The Care of Strangers

by Ellen Michaelson

  Food was delivered to their table shortly after they sat down. It was a small, noisy place. Their table was tiny. And it was all they could do to slurp their soup in the silence between them. When the waitress removed their bowls, Sima filled her mother’s plate with half the beef and broccoli and a generous portion of fried rice.

  She wanted to tell her mother she was waiting to hear if Mindy would be kicked out of her internship. She wanted her mother to know she was waiting to talk with her mentor, her friend. She wanted a friend more than she wanted anything. But she knew if she told her mother that, her mother would get angry and they would speak even less than they ever did. Her mother only understood family and standing alongside each other, no matter what. What was a friend?

  20

  Heart Valve

  It was his third or fourth bout of endocarditis since Sima and Mindy first met Mars Peabody on the Prison Ward almost ten months before. Each admission, he’d been plucked off the locked ward, tethered by the ankle to a bed on A71, and pampered by his very own intern. Each time, he’d left the hospital with the same bravado, managed to get out of Rikers, only to be back on the streets, shooting up all over again. Four weeks into another course of antibiotics, Mars Peabody’s heart was failing.

  Week by week, Sima had watched him grow tired of being sick. Laid out neatly now on his bedside table: a Tom Clancy paperback, the worn edges of its cover curled up off the first page, reading glasses, a slim white vase holding a single red rose. Mars had become a model patient. Like Mrs. Sampson, he was now someone Sima liked to take care of. Like Skinny and Miss Osborne and Alma Mae. She was more comfortable with these sick, poor people than she was with most of the medical staff. But if she became a doctor, she wouldn’t be an outsider. She would be safe in a way her mama couldn’t understand.

  Sima rested a hand on Mars’s buzz cut where it showed at the edge of the blue sterile drape that covered his face from his hairline down to the top of his neck. Stroked in one direction, his hair was soft, but it was bristly if approached from the top. He lay quietly under the drape that puffed up under the bulge of his nose with each exhale, his chest and arms also covered.

  Mindy arrived at the bedside in a yellow cap and mask, gowned and gloved. No need to make eye contact with Sima for the task at hand. They hadn’t worked a shift together for a few weeks. Mindy hadn’t asked for help but Sima showed up at the right time to be there for her friend.

  Mindy hovered over Mars, only wire rims and the end of an escaped curl showing. She pulled back the plunger of a small syringe fitted with a tiny twenty-five-gauge needle sunk into a bottle of lidocaine, and withdrew ten cc’s. She had just disinfected Mars’s neck with Betadine. In sterile gloves, she placed an index finger on the small area of exposed clean skin.

  “You’re going to feel a little prick, Mars,” Mindy said. How many times Mindy had said this to patients, Sima couldn’t imagine.

  “I guess I’m only a little prick now,” he said.

  Finding a vein in an addict with endocarditis for a new IV every three days for six weeks. Mindy had months of experience now. The sores on Mars’s arms and legs had healed, but he was still an impossible stick.

  The drape moved.

  “You have to lie still.” Mindy’s voice was muffled through her mask.

  “My nose itches,” Mars said.

  Sima lifted a corner of the drape, peeked in at Mars, and scratched the tip of his nose.

  “To the right a little,” Mars said. “Yeah, that’s it. Ahhh.”

  They waited for the lidocaine to take effect.

  Mindy’s breath escaped at the top of her mask, fogging her glasses.

  “Let me wipe those,” Sima said. She reached to lift Mindy’s wire rims off her nose.

  “I can see,” Mindy said. “Put my glasses back on before the lidocaine wears off.”

  “You could say, ‘Please,’ ” Mars said from under the drape. “But you’re one of the guys.”

  “There are only six women out of thirty interns,” Mindy said. “You have to become one of them.” She stood gowned and gloved and masked and capped over her patient.

  After a few minutes, Mindy removed the cover from a needle and lightly danced the tip on the skin where she had injected the lidocaine.

  “Do you feel this?” she said.

  “Don’t feel a thing,” Mars said from under his drape.

  She put the needle tip into the skin a little deeper. “Feel this?”

  “Don’t feel a thing, doctor.”

  Mindy settled one hand on Mars’s draped shoulder. With the other, she stuck a wide-bore needle into her patient’s neck, her thumb covering the open end to keep Mars’s blood from gushing out. She pushed an introducer in through the needle, now deep in the large hidden vein. She attached IV tubing connected to a bag of fluid and opened the valve. Clear liquid ran through the plastic, disappearing beneath black skin. She lifted the drape over Mars’s shoulder and taped the line against his neck and down his arm. She removed the drape from her patient’s face and the mask from her own. There were dents in her skin where the elastic of the cap had dug into her forehead. She rubbed at the dents with the back of her hand.

  There were no wrinkles around Mars’s eyes, only a few on his forehead. He sat up in bed, hands on his knees, cross-legged like a Buddha. A Buddha with one leg chained to a hospital bed. The skin on his arms and legs was smooth and clear.

  He spoke softly. “Everybody wants to be white,” Mars said.

  “What are you talking about?” Mindy pulled off her gown and gloves, bunched them into a ball. It seemed as though she couldn’t get away from the bedside fast enough.

  “You’re a Jew, too, ain’t you, doc?” he said. “No Jew woman ever going to be white, is all I’m saying,” he said. “The white man thinks everybody wants to be just like him. But no immigrant ever going to be white, either. Like Sima here.”

  “You think you can change who you are?” Mindy stuffed the used items into a garbage bag. “You’re a drug addict caught stealing and who got sick. Many times.”

  “I’m different now.” He put his hand over his heart. “Mars Peabody, drug addict gone straight.”

  “Your heart is failing and you’ve got a chain around your ankle,” Mindy said.

  Mindy spoke with the same kind of sarcasm Sima now used with her mother.

  Change wasn’t easy for anyone.

  The hospital cop moved Mars’s cuff from the bed to a wheelchair so Sima could take him for an echocardiogram. She pushed the wheelchair with one hand, the IV pole with the other; the hospital cop trailed behind Mars, model patient or not.

  “Why do I need another scan?” Mars said. “Dr. Kahn already said I need a new heart valve, didn’t she?”

  “The surgeons like to be sure.”

  It wasn’t Sima’s job to explain tests to patients, but they often asked her. She wasn’t going to tell Mars the surgeons were dragging their feet. Mindy said they hated replacing valves in addicts just to see them show up six months later, sick again, just like Mars himself before his big reform.

  Mars pulled a smudged brown leather wallet out of the pocket of his bathrobe. He fingered an irregular tear in the leather, gently, like he was touching a woman’s skin. He opened the wallet and held it up for Sima to see the photographs of a little boy with light brown skin and green eyes.

  “My boy,” he said. “Hair so smooth, like his mother’s.”

  Sima’s eyes were glued to the boy’s face, his light skin and green eyes.

  “Look at that smile. Them ears and teeth.” Mars ran his finger along the boy’s lips. “He lost the front ones when he was two.” He handed the photograph to Sima.

  She remembered putting her two front teeth under the pillow for the tooth fairy when she was five. Mama got mad at Papa because he left Sima a big piece of chocolate halavah.

&nb
sp; “That’s young to lose baby teeth.”

  “He got kicked.” The corners of Mars’s mouth turned down. He tapped one of his slippers on the footrest of the wheelchair. “His mother,” he said. “She was piece of work. I gave her everything a street man could, but she always wanted something more, something different.”

  Sima looked at Mars and then at the smile on the little boy.

  Mars closed his eyes. “It was me who kicked him,” he said, as though she had forced it out of him. “I wanted to kick her. She told me she wanted me out of her life and his, too. I was dark; they were light. I got so fucking mad.” Mars grabbed at the handcuff on his wrist, pulled on it until the silver metal dug a line into his skin. “My foot flew out—I kicked the boy. He was standing right there beside her.”

  Sima handed the photograph back to Mars.

  “There was blood everywhere, and the little guy was crying.” Mars shrugged. “She was screaming like I killed the kid. I just knocked out two teeth.” He put the wallet away.

  “Where’s he now?”

  Mars shrugged.

  Sima doubted Mars’s son would even recognize his father, that she would recognize her own father if he were to show up alive after all these years. All she remembered of him was his face scrunched up, lying on the poster for Oklahoma! That and his image in the one photograph in which she stood holding his hand, her mother on the other side of him. They all wore long, heavy coats and hats that covered their ears. Her father’s face was so small in the photograph that she could barely make out his features. All the faces were small.

  21

  Gurney Ride

  Mars lay on a gurney in front of the elevator, his trusty hospital cop, Officer Nelson, at his side. A black beret was perched on Mars’s bristly-soft hair, shaved flat by the hospital barber every week, as regular as his blood draws. His legs were crossed at the ankles, his toes covered with blue foam-rubber hospital slippers. Except for the hospital pajamas and the cuff on his right ankle, Mars looked as though he were lounging at the beach.

  “Where’d you get that hat?” Sima said.

  A big white-toothed grin came across Mars’s face. He put both hands behind his head. “Old friend gave it to me,” he said.

  Sima pressed the up button a third time. “Old drug addict friend?”

  “One of the oldest,” Mars coughed and then propped himself on his elbows, breathy. “He’s fifty-seven years young.”

  “I’ve never seen a drug addict that old.”

  “Sima, my young friend, there’s lots of things you never seen,” Mars laugh-coughed.

  His chart rested alongside him on the gurney. Sima flipped it open, something an orderly wasn’t supposed to do, and fingered the face sheet. “Says here you’re thirty-seven.”

  Mars said, “I met Bug Man when I was fifteen, just starting out on the streets.”

  Nelson, the slowest moving cop at the County, stood up from where he’d been leaning against the wall on the other side of the elevator. Nelson was also the oldest and the fattest but size, age, and speed didn’t matter for taking watch over Mars now that he was reformed. And sick as he was.

  “That Bug Man Bruno you talking about?” Nelson said. “I thought he kicked the bucket ages ago.”

  “Bruno’s been clean for seven years now. He’s living the good life, shacked up with a nice senorita.”

  “I thought he would go to his grave with needles sticking out every which way. He practically lived here, he was sick so much,” Nelson said, moving closer to Mars.

  Sima fingered the up button a few more times. “He quit the way you did, Mars?” she said. “Another reformed citizen?”

  Mars rattled the chain around his ankle against the gurney rail. “I had to get locked up in here to get straight,” he said. “Bug Man, he just quit. Cold turkey. He could feel the bug, the creep of drugs all over his body when it was wanting. That’s why they called him Bug.” He straightened his beret as though he were checking himself out in a mirror for a special lady. “He’s coming all the way from Mexico,” he said. “He’s going to find Derek, my son. He’s going to bring him here to see his old man.” Mars rubbed his chest. “To see his daddy.”

  Nelson bent in toward Mars. “I didn’t know you had a son.”

  “Man, get out of my face,” Mars said. He put his hand up to Nelson’s chest and pushed him away. Nelson grabbed for Mars’s arm, but Mars yanked the arm back out of reach. “You got bad breath like them dogs in the TV commercials. Go get yourself some Milk-Bones. Clean them puppies up.”

  Nelson rolled his eyes and leaned away. “Milk-Bones,” he said. “Hmph. You reformed addicts is worse than the guys still copping for a fix. You think you’re better than other dogs ’cause you kicked.”

  Mars started to cough.

  “Sit up,” Sima said to Mars. “Nelson, help me sit him up.”

  Mars was wheezing.

  “Breathe slowly,” Sima said. There was no red EMERGENCY button in the hallway. “Where’s the damn elevator?” She elbowed Nelson. “Get the oxygen tank.”

  Nelson bent his rickety knees. He strong-armed the tank onto the gurney next to Mars’s legs from the shelf underneath where it sat ready for moments like this one.

  “Tubing,” Sima said. She grabbed the clear plastic bag draped around the neck of the tank. She pulled out the length of tubing with the nose prongs and stretched the elastic band over the top of Mars’ head. She placed the prongs into Mars’s nose, attached the other end to the tank and turned the nozzle on. Oxygen whooshed out the valve and through the tubing. Nelson helped Sima raise the back of the gurney as high as it would go. They propped Mars up against his pillow.

  Mars coughed up a tiny speck of bright red blood and then a tablespoonful. The blood dripped down his chin and onto his hospital johnny. A bit of the red stuff splattered, just missing Sima’s hand on the gurney rail. He coughed again, and a speck of his blood landed on the side rail nearest Nelson.

  The elevator door opened.

  Miss Lawrence stood up from her chair. “This patient doesn’t look good,” she said. “Got an emergency here. Everybody off.”

  They filed off quickly: a lab tech white-coated neck to knee, two shiny-faced med students in their short white jackets, a handful of relatives waving orange VISITOR cards.

  Nelson was at the foot-end of the gurney, Sima at the head. Nelson barely got his big old butt across the threshold before Miss Lawrence pulled out the STOP button and the elevator door closed behind him. Mars was wheezing, more blood drooled down his chin.

  “Got to go directly to the ER—express.” Sima blurted out.

  “We ain’t got no express here, Sima,” Miss Lawrence said. “We just won’t make no stops.” Then she got on the telephone on the elevator wall and was talking to someone in the ER. “We got a very sick man here on this elevator.”

  Nelson leaned into the back wall of the elevator. Sima had one hand on Mars’s back and her other on his shoulder. “Try to breathe slowly,” she said. His lips were blue.

  The elevator door opened, and Sima heard the doctors running down the hall toward them. The side rails of the gurney slipped out of Sima’s hands as they rolled Mars out, as quickly as possible, to the ER. A minute later, a voice on the overhead called out, “Code blue in the ER.”

  Once the code ended, that’s when they usually paged Sima. After the ten rounds of epi and bicarb and three pushes of lidocaine, when the blood gas was dark purple instead of red. When the blood gas came back blue for the second or third time, the head of the code team gave the final command: time of death.

  But Sima was already there this time when she heard the senior resident call it. One doctor and then a few appeared around the edges of the curtain, their heads low and heavy.

  The white sheet was pulled up to Mars’s neck, his hair tidy, his skin clean: ready to see Derek and Bug Man. H
is forehead had no wrinkles now, nor the sides of his mouth down to his fuzzy chin, where he had been trying to grow a goatee. His lips were blue.

  “Mars.” Sima lay a hand on his shoulder, which wasn’t yet stiff under the sheet. At the head of the bed, the ER nurse lifted the sheet from below Mars’s chin. She raised it over his face, his blue lips gone forever. His forehead, his nose, his chin, a silhouette of white.

  “The surgeons waited too long,” Sima said. “It was his only chance.”

  The nurse smoothed a long wrinkle in the sheet over Mars’s chest. “I’m afraid our friend here had used up his chances.” She lifted the edge of the sheet and covered Mars’s fingertips.

  “But he gave it all up,” Sima said. “He wanted to see his son.”

  Sima peeked under the sheet, pulled it aside. An alcohol pad stuck to Mars’s chest near his left nipple.

  “Cover the body, Sima,” the nurse lowered her voice. “We got a room full of patients here.” She reached for the sheet and covered Mars again, his nipples, the curlicue hairs on his chest, the buzz cut.

  “His hat,” Sima said. She scanned the gurney, the floor. The trash barrel by the bed was filled to the brim with bloodied blue pads.

  “Let me help you push him out into the hallway,” the nurse said. She unlocked the wheels of the gurney, situated herself at the head end, and set the deathbed in motion.

  The intermittent screech of gurney wheels and the squish of soft-soled shoes drowned out any other sounds as the two of them pushed the body toward the elevator, where Miss Lawrence held the door open. One last shove and the gurney was inside.