Tooth and Nail

by Linda D. Dahl

  “Can I check him?” I asked when he was close enough to hear me, suddenly remembering I was the corner doctor. A sob crawled up and lodged in my throat.

  “Let’s see. It’s up to him,” he said, walking over to the referee. He spoke something to him then beckoned me to the ring.

  I went up the stairs and stood at the edge. “Can I check you?” I asked Marcus. Sweat dripped off his chest and face and onto my jacket. The cut under his left eye had swollen and filled with droplets of blood. I glanced down at his shorts, tenting over his groin, where his traumatic hernia was blossoming. I needed to take a look.

  Marcos turned to the referee and said something in Spanish. The referee, an old white guy, answered him back in Spanish. I was embarrassed that, although I had spent five years in Bronx hospitals, I still hadn’t learned the language. I could only manage a few medical phrases and the occasional term of endearment, neither of which would help me here. Finally, Marcos spoke one word I did know.

  “Doctora?” Marcos asked the referee and then looked at me and shook his head.

  “He doesn’t want you to check him,” the referee said.

  “Why? He’s injured! He could have a hematoma! Or, worse, his guts could be hanging out of his groin!” I said, raising my voice in disbelief.

  The referee, recoiling at my graphic description, responded carefully. “He doesn’t want you to check him because you would have to do it here. Ringside. And you’re a woman.”

  I didn’t know what to say. No one had ever rejected my help. Even in the hospital, when patients thought I was a nurse, I was more welcome because I was a woman.

  Then the guilt crept in. What right did I have to be there, in this world of men? How dare I insert myself in the ring, in this setting, if I couldn’t even do my job. I felt horribly ashamed; so ashamed, I relented and took my seat. At the loser’s corner.

  A few minutes passed, and Marcos was still standing. He had been silent since I had left the ring, but his eyes were different. They smoldered with dark rage. The bell clanged, signaling that his five minutes of mercy were over. It was time for round seven.

  Curtis, unfazed by his show of cowardice, moved right into Marcos. Keeping his punches high, he pounded into Marcos’s chest, back, shoulders. Marcos took the punches; he barely fought back. He needed all he had just to stay upright. Curtis easily won the round. The bell clanged, and the boxers took to their stools.

  Frank’s favorite ring girl tripped up the stairs again, this time with the help of a dreadlocked man. Her card now read 8. Visibly stoned, she turned too quickly when someone in the crowd catcalled, staggering against the ropes to keep from falling. She was the lucky one. At least she knew what her role was. I had no idea about mine, walking the line between male and female, leaning more to one side or the other depending on the situation. But mostly, I was lost in the fuzzy space in between. A manly woman. A wombed man. Deep down, I was really just a scared little girl.

  The bell clanged.

  The two fighters resumed their dance. I checked both sets of legs—they seemed to know where they were going. But, after the first minute, something changed. Marcos snapped. He moved right into Curtis, landing a sharp uppercut to his jaw. A stunned Curtis went limp and slumped to the floor.

  “One, two, three...” The referee kept a slow count until he reached the number eight, and, seeing that Curtis had lifted himself up and regained some composure, stopped counting. “Fight,” he said. But there was no fight left in Curtis.

  Marcos, with all the rage that life and that low blow had lent him, poured into his opponent. His fists were a flurry of uppercuts, jabs, hooks and crosses. Curtis, still confounded by the head trauma, was defenseless. He had become a vessel of soft meat and bone. The crowd went wild, screaming, booing and cursing.

  And, to my surprise, I felt a tiny smile creep across my lips. I rarely got to witness this kind of karmic retribution in real time, or in real life for that matter. And to be witness to that kind of physical atonement felt good in a way I had rarely known.

  My reverie was interrupted by the ref, who threw himself between the fighters and waved his hands, signaling the end of the fight. The crowd rebelled, throwing cups of ice and pieces of garbage into the ring, pushing forward toward the ropes. The referee was quickly whisked away from the growing mob by two security guards.

  The ring was now packed to compression with the teams of each of the fighters, the fighters themselves, officials and security guards. Someone had located Lou Dibella, the night’s promoter, and had brought him to the ring. Dressed in baggy jeans, a Rolling Stones T-shirt and weathered suit jacket, he stood at the edge, clutching the ropes, where I had stood ten minutes earlier. Bald and hunched, he looked more like an overage rocker than an assertive multimillionaire.

  “What’s happening?” I asked Frank, confused by the delay. I looked up to the balcony at the Venezuelan delegation. They were huddled quietly, no longer waving their country’s flag.

  “They’re figuring out the next bout before they announce the winner,” Frank said.

  “But why is it taking so long?” I asked, feeling a rush of anxiety.

  “See these guys and how angry they are that their man Curtis lost?” He gestured toward three particularly heated men standing directly behind us. “If we announce now that he lost, there’ll be a mob scene. Wait long enough, and they’ll get bored.”

  I had never considered that as a strategy: delaying disappointment to quell a riot. It seemed to be working, though. The pause created a slow leak in the balloon of crowd rage.

  Tom had somehow made his way over to us through the crowd. “Yo, Dahl, you okay?”

  I wasn’t okay. I was a failure on every level. I had failed my fighter because I couldn’t examine him. I had failed the other doctors because I was too meek to work my corner. I had failed myself for enjoying Curtis’s beating. A fight doctor has one primary purpose, and that is to protect the boxer. I had failed in that most of all. I felt more worthless than my first day as an intern.

  * * *

  After forty-five minutes of radio silence, Lou announced the rematch before the announcers claimed Marcos the winner by technical knockout. The ballroom emptied quickly after that. After a cursory check by a male doctor in the dressing room—a psychiatrist who probably hadn’t examined a groin other than his own in thirty-five years—Marcos was whisked away in an ambulance.

  Standing in the corner, the lone woman after the ballroom had emptied, I remembered what Frank had said at the beginning of the night: If things get bad, go under the ring.

  Actually, that wasn’t a new concept to me. It’s what I had always done when I got scared. I tried to make myself invisible, thinking that if I got out of the way the bullets wouldn’t land. I had made it through medical school and residency that way, but those paths were well lit by rules for right and wrong. When it came to standing up for myself and paving my own path, I was lost.

  But Marcos had shown me something that night. In order to get what he really wanted, it wasn’t enough to just step out from under the ring. He had to fight his way out of more than just that boxing match. Getting a bigger piece of the pie meant endangering his life and probably becoming sterile in the process. If I wanted more than what my life was giving me, it wouldn’t be easy for me either. I would have to fight my way out, too.

  2

  I was first introduced to boxing by my husband, Adam, a few months into my general surgery internship in the Bronx. It was a time when weeks were measured in hours, and days were endless without the bookends of sleep. He must have been watching the matches for over a month before I noticed.

  The day it finally registered, I was sitting on the couch, wearing hospital-infested scrubs, bloodstained and full of bacteria. Although I was used to a healthy dose of violence, it was too much to bear in my own living room. I thought back to the morning’s gunshot wound v
ictim—the source of said blood—and remembered how the two units I breathlessly delivered from the blood bank dripped out of his abdominal wounds and onto the floor, splattering my scrubs on the way down. Not the noble outcome the donor of that fluid likely had in mind.

  “Did you see that? God! Look at the angle of his torso!” my husband said to the television. He was rapt. Hunched over a sketchbook, he busily scribbled lines and smudged them into the shapes of the boxers. His fingernails were dirty with charcoal, which wasn’t unusual. That year, new to the Bronx and still trying to figure things out, he had spent most days barely dressed and in front of the television, working on sketches for paintings that would never be completed. Art is never finished, only abandoned, he would say, quoting Leonardo da Vinci.

  I was confused. Why did Adam, the socialistic, self-loathing artist enjoy watching boys punch each other? Was it irony? He professed non-violence, ranting about the military and gun-control laws ad nauseam. Did it sublimate his feelings of being an outsider in a borough whose residents were mostly Caribbean? Maybe he was just tired of how his translucently pale skin incited angry locals, and he needed an outlet.

  New York had been his idea, even if it had been me who had ultimately brought us here. He had wooed me over pizza at Lombardi’s in Soho when we’d visited the city for my residency interview. At the time, New York had seemed like somewhere we could possibly afford, where we could live like bohemians in a downtown loft, not struggling interns in resident housing. But just like that artist’s life, this boxing thing was a fantasy. I couldn’t even watch—let alone enjoy—it.

  Too tired to get up, I stayed collapsed on the couch. After a few minutes, I noticed something green and fuzzy perched next to a half-eaten drumstick across the room. It bore an uncanny resemblance to my cheese sandwich from two nights ago. But instead of inciting nausea, which was now reserved for disgusting sights of the visceral variety, it merely served as a reminder that I hadn’t eaten since lunch.

  Ignoring my hunger, I went to the bathroom to shower. I scrubbed with Ivory soap, but it was no match for what I had encountered at work. Earlier that day—or was it yesterday? I couldn’t remember—I had been made to probe the incision of a new, post-op colostomy, while on rounds. Even sudsed up, I could still feel the moist warmth of bowel and feces between my fingers. After ten minutes of washing, I gave up trying to feel clean and got out of the shower to dress for bed. My filth had penetrated through to the inside.

  “Good night, honey,” I said, peeking into the living room. Adam was still staring at the screen. Although his preference for television over me was painful, I tried to conceal my jealousy. Since I was never around, it made sense that he had other love interests, but they were usually one-way relationships with inanimate things like video games, guitars, art supplies, motorcycles, computer equipment. I could already tell that boxing was different. His pleading for HBO finally made sense. And while I had agreed, I also recognized the real price. On my $30,000 a year salary, which supported not only the two of us but also his computer and painting supplies, that extra cable money meant I was eating dinner off unfinished patient trays instead of splurging on McDonald’s during overnight-call shifts.

  “Ooooh! Did you see those moves? He just beat the shit outta that guy!” Adam squirmed in his chair, sketching the figures even more passionately. His hair, usually in a wild mess, was sculpted forward by two days of natural oils. He probably hadn’t left the house or slept in just as long.

  “I’m going to bed,” I said and fell asleep to the sound of fists hitting flesh in the other room.

  * * *

  The next morning, I awoke in darkness without the alarm. Five o’clock. Adam didn’t stir. Gazing at his naked, muscular body, I saw how easily I flowed into him. He was a necessary extension of me. The appendage that was free, creative, dark and allowed to express rage. Caressing his face, I kissed it gently so I wouldn’t wake him.

  I dressed and prepared for the three-mile run to Jacobi Hospital. For some, including Adam, running was exercise. A rush of adrenaline. For me, it was necessary transportation after my car was stolen.

  Eight weeks earlier, driving over the George Washington Bridge, I knew it was only a matter of time before my car would be taken. Angry, tired faces stood on street corners in the North Bronx. Buildings were crammed together with sardine density. Dirt coated everything with gummy July heat. Parked on a side street, the Minnesota plates on my Acura Integra were as inviting as a tequila shot to a drunk. Someone easily drilled out the passenger-side key chamber, made a copy of the key and drove it away. When it was finally gone, I was partly relieved. Anticipation of the loss had been uncomfortable. I almost preferred the sober reality of the actual theft.

  “Yes, I’m sure it’s gone. I checked everywhere,” I told the police officer on the phone, more vindicated than upset. “I just moved here two weeks ago.”

  “Welcome to New York,” he chuckled, offering no help. “Now you can call yourself a real New Yorker.”

  The violation added to my growing sense of martyrdom. What was more, the insurance payout only covered the remainder of my car loan, so a four-wheeled replacement was impossible. The paucity of early-hour public transportation in the Bronx left only illegal cabs, whose fluid fare schedules and seedy drivers terrified me. I preferred my sneakers.

  Scrubs tied around my waist, I stepped outside and breathed in the cool morning air. The stillness was as energizing as it was scary. Running at this hour, my senses obscured by headphones, was dangerous. I had to jog in the middle of the street to avoid the drug dealers in the park. Even the police officers were suspect. But the music seeping through the quiet darkness transported me.

  In the arms of an angel. If only I could fly away.

  In that otherworldly dawn, when morning shift workers replaced the night shift of gun-wielding teenagers, glimmered the promise of a new day. A promise that lasted exactly twenty-eight minutes—the time it took me to reach the hospital entrance.

  * * *

  Since there was no shower in the call room at Jacobi, I had come up with an alternative. I made my way to the bathroom on the cardiac telemetry floor, which was the most reasonable choice for two reasons: number one, cardiac patients and their tentative hearts never left their beds and, two, hardly anyone else knew there was a shower in there. Still out of breath, I snuck into a rusty stall, rinsed off and dressed in my scrubs, making it just in time to join my team for morning rounds.

  “I told you to stop the heparin last night. How the hell am I gonna operate? She’ll bleed to death!” Dr. Davis, in his usual dramatic mood, chided the overnight intern. Because he hadn’t matched into General Surgery the first time around, Dr. Davis spent two extra years in internship. He was known as much for his comedic rants as he was for his temper—a temper he fed with healthy doses of oxtail, roti and coco bread from the Golden Krust Caribbean Bakery.

  Dr. Haven, the intern, cowered, tears welling up in her large brown eyes. “I...I forgot. I mean, I wrote the order...” I secretly loved watching her suffer, but it wasn’t her fault I hated her. I was jealous because she was luckier than me, as evidenced by her enormous three-carat engagement ring. Unlike me, she had been smart enough to procure a safety net. That ring was her insurance policy.

  “You WROTE the order? What, you think that means something’s gonna get DONE in this hospital? You. Are. A. Surgical. Intern. That means you do everybody else’s work. Trust no one!” Dr. Davis’s lecture turned into a bellow, spit flying, jowls wobbling. “When I say stop the heparin, that means you stop the IV yourself. Hell, stick it in your own vein if you have to! If all you do is write orders, you know what that makes you?” It didn’t sound like a rhetorical question.

  “Um...” she muttered, squeezing her brows together. Accustomed to flirting her way through tough spots, Dr. Haven was at a loss.

  “That makes you a medical resident, not a surgeon!” His
yelling caused the half-sleeping patient to stir. She was an elderly woman, who had been struck by a car the week before. Although those injuries were beginning to heal, Dr. Davis had managed to find some obstructed bowel, and he wasn’t going to let her off the service until he got his hands on it. This was his last year of training, and he needed to cram in as much surgical experience as possible.

  Dr. Davis finally noticed me. “Dr. Dahl, where the hell have you been? It’s 6:02! Take the book. Thank God you’re on call today. Clean up this mess!” That seemed to be my biggest asset, when it came to men. The attention I got from them was limited to patients screaming for their pain medication or senior residents wanting me to fix everyone else’s mistakes.

  I took the book from Dr. Haven. It was a faded green hardcover with the word TRAUMA written across it in large, uneven letters. The title was meant to identify the Trauma Service, but it was more symbolic of how it felt to work on it. Every morning, our team gathered for rounds to review overnight happenings, plan for the upcoming day and suffer Dr. Davis’s tirade. As the on-call intern, I was single-handedly responsible for everything, especially things that were beyond human control. My primary goal was to get it done, no matter what it was, and, especially, if it was someone else’s job. All of these its were collectively referred to as scut. On this particular service, scut often included things like drawing blood, developing X-rays and emptying bedpans.

  I turned to a new page in the book and drew a column of tiny black boxes, creating the list of the day’s duties. The scut list.

  Dr. Davis barked out orders as fast as I could write them. “Bed 2 needs a bowel prep. Get all the shit out of his colon. I want q.4.h coags on Bed 4. Do not kill his vein graft. Bed 3 is too lazy. She spiked a fever last night. Get her ass outta bed, or she’ll get pneumonia.” He rambled on as I completed a full two pages of new scut.

  After the last patient had been seen, he held his hands together and looked directly into my eyes for his version of a prayer. “Do not kill anyone,” he said, bowing his head and taking a moment of silence.