"He's dead," I had said finally, after feeling for pulses.
"You mean DOA, Doctor? No arrest, is that right?" That was right, dead on arrival, The medical jargon was reassuring; it made me feel secure. That boy with the hole in his head had been very different from the bearded man. Sure, the hole had scared me half to death, and I had been greatly relieved to be rid of the responsibility of figuring out what to do with that eye. The main point, however, was that he had had a big hole right through his head that preempted any action by me; hence, I had felt little responsibility. On the other hand, even now, without the sheet that covered him, the bearded man would look quite normal, as if in a deep sleep. That's the thing about death from asthma. You don't find much even at an autopsy, unless the victim has had a massive heart attack.
Sitting in the doctors' room, I tried to picture Joyce Kanishiro in the center fold of Playboy. That would be something. She even had a few black hairs around her nipples. They'd have to touch up the photo a bit.
Joyce was a laboratory technician with a strange schedule like mine. That was no problem, but she did have one gigantic drawback: her roommate was always at home. Every time I took Joyce back to her apartment, the first few times we went out, her roommate was there eating apples and watching television. There was a bedroom, but it was never opportune for us to go into it. Anyhow, the roommate, a confirmed night person, would probably have still been there staring at the test pattern when we came out at 5:00 a.m. After a few nights of situation comedies followed by the late news and the late movie, I knew Joyce and I would have to change the locale.
My reverie about Joyce was interrupted by another memory, an episode that had taken place in the late afternoon some two weeks after I started ER duty. The same routine — siren/ red flashing lights — and this fellow had looked normal, too. As the attendants unloaded him and rushed him inside, they told me he had fallen fifteen stories onto a parked car. Had he moved? No. Tried to breathe? No. But he looked normal, quite peaceful, somewhat like the bearded man only a lot younger. How long did it take to get him here? About fifteen minutes. They always exaggerated on the low side, to forestall criticism. With an ophthalmoscope, I looked into the fellow's eyes, focusing until I saw the blood vessels. Concentrating on the veins, I made out clumps that could only represent blood clots. "DOA," I said. "No arrest." I had been pretty upset about that case, too, although falling fifteen stories onto a parked car was generally conclusive.
Then the family had started arriving, in spurts— not the immediate family, at first, but cousins and uncles, even neighbors. It seemed that the man — his name was Romero — had lost his footing while painting the outside of a building. After the nurses called his wife to tell her that Romero was in critical condition, word of the accident had spread quickly, and by the time Mrs. Romero arrived the place was jammed with people demanding to know how he was and waiting to see him. As I informed Mrs. Romero of the death in my best quiet and confidential tones, she raised her hands to heaven and began to wail. Taking their cue from her, the rest of the crowd began wailing, too. For an hour or so from that moment I witnessed the most incredible and frightening performance by the Romeros and their friends as they, continued to drift in and engulf the ER. They beat the walls, tore their hair, screamed, cried, fought with each other, and finally began to break up the waiting-room furniture. I had no time to brood over the metaphysical implications of the case, being much too busy protecting myself and the rest of the staff. Interns have been killed in the ER That’s no joke.
Later I had seen in the pathologist's autopsy report that Romero's aorta was severed. That made me feel a little better. But I knew that the pathologist would probably find nothing so plainly wrong with the bearded man.
Dozing and musing in the old leather chair, I played with such thoughts and memories while Miss December's gigantic, almost hilarious breasts seemed to grow even larger. Joyce didn't have breasts like that. We had moved to my room to avoid the TV addict, and I vaguely remembered waking up at four-thirty that very morning as she left via the back door before anybody else was up in the quarters. It was her idea; I couldn't have cared less. But that was how we got away from Miss Apples and TV. It was a great schedule. During my twenty-four hours off, I surfed in the afternoon, read in the evenings, and then about eleven, after her work, Joyce would arrive and we'd go to bed. She was an athletic girl, who liked to bounce all over the place. She had great endurance, really insatiable. When she was around I didn't think about anything else.
But the hospital bed in my room made a hell of a lot of noise, and it was pretty small. When Joyce got up to leave at four-thirty or so, it always felt delicious to expand all over it, luxuriating in the spaciousness. For a while I had gotten up with her — it seemed the courteous thing — and waved as she went down the stairs and drove away. But lately I had just propped up on one elbow, watching her dress. She didn't seem to mind. This morning she had come over to the bed, all starchy white, and kissed me lightly. I said we'd get together soon. She was an okay playmate.
When the phone rang to wake me up three hours later, such a short time had elapsed that I half expected to see Joyce still standing there. I must have fallen asleep before she got out the door.
Saturday, busiest day of the week in the ER, 7:30 a.m. Even though I had been in bed for eight hours, I felt physically bankrupt and out of phase. It was that twenty-four-hour baloney. I had followed my usual routine, which started when I balanced against the sink and studied my bloodshot eyes and ended with my arrival at the ER at one minute after eight, as always. Strangely, despite a general tendency toward tardiness, I always managed to arrive promptly at the ER to relieve my colleague, who would slink off gratefully with blood-spattered clothing and drooping eyelids.
Until the arrival of the bearded man this had been a relatively quiet Saturday morning, with no big problems, only the usual procession of people who had dropped a steam iron on their toes or fallen through a plate-glass window. Everything had been handled quickly.
A half hour had come between me and the bearded man, and obviously nothing untoward had happened outside the doctors' room, else I would not have been allowed to sit there musing. My watch showed 10:00 a.m. I knew it was only a matter of time!
After a perfunctory knock, a nurse entered to say that a few patients were waiting. Feeling almost relieved at being tugged from my reverie, I went back into the daylight and took the "boards" the nurse had prepared. My hat is off to these nurses. They routinely escorted each patient into the examining room, took all the administrative detail, the blood pressure, and even the temperature if they thought it was necessary. In other words, they screened the patients very well. Not that they decided whom I should see, because I had to see everyone, but they did try to establish priorities if the place was busy, or to give me a little peace occasionally if it wasn't. Whenever a new intern arrived, I guess the nurses were tempted to handle everything alone, because most of the stuff that came in really didn't rate as an emergency.
But I was the intern and in charge, dressed in white coat, white pants, and white shoes, stethoscope tucked and folded into my left pocket in a very particular way, equipped with several colored pens, a penlight, a reflex hammer, a combined ophthalmo-otoscope, and four years of medical school— apparently ready for anything. In fact, really, only for the ailments I had already seen and dealt with. Considering that the variety of bodily ills approaches infinity, I wasn't ready at all. My inadequacy was like a shadow that fell away only when the place was jammed with crying babies and suturing to be done. After about ten hours, I usually got so tired that even if there were no patients I couldn't think. So the morning was toughest, just getting through to the afternoon; the rest seemed to take care of itself.