O tempora, o mores!
In the week that I was hospitalized, my ward mates came and went. One of them, a teenage kid, or as the newspapers would have it, “a local youth,” was the second patient to occupy the bed between mine and the window. He was admitted from the scene of a car crash. A good friend of his had been killed. He wasn’t talking to anyone, not even his father, who visited regularly. A couple of days after he arrived, a state trooper, in uniform, showed up to question him. You could hear the creak of leather and the rattle of gear when he crossed the room, spit-polished from his boots to the peak of his combination cap. You could almost smell the gun oil and saddle soap. Walking up to the bed, he stood towering over the kid, radiating authority, the reflective surfaces of the tack and the hardware catching light from the window. Even I was intimidated, and he wasn’t looking at me. He had questions for the kid about the car crash, and it was clear from the way he asked them that somebody had been lying about something.
The kid was alone, no parents, no lawyer, and I struggled with whether to tell him, “You don’t have to say anything.” I didn’t want to make things worse, and I didn’t want to get into a fight with the cop. It would have been a hell of a way to say thank you. The cop was one of the people whose job description included saving my life a couple of nights earlier. As things progressed, it became clear to me that the kid didn’t need my advice. To the extent that he was responsive, he was monosyllabic, the same typically sullen, unsociable teenager that his father had found himself up against. He didn’t give the trooper anything to work with.
The kid’s dad was a character. I don’t know what he did for a living. I had him figured for a workingman. He could have been an insurance guy or maybe an accountant, a generation removed from a working-class background, but something about him said blue collar to me. He was a lot like the people in my family, very much the kind of guy who’d be hanging around giving me advice when I was growing up. He seemed old enough to be one of my uncles, a little bit old, I thought, to be the father of a kid so young. He gave the impression of a man who’d come to parenthood late in life. His son wouldn’t say more than a few words to him, so when he came to visit, he spent most of his time talking to me, or just keeping me company. Or letting me keep him company. One day, when I wasn’t really paying attention, he said one of those things that secured for him a permanent place in my memory. He was standing at the foot of my bed, talking to himself, it seemed, as much as he was to me, when I heard him say, “Bob, this is very good,” and I glanced up to see him reading my chart. He nodded his head, looked up from the clipboard, and assumed me, “You’re never going to have a problem with your blood pressure.” I would forever take comfort in that, and never afterward would I think of my blood pressure without thinking fondly of him.
The morning I was admitted, there was a middle-aged fellow occupying bed B, the other windowside bed. I remember him for being the man who set me straight on the correct use of a term one encounters regularly on the Cape. I’d made the mistake of suggesting to him that with my recent acquisition of property, I was about to become a Cape Codder. He was the one who advised me—and all new arrivals can probably tell you from whom they received the advisory—that a Cape Codder is someone, and refers only to someone, who had the good sense to be born on the Cape. Those who wash ashore need not apply.
He himself, I believe, was one of the latter, and he was careful to make that fact clear. To read any class consciousness into his advisory is to be reading from outdated texts. The embrace of the Cape is all encompassing, blind to considerations of pedigree. Among its more festive traditions is the annual Blessing of the Fleet in Provincetown, when the bishop of the Catholic diocese travels out from Fall River to confer benediction upon the fishing vessels of Provincetown’s largely Portuguese-American fleet. In celebration of the town’s seafaring heritage, he stands at the end of MacMillan Pier casting protective aspersions of holy water on the procession of boats as it passes before him.
Provincetown Harbor, once home to sixty draggers, today supports no more than eight, only five of which are in working condition. David Dutra, captain of the oldest working vessel in the fleet, the Richard & Arnold, told the Provincetown Banner, “My boat was the biggest boat in Provincetown, it had a six-man crew, and now I fish it all alone. It’s too much work for one man and not enough money for two.” With the seas overfished and the town now reliant less on a maritime than a tourist economy, the Blessing of the Fleet has become but a small part of a larger Portuguese cultural festival, and the event is no longer the rowdy affair that it was thirty years ago. Held always around the first day of summer, the ceremony back then served as a rendezvous conspicuous for, among other things, the number of motorcycle enthusiasts it attracted. They set out for the Cape from all over the region to converge on Provincetown for the weekend. In the summer of 1979, one of them, in advance of his arrival, wiped out on the Mid-Cape Highway and wound up in the bed opposite mine.
Even without the injuries, as telltale as they might be, and stripped of everything but his hospital gown, he had biker written all over him. Everything about him shouted, “Too much ain’t enough.” It didn’t take a lot to figure out: This was one of my readers. This was a guy who knew all the words to “One Toke Over the Line.” And if my guess was right, it was his second-favorite railroad tune after “Casey Jones” by the Dead. A quick read on the guy when they brought him in, and I was ready to give odds that the people who were visiting me at the time weren’t the only ones holding. Had the state trooper been on the ward that day, just one glance in the guy’s direction, and he would have busted him for felony possession, without even shaking him down.
I know my public.
I don’t think the biker was hospitalized for more than forty-eight hours, and I probably wouldn’t remember him today but for the fact that he was a fan. The day he was released, his girlfriend—maybe she was his wife—showed up with his copy of my book, and I signed it for him as he was leaving. More than polite, he was actually rather bashful, and I doubt that it would have occurred to him, as it seldom does to readers, that when I autographed the book for him, the greater pleasure was mine.
The day my eyeglasses were delivered from the wreckage, Mary Ellen, horrified by their condition—“they were smeared with soot and fuel”—was thoughtful enough to clean them without making a point of it, wordlessly taking them from the bedside table, sparing me one more reminder of how I had wound up in her care. I didn’t make a point of the fact that her name changed in the course of that week. From one day to the next, the surname printed on the ID tag she had been wearing was suddenly no longer in play. The logical inference was that she was shifting between a maiden and a married name. I didn’t know her well enough to ask, but when I learned that she was the mother of an eight-year-old boy, I had a pretty good idea which way she was headed.
I have trouble separating what I learned about Mary Ellen in the course of my stay from what I learned about her after I was discharged. I can’t say with any certainty how our personal friendship got started. I’m not sure that she and I made plans to be in touch when I was released. I remember receiving a phone call from her sometime the following year. She asked if I’d come see a patient, a guy a few years younger than I, who’d suffered a spinal cord injury in a rollover of his Jeep. It may have been around the friendship that he and I struck up that she and I got to know each other as well as we did. However it happened, she and I have been friends ever since.
It’s not a friendship we nurture. We don’t see a lot of each other. What makes it endure, I think, is that back when we saw each other more frequently, it was never less than fun. Without thinking about it, we observed a kind of check-your-blues-at-the-door policy that had taken its shape soon after we met. This was a woman who had managed to get me laughing within hours of my surviving a plane crash. The monkey business she pulled on the day of my outpatient surgery typified the nature of the companionship that had ensued thereafter.
By the time of my release from the hospital, Mary Ellen had moved my bed into the light of the window, which, among other things, afforded me a view. Mine was now bed B. The day before I was discharged, she walked into the room carrying crutches.
“On your feet,” she said.
She helped me up out of bed and maneuvered me into a standing position for the first time since I’d escaped the wreck.
“Walk,” she said.
And I did. Kind of.
“Try it one leg at a time.”
She wanted to see me walk in what is known as a four-point gait, one crutch and the opposite foot moving forward sequentially, ambulating normally, in a natural, reciprocating stride, with the crutches merely providing stability. I was using what is called a swing-through gait, moving both crutches forward and then projecting my lower body between and beyond them. I didn’t know any of this terminology at the time, but neither was I new to walking on crutches. Thanks to a couple of sports injuries and the manifestation when I was seventeen of a degenerative cartilage disorder of the knees that would eventually disqualify me from military service, I had spent a portion of my last three years in high school confined to crutches. I was pretty good at getting around on them. I’d seen people use them her way. My way, however, had the advantage of being faster.
“Give it a try,” she said.
I gave it a try.
My way also had the advantage of being something I was able to do.
“OK,” Mary Ellen said, “that’s good. Back to bed.”
She said it with a smile, as if my failing to master the four-point gait was a charming idiosyncrasy.
“I can’t do it that way,” I told her, as she walked me back across the floor.
“I can see that,” she said, and smiled again.
I’d seen that smile before. Mary had it down pretty well. It’s the practiced smile all nurses master early in their training, the polite and evasive smile they give you when the X-rays or the lab results come back, and they answer your question this way: “The doctor will be out to talk to you.”
In this case, the doctor, an orthopedist, had apparently dismissed the evidence of the X-rays. And then Mary Ellen, after putting me on crutches, reported that I couldn’t raise my right leg. That’s when the doctor, my attending physician, a week after I’d been admitted, finally came around to noticing that my pelvis had been broken.
“I came in to gait-train you, and you couldn’t walk,” as Mary Ellen remembers it today.
I had been admitted with the previously described L5 fracture, with abrasions of both wrists, a large hematoma (subcutaneous swelling) of the left triceps muscle, and contusion and ecchymosis (internal bleeding) of the right groin. On my second day in the hospital, being treated for these injuries, I complained of pain in my lower abdomen. The orthopedist, in the clinical résumé that he later entered into my file, reported that I had “developed some lower abdominal pain and mild distention.”
As a result, I was seen by a surgeon.
The abdominal pain wasn’t acute, it was dull and throbbing, more an insistent discomfort, the kind of numb sensation you experience when the Novocain pumped into your mouth by a dentist starts to travel and your lower lip feels as if it’s outgrown your face. When the surgeon asked me to describe the symptom, the closest I could come to nailing it down was to tell him, “My testicles feel like they’re the size of an elephant’s.”
This prompted a smile, but I’m not sure if he smiled because he found what I’d said so funny or because what he was about to say was so much funnier. Speaking in a cadence distinctive of what I took to be an advanced education in Punjab, he made an observation that syllable for syllable is as entertaining as any I’ve heard from a doctor:
“Seldom do we find that to be cause for complaint,” he said.
The emergency room X-rays of my right pelvis had been deemed normal by a radiologist and “essentially normal” by the intake physician. Reading new X-rays taken the afternoon of the surgical consult, a second radiologist guessed he was looking at a distended urinary bladder but would not rule out the possibility of a pelvic hematoma. X-rays were again taken the following morning. I have to assume this was done on the instructions of the surgeon, who unlike my orthopedist, would have been unsatisfied with the explanation, not because he was a surgeon, but because he was a good one.
Reading these last X-rays, the first radiologist found evidence of a possible “undisplaced acute fracture of the right superior pubic ramus,” suggesting at the same time, however, that the cortical irregularity in question might simply represent an old break. My orthopedist took the optimistic view.
It didn’t matter, anyway. My pelvis was busted, and the prescribed treatment was pretty much the same as the treatment I was receiving for my broken back. But it was just one example of what I would come to see as a lack of enthusiasm on the part of my doctor, and it was enough for my old man.
My father, assigned to the navy’s Hospital Corps, had received his commission while fighting in the Pacific. After the war, as an officer, he was assigned to the service’s newly established Medical Service Corps. He spent the next twenty-two years of his military career—midway through which the navy put him through an Ivy League university—in hospital administration. At the time of his retirement, stationed at the Bureau of Medicine and Surgery in Washington, he was serving on the staff of the surgeon general of the navy. Remaining in the field as a civilian, he was the director of a hospital in Boston when I was laid up on the Cape.
My father had been answering to doctors and they to him pretty near all his life, and he held them in high esteem, but he didn’t need to meet mine to know that Barnstable was a pretty small town of which Air New England was a pretty big part. What he knew from instinct and experience back then is born out by the record of treatment that I have before me now, and by the leap in the level of treatment I received once I was placed in the care of a physician more . . . let’s say . . . energetic . . . than the orthopedist who had caught my case.
By the time I was discharged from Cape Cod Hospital, where my care was overseen by an otherwise excellent array of professionals and where the caliber of the admitting physicians today is extremely high, my father had lined up an orthopedist in Boston. It was this doctor who ordered the X-rays that showed that the pain developing in my upper back, the pain that ten years later in Santa Barbara drew Gael’s curiosity, was being referred down from a displaced cervical vertebra. This was the source of the discomfort I would continue to live with long after the injuries to my pelvis and lower back had healed.
While they are somewhat easier to talk about than the subtler and often more serious psychological effects of such trauma, the physical injuries I sustained in the plane crash do not reward a lot of scrutiny. What little I’ve said about them here is more information than I’ve communicated to anyone, more information than I’ve communicated to everyone, in the years since they occurred. Charting the progress of one’s physical incapacitation is an indulgence I associate with the more sedentary residents of Sunbelt retirement communities. A staple in their conversational diet, it is not my cup of tea. Perhaps it’s the way I was raised. I’m no more likely to participate in the exercise when they throw me in a wheelchair than I was when I was a kid. Apart from maybe allowing that I’d rather not sit under a ceiling fan, where the draft might stiffen my neck, I’m no more apt to raise with you the subject of the arthritic changes afflicting my upper back than to share with you the current state of my kidney or bowel function.
But there is something to this other than upbringing. It is something I learned relatively early in the course of my recuperation, when stuck between the eagerness to get back up on my feet and the necessity to inventory my losses for the purposes of compensation. And it saved me a lot of heartache. Somebody—it may have been my lawyer—sat me down and gave me some of the best advice I was ever lucky enough to receive. And now I’ll give it to you: There is nothing more debilit
ating than to think of yourself as a casualty. To measure yourself in terms of your inadequacies, to keep pausing to monitor your losses, is more than psychological quicksand, it is physically unhealthy. Not until I was free of that kind of thinking would I be able to regain my strength.
Itemizing your deficiencies is no way to live your life. I was bred to believe this from childhood, but it was something I had to relearn. That I happened to get beat up in a plane crash was just one more of those things the world served up over which I had no control. That’s how I came to see it. It was of no more passing importance, I decided, than the fact that I’d suffered bronchitis as an infant or that I happened, say, to be near-sighted. I’m not as tall as I’d like to be either. I’m more dashingly handsome than Robert B. Parker, and there’s plenty more where that came from. I fall asleep counting my blessings.
A word about compensation. Americans will more readily volunteer their medical history than talk to you about their money. I don’t know what kind of settlements my fellow survivors reached with the airline. I didn’t bother to ask. I wasn’t interested in the numbers, and I knew everything I needed to know about the experience. Theirs would have been no different from mine in any way that was instructive. The claim to which I was a party, thanks to the caliber of the advocates on both sides, was handled in as dignified and professional a manner as such endeavors ever enjoy. And still, there was nothing enriching about it. There are few things that come with greater spiritual cost than involving yourself in a lawsuit. No matter how successful you emerge, the trade-off is never worth it. All they give you is money. And in liability cases, to make serious money—if that’s what you’re after—what you really want to do is die. Mine was a case where proving liability was unnecessary. I was well represented, in the end I was treated fairly, and it was three years of my life you can have. Damages are compensatory, an indemnity, not a reward. You keep the cash. I’ll take the no-plane-crash option.
Down Around Midnight Page 12