her a few treatments for the pain.”
“Thanks for coming in,” Mindy said.
“Thank you for getting her down here,” he said. “These are the ones we don’t want to miss.”
18
Case Review
Sima opened the door to the House Staff Library on the sixth floor. No one was there. The interns and residents were across the hall in the conference room. The smell of pizza delivered by a drug rep for their noontime lecture permeated the corridor air. Sima was surprised Chief Danielson had scheduled the case review for this time of day. She wondered if Mindy had asked anyone to save her a piece of pizza, but then she’d have to explain why she wasn’t attending the conference. It was likely Sima was going to miss lunch too.
She stepped inside the library and sat down in the closest chair. She and Mindy hadn’t talked about Mr. Shtrom or the visit with the family or the case review, but both knew they had each received a letter. Sima expected Miss Armstrong to show up. She figured she was the one who instigated the whole thing. She was the one who had found Sima asleep in the library and reported her to Chief Danielson. She was the one who seemed most interested in seeing Sima go to medical school. Maybe she was trying to make Sima look good. Or maybe not.
She had arrived too early. She got up and paced the room. One side was windows halfway from the floor to the ceiling. The door side of the room was shelves of journals as high as the windows. In the middle of the room was a long, oval table. A few of the chairs on the side closest to the door jutted out. Sima stopped behind these outliers, pushed each one in, setting them right.
A whiff of pizza preceded Chief Danielson as he walked in. He might miss lunch too.
“Sima,” he
said. He set a large manila envelope down on the table and pulled out a chair, his back to the windows. “Have a seat.”
Sima sat down again on the opposite side of the large table. The Chief seemed so far away and more serious than usual.
“Dr. Kahn should be here shortly,” he said.
“Is anyone else coming?” Sima said.
“Not at this time,” the Chief said.
More pizza scent and Mindy made her way in to join them. Her head down, she didn’t make eye contact with Sima. She didn’t seem to know where to look, where to go.
“Have a seat next to Sima,” the Chief said. He stood up and walked to their side of the table. He opened the envelope the way he had done before and placed the pink progress note pages in front of them. “Do either of you know what we’re here to talk about today?”
Both young women said nothing.
“Dr. Kahn, why don’t you review the last note in these pages.”
Mindy reached for the pages, turned them one by one, till she found the last entry. She took a minute to scan the page.
“Nothing is inaccurate,” she said.
“That’s what Sima said when I asked her to review it,” the Chief said.
Sima hadn’t told Mindy about her meeting with the Chief. She avoided Mindy’s gaze.
“Is that your last note, Dr. Kahn?”
“It’s the death note,” Mindy said.
“Did you write that note?” he said.
Mindy stared at the page. She didn’t look up.
“Is that your handwriting, Dr. Kahn?” He clicked his pen, tapped on the table.
He turned to Sima. “Did Dr. Kahn ask you to write this note?”
Sima never wrote anything in the hospital. How did the Chief know she had written it?
“No, sir. She was upset and I was trying to help.”
“Miss Armstrong said you were very helpful with the family,” the Chief said.
That was it. Miss Armstrong had changed her mind about Sima—she was meant to be a translator, not a doctor. Maybe she was right.
“I should have written the note,” Dr. Kahn spoke up. “It was my responsibility.”
“Yes, Dr. Kahn, you should have written the note,” he said. “The chart is a legal document. Medical students write in charts, signed by an intern or a resident. Sima is an orderly. Orderlies don’t write in charts. You should have written the note and signed it.”
The final edict: Sima was an orderly.
They were both in trouble. She was trying to help and now Mindy’s career was even more on the line than it had been. Chief Danielson would never write Sima a letter. She had lost her mentor, and her friend.
They sat at the table side by side, Orderly Sima and Mindy Kahn, MD, Intern, staring down at the death note. No eye contact. No words.
“Do you both understand?” the Chief said.
Sima didn’t know what more was there to understand. She raised her eyes to the chief, in search of an answer. She heard the door open and the chief looked past her. And then Miss Armstrong was standing alongside the table where she and Mindy sat.
“Miss Armstrong has a few concerns,” the Chief said.
He nodded at the tall, dark, hefty woman in white, crispy clean cap neatly secured to her stiff brown hair. He motioned towards the end of the table closest to him. Head Nurse Armstrong pulled out a chair and sat down. She folded her hands in front of her.
What could Miss Armstrong want to know? Sima couldn’t imagine.
The Chief cleared his throat and looked across the table at his charges. “Sima, Miss Armstrong tells me you gave Mr. Shtrom nitroglycerin that night,” he said.
The woman had seen Sima hold the pill out to the old man.
“Miss Armstrong told me to get the bottle on the counter,” Sima said. “I thought she told me to give him a pill and so I gave it to him.” At least she had tried to give him the medicine that might ease his chest pain. She was an orderly. She did what she was told to do. She held the tiny tablet near his mouth, told him to take it under his tongue, sublingual. That’s how it was given. That’s what Miss Armstrong said to do. Sima had seen nurses do it all the time.
“Where was Dr. Kahn?” Chief Danielson asked.
Sima could feel Miss Armstrong’s stare, heard her take a deep breath.
“I don’t know,” Sima said.
“Wasn’t she in the on-call room, Sima?” Miss Armstrong said. “Didn’t you tell me that?”
“I saw her in the on-call room earlier,” Sima said. “She wasn’t in the CCU when Mr. Shtrom needed the nitro, that’s all I can say for sure.” She didn’t want to say any more. What did they want from her?
“Miss Armstrong is concerned about Dr. Kahn,” the Chief said. “We both are. We need to know what happened.”
She couldn’t look at Miss Armstrong or the Chief. She could hear Mindy’s breath getting faster. She didn’t want to rat on her friend.
“You’re a smart young woman, Sima,” Chief Danielson said. “You could be an excellent doctor. I would like to be able to write you a letter of recommendation.”
So this was it: lose a friend and her friend’s future, or lose her own.
“Miss Armstrong said she paged you to CCU, Dr. Kahn,” the Chief said. “Several times.”
Mindy hadn’t raised her eyes from the progress note. “I came when I could,” she said.
“Sima, Miss Armstrong said she sent you to the on-call room to find Dr. Kahn,” the Chief said. “Is that what you did?”
“I’m an orderly,” Sima said.
“Did you go to the on-call room as Miss Armstrong asked you to?”
“Yes,” Sima said. What else could she say?
“Was Dr. Kahn in the on-call room?”
“She was there.”
“Did you inform her Miss Armstrong needed her in the CCU?”
“Her pager went off,” Sima said.
“That isn’t what I asked you,” the Chief said.
Sima and Mindy side by side, their hands below the table, Miss Armstrong at the end on their left, her hands still folded in front of her. The faint smell of pizza in the air.
Chief Danielson stood. He passed behind Miss Armstrong to where the two young women sat. He reached over Mindy and collected the progress notes. He slid the pink pages into his large manila envelope, closed the clasp at the top. He tapped the envelope on the table.
“That will be all for now,” he said. He opened the door to leave the library.
19
Hurry Up and Wait
Waiting was a New York City pastime Sima sometimes found hard to live with: waiting in line for a bus, for a subway train, to register for another course at Brooklyn College. Waiting in line to deposit her paycheck at the bank. Waiting for an elevator at the County. That’s what being an orderly was all about. How many years of her life would she spend waiting? She found herself waiting for a seat in a cheap restaurant in Chinatown with her mother, and now her mother was nagging in Polish, pulling at Sima’s sleeve to get her to ask the Chinese-speaking waitress if their table was ready yet.
These days she was willing to wait in line at the Korean corner market in her neighborhood to pay twice as much for a quart of milk as she would in the grocery store—where she’d have to wait even longer—because then her mother wouldn’t be mad that she’d forgotten to pick up milk, again. At least she’d never have to wait to move her car to the opposite side of the street, since she didn’t have a car. Mindy said she didn’t live in the City because she lived in Brooklyn, not Manhattan. But Sima knew she was a New York City New Yorker when it came to cars: she didn’t know how to drive, like so many life-long borough dwellers.
On days off when she occasionally ventured into the City alone, she saw people during rush hour wait to flag down an available cab. In the rain and t
he wind, on the kind of day that turns quick-draw umbrellas, five dollars a pop, inside out with no bus in sight, not even the Local that stops at every corner from Ninety-Sixth Street down to Alphabet City, Sima saw New Yorkers scramble and shuffle and fistfight their way into the one cab on Second Avenue: the business suit, the little old lady with purple hair, the banker babe in Brooks Brothers navy blue, red nails, red lipstick, and running shoes. Running shoes on women’s feet all over NYC.
Waiting in line with her mother in lower Manhattan. She wished she could laugh.
It was their splurge. Once a month her mother wanted to get out of Brooklyn. Her mother now trusted Sima knew how to get around. They walked down the street together, headed for the B train at Kings Highway, six stops to DeKalb Avenue, then a change to the N train, to get off at Canal Street. Canal and Mott, the center of Chinatown. From there, they could see Hester Street, a landmark for the old Jewish section of the Lower East Side. It was two blocks from Delancey Street and Ratner’s, the milkhik dairy restaurant famous for blintzes, her mother’s favorite. But today Sima’s mother preferred a no-name hole-in-the-wall.
“You should be grateful your mama leaves the apartment with such a daughter,” her mama said as they got off the train. She marched ahead to the nearest Chinese restaurant, the only one they ever went to, and stood there like a statue. “I slapped my daughter in shame.”
“Enough is enough, Mama.” The slap had been more than a month ago.
Once inside the restaurant, Sima put their name on a list. She handed her mother a menu.
“We could sit at Ratner’s. Here we can order while we stand and wait.” Sima never used to talk to her mother like this, but since the slap, she couldn’t help herself. Every word was sarcastic. Maybe her mother was right to feel shame.
Her mother couldn’t read the menu. She pointed to the pictures of what she wanted to eat.
“Beef and broccoli, fried rice?” Sima confirmed. “A bowl of wonton soup?” Her mother nodded. Nothing here was kosher but outside of the house, that was all right. There was no such thing as kosher in Poland, but this was America. And her mother had become an American Jew when it came to the few restaurants she and Sima could afford to visit. She drew a line at eating shrimp, which some American Jews chose to do outside of the house. It didn’t matter that her mother didn’t keep kosher now that she could. Her mother had no plans to ever eat shrimp.
The Care of Strangers Page 10