Noise

by Zach Reichert

“Why’s it gotta be so loud?” the patient in Room 2 groaned. “I’m going crazy in here.”

A high-pitched alarm chirped beside his head, slicing through the room with each tone. He covered his ears.

I reached to mute the noise. “How’s that?” I asked.

He paused and looked around the room. Sounds echoed from every corner of the hospital, building to a volume that was impossible to ignore. He looked back at me, his eyes half-closed against the glare of the sun in the window.

“Still sucks,” he answered. “Any idea what it’s like trying to sleep with all this noise?”

I can’t speak on sleeping in hospitals, but I know enough about the noise to sympathize. I think of the alarms and monitors, the voices of nurses and doctors, the cries and moans of the injured and sick filling hospital rooms like smoke. Many patients get lost in this cloud of noise, left to cope with their illness in loud and crowded rooms.

Unlike my patient in Room 2, Gloria was accustomed to coping. At only twenty-one, she was already a hospital regular. She had her favorite rooms and meals: the seventh floor was best, where the rooms were brightest and the food was warm. She knew that she needed exactly two blankets and four pillows to rest comfortably.

“I’m telling you, man, I could write Being a Patient for Dummies. I’d strike it rich,” she told me.

We met during Gloria’s second hospital admission of the month. Not a personal record, according to her. Not even the worst month in recent history. She looked at me and shrugged. “I’ve been sicker than this,” she said.

Gloria was born with spina bifida, a defect in her spinal column that damaged the nerves feeding her entire lower body. She told me that, as a child, she often sat in her wheelchair at the park, watching her brothers race from tree to tree. They dodged leaves and branches, jumped over rocks and fences, and zig-zagged through rows of swings.

“I watched them, then looked at my own feet and wondered how it felt to move them. To feel the ground. I dreamed about it all the time.” She glanced at her legs. “I even wanted to fall and scrape my knee, just to see how it felt.”

Bladder control was another dream. Every few hours she catheterized herself to prevent her bladder from overflowing, and wore diapers, just in case. She had frequent urinary tract infections and took antibiotics like daily multivitamins. It made her feel dependent, old, abnormal. Either that, or “normal” meant fevers, chills, and nausea. It meant relying on others to help her bathe and living with greasy hair and dandruff when they couldn’t. It meant days filled with shots, pills, IVs, and surgeries.

“I’ve seen some pretty old and sick people around, and I think, yep, I’m just like them. Fine in the morning, but in the ICU by night.” She stopped, her jaw set, eyes still on mine. “But I’m not the only one here. Others have it worse.”

There was her older cousin with Down syndrome and severe heart problems, a friend who was orphaned after a tragic accident, a hospital roommate who died in bed only ten feet away. And then, there was her father, who had spent the past twenty years downing plastic bottles of whiskey and vodka, who came home for a few days at a time before wandering off again, leaving her mom and two brothers alone for weeks.

“Maybe he lived with another family,” she thought, “one that was easy to care for.”

But this wasn’t where it ended for Gloria. Her father was more than just a disheveled, absent alcoholic. He was aggressive and violent.

“When we were kids, we could almost feel it, my brothers and I,” Gloria said. “After he drank, his voice would get loud and he’d start walking and stumbling all over the place. He’d yell at Mom, and that’s when we went to the other room. We had a piano in there that my older brother could play. He’d start playing and tell me to sing. I sang and cried and sang until Mom came back.”

“You sang?” I asked.

“It was all I could do,” she answered. “There was nothing else. It helped me get out of that house. Took me somewhere else until it was safe to come back. I did the same thing when I was bullied at school. I do it here, too.”

Gloria’s eyes drifted away from mine. For the first time, the room was silent. She shifted in bed and began to fidget with a pair of headphones that rested on her legs. After a minute, she sniffed and took a deep breath.

“You know I learned to sing first, before I spoke. That’s why it’s so special. As a kid, I just couldn’t put words together. My brain worked faster than my mouth. So, the speech therapist had me sing everything first.” She smiled down at the cords tangled between her fingers. “Now I’m at the community college studying music. I have to take the year off, though, because, well, you know.” She rolled her eyes good-naturedly. “I’ll go back though. And someday I’ll teach other people how to sing.”

Later on, after Gloria had left, as I walked from bed to bed seeing other patients, I heard something new. It began with what sounded like a faint, rhythmic tap of the foot, like a marching band far in the distance. The sound grew louder as I moved closer. Voices rose, with notes pitched high and low. In a room near the end of the hall, a group of four swayed back and forth over an old lady’s bed, singing spirituals like any other day in church. An old man tapped his foot and leaned on his cane for balance. The rest held hands and sang.

Nobody knows the trouble I’ve been through

Nobody knows my sorrow

Nobody knows the trouble I’ve seen

Glory hallelujah!

The music carried through the room and into the hall, where alarms kept ringing and patients kept moaning. Voices interrupted over the intercom. Phones rang nearby. The old lady’s infusion pump clicked out of rhythm. I wondered if she noticed the chaos still filling the hospital as the choir sang from trouble to hallelujah—if she felt bothered at all as she took a breath, filled her tired lungs, and joined in song.

I pictured Gloria smiling at my question. “I doubt it,” she’d tell me, and sing along.

Zach Reichert is currently a medical student in southern California. He plans to eventually practice Emergency Medicine as he continues writing fiction and non-fiction pieces rooted in his experience both in and out of the hospital.

Pre-Med Primer: 1960

by Claude Clayton Smith

            I turned sixteen during March of my sophomore year in high school and several days later began searching for a summer job. I needed to save money for college. I intended to become a doctor. So I put on a coat and tie, brushed back my crew cut, and caught a bus downtown to Bridgeport Hospital, where I soon found myself in the narrow, out-of-the-way office of the Housekeeper, Mrs. Ogilvie.

“Mrs. O.,” as she was called, was a short, trim woman in her fifties, who dressed all in white like a nurse but wore no nurse’s cap. Her small mouth was a perfect oval of bright red lipstick. She studied me for a moment with her piercing dark eyes, before quietly informing me that there was currently an opening in her department for a wall-washer, and if the position were still open when school let out, it would be mine. It was only after several weeks on the job that I realized why the position had not been filled—Housekeeping was the lowest department in the hospital, and wall-washer was the lowest job in Housekeeping.

But it was mine—my very first job, the gateway to my future—six days a week, eight hours a day, a dollar and five cents an hour.

When I reported for work, Mrs. O. showed me how to punch the time-clock, then sent me to the laundry for a uniform—a khaki shirt with long sleeves and a pair of khaki pants with wide cuffs, folded flat and starched as stiff as cardboard. The uniform was to be exchanged for a fresh one every Monday and Thursday, just when it had become comfortable enough to work in.

Then I was sent to the foreman, “Mr. Steve,” an immigrant or refugee from behind the Iron Curtain, whose long last name hardly contained a single vowel. He was a thin, anxious man with thick-framed black glasses offset by a tidy white moustache. In what he called “the old country” he’d been a lawyer, but the difficulty of learning English at an advanced age—he appeared much older than Mrs. O.—had kept him from practicing law in America. I later learned that when he began working at the hospital, Mr. Steve had been twice his present weight. A heart attack, plus the strain of supervising the men of the Housekeeping Department, had reduced him to a nervous wisp.

Mr. Steve prefaced all announcements, orders, or small talk with a quick “Ahem, ahem …,” a verbal tic more throat-clearing than intelligible. He wore khaki, as did all the male housekeepers, but his pace was triple that of anyone’s. Except mine. I kept right up as he escorted me down the long corridors and flights of stairs to the men’s locker room, a cramped area in the very bowels of the old hospital, where I had to duck beneath the heavily bandaged pipes.

And as he assigned me one of the battered green lockers, Mr. Steve somehow discovered that I was studying Latin in high school. “Arma virumque cano,” he recited proudly, lifting his eyes to the insulated pipes. I would need two more years of high school before I could quote Virgil to Mr. Steve in return, but he seemed more than

satisfied with my sophomoric offering from Caesar: “Gallia est omnis divisa in tres partes.” Latin, Mr. Steve reminded me, was the language of the legal profession.

“And medicine,” I added brightly.

The dingy locker room had a few benches and half a dozen barroom-style chairs at a round wooden table in the corner. As I was putting on my uniform these quarters suddenly filled with the Housekeeping crew—African-Americans (then called Negroes), Puerto Ricans, and a contingent of short, sullen, broad-faced men whom I soon labeled the “Mushka-Pushka Men,” for that is how their language sounded to me: “Mushka-Pushka! Mushka-Pushka!”

It was 9:15. Time for a coffee break.

Very quickly, as if it were understood, the Mushka-Pushka Men occupied the table in the corner, and from their wooden circle came only one word I ever understood, a word that rose heatedly during every coffee break: “CommuNEEST! CommunNEEST!”  The Mushka-Pushka Men—Mr. Steve spoke their language—came from Hungary, Czechoslovakia, perhaps Poland. But my geography was weak, my interest in history even weaker.

            Then Mr. Steve was standing at the door, tapping his finger on his wristwatch. “Ahem, ahem … Gentlemen.” Coffee break was over. Time to get back to work.

            As the locker room emptied—more slowly than it had filled—I lagged behind to wait for Mr. Steve, who was always the last to exit. I had been on the job since 7:00 a.m. and was yet to lift a finger. Before long, however, I found myself in a dim, windowless corner of the basement in which rows and rows of Venetian blinds were suspended from the ceiling like so many room dividers. Mr. Steve neatly rolled back his sleeves, drew a pail of hot water from the sink on the wall, added liquid detergent like a waiter pouring wine, and demonstrated how to wash the blinds on both sides, dampening the rag just so, careful not to get the drawstrings wet. When he returned at noon I had completed the job—had been standing around, in fact, for an hour, watching the Venetian blinds dry—and Mr. Steve seemed confused by my efficiency. I think he had expected the task to take me all day. Now he was stuck with finding something else for me to do.

            “So this is what it’s like to work in a hospital,” I remember telling myself. But what about wall-washing? I had been hired as a wall-washer.

            As we returned to the locker room for lunch—I had to be shown the way, still disoriented by the hospital’s subterranean maze—Mr. Steve muttered something about seeing Mrs. O., then he’d get back to me.

            I took my lunch, as became my habit, upstairs. The cigarette smoke in the locker room burned my eyes, the African-Americans frightened me, and the Spanish of the Puerto Ricans was as annoying as the chatter of the Mushka-Pushka Men. Any laughter, I assumed, was at my expense, so I trotted my brown bag (two peanut butter sandwiches, one apple) to the cafeteria, a room as big and bright as our high school gymnasium. Here a hundred or more diamond-shaped tables hummed with the conversation of the staff—nurses all in white (except for the rims of their caps, which, I later learned, identified the place of their training), technicians in long lab coats, Operating Room personnel in loose-fitting green coveralls, silver-haired volunteers in pink pinafores, and their counterparts, the young candy-stripers, as pert and pretty as cheerleaders. And then there were the doctors—haughty and harried—in green surgical garb or, on certain days, Madras sport coats, bright pants, narrow ties.

            At a far table I noticed Mrs. O. in animated dialogue with a nurse twice her size. I noticed, too, that I was the only one in the cafeteria wearing khaki. Fortunately, Mr. Steve came through the cafeteria line and, catching my eye, joined me. “Ahem, ahem ….”

            Picking at his lunch, he began talking about his wife, Bronislava, whom I imagined as a short, square woman with a babushka and dust mop. Apparently she was seriously ill. Then he talked of his coming day off, which he planned to spend at the local park, a pathetic patch of green not far from the hospital that had once been the showplace of Bridgeport. But before our allotted half-hour was over, Mr. Steve excused himself, emptied his tray, and hurried off. He had to rouse the men from the locker room at exactly 12:30. On his way out, however, he stopped for a brief word with Mrs. O.

            Later that afternoon, relieved of Venetian blind duty, I followed Mr. Steve out a rear door of the hospital and across a narrow parking lot to a row of duplexes—housing for the resident doctors and their families. Several units were empty, awaiting new tenants, and I was to clean them in the meanwhile.

            “This is more like it,” I told myself. There was room to move—kitchens, hallways, bedrooms, baths—and windows to open for looking about. Mr. Steve issued me a scrub brush, pail, sponge, and jug of detergent, and demonstrated how to do the walls. I was not to touch the floors. The Mushka-Pushka Men would do the floors.

            After Mr. Steve left, my euphoria turned to depression. The apartments were filthy—grease on the ceilings, stains on the walls—and this was where the doctors lived! Bridgeport Hospital, as I would learn, was a teaching hospital, but unlike Massachusetts General and similar institutions, it could attract only foreign doctors for residencies and much of its staff. They came from Latin America, India, Turkey—the educated elite of their respective homelands—but if these empty apartments bore accurate witness, they had brought the squalor of their homelands with them.

            Later that summer I was sent to clean the dormitory of the unmarried male interns, a barracks-like arrangement on the hospital roof, where unshaven young men of all colors lay about on narrow cots, thick textbooks propped about them, small electric fans riffling the hot air. Not many were American, and it saddened me to see how they lived. But I was earning money for my own education, so … scrub, scrub, scrub.

            By the end of my second week in Housekeeping I had finished the apartments and returned my scrub brush to Mr. Steve, its bristles worn to the nub. He showed it, in turn, to Mrs. O. as she inspected the apartments, shaking her head and smiling sadly as if there were something I didn’t understand. She had given me that same sad smile my first day on the job when I answered “Yes” to her initial question: “Well, did you make all A’s?”

            What I didn’t understand was why the men of Housekeeping (the men of the

world?) hardly worked at all, but spent their days hiding in broom closets and toilet stalls, listening for the click of Mr. Steve’s heels. I had discovered that time passed quickly when I was busy, so I stood there like a soldier awaiting my next order.

            The following week Mrs. O. herself took me to an old, high-ceilinged ward that had been out of service for years. Removing the padlock from the heavy swinging doors, we pushed our way in. “This,” Mrs. O. announced in a rare moment of drama, “is going to be the new ICU.”

Bridgeport Hospital        Photo Credit Brian Smith

            Intensive Care Unit. Even with the initials translated, I couldn’t imagine anything

in that ward except a flophouse for the homeless. The yellowed shades were drawn on the

tall, narrow windows, cobwebs laced the overhead pipes like camouflage netting, U-

shaped metal rails, like shower-curtain rods, arched from the walls at head level, above empty spaces once occupied by beds. These rails were tilted and bent, the metal rusty.

At the far end of the ward a rickety scaffold of boards and pipes rose to the ceiling.

The abandoned ward was the cause of the vacancy that I’d filled. The former wallwasher had flatly refused to work there. But, Mrs. O. informed me quietly, as if to prevent my own defection, she was hiring a second wallwasher to help me. We were to “have at the ward,” and once we finished, the painters and plumbers would follow. It was a job that would take the rest of the summer.

The new wallwasher—Roberto—was a Puerto Rican about my own age. Born in Bridgeport, he knew English as well as Spanish, and he laughed readily when I told him the old joke about a Spaniard hearing the national anthem at his first baseball game: “José, can you see?” And suddenly I had a pal in Housekeeping.

Short and slim, Roberto was deceptively strong, and a good worker. He was

trying hard to grow a moustache—“to impress the señoritas”—and had a ripe sense of fun. Once, when I was perched on the very top of that rickety scaffold of boards and pipes, snapping a wet rag at cobwebs in the corner of the ceiling, a soapy sponge smacked the back of my neck. Ten minutes of wet warfare followed, after which—the boredom of our enormous task dispelled—we returned to work with renewed vigor.

Roberto made it easy for me to be in the locker room, which made the coffee breaks, finally, enjoyable. The turning point came soon after he was hired, at the expense of Lester Mirfin, the oldest man in Housekeeping, and, except for the Mushka-Pushka Men, one of the few whites. “Leslie,” as he was called, was a frail specimen whose job was to sweep the stairs about the hospital, which he did with a broom and long-handled shovel. I used to think that, if he ever had to bend over to do his job, he would never straighten up.

One day during the coffee break, slipping into the locker room after the crush of men that would have otherwise trampled him, Lester leaned against the doorframe and lit a cigarette as if it were his last.

“Hey, Leslie,” I called out, surprised by my own boldness. “Does your mother know you smoke?”

Roberto translated and the Puerto Ricans exploded with laughter, silencing the Mushka-Pushka Men at the table in the corner. The African-Americans laughed, too, confirming my status as one of the crew. . . .

I spent two more summers at Bridgeport Hospital, getting myself promoted to oxygen technician in Inhalation Therapy, where I wore a smart gray tunic and white duck trousers and assisted a doctor with pulmonary function tests. As it turned out, however, I would abandon pre-med during my sophomore year of college, discovering that I had no real love for the requisite sciences. But I did return to Bridgeport Hospital a few years later, driving in a panic all the way to Connecticut from Washington, D.C. to visit my father in the ICU—the very unit I had helped to establish as a wall-washer—where he’d been admitted with a blood clot on the lung.

I found him in an oxygen tent, looking shrunken and immensely old. And suddenly the hospital and everything to do with it seemed utterly foreign.

Professor Emeritus of English at Ohio Northern University, Claude Clayton Smith is the author of a novel, two children’s books, and four books of creative nonfiction. He is also co-editor/translator of The Way of Kinship, an anthology of Native Siberian literature (University of Minnesota, 2010). His latest book is Ohio Outback: Learning to Love the Great Black Swamp (Kent State University Press, 2010). A native of Stratford, Connecticut, he holds a BA from Wesleyan, an MAT from Yale, an MFA from the Writers’ Workshop at the University of Iowa, and a DA from Carnegie-Mellon. His work has been translated into five languages.

Strange Truths

by Aimee Henkel

We shared a ward together, he and I; the kind of place you find homeless junkies, schizophrenics, shell-shocked wanderers, drug abusers. They called it a dual-diagnosis unit. The hospital complex was in the center of Westchester, NY, across the street from Macy’s and the Galleria. I could see it from the windows. It was beautifully kept: emerald lawns, pearly white buildings with bright red roofs, lots of flowers and shrubbery. Inside, our ward was septic, strange. There was a padded cell in detox. The night I arrived, they brought in a pregnant heroin addict who screamed for eight hours straight. No one slept. We stood at the edge of our doorways in the dimmed halogen lights and watched the door, listening to her scream. Every hour or so an orderly or a nurse would go in and through the brief opening we’d see the poor thing on the floor, curved around her belly, her legs kicking.

It was a locked mental ward. Orderlies watched our every move.  Doors locked automatically from the outside. There were call buttons on the walls and “take down” lights on the ceilings. There were doctor’s rounds each morning: three white coated men asked questions, nodded with the answers, and wrote them down. There were meds, lots and lots of meds. And then there were the people. My roommate was a prostitute from Yonkers who had three kids, all of whom she lost to Child Protective Services. She had no idea where they were. She was on a lot of Thorazine, and she was touchy. The food made us all gassy, and she was particularly offended by the smell of her co-patients on the ward.  Other people came and went, some to other parts of the hospital, others just refused treatment.

James wasn’t the kind of person who belonged in that kind of rehab, although it was clear he was an alcoholic. He was the kind of guy I liked: jolly, open, friendly. Short and squat, he was Italian and Irish, his face pocked with little scars I assumed were acne or early chicken pox. He wore a moustache and I wondered what his face looked like without it. He was rotund, which I figured was from all the liquor, but then, I didn’t know much about his life before he got there.

We connected right away. He smiled and joked with everyone, but we shared a strange sense of humor. Being the only alcoholics on the ward, it was easy to latch on to each other, somewhat like drowning cats to a stick of wood. Outside during smoke breaks, we talked, but he was reserved. He listened to me, wanted to know what my life had been like before rehab, was I with someone—all that. It was easy to tell him my girlfriend was in the eating disorder ward across the quad and that we had been nude strippers together until she tried to kill me.  That I had graduated from NYU summa cum laude, and worked as a corporate writer until the booze got me. My best idea had been to take my clothes off for money so I could drink full time. It was like letting my breath go. The strange part about telling him all of that was he understood. He got that I wanted to drink all the time and that I wanted nothing more to do with men. I told him I wasn’t going to drink again ever. Just for that day.

He agreed with me. We had a lot to agree upon. When the Narcotics Anonymous speaker came and admitted he woke up one morning with another man, who said to him: “Good morning, papi,” we laughed so hard we cried. And when we had to pretend we were animals in therapy, we egged each other on because someone willing to stay clean and sober “would do anything.”  And when we were finally allowed out to roam the grounds, he told me about his English bulldog that had to be delivered by Cesarean section because their heads were so big, they couldn’t be delivered naturally anymore. I wondered if eventually that would be true of people; would our heads be so big that no one would have vaginal births? He didn’t answer.

He and I liked to play trivial pursuit, although he was much better than I. We sat around the day room at night, the summer Olympics blaring, while he beat me over and over. The only questions I got right were entertainment. I was terrible at history, sports, geography. We were inspired that summer, watching the athletes struggle and win. Working as hard as we were during the day, trying to get it right: the steps, the therapy, the family entanglements, the reasons, reasons, reasons; these nights were part of a routine I needed more than anything else. We joked and teased, and nothing got too serious.  Until the therapists got serious about us.

I was called into the head counselor’s office on a Thursday. I remember because it was AA day, and we always liked their speakers.

“You and James are too close.” She said, opening my file. She wrote something in it and I thought for sure I was going to be thrown out. I wondered if it was anything like getting suspended from high school. Would I have to do this all over again if I was? “You two need to separate. His treatment isn’t going to work if he can get out of himself with you.”

I looked at her as if she had two heads. I thought his treatment was going just fine.

“No. He needs to address what happened.”

“What happened?” I asked. This was a new element in our relationship. What hadn’t he told me?

“James was married up until a year ago. Then his daughter died.”

“You’re kidding?”  I couldn’t believe he wouldn’t tell me about this. “How did she die?”

“He and his wife had been out at a party, drinking, and they forgot to close the baby gate all the way.  She fell down the stairs and broke her neck. Died instantly.”

“He had a daughter?”

The therapist nodded and closed my file. “You two need to separate.”

“But I need to talk to him about this. It’s not fair he didn’t tell me.” I think I cried then. “I told him everything.”

“Good distraction for him, I guess. Being a stripper and all.” She raised an eyebrow at me, kind of smirked. I didn’t like that little observation one bit.

I left her office with strict instructions not to talk to him. It seemed strange, to know so much about a person, who they were, what made them laugh, what sports they liked, what they did for a living, and not know about the hole in their lives. It was as if he had danced around it in every conversation. There had always been something but I never knew what it was; words on the edge of his tongue, a thought never expressed. Perhaps he had wanted to tell me, but I hadn’t let him get a word in edgewise. I beat myself up for not knowing, not giving him the room to say the words.

That afternoon, he must have gotten his talking to as well. He didn’t avoid me at dinner, just sat two seats away instead of next to me. I leaned over and asked to talk to him on the walk back.

“Why didn’t you tell me?” I asked.

“Tell you what?” He smiled and handed me a necklace he’d bought me from the gift shop that morning.

“About your daughter.”

He looked crushed. The person I knew disappeared in an instant; his expression collapsed. “She fell.”

“What?”

“She went down the stairs. She was two. Our townhouse had steep stairs. She got up in the middle of the night, fell and broke her neck. I don’t know who forgot to close the gate. I think it was me.”

“Oh my God.”  I cried then. At the time, I was sad for him, because of the broken expression, the empty eyes. The jolly man I had known was gone.  But later, I realized I had known something else. He would never stop drinking.  We knew it then, but neither one of us had the courage to say it.

All of a sudden an orderly was between us. “Let’s get going.”

He was discharged a week later. We tried to laugh, make jokes, but they fell flat. Nothing was funny, now that we had to face the real world. I never saw him again, although fifteen years later I can still see him saying: “I don’t know who forgot to close the gate. I think it was me.”  I want to believe he got sober, that it wasn’t anyone’s fault, but I’ll never know. And that’s how it is sometimes when you stay clean this long; you learn to live without knowing.

Aimee Henkel studied fiction and poetry at New York University, Manhattanville's MFA program, and the Sleepy Hollow Writer's project. In a previous life she was a corporate communications professional, published anonymously in national and local newspapers and trade journals. In her current incarnation as a writer of fiction and poetry, she has been published in Poetry Motel, Beginnings, and most recently, Sleet.com.