The Care of Strangers

by Ellen Michaelson

  Sima, Mindy, the A41 intern, and the head nurse stood by the bed and watched the man breathe on his own.

  The A41 intern reached out to pat Mindy’s arm. “Good save,” he said.

  The head nurse nodded, her blue mask moving up and down. “Good job, Dr. Kahn.”

  Sima had never seen a patient survive a code. Mindy’s first code as the one in charge. And still an intern. And the patient was alive.

  * * *

  —

  SIMA AND MINDY DROVE INTO the City. They took the Brooklyn Bridge this time. It was June and wasn’t dark yet at the end of their workday. Sima watched the buildings in Manhattan just begin to light up, reflecting over the waterfront, the bows of boats, and the surrounding boroughs.

  Sima noted a small tear in the elbow of her old top. She liked the blouse Mindy was wearing. It was loose, with a scoop neck and horizontal gray pinstripes. The bottom edge came just to the waistline of her black skirt. It was airy and cool, perfect for a warm New York City night in early June. Long silver earrings with tiny dots of red and green stone hung from Mindy’s ears. Her hair was not post-call kinky but smooth-curly and still smelled of a shower. It was the first time Sima had smelled Mindy so clean, the first time they had gone into the City together for the fun of it.

  “The last time we—” Sima said before stopping herself. She had been about to say, The last time we went into the City together was the night we went to your father’s, but she didn’t want to spoil the good feeling in the air.

  “The last time we what?” Mindy said. She pulled her left arm inside the car, rolled the window up halfway, and turned on the radio.

  “Never mind,” Sima said and rolled her window up, too.

  Mindy’s head bopped to the familiar notes just beginning on the radio. “ ‘Rubber Soul’!” she said. “My favorite Beatles song.” She reached for the dial and turned it louder. The Beatles’ chiming voices filled the car, singing of unforgettable faces, of wanting all the world to see.

  “Rubber Soul,” Sima said. “I know every word on that album.”

  Mindy shrugged. She smiled and sang along.

  Sima had never considered that American-born girls her age might like the Beatles as much as she did. Well, almost as much. Sima joined Mindy in singing at the top of her voice.

  When the tune ended and Mindy turned the radio down again, Sima reached out over the Rebel’s long, flat front seat. “You know,” she poked Mindy’s elbow, “ ‘Rubber Soul’ isn’t the name of a song.”

  Mindy was still tipping her head side to side, tapping one hand on the steering wheel. She gave Sima a short but penetrating look. “You always have to get it right,” she said.

  “Well,” Sima said, “The truth is the truth.”

  “So, ‘Rubber Soul’ is not a song,” Mindy said. She frowned for a couple of seconds, her face long, her mouth down, and then she turned to Sima and smiled.

  “We all need a rubber soul!” Sima shouted, “So we can bounce back!”

  “Bounce back,” Mindy said. “I like that!”

  I’m rubber, and you’re glue. What you say bounces off me and sticks to you too. Like Teflon and Ronald Reagan. Moral crises, years of lies, deceit, torture. Having a rubber soul meant you could bounce back from anything.

  “There could be a black market for rubber souls,” Sima said, “or maybe the Greek coffee trucks could sell them. Coffee, bagels, rubber souls!” she called, her hands up to her mouth like a megaphone. “Get your rubber soul here! Fresh from the factory. No delivery charge. Two for a dollar. Special today. Buy one for that lovely lady. No extra charge.”

  Bounce back when life dents you. The dimples popped out again, the edges rounded smooth.

  Mindy glanced at Sima. “Black market for rubber souls,” she said. “Ha. And I thought I was sleep deprived.” They both laughed.

  The end of the bridge was just up ahead. They were over the river into the warm rush-hour New York City summer night. Twilight. Not quite light anymore but not quite dark, either. The City with a capital C.

  “I never saw a cardiac arrest where the patient sat up and talked,” Sima said.

  “It happens sometimes,” Mindy said. “People make it.”

  “Not very often at the County,” Sima said. “You were really on. It was pretty cool.”

  “You did as much as I did,” Mindy said.

  “No way,” Sima said. “I just did what you told me to do.”

  “He was your save as much as mine,” Mindy said.

  Save. Money in the bank. A big sale at Pottery Barn, at Zabar’s, at the Times Square ticket booth, places Sima could only dream about. A big sale at Macy’s—her mother could buy new towels. Save a life. Sima had never seen a dead person come back to life.

  “Why did ask me to come with you to the code?” Sima said.

  “I knew you could help me,” she said. “You’ve been at almost as many codes as I have.”

  “I usually get called when the code is over,” Sima said.

  “I knew the A41 intern was out to lunch, the head nurse, too. She never does anything except page the intern on call for every little thing she never wants to do.”

  “My fingers got sore bagging him,” Sima said. “They’re still sore.”

  “I wanted you there,” Mindy said.

  “Chief Danielson was smiling this morning,” Sima said. Mindy tilted her head toward her side window. “He does that sometimes,” she said.

  “He hasn’t smiled at you since November.”

  “Slap on the back, ready to hand you a cigar,” Mindy said. “ ‘You’re one of the boys now.’ Take that damn English class and you’re going to be one of us too, a good one.”

  “Chief Danielson said he’d write me a letter.”

  Sima rolled down her window again, stuck her lifesaving fingers out into the warm air. It was time to tell her mother she was about to become a college graduate. One course to go. And she would have a letter of recommendation to medical school. She would make tea and sit down with her mother. If she told her with conviction, with her truest feeling and without sarcasm, her mother would listen. She was her mother’s only child. She was all her mother had. She was her mother. And Sima was her daughter. That would never change. Her prosta mother would be proud.

  Mindy sat up higher in her seat. “What happened to that patient you left in the wheelchair?”

  “The patient wheeled herself down to the Nurses’ Station in a fit,” Sima said. “Nurse Armstrong heard about it. She said she was going to report me. But then she smiled.”

  Mindy laughed. They laughed together.

  Mindy would push Sima to apply to medical school, she needed her friend to do that.

  “She has a better sense of humor than when I first started working there,” Sima said.

  “Hey, I’ve never eaten real Polish food,” Mindy said. “Let’s go to a Polish restaurant.”

  “Yeah?” Sima said.

  “East Village,” Mindy said. “There must be a place there.”

  “The Kiev,” Sima said. “Let’s go to the Kiev.” She’d bring home a babka for tea.

  “No better place to watch rubber souls in action than the East Village.”

  They got off the FDR at the tip of Manhattan, the City, where it was only a few blocks from one side of the island to the other, and headed to the Kiev. They spent the next two hours stuffing themselves on Eastern European delicacies: blintzes, borscht, and babka, kasha varnishkes, and thick slices of golden challah.

  23

  Museum Beads

  Sima saw Mindy standing by the door to the six-bed Female Room. Mrs. Sampson was back again, this time for shortness of breath, and Mindy stood there, intern tall. Her hair was post-Kiev and pre-call clean, her curls still holding their own against the night. She wasn’t wearing her short white jacket on her last
night on call as an intern. In a few days, she’d become a resident.

  The short Chinese oncology fellow in charge of Mrs. Sampson’s chemo marched out of the room with Mrs. Sampson’s chart under his arm. He brushed Mindy’s shoulder on his way out.

  “What did you say to Mrs. Sampson?” Sima heard Mindy ask him.

  From where Sima stood across the hall, she could see Mrs. Sampson’s long face, her eyes closed, her head down.

  The oncology fellow slowed his step, just enough to glance at Mindy over his shoulder. He wore a long coat because he was a fellow, which meant he was closest to being an attending. “Patient have breast cancer,” he said. “Metastases all over her lungs. She will die soon.”

  Mindy grabbed Dr. Shum’s sleeve. “You can’t talk to her like that,” she said.

  Dr. Shum turned to Mindy, and Sima saw the whole of him, shaped like a block—block body, block limbs, block head.

  “I am the oncologist,” he said. “That is my job. Must tell patient the truth.” Eye to eye with Mindy, no smile, no frown, just the facts.

  “But that’s not the way to do it,” Mindy said.

  “All patients are upset when they will die,” he said.

  “You should have told her when her family was here,” Mindy said. “Her daughter.”

  “Can’t wait for daughter,” he said. “Must see other patients.”

  “You can help this patient find a little hope.” Mindy wouldn’t let go of his sleeve. “That’s part of your job.”

  He stood so still. He turned his block body out of Mindy’s reach, and walked away.

  Sima tried to get Mindy’s attention, but Mindy followed Dr. Shum down the hallway, still ranting at him to no avail.

  The truth, whatever that was. How to tell the truth. That patients with bad breasts like Mrs. Sampson, bad hearts like Mr. Shtrom, bad valves like Mars Peabody, with body parts that wouldn’t do their share of the living anymore, would die. No matter what the doctors did. No matter how much chemotherapy or how many cardiac meds and IVs and antibiotics. No matter how many or how few times a nurse or a doctor came to their bedside and felt for their pulse. Whether the doctors made mistakes or not. Whether they told the truth or not. Whether they managed to leave the slightest bit of hope. They would die. Some sooner than later.

  Sima stood in the doorway of the Female Room, on the same squares of linoleum where Mindy had just stood. Mrs. Sampson’s long sewing fingers were spread out over her chest on the side where the breast was gone. Mrs. Sampson, only one day back but already with pillow hair. The whites of her eyes were red, her face was wet.

  “Mrs. Sampson,” Sima said.

  Thin old-lady fingers moved from her chest to the bed. Sima studied the thimble finger, the middle one, on Mrs. Sampson’s right hand. It moved more than the other fingers—it was the finger in charge. The fingers needed something to do, some sewing. But there was no sewing, no small plaid button-down shirt, and the fingers only patted the mattress. Sima sat down on the side of Mrs. Sampson’s bed. Her bony knees bumped up under the sheet, the outline of her covered legs was so thin.

  “Sima,” Mrs. Sampson said, “I want you to give something to Sammy for me.”

  “You can give it to him yourself,” Sima said. “When he comes on Sunday. That’s tomorrow. Tomorrow is Sunday.”

  “No, Sima,” she said. “I want you to give it to him.”

  “I’ll be here. I’ll take you down to see him in the lobby.”

  “Maybe I’ll be in X-ray when he comes,” Mrs. Sampson said, her head down. “You’re working on Sunday, aren’t you?”

  “Yes.”

  “Well, see, there you go.” She wouldn’t look at Sima. “You can do it for me, then.”

  Mrs. Sampson lifted her pillow-hair head from the pillow. She hauled her skinny body forward, toward Sima. “Get me my purse in the nightstand,” she said.

  Sima reached over and opened the cabinet. She pulled out Mrs. Sampson’s big black purse. From it, Mrs. Sampson pulled out a handkerchief, a hairnet, a lipstick, a mirror, a comb, and then a little silk bag with a purple flower on the outside. She unzipped the bag and emptied it onto the white sheet between her knees. Beads dropped out, round and shiny, yellow and red and gold and green.

  “My special beads,” she said. “Marbles I gave to him one Christmas. He asked me to keep them for him so they wouldn’t get lost.”

  One bead rolled away from the others. Yellow like the fiery orphan of a solid golden sun spooled against the inside pink of Mrs. Sampson’s fingers. She placed the yellow bead in Sima’s hand.

  “I want you to give these to Sammy, in this bag.”

  The yellow bead was already warm. “What’s he going to do with them?” Sima said.

  “The beads will remind him of his grandma,” she said. “I always bring these beads when we go to the natural history museum,” she said. “When he gets tired of looking at the dinosaurs, we go to the cafeteria. I have a cup of tea and Sammy sits on the floor by my feet and plays with the beads, the marbles. I think he likes them more than he likes the dinosaurs.”

  She collected each marble off the sheet in front of her, returned each one to the little silky bag. She motioned for Sima to drop the yellow one into the bag along with the rest, and then she zipped the bag and pushed it into Sima’s hand.

  “Promise me, now,” she squeezed Sima’s hand around the bag. “Sima?”

  Sima closed her fingers around the soft bag. “OK,” she said. “But you can do it yourself in the morning.”

  Mrs. Sampson didn’t say anything. She held her purse up in the air and waved it to say that Sima should put it back in the nightstand. Then she lay back on the pillow and closed her eyes.

  “Mrs. Sampson?”

  She kept her eyes closed and didn’t say a word.

  * * *

  —

  SUNDAY MORNING, THE ELEVATOR TO A71 was empty. It was Miss Lawrence’s day off. Only God of the Tunnel knew how that elevator worked when it was on autopilot. Sunday, the day of rest for Catholics and Protestants, but not for Jews. Or for interns or orderlies, for that matter, Christian or otherwise. Doctors, orderlies, patients all had their schedules to follow. None of them had a day of rest.

  Sima passed by the Male Room on the ward. There were three empty beds. She never saw half-empty rooms in January, when it was three days’ wait in the ER to get onto a gurney, never mind into a bed, all the street people coming in from the cold. But it was June now, summer, and street people had cooler, more inviting places to lay their heads than the plastic-covered mattresses at the County.

  There was only one empty bed in the Female Room. There weren’t any sheets on it, just the gray mattress, a tear in the plastic near the foot end.

  Sima saw Mindy leaning over a chart at the Nurses’ Station.

  “Hey,” Sima said. “Where’s Mrs. Sampson? Did someone take her to X-ray or something?”

  “Or something,” Mindy said. “That damn oncology fellow.”

  “Dr. Shum? What about him? I heard you talking to him yesterday.”

  Mindy lifted her head from the chart. Her post-call hairdo looked as if someone had just shot her through with an electric current. She stared straight ahead at the white wall in front of her and took a big breath. “He killed her,” she said. “The jerk killed her.” Her head down again, her clawed hand scribbling twisted letters on the page. She stabbed the page with the point of her pen, made a huge period in the middle of a sentence.

  “What do you mean?” Sima said. “Where is she?” She could feel the bag of beads in her pocket.

  “She died,” Mindy said. Her shoulders sagged over the chart. “Last night. She gave up and she died.”

  Sima moved her leg, and the beads clicked against each other in her pocket. She could feel her heart hammering in her ears. “She gave me her beads, to give to Sammy.” M
indy kicked the Nurses’ Station. “He had no right to say that to her.”

  “But it was the truth, wasn’t it?” Sima said.

  “People don’t always want or need to hear the truth.”

  “She gave me her beads to give to Sammy,” Sima said. “To give to him today.”

  “She knew she was going to die,” Mindy said. “Patients know. They give up hope and they know. I hate when they tell me they’re going to die. They always do.”

  “She didn’t tell you that, did she?”

  “She gave you her beads,” Mindy said. “She told you.”

  Sima didn’t want to hear that. She opened the bag and pulled out the yellow bead.

  Mindy opened her hand. She poked at the yellow bead, rolled it around on her palm. “I’m not sure I can take all this truth-telling,” she said.

  Sima pulled out another bead, a blue one.

  “You don’t have to do it the way Shum does it, or anyone else for that matter,” Sima said. She placed the blue bead in Mindy’s palm.

  “Yellow and blue make green.”

  “There are green ones in the bag too. Green is a secondary color.”

  * * *

  —

  MINDY AND SIMA WERE ALONE together in the elevator, going down. The door opened into the lobby. Not like the lobby of some fancy East Side hospital in Manhattan, marble floors and alabaster columns and valet parking. The County lobby was a few banged up chairs chained together up against the back wall. Scruffy people standing every which way—women, mostly black, holding onto little kids’ hands. Waiting for visiting hours to start. There were hardly ever any men.

  And there was Mrs. Sampson’s good daughter, Mrs. Wilson, and Sammy. Waiting. Like the rest. On a Sunday morning. Come to visit their sick relatives. Waiting for the County cops to give them each a bright orange plastic visitor’s pass that let them take the elevator and walk the hallways to wherever they had to go.