Thirteen West

by Jane Toombs

  No noticeable gray, he thought with satisfaction. Gray could be flattering and distinguished in a dark-haired man but with blondes it dulled the natural shine. He smoothed his just-right mustache and turned away from the mirror.

  He really should do something about getting a place in town. There was something distinctly déclassé about inviting a friend to quarters on the state hospital grounds. Of course it was cheap to live here—unfortunately in more ways than one. He sighed and picked up his raincoat.

  No use to dwell on what might have been if he'd managed to be just a tad smarter five years ago. Who'd have dreamed a friend could be so vindictive?

  Crawford let himself out into the wet evening and hurried to his car. He certainly didn't plan to walk over to the Ad Ward in this downpour. Why on earth people couldn't get to the hospital at a reasonable hour for admission was more than he could understand. This wasn't even an emergency admit and, to top it off, the patient had managed to slice himself up on the way here.

  My luck to be MOD tonight, he thought.

  He hated suturing. For that matter he didn't like medicine itself particularly well. His mother had thought only of the prestige. She'd never been forced to handle bodies with all their disgusting illnesses. He had to last one more year at this cesspool of insanity before he'd be free to move anywhere he wanted. It certainly wouldn't be anywhere within the state hospital system.

  There were pleasanter ways to practice medicine. The big companies, for one. Goodyear, he'd heard, had hospitals in Europe—one could travel. The insurance conglomerates offered big bucks and lots of perks. He might even decide to teach—although that could be a bore.

  Crawford parked and let himself into the Ad Ward where he found the new patient unconscious on the table in the treatment room.

  "We had to give him a few milligrams of Thorazine to calm him down, Dr. Greensmith," Frank told him.

  Crawford felt the radial pulse in the right wrist. "A tad fast. What's his blood pressure?"

  "110 over 60 at the last reading," Alma said.

  "Hmm. Well, he certainly won't need a local—we'll just stitch him up and get him to bed." Crawford opened the packet of sterile gloves.

  "I irrigated the wounds," Alma said. "There didn't seem to be any embedded glass splinters."

  "Good, good." Crawford fitted the needle into a holder and poked it through the flesh of the patient's palm. The man gave no sign of feeling anything.

  "How's the girl on Ten East you called me about earlier?" Crawford asked Frank, continuing to sew up the injured hand. "Still running a fever?"

  "Down to 101 on aspirin," Frank replied.

  "If she doesn't develop any other symptoms, I think it can wait until morning."

  Frank nodded.

  Crawford finished and peeled off his gloves. "You can apply the dressing," he told Alma. "Take the sutures out in seven days if it looks healed. Did you give him tetanus toxoid?"

  "Not yet, Doctor. He wasn't able to tell us if he'd ever been immunized against tetanus."

  "Go ahead with the toxoid—we'll assume he has been. Looks like a clean wound, he shouldn't need antibiotics."

  "Can I have an order for restraints?" Alma asked. "And for more Thorazine if he needs it?"

  "Where's his chart?"

  "I only have a partial ready but here's the doctor's order sheet."

  "The man who brought him in, Mr. Ron Morris, is waiting in the lounge," Frank said. "He can give you a history. Mr. Benning is a voluntary admit. He signed preliminary papers on the outside—we have copies."

  Crawford waved a hand. "They can take care of all those details on the day shift."

  "Do you want to talk to the brother-in-law?"

  "I suppose I'll have to. Send him into the office." Crawford took the chart papers Alma handed him and walked across the hall to unlock a door labeled: Physician.

  "Dolph was always kinda odd," Ron said when he was seated on the other side of the desk from the doctor. Crawford looked with distaste at the red-faced stout man with the wrinkled pants. A mingled odor of stale whiskey and sweat emanated from Mr. Morris.

  "He used to drink a lot and that made him really dingy. He got to thinking someone was after him. With knives. You know?"

  Crawford nodded wearily.

  "So then he'd get violent and have to be locked up in jail. Some judge had Vera—that's my sister—put him in a state hospital up north near where they used to live. After they let him out and he and Vera moved down here, he lost the pills he was supposed to take. Then he fell off the wagon and the booze got him to acting up again."

  "How old is he?" Crawford asked.

  "Thirty-six."

  My age, Crawford thought. I've lived thirty-six years and got a damn expensive education so I could sit in a room that stinks of sweat and listen to a moron rattle on about his schizy relative.

  "You won't let him out without he's okay, will you?" Ron asked. "Me and Vera can't take much more of this crazy stuff."

  "We'll take care of him," Crawford said automatically. People never seemed to understand their afflicted relatives never would be "okay." If this Dolph stayed on Thorazine or some other tranquilizer and off the booze he might be able to function outside. But who was going to make him do either once he left the hospital?

  "Think I oughta look in on Dolph before I leave?" Ron asked. "Sort of say goodbye?"

  "He's asleep," Crawford said. "We had to give him something to stitch up that hand."

  "Yeah, I heard him yelling."

  "You can be sure we'll take care of everything, Mr. Morris."

  Ron stood up, hesitating, as though he wanted to say more.

  Crawford, who'd already heard more than he wanted to about the new patient, rose, came around the desk and opened the door. Spotting a passing psych tech he vaguely remembered as David, he motioned to him, saying, "Please show Mr. Morris out, will you?"

  As Ron followed the P.T., Crawford heard him ask the man whether the hospital checked out the patient's belongings. "We go through everything," the tech told him. "You never know what a patient will take it in his head to do. We had one woman who ate her X-ray film when she was left alone in the treatment room."

  Crawford remembered that incident. Naturally he'd been on call—he always got the weird ones. She wound up being operated on to get the damn film out.

  He waited until the relative was well on his way before letting himself out.

  * * *

  Once he'd done what the doc asked, David Boyer took his break. Things were quiet now. The rain seemed to calm everyone down, he'd noticed—unless you were working on one of the outer west wards after a week of rain when you couldn't let the patients out into the exercise yard. Knock on wood, he wouldn't ever get transferred back there again.

  He entered the lounge where the other tech, Carrie, and Mrs. Reynolds were having a cig.

  "Finish rounds?" Mrs. Reynolds asked.

  David hesitated, tempted to lie but instead sighed and shook his head.

  She jerked her head at the door, raising her eyebrows at him.

  Shit. If he was Frank she wouldn't treat him like this. Laid it on for old Frank—for all the good it did her. Walking down the corridor and glancing through the spy window in each door, David told himself he'd start classes next semester, he really would. No reason to be treated like shit when he could make it as an R.N. Frank had been a tech once, he'd heard. Came up the hard way.

  David stared in at the new patient who was still restrained in a Posey. He started to turn away, then looked back. What was that brown stuff on the pillow? Was the guy bleeding? He unlocked the door and, as he strode toward the bed, the sour odor of vomit hit him.

  He hated to handle puke. He'd stick a towel over it for now and clean it up when he made last rounds. Leaning over to get a better look at the patient's face in the overhead light that was dimmed for night, he frowned. Hurrying back out the door, he flipped on the full light.

  Blue as hell. David grabbed a wrist. No
pulse. He yelled for Mrs. Reynolds, wiped the patient's mouth out with the sheet, then kneeled on the bed and started mouth-to-mouth resuscitation.

  Alma, reaching the door, took one look at David hunched over the patient and called to Carrie to bring a stethoscope and blood pressure cuff. At the bedside, she untied the Posey so David could bend the man's head farther back. Grabbing the stethoscope from Carrie, she shoved the diaphragm over the patient's chest and listened. Fluttering, irregular, but there—no need for cardiac massage.

  "I'll spell you," she told David.

  But as he slid off the bed while she prepared to take over, she saw the patient gasp and waited. Exhale. Inhale. Alma put the scope to his chest again. Good breath sounds, stronger heart beat, more regular.

  "Turn him on his side, David," she said, "in case he vomits again. I'll call Frank and see if he wants to try to catch Dr. Greensmith before he goes to bed."

  "Want him Posied?"

  "No, let's leave it off for now."

  When Frank came onto the ward ten minutes later, he and Alma hashed over what Ron Morris had said about the smashed pint of whiskey.

  "Do you suppose Dolph drank it all first?" she asked.

  "Could have. Then we shot him full of Thorazine. Bad scene. I'll call Dr. Greensmith."

  "What now?" Crawford said into the phone. He listened to Frank's explanation.

  "Well, what's the current B/P? Have her take it again—I'll hang on." Crawford ran a finger over his mustache while he waited. What was the use of hiring R.N. supervisors if they couldn't take care of things without calling him every five minutes?

  "80 over 40? Does he respond to verbal stimuli at all? How about a fingernail run up the sole of his foot? You didn't? Try and let me know."

  Again he waited, flicking his thumbnail against his middle finger. "He draws his leg up? Fine. He'll do until morning. Don't give him any more Thorazine until he gets the alcohol out of his system. No, I don't need to see him. Yes, I expect you'll call me if his condition deteriorates." Crawford dropped the phone back into the cradle.

  "Doc's not coming over, is he?" Alma said when Frank hung up. "I knew he wouldn't. They have to be hemorrhaging or running a temp over 105 for old Greenie to bestir his lazy bones."

  "Dolph Benning seems to be a survivor," Frank said.

  "He was lucky Dave got to him in time."

  "You know there's a special dispensation for drunks and nuts," Alma said. "I think David ought to get a commendation, though. If I write one out, will you sign it and send it on up?"

  Frank nodded.

  "Want some coffee?" She smiled and tipped her head to look up at him.

  "No, thanks. I have to get on with rounds—haven't finished west wards yet."

  Alma shrugged and walked away, going to recheck Dolph Benning. Maybe it was true what she'd heard whispered about Frank Kent. God knows if she couldn't get a rise out of him, she'd like to see the gal who did.

  Chapter Three

  Sally Goodrow clutched her hands together in her lap, sitting straight and still in the hard chair. Why, oh, why had she selected a front row seat? She watched as Dr. Fredericks steepled his hands together, his gaze drifting from one to another of the people seated in the two rows of chairs across the desk from him. Taking a deep breath, she nerved herself to meet his glance when it came to her.

  His eyes were bright and brown. Sally swallowed, tried to smile and failed. Dr. Fredericks probably wouldn't have smiled in return anyway.

  Lionel E. Fredericks, M.D., Superintendent, the sign on his office door said. He was a big man, fat even, with red-brown hair that curled at his collar. Not jolly, though. Sally tried to hedge herself round with rallying words from her psychology text-book: "...authority figures may call up responses from the subconscious totally inappropriate to the situation..."

  She was terrified of Dr. Fredericks.

  When he'd talked to her earlier today she'd trembled with apprehension.

  "Ah, Ms Goodrow," he'd said. "Your nursing instructor at the college tells me you've been ill and missed the affiliation here with your classmates."

  Innocuous enough. Had he paused for a fraction of a moment between been and ill, though? Did he know? But that was impossible—not even her instructor knew.

  "We are not accustomed to student nurses on any shift except the day shift," Dr. Fredericks had continued.

  "However, quite coincidentally, your needs fit in with a new project of ours so I shall make an exception. I'd like to have you join the group meeting in my office this afternoon at fifteen hundred."

  Sally frantically counted off on her fingers—would she ever get used to the hours going up to twenty-four instead of repeating themselves after twelve?

  "Yes, Doctor," she'd said, then started to stammer an apology for taking so long to answer him.

  He'd waved a hand, dismissing her apology while his small bright eyes seemed to pick out all her faults, interior as well as exterior. Was her hair straggling down from its topknot? Had he been able to see into where her stomach churned and spasmed?

  She jerked herself to awareness, suddenly realizing she was missing what he was saying here and now.

  "...quite experimental."

  What was experimental? she wondered worriedly.

  "I'm sure you all, as I do," he went on, "look forward with enthusiasm to our challenging venture in complete desegregation. A unique opportunity for our patients as well as ourselves."

  Sally hadn't a clue to what he meant by desegregation. The hospital, she knew, had been racially desegregated for years. And some, if not all, of the wards were a mixture of male and female patients.

  Maybe she wouldn't find him so intimidating if he weren't so big.

  Dr. Fredericks smiled. His teeth were small and white and even. He laid his hands flat on the desk. "We have a newcomer in our midst," he said. "Ms Goodrow, a student nurse, who was unfortunate enough to be ill and miss her class affiliation here. After this week of orientation, she will be joining us on Thirteen West to work the afternoon shift as, of course, all of you will be doing. Ms Goodrow, if you'll stand, please, so the staff can see you."

  Sally got to her feet and turned to those seated behind her. Their faces blurred together as she managed a clenched teeth smile. She sank back onto her chair, hands knotting together convulsively. A brown hand reached over and touched hers gently, then withdrew. Once again she concentrated on what the doctor was saying.

  "Some members of the medical staff have expressed the opinion we should have a Fourteen West instead of a Thirteen. I admit to surprise at the extent of superstition among psychiatrically oriented personnel. Does any person in this room suffer from a similar triskaidekaphobia?"

  Silence. No one so much as moved.

  "When we split Twelve West in two for the new ward, logic demanded that it should be Thirteen. I cannot countenance pandering to superstition." Dr. Fredericks' normally high-pitched voice rose shrilly. "We shall not!"

  He slapped his palms on the desk, making Sally jerk nervously.

  "To get on with the agenda," he continued, "you are a hand-picked crew, as is every person working every shift on Thirteen West. Starting to my right in the first row, we have Mr. Boyer, Psychiatric Technician I, who has just received a written commendation for his abilities. Next is Ms Reynolds, Registered Nurse, who will be our evening charge nurse. Ms Reynolds has shown a marked capability for dealing with the wide variety of problems occurring on the Admission Ward.

  "You've met Ms Goodrow, whose potential is unknown at present but who, I assume, is eager to learn. Mr. Alinosky, Psychiatric Technician I, is next, transferring from days where he has been working with adolescents most creditably. Seated behind, right to left, is Ms Dominguez—"

  "Mrs." The word was said quietly, with a trace of accent.

  "Of course, of course, Mrs. Dominguez, Psychiatric Technician I, a woman of principle, who has been working with our chronic cases compassionately—which sounds simple, but is not. Then Mr. Kent,
Registered Nurse, who is evening supervisor for the entire hospital, a man of multiple talents. Next Ms Geibel, Psychiatric Technician I, a transfer from nights with expertise in retardation. And, on the end, Ms Young, who is joining us from a private psychiatric hospital and comes highly recommended. She is a licensed vocational nurse whose status here will be Psychiatric Technician II."

  There was a tap at the door and a man's head poked in. "Come in, Doctor," Dr. Fredericks ordered. "Glad you were able to join us."

  Sally stared at the average looking young man who entered, feeling a certain kinship with him as he stood by the superintendent's desk. Dr. Fredericks had made it sound as though she'd deliberately gotten ill just so she could screw up everyone's schedules and she was convinced he meant to make this doctor suffer for not being here at exactly three—correction, fifteen hundred—with the rest of them.

  "Dr. Jacobs will be the ward physician for Thirteen West," the superintendent said. "He is, of course, a fully qualified M.D., now receiving his psychiatric training here, and has volunteered for the position. A challenge—correct, Doctor?"

  Dr. Jacobs cleared his throat. "Yes. I see it that way."

  "Are there any words of wisdom for your new evening shift staff?"

  "Not at present." Dr. Jacobs shifted from one foot to the other, his eyes fixed over their heads. Sally's stomach tightened in sympathy.

  It wasn't so much what Dr. Fredericks said as the way he said it, seeming to put you down somehow, making you defensive. Or was she being unduly sensitive? Why would a psychiatrist who was superintendent of a state hospital behave as she was thinking he did?

  "I'm certain Thirteen West will prove to be a showcase ward with such unusually capable individuals staffing it," Dr. Fredericks said. "Thank you for coming in."

  End of ordeal, Sally thought, getting to her feet. She glanced at Ms Reynolds, next to her, who'd touched her hand so reassuringly. Charge nurse. As she followed her out the door she heard Dr. Fredericks say, "I'd like to talk to you, Barry, if you have a few minutes."