“The surgeon feels that Mr. Gunther will have a rather lengthy recovery and will need extensive physical therapy and rehabilitation,” Kathleen stated.
“So what’s the difficulty? The case seems rather straightforward to me.”
“Looks can be deceiving, Tim. Mr. Gunther is not one of the most cooperative patients. While some young males have difficulty in adapting to hospital routine, Mr. Gunther appears to be one of the more extreme of those cases. Personally, I’m thinking it has to do with his own frustration over his loss of mobility and independence. However, I also think there is a possibility of some psychological problems that have nothing to do with the accident. According to the report, he has extensive scarring on both legs, which indicates there were some kind of previous wounds. The surgeon said it look to him like it was very similar to shrapnel wounding, like he saw in Vietnam. I just think, in this case, someone more his own age might be more successful in dealing with him.”
What she didn’t say, of course, was that I was the youngest member of the social work staff, being at least ten years younger than any of the others. I was also the only single male, which is the reason I had given for volunteering to work most weekends – especially this one, the one including the actual anniversary of Todd’s death. I didn’t tell them I wanted to just lose myself in work so I didn’t have to think about Todd. I think Kathleen was well aware of the reasons but hadn’t said anything. She just put me on the schedule for the entire weekend.
“Of course, I’ll be glad to take on Mr. Gunther. Is there anything else?”
“No, Tim. I will be around some this weekend if you need any help.”
I realized this was her way of letting me know she was there for me, in case I wanted to talk or felt lonely. She knew about Todd’s death three years ago and knew I had worked most weekends and holidays the last three years. I guess she figured out I was avoiding my family or anything that reminded me of the loss I’d suffered.
Actually, she was only partially right. I was avoiding my parents. Holidays, especially family holidays like Christmas and Thanksgiving, were hard enough without Todd but to see the walking dead our parents had become was too much for me to handle. But I couldn’t forget Todd. Still couldn’t accept the loss. Though he was my brother, he was the only male I had ever loved. Oh, not in a sexual way, but he was the only person who knew me intimately. The only one who knew everything about me. The one person I could trust with my feelings and my secrets. But now he was gone and there was no one to take his place. There was no one to help me stop thinking about him. No one to help me let go of him.
I figured I should get my new assignment out of the way so I headed up to the third floor. The third floor of Central General contained the indigent wards where we placed patients who were unable to pay for their medical care. As a hospital funded with tax dollars from the city, county, state and federal governments, we had an obligation to provide care for everyone – including citizens who had no funds or medical insurance. Unfortunately, that segment of the population was constantly growing as more and more people ended up uninsured because their jobs either didn’t provide medical insurance or stopped providing it because it became prohibitively expensive. In fact, originally, the so-called “indigent ward” was exactly that – one ward with eight beds. Now, it comprised the entire third floor of the hospital and contained a little over one hundred beds and could still end up full, causing us to place patients into other, non-indigent rooms.
However, for some reason, census in the indigent wards, as well as the rest of the hospital, was down and when I walked into the ward where Mr. Gunther was housed, I found only three of the eight beds containing patients – the two on either side of the door and one all the way at the other end of the room. From the bed number, I knew it was this bed, isolated from the other two patients by the entire length of the ward, which Mr. Gunther occupied. I noted as I walked the length of the room his bed stuck out about a foot past the other beds, meaning that Mr. Gunther must be rather tall and had to have one of the “extended” beds.
I couldn’t see him because of the privacy curtain drawn between his bed and the rest of the room. It came as somewhat of a shock as I came around the edge of the curtain to note just exactly how large a man Mr. Gunther was. He lay there, his left leg, almost completely encased in a white plaster cast from the tips of his toes to his hip, propped on a pillow. He appeared to be well over six feet tall with broad shoulders and thick, muscular arms and an equally muscular chest. His waist appeared narrow, however. I would guess his body fat percentage to be one to two percent at most. His legs were equally muscled, if the size of the cast was any indication.
All in all, Mr. Gunther appeared to be a prize physical specimen, a type which we rarely saw in the hospital as a patient. His hair was dark and quite shaggily in need of a trim but not unattractive in a wild, unkempt way. His face had high cheekbones and a square jaw, covered in several days’ growth of dark whiskers, which gave him a rugged look. It was his eyes, however, which were the standout feature. So dark they were nearly black with an intensity to them, which seemed almost hypnotic. Eyes which could trap you in them like the vortex of a black hole. Eyes which made you feel as if they could look deep down into your soul and see all of the dark, personal secrets you hid from everyone else. Eyes which could make your blood run scalding hot or icy cold, depending on how they looked at you.
All of this I noticed within moments of first seeing him. He was lying there, obviously in some discomfort, in a hospital gown, which certainly was not meant to cover such a broad expanse of male flesh. Hospital gowns basically come in one size – one size fits all. It was quite apparent, however, that in this case, Mr. Gunther fell far outside the parameters of “all.”
Another thing I did notice that I found odd was a tattoo on his upper left arm: the globe, anchor, and eagle of the United States Marine Corps. In fact, beneath the artwork were the letters USMC, tattooed in a type of Gothic font. The reason that this was odd was that I knew from what Todd had told me when he had come home on leave sporting the same, identical tattoo that only a member of the Corps would dare wear it because other Marines would physically annihilate anyone caught wearing such a tattoo who was not either a currently serving or former member of the Corps. However, if Mr. Gunther was indeed a Marine, or had been, then why was he being cared for in Central General? He could be transferred to the large, modern Veterans Administration hospital about ten miles outside of town.
It took him several moments to notice me standing there. When he did, he looked at me, his eyes cold and intimidating, almost as if to say, Who the fuck are you and what the fuck do you want? I took a deep breath and drew myself up to my full five feet nine inches before saying anything.
“Good morning, Mr. Gunther. I’m Tim. I’m with the hospital’s social work department,” I said, using my best professional voice.
“Yeah? What do you want?” he asked, not a professional voice at all but more a low growl, along with the continued intimidating stare from those beautiful, dark, hooded eyes.
“I’m here to see if there is anything that you need or if you have family you want to contact.” I stood my ground, refusing to be intimidated though, in truth, part of me wanted to cower in a corner at the intensity of his stare.
“What family I have wants no more to do with me than I do with them,” he said, turning his head away in dismissal.
“Well, is there anything that you need?” I asked.
He turned back looking almost surprised I was still standing there after being dismissed.
“Yeah. Get me something to wear that ain’t sized for a fuckin’ midget,” he said, tugging at the ill-fitting hospital gown.
“Yes, I’m sorry about that. Unfortunately hospital gowns only come in one size and you’re a rather large man. I’ll see if I can’t find something else for you.”
Now he looked at me differently, almost like he hadn’t seen me the first time. This time, he really lo
oked me over, head to toe. I felt for a moment like I was being judged and evaluated but, for what, I hadn’t a clue.
“Thanks,” he growled, almost reluctantly, as if he was not in the habit of offering even a modicum of politeness.
“May I ask you a question, Mr. Gunther?”
“Yeah, if you stop calling me ‘Mr. Gunther.’ You make me think you’re talkin’ to my old man. I hate that bastard and I don’t need reminding of him. My name’s Ty. Got that?” he growled again, looking straight ahead, avoiding looking at me.
It appeared as if growling was the only way that Mr. Gunther…or rather…Ty could communicate.
“Ty,” I said, smiling at him, letting him know that he could growl all he wanted, he wasn’t going to get a rise out of me. “I couldn’t help but notice your tattoo. It’s exactly like my brother’s. You’re a Marine?”
“Used to be. Your brother’s a jarhead?”
“Yes, he was a Marine. He was killed in Iraq,”
For the first time since I’d first approached him, Ty’s eyes softened at this and when he spoke, it was no longer a growl. His voice was deep and masculine but soft.
“I’m sorry,” He dropped his eyes so that he wasn’t looking at me.
“So, if you were a Marine, we can have you transferred to the VA hospital. To be honest it’s a much nicer facility,”
Ty didn’t say anything for a while, nor did he look up. When he finally did, I could see his eyes were blazing in anger. I couldn’t imagine what I had said to piss him off.
“I can’t go there.” His voice was supremely controlled, each syllable clipped as if he could barely contained his anger.
“If you were a Marine, if you served in any branch of the armed forces, you’re eligible to be treated there,”
“Trust me. I can’t go there. Now go away and leave me alone.” His voice obviously filled with fury, he turned his head completely away from me as he settled back on the pillow.
At this point I didn’t know what to do or say so I did the only thing that made sense. I left. However, I now could understand why Kathleen had spoken of psychological problems not caused by the accident. Ty was obviously a very angry young man. Angry all out of proportion to simply being incapacitated in a hospital. Since he had been a Marine, I wondered if that could be the underlying cause of his anger.
I went back to my office and called one of the social workers at the VA hospital who I had worked with frequently. Jerry Metzger was a Vietnam vet who had come home from the war and gone into social work to help his fellow vets. I knew that over the last couple of years, I had referred several patients to Jerry’s veteran discussion groups. Since a lot of vets never wanted to admit to any psychological problems, Jerry never referred to his groups as “therapeutic.” He merely calls them discussion groups – a place where vets could sit and talk with other vets about their lives and their experiences in the military. The fact is these groups help a lot of men – and women – to work out the horrendous guilt and trauma that many of them carried back from various wars and “police actions.”
“Jerry, this is Tim over at Central. Listen, Jerry, I’ve got this patient, twenty-eight-year-old Caucasian male, former Marine. He was hit by a car and suffered multiple fractures of one leg. Seems incredibly angry. Would barely talk to me at all. Think it could have anything to be with him having been a Marine?”
“Well, that’s a good question. Excessive anger could be indicative of a lot of things. Why aren’t you shipping him over?” Jerry asked.
“He says he can’t be treated by the VA, though I can’t understand why not and he won’t tell me.”
“Hmm…well, I think that could be your answer right there. What you have on your hands may not be a former Marine, but an ex-Marine.”
“What’s the difference?”
“Well, to anyone but a Marine, there is no difference but to Marines there’s a huge difference. An ex-Marine is what they call Marines who are thrown out of the Corps, those with a dishonorable discharge. Ex-Marines, of course, are not eligible for VA services.”
“Is there any way you could check and see if he was thrown out and why?”
“No can do, compadre. All I could tell you is if he was eligible for VA services and since he’s already told you that he’s not, I can’t be of any help. Those records of dishonorable discharges are pretty much sealed unless there’s pending criminal action against the guy. The only one who could tell you why he was dishonorably discharged is him.”
“And he’s not likely to tell me that. I just wondered, considering his age, if he served in Iraq or Afghanistan. I thought maybe I might be looking at a case of Post Traumatic Stress Disorder.”
“It’s possible. But it takes more than anger to diagnose PTSD.”
“Like what? What are the symptoms?” I grabbed a pen and legal pad from my desk and began making notes.
“Well, they fall into three main categories. Not everyone gets every symptom but basically, the symptoms include constantly reliving the event either by memories, flashbacks or dreams. There also tends to be avoidance behavior – lack of interest in normal activities, feelings of detachment from life and those around them, a sense of having no future, and emotional numbing or, in other words, feeling like they don’t care about anything. Lastly, there is arousal, which can include irritability or outbursts of anger but also difficulties with either concentrating and sleeping.”
“So far, all I’ve seen is the irritability and anger. I’ll have to check with the doctors and nurses to see if any of they’ve observed any of the other symptoms.”
“If this was a battle-related trauma there might be a sense of guilt, survivor guilt, which can manifest physical symptoms that are typical of anxiety, stress and tension such as paleness, headache, fever, fainting, dizziness or palpitations.”
“Okay, I can check on these as well.”
“So tell me, why all the interest in this patient? Is this about your brother?”
Jerry knew that my brother had been a Marine who had died in Iraq. In fact, he was the only person outside of the people at the hospital I work with who had come to Todd’s burial.
“Yes, I guess so. It just seems so strange that this would come up today of all days. Todd died three years ago today.”
“Look, Tim, if this is PTSD, he needs treatment. I know he can’t see the doctors here but he needs to see someone who knows something about PTSD. If you want, I can recommend a few therapists around who might be able to help.”
“Yeah, that would be good.”
“I’ve got a list of them. I’ll fax it over to you.”
“Great. Thanks a lot, Jerry.”
“No problem. You hang in there, kid,” Jerry said as he hung up.
Kid? Well, I guess to Jerry, who was old enough to be my father, I was still a kid. While I waited for the faxed list of therapists, I decided that I needed to start building rapport with Ty Gunther, and the best way to begin that process was to do what I promised to do – get him something to wear in the hospital that fit his large, muscular body better than the hospital gowns.
Chapter Three
Two blocks down and across Central Avenue
was a Target. I went there to the men’s department and picked up several men’s colored T-shirts in size XXL, wanting them to be nice and loose on him, along with a few pairs of soft, cotton knit lounging shorts in black and dark blue to go with the T-shirts. From what I could see of his waist, my best guess was a thirty or thirty-two so I got size medium. I figured these two articles of apparel would be the most comfortable as well as the easiest to get on and off over Ty’s cast. I also bought him a pair of men’s scuffs for once he was allowed out of bed. I thought about the foot I had seen sticking out of his cast and bought a size twelve, hoping it was big enough.
When I got back to the hospital, I stopped by the nurse’s station to check on whether or not the crew that would have been on when Ty was brought in was going to be on that night. I wanted them
to watch for any symptoms of PTSD Ty might display. I also talked to the nurses who were currently on duty. All they had seen was the same anger that I had.
I walked down the hall to the ward and found Ty asleep with the privacy curtains again pulled around his bed. He evidently didn’t want to interact with the other patients in the ward, something I couldn’t necessarily blame him for. Dealing with strangers was difficult when you were in pain or incapacitated.
I stood there for a moment, looking down at him while he slept. The angry lines of his face that were so visible when he was awake had disappeared as he slept. In fact, he looked much younger asleep – almost like an overgrown little boy. An incredibly handsome little boy, truth be told. I felt a heat building in my heart and in my gut as I stood there looking at him. However, I quickly brought myself up short. I had no business thinking of a patient in this way and I knew it. But I just couldn’t seem to help myself.
Suddenly, as I stood there watching, things began to change. Ty’s face started to react to something he was evidently dreaming. His body began to twitch and his arms to flail. Unexpectedly, he began to murmur, words that were not intelligible until he sat up in the bed, his eyes open and began to scream.
“NO! EVAC! EVAC!”
I dropped the package of clothing I had for him and grabbed hold of Ty instead, fearing he would rip out his IVs with his arms flailing as he shouted.
“Ty! Wake up! It’s a dream!” I shouted, hoping to snap him out of whatever nightmare he was having.
His fists grabbed my shirt, pulling me forward and bending me over the bedrail as he looked at me in confusion. It took several long moments for him to finally realize who I was.
“You had a nightmare,” I said quietly, looking into his frightened eyes.
The Veteran Page 2