New York City Hospital
Dr. Bessie McDonald didn’t like seeing the sun go down. The gathering blackness reminded her too much of her own end of days, and her breathing got worse at night.
She felt depressed, stuck in her hospital room. At least the nurses had allowed her more than the usual personal effects to help make it easier. She had a dozen framed photographs – a black-and-white of Fred in his uniform, smiling before he went off to Korea to be slaughtered and leave her a widow; color snaps of her son, Fred Junior; portraits of her three young grandsons, all grinning at her with various front teeth missing. She’d also brought a set of figurines depicting a young woman doctor performing her daily functions: administering to a newborn baby, listening to an old man’s chest, comforting a sick child. Though she never told anyone, the face on the porcelain statues was hers as a young woman, fired especially for her by a craftsman who had been her patient in the first years of her practice. She took nearly as much comfort looking at the figurines as at her family, not out of narcissism, but from pride at how she’d spent her life, from those early halcyon days up until the moment her own rendezvous with illness clipped her wings as a general practitioner.
She’d always been at risk of a stroke because of her crazy heart flying in and out of funny rhythms: a racing yet steady-as-a-jackhammer burst called PAT, or paroxysmal atrial tachycardia, when she was forty-three; then, in later years, atrial fibrillation, a chronic, wildly erratic tattoo. Whatever the beat, the muscle began to wear out, and eventually she slipped into congestive failure. Luckily, Melanie Collins saw her through it all. But she hadn’t suffered her first embolic event until four years ago at age sixty-six, when a blood clot formed in the fluttering upper chamber, broke off, and flew into her brain. Initially paralyzed on the right side, she’d been left with just her speech affected, again thanks to the precise diagnostic skills of Melanie and the quick use of clot busters – thrombolytic enzymes that break down the blockage before damage is done. Therapy got her back to talking so that no one would notice; however, at times, she had trouble finding the word she wanted.
The lasting harm had been done to her work, the ordeal derailing her from the practice of medicine for nearly a year. Although she’d arranged for a temporary replacement, many of her patients worried that she would stroke out again despite her intention to return, and found new doctors. With each departure, the sense of purpose she fought so valiantly to regain shriveled a little more.
Then, just three months ago, while digging in her garden, her right side went numb. She tumbled to the ground, her arm and leg like deadwood for all the good they were to her. She lay there, her face pressed into the earth, dirt up her nose, and bugs crawling between her lips. A worm’s-eye view of the world, she thought, wondering if it would be the last thing she ever saw.
She’d had no pain, and knew this was the same kind of stroke as before, a blockage, not a bleed. If she got help fast enough, maybe the clot-busting enzymes that rescued her before could help again. Yet second by second, her time nearly ran out. When a neighbor spotted her and called an ambulance, she knew the three-hour window for treatment would soon close.
Once she got to the hospital, there had been no Melanie on hand to speedily diagnose and treat her.
“Since she’s already anticoagulated, it must be a bleed,” one of the ER residents, a sleepy-eyed kid, had said to her nurses as he methodically checked her reflexes.
No! she’d wanted to scream as she pawed feebly at his arm trying to get his attention.
He’d ignored her, and added, “Besides, we don’t know how long it’s been since she stroked out.”
Two hours, forty minutes, asshole! There’s still time.
“Send her for a CAT scan?” one of the women had asked, recording her vitals.
“Of course,” he said, and wandered out of the room.
No, don’t leave. Talk to the radiologist yourself. Bump me to the head of the line!
Three hours too late they’d made the correct diagnosis.
Her speech returned, but the delay cost her partial use of her right arm and her ability to walk normally. It also turned her into an old woman overnight.
“Hi, Bessie.” A pint-sized nurse with a GI haircut and a name tag that read NURSE TANYA WOZCEK pinned to her uniform bopped across to her bed. “All set for your meds?”
“As much as I’ll ever be.”
Everyone called her Bessie. It sprang from her insistence that she be registered as Mrs. Bessie McDonald, not Dr. McDonald, during her admissions. “Things go wrong when they know you’re a physician,” she’d repeatedly explained to the admitting office. “Doctors, nurses, techs – they all start doing what they wouldn’t normally do, second-guessing themselves. Leads to mistakes.”
But since the night of this most recent stroke, she’d had plenty of time to do some second-guessing herself. Had they known she was a doctor, would they have listened to what she was trying to tell them?
“Here, let me prop up your pillows,” Tanya said.
Bessie grew short of breath if she didn’t sleep partially upright. The result of heart failure. “Thank you, dear.”
“And here are your pills.” Tanya handed over a paper cup that had five tablets in it.
Bessie poured herself a glass of water from her pitcher, then downed the bunch of them in a swallow. She’d been on them for years: Digoxin to control her heart rate and increase its pump action; furosemide to keep water from accumulating in her lungs; rampril to relax her arterial tree and reduce the cardiac workload; warfarin, also known as rat poison, the anticoagulant that had led the resident off track; and a baby aspirin, to thin the blood and prevent more clots. As easy as one, two, three, four, five. Except having to take pills at all bored her, and the treatment, like all regimens, wasn’t perfect.
To control her angina, she had to take a spray of nitroglycerine under her tongue, in addition to wearing a patch of it on her skin. The latter could be worn anywhere, but most patients put it on their arm or chest. She stuck hers on her ass every morning just to be contrary, having precious few other ways to say, I’m here and I’ll do things my way.
“Skin’s skin,” she told the residents whenever they objected.
“You go right ahead and put it where you want, girl,” Tanya would say to her in private.
She liked Tanya. The woman always worked evenings, which led Bessie to try figure out what this nurse did during the days. She never talked about herself, and, of course, Bessie never pried. The fun lay in the guessing, not the answers. Bessie’s active mind grated against the hours of idleness and pounced on any puzzle for entertainment.
“I see you’ve been reading about Kelly McShane,” Tanya said, picking up a newspaper from the nightstand that lay open to the article. “The whole hospital’s buzzing about it.”
“I’ll bet. How’s Chaz Braden taking it?”
Tanya looked up from scanning the column. “Do you know him?”
“He was my cardiologist the first time I got admitted for my heart, about six months before his wife disappeared. Didn’t like him.”
The nurse’s expression slipped into neutral, and she glanced nervously at the doorway. “Can I get you anything? How about some juice?” Obviously, she wasn’t about to engage in a round of bad-mouthing the man, which, of course, was professionally correct.
But not fun.
Tanya leaned in close as if fluffing up the pillows a second time. “Our supervisor’s warned us not to gossip about it, but I bet you want to tell me every word of what went on back then, don’t you?” she whispered, dispatching propriety with a grin.
Nice girl, Bessie thought. “Of course I do.”