Bloodletting and Miraculous Cures

by Vincent Lam

  “We’ve got thirty in the waiting room,” I said. “Funny night.”

  “Well, you’ve got to know how to laugh,” said the female officer, badge 6982.

  Police stand and talk and lean on things as if they belong anywhere. For most people, there’s a distinction between a place that is theirs and one they are visiting. Cops—you see them with their sidearms jutting out, their elbows resting on diner counters, parked in no-parking zones, using the staff washrooms in the hospital. Their hats hold in their hair, tidy.

  “Tell me about your man here,” I said. The bed rattled as he lunged though held down by cuffs.

  “Not much to tell,” said the male officer. “Fell, cut his head open. We need him fixed.” Some fall. Forehead split open, bleeding a red curtain. He shouted obscenities, shook his head. Not even a scrape on his hands. People put their hands in front of them when they fall.

  “Fell, huh? Clumsy guy,” I said.

  “Eli has very poor coordination,” said officer 6982.

  “What made him so clumsy?”

  “You see, Eli is a bad man, and we find that many such people are accident prone,” said officer 1483.

  The game is supposed to go like this. The police give the precis: Look doc, this guy did such-and-such, and we caught him, and now this-and-that has happened so we brought him to hospital. Maybe they say what they think the diagnosis will be. The officers usually imply what they think should happen to the prisoner. They can’t say it outright—’course, you’re the doctor, they must say in conclusion, as per protocol. Then the physician can respond to this play: Well, officers, I need to do test A, procedure B, and check for problem C. If A turns up normal, B works out well, and C is absent, I’ll pronounce your prisoner, my patient, healthy and you’re good to go. All with a wink and a nod.

  I was irritated that these officers seemed to want to play a modified version of the game: You do your thing and we’ll do ours. This is sometimes the case with more serious charges, and all the more reason for me to play carefully. Cops and robbers and doctors. It’s a game where mostly everyone can be happy if we all play nice. The police are surprisingly kind to the prisoners, as long as they’re docile. They treat them like younger siblings, showing them where to sit and filling in forms for them. Just like an older brother, the police turn nasty in an instant if the prisoner becomes difficult. You better settle down. Benevolence and cruelty are separated only by a veneer of whim which, in medicine, we understand.

  I opened the door, went in. His smell grabbed me and twisted my stomach so I had to force down the urge to vomit.

  “Hi Eli,” I said.

  “Get me out of these,” he said.

  “I’m Dr. Fitzgerald, the emergency doctor. What happened?”

  “They’re fuckin’ nuts. Get me out.”

  “I am Dr. Fitzgerald,” I repeated. In medicine we pretend that our names may be enough to control a situation.

  “Breathe,” I said. I sat on the edge of the stretcher, next to Eli’s cuffed ankle. Always sit down with the patient, I was taught. It makes it seem like you’ve spent more time and that you care. In a chair, on the stretcher. If you give this impression (this is the subtext) then the patients will do what you say and leave quickly. I liked the stretcher, since sitting on the edge of the bed is what everyone’s parents once did. Where is it sore, dear? “Speak–slowly. How–did–you–cut–your–head?” Speaking slowly and loudly transcends both agitation and language barriers. Another clinical pearl.

  “Set-up. It was a set-up.” He pulled and rattled at the metal bands tight on both wrists.

  It was nauseating to breathe, with the closed-in smell of piss and sweet-sour human stench. I pulled on gloves, flexed and extended my fingers so that the latex was tight on my skin.

  “Pain anywhere?” I asked. I felt inside Eli’s split-open forehead, ran my finger over the warm smoothness of skull. It was a straight gash from the hairline to the top of the nose. The blood flowed hot, an anxious stream. A man can bleed to death from the scalp, but not the forehead. Cuts in the face look worse than they are. I explored with my finger, to feel for smashed fragments of bone.

  “Shit man, stop that,” said Eli. He swung his head.

  “They say you’re clumsy.”

  “Fuckin’ cops playin’ drums with my head say I’m a killer gonna make me pay some shit.” Eli kicked against the cuffs on his ankles, which rang out on the stretcher’s chrome frame. I stood. “Fine bitch cop there, huh?” said Eli. He winked at the female officer through the window. Her expression did not change, but she enclosed her right fist in her left hand while looking at Eli.

  I left the room, took a big breath of clean air. The clatter of Eli’s rage drifted through the wire-strung windows. The child in the next stall was crying.

  “What’s the deal here?” I said to the two police, who were leaning on the nurses’ counter.

  “We need him fixed,” said officer 6982.

  “Right,” I said, and did not move.

  “That’s the deal,” said officer 1483. He turned toward the quiet room and smiled at Eli. Officer 1483 had a fresh haircut. The nape of his neck was raw from a razor.

  “And his head split open? Like that when you got him?”

  “Fell. And banged his head getting into the cruiser,” said officer 1483. “Already filled out an incident report.”

  “Did he pass out?”

  “Nope.”

  “Vomit?”

  “Nah.”

  “Something about being a killer,” I said.

  “When you’re done, we’ll take him to the station,” said officer 6982. “Get him out of your hair.”

  Cops. They want to get seen first. Put them at the front of the line but then they won’t talk. None of my business, they figure. They were responsible for his legal ailments, but I was now liable for his medical misdemeanours. It would be awkward for me at the inquest if the Crown said, Doctor, tell us a little more about the head injury that led to Mr. Eli’s demise. The police records state that all circumstances were explained to you. The doc holding the chart last has to explain everything.

  Maybe Eli needed to see a psychiatrist—a name after mine on the chart. Was Eli psychotic? Could be. I’d better find out. Police inquests are tedious, nitpicky, and it’s lonely being the only physician on the stand. I went back into the room, into the thick piss smell. His pants were dark. Can’t blame a man for that when he’s scared and cuffed. Acid—that’s what it must smell like inside a pelvis.

  “Listen to—”

  “Get me out doc get me out I gotta get out.”

  “Shut up. Listen to—”

  “Ya fucking, you’re not a doctor, ya fuck.”

  Now both of us shouting: “Listen to me. I am your “Last month I’m minding my own business, this guy doctor. Are you hearing voices? Are you seeing things comes up he says he’s gonna shoot my dog unless I give that other people don’t see? Is someone out to get you? him some names. See, I love my dog, she’s all I got, and Are you receiving radio or telephone messages? Do you I don’t got the names he wanted so things got a little want to hurt someone? Do you have a psychiatrist? outta hand and anyhow how’s I to know he’s a cop? He What medications are you taking? Do you feel that hit me first, sucker punch. I hit him back. Betcha he’s people are plotting against you, out to get you, that banging that bitch cop there. Fuckers they said my there’s a conspiracy of some kind?”

  time’s up now they got me.”

  Then both of us stopped talking. In the sudden quiet, I stepped back and wrote in the chart for a little while. Then, “What can I do for you, Eli?”

  Eli paused to consider his situation, and then said, “Why don’t you suck my cock?”

  I tried to breathe shallow, but the urine smell was so insistent I thought I could taste it. Outside the window, the officers watched and grinned. The female officer said something to the male officer, who laughed. When he saw me looking, he turned the other way.

 
“You’re right,” I said to Eli. “They really are fuckers—just like you.”

  I went into the hallway. “What’s so funny?”

  “Talking about something else,” said officer 6982, smiling.

  “You seem to think me and your prisoner are pretty funny.” Cops, backwards garbagemen, always bringing in the trash.

  “There’s something I don’t understand here.”

  “You should watch yourself,” officer 6982 said.

  “That a threat?” I asked. If these cops wouldn’t play the game right, I’d look for a new game. I wasn’t going to be the last doc signing the chart.

  “Watch yourself with Eli,” she said. “He’s quick. Watch yourself.”

  “And he’s mentally ill. We’ll keep him here.”

  “Whaddya mean?” she asked, her voice now less relaxed. “We gotta get him back and book him.”

  “After our psychiatrist sees him.”

  “When’s that?”

  “Tomorrow morning.” It was ten at night.

  “What makes you think he’s nuts?”

  “Eli told me about someone threatening to shoot his dog, trying to get information from him, punching him,” I said, and felt the first nervousness of enjoying this. “It’s funny, he said it was a cop. That would be coercion, police brutality. Can’t be true. So, Eli must be paranoid. Psychotic.”

  “You can’t believe these things,” she said.

  “Not for a second, but I have to document what he told me, right here on the medical record,” I said. I showed her the chart on which I had transcribed Eli’s statements. “Must be delusions, poor Eli. He must be imagining the police punching him and so forth. Although I guess he’s not psychotic if it’s all true. You know anything about this stuff?”

  “Can’t say,” she said.

  “’Course not. Mental illness. Tragic. He needs help. I’ll fix his cut after we scan his head.” I was looking forward to finishing my shift, to saying goodbye to the officers as I left. They would be here all night unless someone relieved them. We all have our quiet ways of asserting ourselves.

  Two hours later.

  The CT scan showed no intracerebral blood, but an old broken nose. Eli was quiet. The officers had already called the station and requested relief, but no one had arrived. They were no longer jovial, but they still wore their blue-banded caps and sat up straight. I put on a surgical mask to breathe through.

  “We’re gonna fix you now,” I said as I wheeled the suture cart into the quiet room. I scrubbed Eli’s face and the side of his head with saline-soaked gauze. I poured salt water over his head through curses.

  Eli said, “Fuck off.”

  “Listen to me carefully. Have you ever seen a psychiatrist?”

  “No ya fuckin’—howdya like my face, huh, doc?” With the jellied blood washed away, I could see the cut was four centimetres long. A forehead bleeds more than you would think for that length.

  “I got a good face?”

  “You hearing voices?” I couldn’t tell him to act psychotic. “Seeing things that other people don’t see?” But a little fishing never hurt.

  “Ya better fuckin’ make it look good.”

  “Anyone out to get you?” With the otoscope I peered inside his ears. No blood behind the drums. The cut had a neat, straight edge. “You want to look good? Better hold still.” This fish needed bait. “Eli, I’m worried about your mental health. Crazy people have to stay in hospital.”

  I drew lidocaine into the syringe. The anaesthetic swirled into the graduated barrel. I flicked with my finger, clearing the bubbles toward the needle, and expelled the air like a sneeze with a quick motion of the plunger.

  “I don’t want it to hurt,” he said.

  “It’s gonna hurt.”

  “I’m hearing fuckin’ spooky voices and seeing pink dinosaurs and shit,” said Eli. He began to giggle.

  “Thought so.”

  “I don’t wanna feel nothin’, man.”

  “It’s gonna sting when I freeze you. You won’t feel it when I’m stitching.”

  The syringe was between my index and middle fingers. My thumb was on the plunger. With my other hand, I held open the end of the cut. I slipped the needle under the edge of skin, and my thumb eased down on the plunger. The tissue swelled and turned white at the injection.

  Eli swung his head. “Hey that fuckin’ hurts.”

  I held the syringe pointed into the air the way a cowboy raises his pistol to fire a warning shot.

  “Don’t move,” I said. Sharps were open, syringes and needles. A physician should be morally opposed to cutting himself, I was taught. These instruments were for piercing patients, opening their skin. Sudden movements cause accidents, and it is a sinful violence to cut oneself. “Be absolutely still, Eli.”

  “Yo. It hurts.”

  “It’ll hurt more if you move. One more chance, then the officers hold you.” I didn’t look up. I could feel the police watching through the window. Enjoying the show. I didn’t want to need them. One more try. Again, I slipped the steel sliver through the edge of the cut, ran it under the skin’s surface. Again, upon injection, he bucked. “All right, we’ll get your friends in here.”

  I opened the door. They sat there grinning. “Come on in here. Hold your boy.”

  “Like we said, we just want him fixed,” said officer 1483. “This sure is getting complicated.”

  The two officers clattered into the room, pulled on thick blue latex gloves, snapping them at the wrists.

  “One at the head, one on the legs,” I said.

  Then it was a tumbling, struggling effort as Eli flailed and kicked. Restraining people is an ironic task. The more you restrain them the more they resist and the harder you must hold them still, strap them in, beat them down until a certain point is reached, until there’s no point resisting. Once they know who’s boss, it’s done. Like breaking a horse, I was taught. A show of force is best. A hand on each limb—make them see who’s in charge, because then they won’t resist anymore. More limb jerking. Eli cursed, grabbed, pushed, and through this the officers shouted at him until they got him down. Now I was on him with the needle, injecting. Mostly for show now. The record would not state that I hadn’t provided anaesthesia. I jabbed the needle in a few times as Eli bucked his head. I tossed sterile drapes over him, over the hands of the female officer who gripped his head securely between both palms and outstretched fingers. Now the thread and needle; the thorn in my needle driver. The sewing is easy, it’s getting the head to hold still that is difficult. The needle pierced skin, the black line pulled through, a one-handed knot. I couldn’t tell whether he felt it or not, with all the roaring and thrashing. Maybe he really was psychotic. Then a flashing surge of movement, and the drape shook off as Eli lunged quickly and officer 6982 jumped back. There was red on the back of my hand, and wetness, and a gash in my glove from the new cut.

  Upon seeing it, I felt the pain. It was a bloody hurt that dripped into the fingers of the glove.

  “You piece of shit,” I said to Eli. My tired annoyance was suddenly eclipsed by panic, my heart pounding, pushing the blood from the back of my hand.

  “Told you to watch yourself,” said officer 6982.

  I ripped off my glove. “Why’d you let go?” I said, my own blood hot and running.

  “Slipped.”

  “Your boy too strong for you? Get a good hold of him.” I pointed the needle at her. She didn’t know that needles are our pistols, because she calmly put on new blue latex gloves, and then the leather gloves that flopped out of her back pocket. I stuck my hand in the sink, and poured a litre of saline over it. I told myself to slow my breathing.

  “Too quick for you,” said Eli with a giggle.

  Officer 6982 grabbed his head from underneath and at the sides, pinched his ears under her thumbs.

  “Time to fix you, Eli,” I said. I poured another litre of saline over my hand, tossed the empty plastic bottle into the corner of the room, and flexed my finger
s. No tendon damage. Just skinned. I pulled on fresh gloves, then a second pair over the first. Breathing hard.

  I reached over to the suture cart and grabbed a stapler. Usually we staple scalps and sometimes legs. It’s less accurate, and when the staples come out they leave little marks like train tracks. I squeezed Eli’s forehead, not paying attention to the alignment. Thunk thunk, in went the staples. The male officer forced down Eli’s knees as he bucked at the hips. Thunk thunk.

  “Aw fuck! That hurts, man.”

  “Shut up, you piece of shit,” I whispered. I leaned the sharp corner of my elbow on his sternum. This leaves no bruises, and we use the pain of this spot to wake the comatose. I rolled my elbow over his chest, could see the blood smudging over my gloved hand. Thunk thunk, I put in a few extra just for the sting. “Don’t bite the doctor.” My fingers were sticky with blood inside the glove.

  “Didn’t mean to bite you, man,” Eli laughed. “Trynna taste that sweet police meat.”

  “Watch your mouth,” said officer 6982.

  Had Eli been trying to bite the cop, or me? It’s hard to know what occurs mentally in a lunge, in a movement. Maybe the motivations of an instant are most true. Did officer 6982 feel him slip, or did she let go? Did she sense he was going for a bite, and then pull herself out of the way? Had he intended me instead of her? Did motive matter now that my skin was ripped open? Anger needs to lay blame.

  “Who ya trying to bite?” said officer 1483 from where he leaned over the knees.

  “Yummy yummy,” said Eli. His shirt had been pulled open in the struggle, and his belly shook as he laughed. Eli wiggled his tongue at the female officer. I saw her forearms flex as she compressed the sides of his head. Her expression did not change.

  “Aiee!” said Eli, squeezing his eyes together.

  Thunk thunk.

  “I’m done.” I threw the stapler across the room, clanging into the trash can. I peeled off my gloves and opened another bottle of saline, poured it in a steady stream. It ran clear onto the translucent flesh of my hand, and red streaming down into the sink. “Send in one of the nurses, will you?”