Chapter 4. December
December 10.
I’m done at the Kennedy Center early this Saturday, since none of the long-term patients came down with new problems overnight. I’m beginning to conclude that this rotation in rehabilitation and long-term care away from the County, while relaxed, really doesn’t offer much challenge.
But no argument with a month of no night and weekend calls, especially in December. Ahearn’s a good teacher, but it’s mostly up to me to read. Nice to have time to do that, but I don’t know about full month of it, away from action.
“You’re already home?” asks Karen looking up in surprise from her novel, as I open the apartment door. “It’s not even 11:00.”
“Where’s the mailman hiding?” I joke, taking off my green Loden coat and shaking off the melting snowflakes in the hallway, before closing the door and hanging it up in the entry hall closet. “He’s not in here.”
“You’re the only one I need delivering things,” says Karen, giving me a welcoming kiss. “Oh, your lips are cold. We were going to buy ornaments today and look for a Christmas tree. We’ve got the ones that Mom sent us when she moved, but I think we need more. Want to go now or after lunch?”
“What else do we need to do? We sent off the presents to your mom and my parents last week, so those are out of the way.”
“We’ve still got a few cards to write,” says Karen. “Why don’t we have a quick bite and go get our tree while it’s still snowing. We don’t know when the snow will stop and it’ll be really pretty, looking at the trees with snow on them.”
“We can get both the tree and the ornaments at the same time if we go to Sears.”
“That sounds good. How about cheese toast and vegetable soup for lunch?”
At Sears we manage to find a parking space. The snow is still falling. It’s not sticking in the lot where the traffic is heavy but it does clump whitely on the shrubs around the building, and up on the surrounding roofs. Inside the store the heat steams up my glasses, and I wipe them off with tissue. We look for the trim and ornaments section.
“Do we need lights?” I ask Karen.
“If we get a small tree, these lights will look huge on it.”
“Do you prefer the old metal tinsel or this new plastic stuff? And look, they now sell flocking in an aerosol can. If we decide to flock, we won’t have to mix up laundry soap flakes anymore.”
“Unless you want to try the new tinsel let’s stick with the tried and true. And I think that flocking will mask the nice piney smell,” says Karen, “Oh, look at these. They have some old style ornaments from Germany and Poland.”
“They remind me of the ones we had when I was a kid,” I reply, “I guess my folks must still use them.” A long time since I spent Christmas with Mom and Dad. “Let’s get a box of a dozen assorted to go with the ones that your mom sent. That should be enough.”
“And we have a Christmas project in class, making paper garlands. I’ll bring some home.”
“I remember making those in school.” Nine years since I was home for Christmas. But whose home would we go to? There’s Karen’s too. Tom’s lucky; just a short drive from Davis. Nine years. Where’d the time go?
“We also need a tree stand,” Karen reminds me.
We go back to the car, indicate to a hopeful, waiting driver that we’re not leaving, stash the ornaments and tree stand in the trunk, and then walk to the Christmas tree enclosure in the back corner of the lot.
“What do you think, about five feet?” I ask.
“Oh yes. Ummm-—just smell these fresh trees. And don’t they look nice with the snow on them? I’m so glad that it’s snowing today.”
“And I’m glad that we don’t have more than three blocks to drive. Why don’t we take a walk through the Fens in all this new snow after we drive the tree home? I love leaving fresh tracks as it’s coming down. It’s like walking in a brand-new world. Then afterwards we can go home and brew up a little punch and decorate the tree. Do you have any cinnamon sticks?”
“No,” says Karen, “But I’m sure we can get some. What do you think about that one? Could you lift it up and turn it so I can see the other side?”
December 16.
“Remember, tomorrow morning you don’t need to come in,” says Dr. Ahearn. “It’s my Saturday to round. Spend the weekend with your family.”
“Thanks, Dr. Ahearn, but I don’t mind. There’s just my wife and me.”
“No, you spend the day with her. You’re away enough during residency.”
“Thank you,” I say gratefully. “I’ll just finish up a few things before leaving this afternoon.”
“Dr. Ahearn’s sure a thoughtful man,” I say to Sister Theresa after he leaves. “How’d he come to be director here?”
“He and the older Kennedy boy were classmates at Harvard, so after he became a pediatrician, he was a natural choice.”
“Wonder if he’ll be appointed to something in Washington after Jack takes office?”
“In a way, I hope not,” says the Sister. “He’s been so good here. He’d be very hard to replace.”
After finishing, I drive out of the parking lot. It’s dark and cold; the Friday pre-Christmas traffic is heavy, and I drive defensively. The streets have been salted, but the falling temperature makes the driving slippery, and my wheels skitter when they catch the shiny streetcar tracks.
* * * * “Hi Sal. Got all your Christmas shopping done?”
“All that needs doing is done. How about you?”
“Sneaking over to that arts-and-craft store above Harvard Square, to pick up a pair of sterling silver ear rings for Karen, last Saturday after rounding, was the last thing I had to do. What would you have wanted for a present, Sal?”
“A gold nose ring, Bob. You sure are one persistent fisherman.”
Think he’s trying not to laugh. “Well, it’s your own fault, you won’t show me anything about yourself.”
“Do you know Ecclesiastes? ‘To everything there is a season, and a time to every purpose under the heaven.’”
“That’s too damn deep, Sal.”
“Then let’s talk about something else less controversial,” says Sal.
“Okay.”
I get a happy kiss from Karen as I come through the door. “I’m on vacation. Last day of school today for two whole weeks! And we got a CARE package from your parents today; I put it under the tree with Mom’s. Did you send cards to everyone on your list? One came today that I didn’t recognize.”
“We can open the package. Mom likes to wrap up things individually, and she’ll have included other things for eating now that aren’t Christmas presents. That way, there’ll be more bundles under the tree too.” I pick up the package and give it a tentative shake; then cut the twine and tear the brown paper off the cardboard box.. “I thought so. She sent a fruit cake again. She always did when I was in school. And here’s a letter from them.” I read it first, then give it to Karen to read.
“They’re going to have your brother home for Christmas,” she says. “I’m sure they’ll be delighted to be with their granddaughter. How old is she now?”
“Beth is one and a half. Funny—Tom is two years younger than I am, and he got his family started first. I’d sure like to see her. I guess it’ll be a while before either you or I get home for Christmas. Did your mother say what she’s doing?”
“She hasn’t decided. She’s got a couple of invitations from friends.”
“Oh, and Dr. Ahearn gave me tomorrow morning off,” I say, “So I can help you with the shopping for the party.”
“That’s good. I was planning to go early tomorrow morning, and it’ll be easier with the car. At least I don’t have to worry about dessert, since Maggie insisted on bringing it.”
Hope her idiot husband Tom doesn’t get on anti-doctor kick again. Allie and Joan won’t take any crap from him. Christmas Season or not.
Later over dinner Karen says, “Since you don’t work tomorrow, want to go over to the Commons area and walk around Beacon Hill tonight? The homes should be really pretty with their windows decorated and lighted, and the snow will make it feel really Christmassy. We can catch the street car over to Park, so you won’t have to drive.”
“Something right out of Currier and Ives.”
“Not like the East Bay, that’s for sure.”
* * * * “Hello Sal. You doing anything tonight? Would you like to come along with us, or have you already had a look at Beacon Hill?”
“Thank you Bob. No I haven’t. I’d enjoy quietly tagging along and seeing it through your eyes.”
Not going to see it in person?
December 18.
“One week to Christmas,” I say to Sal. “What are you going to be doing?” I’m bundled up and out early to buy the Sunday paper at the little grocery and sundries store half way down Beacon towards Kenmore Square. Karen is still asleep.
“Oh, I’ll be spending the day with some old familiar faces. But tell me about your party last night. How did the mix of docs and teachers go? Especially Tom Smith who you were worried about.”
“It went well,” I say. “Tom behaved himself. Surprised me. Perhaps last time he was just out of sorts with a toothache or something. We had Wilson and Gloria, a girl we hadn’t met before, Allie and her date Paul, and Joan and Ulrich. Then there was also Frank, the second grade teacher and his wife Linda, the librarian. So it was almost evenly split.”
“Did everyone mix, or did you have two parallel parties going on?”
“No, thank God everyone mixed. There were twelve of us, and our apartment is so small that we were all forced together. I overheard Tom and Ulrich talking. Tom was getting Ulrich’s thoughts on how post-war German youth feel about the atrocities of the Nazi era. They went on for quite a bit about where guilt and responsibility begin and end.”
“Pretty serious stuff for a holiday party. How about Allie and her date, and Frank and Linda?”
“Well, Paul is going to get his Masters in Education soon, so he had a lot in common with the teachers, especially Frank. Paul taught for three years before going back to grad school. All in all, it was a pretty nice party that kept to the spirit of Christmas—-Peace on Earth.”
I reach the store and my glasses fog immediately upon entering. I wipe them off and then pick up a Globe and a New York Times.
Sal and I continue to talk on the way back, saying goodbye at the apartment house. After I shed my coat, I sneak a peek in the bedroom and find Karen stirring.
“Want some coffee with the papers in bed?” I ask as I stand at the door.
“That would be nice,” Karen says, lifting her head from the pillow.
I come to the bed and bend down to kiss her.
“Oh your hands are cold,” she says.
“But my heart is warm for you.”
December 24.
The early evening candlelight carol service at Trinity Church in Copley Square is packed as usual, but we’ve come early and found seats in a back pew. There is the faint smell of damp wool and wax. The streets are slushy, and we’ll need to walk carefully when we leave because the slush will freeze after sundown. Karen and I hold hands as we wait for the service to begin. The stained glass windows are already darkening as the overcast Saturday afternoon fades to night.
“Help me slip my coat off,” she says, “it’s starting to get warm from the candles and all the people.”
I catch a whiff of her Chanel No. 5 as I do. Nice.
“It’s a good thing we came early,” I say. “You don’t need to use the bathroom before the service begins, do you? It’ll be impossible later.”
“No, I’m okay. Well, if we couldn’t get back home for Christmas, this is the next best thing. It’s wonderful that you aren’t on duty this Christmas like you were last year.”
“Yeah, our first married Christmas Eve and Christmas together,” I reply, and gently squeeze her hand, “But I’ll be in the ER back at the County on New Year’s Eve, so no partying this year.”
I think, “Hi Sal, you getting all of this? So what’s your impression, kind of different from a Catholic service, eh?”
“Thanks for letting me come along to see it through your eyes,” Sal says, “What makes you think I’m a Catholic anyway? Oh I see—-that was a little test. You’re still trying to play detective. Well, I wouldn’t admit it if I were, and I certainly wouldn’t admit to being a priest. That’s a pretty devious trick for you to be trying during this season of good will.”
“You can read me too easily, and I can’t do it to you at all. That’s not fair,” I protest, “I wonder how you’d feel if there was always someone around who could read your innermost thoughts, not that you do that to me anymore without permission.”
“To be honest, there was . . .” begins Sal.
“Oh, there’s the organ prelude. The service will be starting soon,” says Karen, shifting around in her seat to look behind us at those standing. “It must be really hot for the standees, all packed together.” We lean against each other. I give her a quick kiss on her cheek.
“Sal, what did you mean to say just now? Am I really the only person that you’ve ever been able to have two-way communication with?”
“You caught that, eh? Well, actually, there was someone before you. I wasn’t totally truthful with you that first time we spoke, when I told you that you were the only person I had ever been able to contact.”
Yeah, I sure remember that first day. What other things aren’t true?
“Who else?” I ask.
“It almost makes me sick to remember. She was–she is–in Waltham State Psychiatric Hospital where she’s been for years because she hears voices. I located her by chance, just randomly sweeping about, listening in on minds. It was such a thrill to realize that I had reached someone like myself. But by the time I found her, she was totally mad. I don’t think she started out that way but when, as a child, she spoke of hearing voices that others didn’t, she was given psychiatric treatment. And when the voices did not go away, but in fact got stronger and more numerous as her telepathic skill strengthened, she was judged to be getting worse. She was electroshocked but of course that didn’t stop the voices. They finally managed to convince her that she was mad. And so she became insane, without ever realizing that she was a telepath. When I reached her, she was hallucinating as well as receiving telepathically, and everything was jumbled together in her mind. She was very strong, and tried to seize me and pull me into her world. I was lucky to break free. I can still occasionally feel her reach out to me, but she’s so confused now that I can easily slip away from her.”
“That’s horrible. You must have been lucky to have avoided her fate yourself,” I say. And how’d you manage that?
“Yes–I was lucky,” replies Sal.
“That’s it? Just ‘lucky?’ You won’t tell me anything more? God, you’re frustrating.”
“It—well–it just wouldn’t work–right now–to tell you everything.”
I realize that Karen and the congregation have risen to their feet and Karen is looking quizzically at me, waiting for me to rise to sing the first carol. I smile sheepishly at her as I stand and share her hymnal. One of the few times I’ve heard Sal hesitant.
“What happened to you?” Karen whispers.
“Sorry. Just daydreaming,” I reply.
“I love this carol,” says Sal, “My mother used to sing it to me.” And the sudden brief glimpse I get of Sal’s love for his mother and his deep longing for her, make “The stars in the sky . . .” catch in my throat for an instant, as I sing.
December 25.
We turned the alarm off last night, so it’s the gray light of morning, filtering through the blue and white curtains, that wakes us. That and the radiator’s hiss, as it begins to put some warmth into the room.
I raise myself on my left elbow and look at Karen. “Merry Christmas, darling. Last night was really nice.” A sweet Christmas Eve. Forget morning breath. And I lean over and gently kiss her lips.
“Merry Christmas,” she replies and stretches, smiling. “Shall we get up, wash, make some coffee and open our presents before breakfast?”
“Why don’t we just stay in bed and give ourselves a present.”
“A scandalous suggestion for Christmas morning,” she says with mock schoolteacher propriety, as she sits up, “ Come on, get up–help me make the bed. We can always take a nap this afternoon.”
Love those matinees.
In the shower, I think * * * *
“Good morning Sal, a Merry Christmas to you.”
“And Merry Christmas to you and Karen, Bob.”
“Sal, I want to tell you. You’ve become a friend. It no longer matters so much to me whether or not I ever get to know more about you. I never thought that I would say it, but I am very grateful that you came into my mind and life in September. If you’re really not real, then I don’t mind being a little mad. That doesn’t mean that I still wouldn’t like to learn something more about you. My only real regret is that I can’t tell Karen about you and have her know you too.”
“Thank you for feeling that way and telling me. I too value our friendship very much. I know that at times you still have doubts about whether I exist. It may help to remember what Lord Byron wrote, ‘Tis strange–but true; for truth is always strange; Stranger than fiction.’ And with that thought, I’ll take my leave. You should be spending this day fully with Karen. Talk with you tomorrow.”
“Hope your Christmas is a good one too.”
“Coffee’s ready,” says Karen, at the bathroom door.
“Coming. I just need to rinse off the soap.” Stranger than fiction? For sure.
I towel dry and dress in chinos and a crimson college sweatshirt, then pad in bare feet across the varnished wood floor to join Karen in the living room. She hands me a mug of black coffee and holds out a plate of fruit cake slices, full of California’s sunshine stored in the dried fruits and nuts. We sit side by side on the small rag rug next to the Christmas tree.
“OK, Santa Claus,” she says, “I’m ready for my presents.”
“Well, here’s the first one,” I say, leaning towards her and giving her another kiss.
December 31.
I drive directly in to the County after checking the patients and saying my good-byes to them and the staff on my last Saturday morning at the Kennedy Center. It is sunny and cold and the roads are clear. The snow piled along the sidewalks and curbs melted in the warm spell that followed Christmas and I find parking easily. I’m starting in the Emergency Room at noon, and I’ll be in the hospital until 10:00 PM tomorrow. Nice break at Kennedy during Christmas–now back to full grind.
I look both ways, then cross Franklin Ave. It’s only 11:20 so I’ll have time for lunch before going on duty. The corridor is warm, the hot water pipes running the length of the wall just below the ceiling gurgle and clank. I pass an older couple in dark, heavy overcoats, their wool scarves hanging loosely around their necks, carefully walking along slowly, arm in arm. How many more New Year Eve’s do they have together? A lab tech hurries past, carrying her blood-drawing supplies with her in a tray, heading towards the surgical building. Just before I reach the double doors to the cafeteria, an orderly rolls a gurney past, its passenger covered by a tightly tucked in sheet, bound for the tunnel leading to the morgue in the Robins Institute of Pathology. To die at year’s end. R.I.P. Years and people have beginnings and ends; only seasons have cycles. God, that’s dark.
The meal line is non-existent; there are few other diners but no one I know. I sit by myself, and quickly dispose of a forgettable lunch. Then I fill my pipe and light up, puffing and sipping coffee, enjoying a quiet moment before what will likely be a busy time in the ER.
At 11:45 I report in, to take over from Joan and her partner, Lou. Cliff Symonds will be working with me, and he arrived just before I do. Cliff is single and lives in the House Officer’s Building.
“OK. Bob and I are here to relieve you,” says Cliff. “You guys are free to party, while we work our asses off. Any patients hanging over from the morning?”
“Nope, this morning wasn’t bad, so we’re handing you a cleaned-out room,” says Joan.
“OK, Happy New Year. Drive carefully tonight. Don’t make extra work for the ER,” says Cliff.
The pediatric emergency room is a long narrow room down the hall from the adult ER and the registration desk. It has six partitioned stalls, which can be curtained off, with three cribs and three full-size examination tables. In the hall outside four long wooden benches with backs stand end to end against the walls for overflow waiting, looking incongruously like church pews. Nothing holy here.
Cliff and I sit around the two small desks next to the door, and wait for business. Kate Kelly, the ER charge nurse joins us.
“It probably won’t stay this quiet for much longer,” she says, “It never does on New Year’s Eve.”
“Shhhh. Don’t jinx us,” cautions Cliff, knocking on the wooden desk.
“I see Mark is the SR covering today,” I say, checking the schedule, “I feel so out of touch after being at the Kennedy.”
“I would’ve traded with you in a flash,” says Cliff. “No calls for thirty days and Christmas Eve and Christmas off! What a deal.”
“Yeah,” I say with a grin that probably irritates Cliff, “Better to luck out than to be smart.”
The phone rings, and Kate picks it up, “OK. Send them over.” She hangs up. “That was registration. The vacation’s over.”
A large woman appears at the door with a small, anxious-looking, four-year old boy in hand. “My boy’s got asthma again,” she says, handing me the registration sheet, since I’m sitting closest to the door.
Kate gets up, “OK mother. Follow me. One of the doctors will check him over after I get his weight and temperature and dress him in a gown.”
“I’ll go first,” I say to Cliff, and look over the registration form.
Kate returns. “He’s all yours. No fever.”
“Hello Mrs. Jones. Hi Arnett.” I enter the cubicle and pull the white curtain closed behind me. “What brings you here?”
“He’s got asthma. It started up last night, and I got no more medicine for it.”
“Has he been here before?”
“You folks should have his record; he’s been here so much.”
“Unfortunately, today’s a holiday, so we can’t get any records in the ER.” Also can’t get them if it’s not. “I know it seems kind of repetitious and foolish, but I’ve got to ask you some questions. How often does he get asthma?”
His mother sighs in mild exasperation.
No wonder they call us “The Suc.” Makes us look stupid.
“Sometimes once a month, sometimes not,” she says, “But if I got the medicine, I gives it to him before he gets like this and it helps. Winter is hard on him.”
“And was he ever admitted for asthma?”
“Nope. Usually they just gives him the shots, and sometimes those IV’s, and then we goes home.” At the mention of shots, Arnett begins to cry. “Hush now. No need to cry, you ain’t got no needles yet.”
“Hey Arnett, I’m just going to talk to your mommy now, before I check you, OK?” I lean forward and reach out towards him, but he retreats against his mother and cries louder. I take my hand back and lean away from him.
“You be quiet. The doctor ain’t touched you yet!”
“If he’s been here a lot, it’s natural that he’s scared. Has he had a cold, or is there anybody home with a cold?”
“Arnett’s just had a little one, and my daughter too, but she’s not wheezing.”
“Has he been vomiting? Is he drinking okay?”
“No, no vomiting. I guess he’s been drinking.”
“Okay. Maybe he’d be happier if you carry him when I check him. Can you sit up here on the table and keep him in your lap? Arnett, Mommy’s going to carry you, while I look at you.”
Arnett clings tightly to his mother when I open his gown and look at his chest. A little hyperexpanded; not using a lot of accessory muscles. Color’s good. Not flaring. Luckily he does not cry harder when I listen to him, and even settles down a bit. Breath sounds are pretty good, equal. No inspiratory rales; definite prolonged expiration; lots of expiratory wheezes.
“Mrs. Jones, no chance, is there, that he could have choked on anything before he began to wheeze? He doesn’t carry toys or coins around in his mouth does he?”
“No, he just had the cold, and then his wheezing got worse and worse.”
I complete my exam without finding anything else and go to look for Kate to ask her to give him a shot of epinephrine while I check the next patient.
Arnett cries at the shot, and cries again when I come back to listen to him after I’ve seen another patient. “He sounds clearer,” I tell his mother, “But this medicine will only help him for a little while. I want to give him a long-acting shot so that his improvement will last longer. Okay? I’ll also give you a prescription for some medicine that he can take by mouth at home; he’s probably had it before. Does ephedrine sound familiar?”
“Do I have to buy that medicine?”
“Yes. You can get it either at the emergency room pharmacy or elsewhere.”
“I don’t gets paid till after New Year’s. Can you give me some?”
“I’m sorry, but we don’t have any samples to give out. It’s really important for Arnett to take his medicine.”
“Yeah, I knows that. But I just don’t have the money.”
“Maybe one of your family or friends can loan it to you till payday?”
“Well, give him the shot. I’ll see what I can do. I knows he needs it.” Arnett cries again as the nurse comes back bearing another syringe and needle.
Mother and son leave with the prescription. Hope she gets it filled. Could save return visits if we gave out free meds. Ephedrine’s pretty cheap.
A steady stream of patients keeps us on our feet all afternoon. There’s a lull at six, and Cliff and I alternate going to dinner—canned ham and canned sweet potatoes with canned pineapple for dessert–tonight the kitchen staff is also down to an unlucky few and they want out early. Things stay quiet till 7:30, and then we have a flurry of visits till 9:45. Since Saturday is the Night Float’s night off, and it’s a holiday, Cliff and I have been assigned to split the Float duties. We flip for it, and he takes the first half of the night, and I the second. I head upstairs to shower. Three AM will be here before I know it.
I call Karen before going to bed. “Happy New Year’s Eve, Baby. I love you.”
“Thanks for calling. I love you too–don’t you go celebrating without me. I’m going to watch TV and see the ball drop at Times Square and then go to bed. See you next year.”
I hang up, and then, just before I fall asleep . . .
“Hello Bob. I took a peek to make sure you weren’t asleep. I wanted to wish you Happy New Year before midnight.”
“Hi Sal, I thought about calling, but I didn’t want to take the chance of waking you. Thank you for calling me, and a very Happy New Year to you too.”
The Long and The Short of It 