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Threshing the Chaff from the Wheat

Frank Bob Kull
 1990
Montreal, Canada

 

Down from the rank winter sky came iron bars of freezing rain.  Hunched against the cold, it was easy to feel bound by the ice; hard to climb out and see into the clouds.  In Montreal, on the shoulder of Mount Royal, beneath the cross, the Royal Victoria Hospital waited.  Its granite walls were heavy and imposing and they protected the world within from the falling wet outside.

Below the hospital, sitting dignified and dowdy, McGill University was doling out education to its students with a three-credit ladle.  In the lecture hall, four hundred and fifty undergraduates were crammed into packed rows of seats.  The room seemed draped with a pall of mind-numbing boredom; in fact, life raged – just barely controlled and focused into daydreams.  Down at the podium, the lecturer, a visiting doctor from the hospital, noticed nothing at all.  Rapt in the glory of his subject, he droned on and on.

At the bell, two of the students left and hurried through the slush along Pine Avenue toward their next class.  Fascinated by the power of success, they saw no side roads ahead, no roadside attractions – only the driven concrete expanse of the future.  As they crossed the avenue, they were delayed briefly by the screaming passage of an ambulance.  Then it was gone, and they hurried forward into their lives.

In the back of the meatwagon lay a pain-wracked body; the right leg torn and bloody, the foot nearly ripped off at the ankle.  The body’s eyes spun around and fought through a fog of morphine to focus on the face of the black attendant.

*               *               *

“Am I almost dead yet?”

“Naw man, relax, you’re not gonna die.”

“Aw shit.”

*               *               *

Then the man passed out and was just meat again.

The ambulance hushed its wailing and backed to the Emergency doors.  The attendants unloaded their cargo and wheeled it into the hungry maw of the hospital.  A nurse met them as they came in.

“Hi Larry, how ya doing?  Got something for us?”

“Hey Darlene, what’s happening?  Yeah, we picked this guy up at the Mirabel Airport.  He just flew in from the Dominican Republic.  Had a bike wreck down there, I think.”

“Oh yeah, a friend of his called a while ago to say he was coming in.  I think his leg’s all messed up.  Jackie,” she said to another nurse who had joined them, “this is the leg we received the call about.  Will you tell Dr. Mackay it’s here?  OK, thanks Larry.  Gotta go now.  See you later on.”

As usual, the waiting room was crowded.  While no one there was seriously injured (those who required immediate attention were wheeled directly into the examination rooms) nearly all were frightened by their wounds.  There was sullen muttering as some of the people complained to each other about the long wait.

One man, scruffy, unshaved, mean, blood-shot eyes, was angered that he hadn’t received instant treatment.  Hand wrapped in a bloody rag, he was repeating his story yet again to the skinny woman moaning beside him.

“This guy was sitting in his car down on Saint Catherine Street, ya know.  Just sitting there talking to his broad and taking up a space.  So I let him know that I wanted to park, but the little shit wouldn’t leave.  Can you believe that?  He just sat there.  So I got out and went over and punched his face in.  Little chicken-shit had his window rolled up, but I never saw it.  Pissed me off.  Cut my hand all to hell.”

As the nurse tried to wheel the new patient past, the man stood up and blocked her way.

“Hey, how come this guy gets to go straight in?  I’ve been here for two hours.”

“Yes sir, I know,” said the nurse, “but this patient is in critical condition.  If you’ll just relax, we’ll be with you as soon as possible.”

“Goddamn it.  You think ‘cause I didn’t come here in an ambulance like that wimp, I’m not hurt bad?”

“Sir, if you want to go out, get your foot ripped off, and come back in, we’ll attend to you immediately too.  Now get out of the way!”

The man backed down into his chair again, cursing under his breath, and the nurse wheeled the stretcher down the long, dingy hallway into the depths of the hospital.

The examination room, like most of the hospital, was painted pale, noxious green.  Although relatively clean, it was so old and shabby it seemed to reek of disease.

“Hi Darlene.  Is this the man who had the motorcycle wreck down in the Caribbean?”

“Yes, Dr. MacKay, it happened in the Dominican Republic.  He just arrived on a flight from there.”

“When did it happen, do you know?”

“His friend said it happened yesterday, but she isn’t sure what time.  She received a phone call from down there asking her to meet him at the airport and get him to a hospital.  She doesn’t really know what happened though.”

“Well, we need to find out what time it happened,” said Dr. MacKay.  “I’ll try to wake him up before we give him something for the pain.  Give me a cold, damp cloth, will you?”

The doctor laid the cloth on the patient’s forehead and gripped his shoulder with a strong steady hand.

“Hello, are you with us at all?”

*               *               *

I came slowly up through the swirling mist.  Above me, I saw eyes deep with compassion.  The face was haloed in light and the figure cloaked in white.

“How are you feeling?” the face asked.

“I’ll be damned,” I thought, “God has a Scottish accent.”

“Better now that I’m dead, thanks.  I could use a shot though; the pain in my leg is killing me.  No, that can’t be right, not if I’m here.”

But the pain in my ankle wouldn’t let me pretend.  This was no dream, no nightmare either.  I was still right in the middle of life.  Then the pain sucked me away again.

 

Bitterly betrayed by my body, I lie defenseless against an onslaught of pain I can’t believe possible.  It’s not the pain that comes with a stubbed toe or a toothache.  That pain is real too, but it’s part of the everyday world.  This pain seizes and drags me away.  It’s a brutal land: scorched desert-sand strewn with razor-edged shards of burning agony; sledge hammer sun beating out of a malevolent sky; cactus spill the only shade, but even their shadows are studded with spines.  Blinded, bewildered, I crave release.

Twisted spires of volcanic rock, pitch-black and smooth as glass.  Frantically I climb but slide back.  I must escape!  I claw my way up and look out over endless desolation into a pit of despair.  Pain is forever.  I fall back and lie panting on the burning sand.  I long for cool water and soft breezes.  Somewhere there are fields of wildflowers and butterflies, but for me, there is only the vicious hammering of pain.

 

Usually, memory selects and weaves different parts of our chaotic existence into a fabric we call self.  But during that time, pain was the only unbroken thread connecting the jumbled tangle of events.

“Yes, I’m, here,” I told him.  I wasn’t too sure though.  The pain hadn’t let me go, and it was pulling me out toward the darkness again.

The figure in white didn’t seem too sure either, because he kept holding my shoulder as he called me back again.

“Richard, I’m Dr. MacKay.  I’m the orthopedic surgeon on call now, and I’ll be taking care of you.  Richard, when did the accident happen?  Can you tell us what time it was?” he asked me.

“When?  I’m not too sure, but I think it happened just before this pain started.”

“Yes, we know that.  But what times was it?  Try to remember,” he said again, his voice as patient as a drip of water wearing away a stone.

“I need some painkiller.  I haven’t had anything since before I got on the airplane.  Can I have a shot?”

“Yes, Richard, the nurse is preparing one now.  Try to remember when the wreck happened.”

The voice was kind, but it wanted an answer.  I felt myself relax and start to trust this Scottish doctor.  What choice did I have?  I followed his question back through a nearly endless tunnel of time to the previous morning.

*       

 

Filled with peace in the dawning, I leaned through the curve and into a straight stretch.  There were phantoms in the first light:  cattle standing scattered across the fields, and palm trees motionless in the dying breeze.  The world was a silhouette, and an early morning softness hung over the land.  I felt young and strong and free.  The motorcycle, moaning its sweet song beneath me, was carrying me away from the daily hassles of running a scuba business in the Islands.  I was on my way to Samana’ to go diving with the whales.  It was a long-time dream finally coming true.

From out of nowhere, a broken-down, mud-splattered pickup turned onto the highway in front of me.  Swerving, I almost made it by, but caught just enough bumper with my leg to send me crashing into the ditch beside the road.  It wasn’t a bad place to land.  There were no rocks, trees, or barbed-wire to stop my roll; just soft, rotting grass and mud.  I thought I’d lucked out until I felt the pain and saw my right foot wasn’t hooked to the end of my leg where it should have been.  It looked like it had been chopped off with an ax and left hanging by just a bit of skin and meat.  Then I knew I was fucked.

Immediately, I thought of getting the foot reattached (very rational and sensible).  Then the gore and horror of it struck home.  Arghhh!  That’s my leg, my foot, and me who could become a cripple.  The life I’d been living was finished – maybe forever.

A wound more dangerous than my butchered ankle opened and filled me with fury and desperation.  I was alone in a muddy ditch in some banana republic, and I was afraid.  I could die here.  Screams came welling up out of the dark places:  frantic, mindless surges of savagery.  The darkness didn’t surprise me; I’d been down there before.  But its power was gathering, and this time I was helpless before it.  There was no escape, no turning away.  I waited, and as pain and terror engulfed me, a strange thing happened.  Within, from the heart of the darkness, a light flickered, then spread.  I watched as the light cradled and lifted me to a place of stillness and peace.

Soon, people came from their shacks to help.  They carried me to the side of the road and we waited for the truck that would carry me for hours over rough roads to the nearest hospital.  As we waited, I searched their faces, and I found pain in each of them.  Slowly I realized that my pain was only a prison if I tried to escape it.  When I followed the pain, it became a pathway out of my solitude.  But it’s easy to forget the lessons it’s so hard to learn.  The pain came back to ravage me again, and I hated it and fought against it.

*

“It was about six-thirty yesterday morning,” I told them.  There were several faces up there now.

“Thank you Richard,” said my doctor.  “This is Dr. Gould, my head resident,” he added.  “He’ll be working with me until we get you fixed up.”

“Mr. Freeman, I have a shot for the pain.”

The nurse held up the fetish of my new faith.  Scalpels, bandages, IV bags, and especially needles:  for me, these now were sacred objects. I had sacrificed my will and individuality at the altar of modern medicine.  I was no longer a person, I was a patient.  Willingly, desperately, I accepted the dogma: ‘The doctor knows best.  He is perfect in his knowledge and skill.  No matter what the physical or mental damage, medicine, as practiced by my doctor, will cure me.’  Yes I believed; I needed to.  I had confessed pain, and now the nurse began the rite of absolution.

“Mr. Freeman, would you like the shot in your bum or in your arm?”

“Oh hell, I don’t care.  Just jam it in anywhere.”

 “Turn onto your side, please.”

There was a sweet, delicate prick as the shining steel slid into my butt.  I felt the sacrament washing away my pain.

“There you go.  You should feel better soon,” said the nurse.

The voices were starting to fade in and out.  I rolled onto my back again and looked up at the circle of faces above me.

*

Lying on my back beside the road, surrounded by people, was like lying on a forest floor and seeing the tree trunks soaring up and the branches looming overhead.  It was like that; surrounded by bodies soaring up and faces looming overhead.  Through the haze that lay over those hours and days, the images I saw most clearly were the faces.  Laden with the fruits of their lives, compassion, professional interest, or morbid curiosity, the faces appeared above me.  They talked or just looked, and then they were gone again, leaving me to stare up into the empty sky of aloneness.

*

Dr. Mackay was calling me again.  “Richard, we’re going to look at your leg and see what we can do with it.”

“Doctor?”  He leaned down to hear me better.  I tried to stop the tears and keep a brave face, but couldn’t.  “Doctor, save my foot.  I don’t want to be a cripple.  I don’t care how many operations I have to go through, or how long I’ll be in here, or how much pain it costs me.  If you save my foot, I’ll teach you to scuba dive – for free.”

*               *               *

Outside the granite walls, time was passing and Friday night in Montreal was on the move.  People were having dinner, going to movies, making love.  But here in the cloistered hall, illusions of time and place dissolve into endless cycles of impermanence.  And borne by these winds of change comes the only challenge which endures:  Can we embrace life and delight in our new beginnings, or will we sink down under a load of grief for our losses, still clutching with senseless fingers to what has gone and can never come again?

*

The moment passed and the medical staff settled comfortably into their professional routines.  Only Dr. MacKay still paused, looking down at the unconscious form.  Sadness lingered in eyes that saw through the body and into the life beyond.  He was a doctor who couldn’t separate the patient from the person, and at times he paid a heavy price.

“I think he’s out again,” said Dr. Mackay.  “Jim, are you ready?”

“I just need to wash up,” the head resident replied.

“OK, I have to change and make a call.  Will you get started unwrapping the leg and cleaning the wound?  Is the anesthesiologist here?”

“Yes, we’re all ready to go.  I called Brian, the head resident in Plastics, and he’s coming down too,” said Jim.

Twenty minutes later, the patient was securely wrapped in a blanket of sodium pentothal.  The head resident from Plastic Surgery had arrived, and the two doctors unwrapped and were cleaning the damaged leg.

“Jesus, what a mess,” said Brian, the plastics resident.  “Think we’ll be able to save the foot?”

“I doubt it, but we’ll probably try,” said Jim.

“I know my boss will want to have a go at it,” said Brian.  “It will give him a chance to use the new microsurgery techniques.  Did you hear that he just got invited to give a seminar in New York on the grafting procedure he’s been developing?  How is this guy taking it?  Did you get a chance to talk to him?”

“Yeah, we tried, but he was pretty far gone when he got here.  Kept drifting off.  Seemed pretty torn up about losing his foot though.”

“Lousy pun, Jim.  Hey did you hear about the dirt-poor Mexican kid in California?  Well, he woke up in the hospital and asked the doctor what had happened.  The doctor said ‘Son, you’ve been in a bad motorcycle wreck and I’ve got some good news and some bad news.’  So this poor kid says, ‘Tell me the bad news first, Doc.’  ‘Well the bad news is that I had to amputate both your legs.’  ‘Oh shit,’ cried the kid, ‘what could be good news after that?’  ‘Hey,’ said the doctor, ‘you see that guy in the next bed?  He wants to buy your boots.’”

“Darlene, hand me the forceps please.”

“Here.  You know, you guys are sick.  Doesn’t it seem a little insensitive to you to laugh at misfortune?” she asked.

 “You’re right, Darlene.  It isn’t very professional of you, Brian,” said the orthopedics resident.  “In a more serious vein, I was just reading about the recommended response if someone starts have an epileptic seizure while taking a bath.”     

The anesthesiologist looked up with interest, “Oh, what’s the correct thing to do?”

 “You throw in your dirty laundry and a cup of detergent.”

The joke caught Brian off guard, and he had to stop cleaning bits of mud out of the wound until he could stop laughing.  Then, more relaxed, he went on with his work.  Anger tightened Darlene’s jaw muscles into a knot, and her eyes lost their warmth.  She had been trained to keep personal feelings out of the operating theater, but she couldn’t hold in her thoughts.  Although she spoke politely, there was a cold edge in her tone.

“Are either of you aware of the research on post-operative depression that’s been done at the University of California?”

“Hey, Brian, I think she’s serious,” said Jim.

“Yes, I am, and you should be too,” replied Darlene.  “Using hypnotism, they have discovered that although patients are unaware of it, they do hear what is said during surgery.  And what they hear can affect their recovery.”

Both residents stopped and looked at Darlene.  “Are you really serious?” asked Brian.  Even if they’re under total anesthesia, they can still hear us?”

“According to the research, yes.  The exciting thing is that if we say the right things, it could speed up their recovery.”

In a more somber mood they continued their work, and a few minutes later Dr. MacKay came in with a group of young residents and began examining the wound.  “I don’t like the look of this infection,” he said finally.  “It looks like it has gone deep into the bone.  If we can’t clean it out, we won’t save the foot.  Brian, we’ll have to get your boss to look at it before we decide how to proceed.  We have a chance, but not a very good one I’m afraid.  For now, all we can do is try to control the infection with antibiotics and cut away any bone and soft tissue that dies.  If he’d gotten here sooner, we’d have a better chance of saving it.  I guess they did the best they could in the Dominican Republic, but they sure didn’t help him much.  We’ll fix the foot into place with a Hoffman apparatus.  We need to set stainless steel screws into the tibia just below the knee and also into the bones of the foot.  Then we’ll link up the screws with a series of rods.  That will keep the foot in its proper position and still allow us to work on the wound and change the dressing regularly.”

Having explained the procedure to the new residents, he began cutting away dead flesh and bone and then drilled holes into the bones of the foot and the leg.  They inserted the screws and aligned the foot into its correct position.

Just as they were finishing the intercom buzzed into life.  “Dr. MacKay.  Emergency.  Three multiple fractures have just been admitted.  Please respond as soon as possible.  Thank you.”

Dr. MacKay smiled over at Jim.  “Are you pretty beat, or can you stay with it a while longer?” he asked.

“Tired?  Why would I be tired?” replied Jim.  “We’ve only been at it for fourteen hours.  Hell, I’m just getting warmed up.  A cup of coffee and we’re on our way.”

*               *              *

Drifting into consciousness, I was greeted by a new message from my leg.  The fire in the ankle was familiar, but there was also an unbearable throbbing, as if someone were hitting my shin with a ball peen hammer.

 “Whores and sluts!”

 “Pardon me?” said the nurse.

“Holy shit! My leg.”  Fearful of what I’d see, I looked up at my leg which was slung from a system of ropes and pulleys like something dead and unfamiliar.  Only the hammering fire convinced me that this bloated object was mine.  I looked closer and felt my skin crawl.

 “Jesus Christ!  Those screws are going into my fucking leg!  They’ve drilled holes right into my shin bone.  No wonder it feels like somebody’s beating on it.  What the fuck did they do that for?  Those Goddamned doctors are insane.”

“Mr. Freeman?  Mr. Freeman!  Calm down,” said the nurse.

“What? Calm down?  What in hell are you talking about?  Would you be calm if you had this thing screwed into your leg?  I’m just lucky I’m not a Mexican.  They’d probably have just chopped the whole damn leg off and been done with it.”

“Mr. Freeman, I realize you are in pain, but that’s a rotten thing to say.  What makes you say something like that?  We treat all our patients the same here.”  I could see she was angry, and since I needed her to bring me a shot for pain, I tried to be nice.

 “Yes, you’re right.  I’m sorry.  It’s just the pain.  I don’t know why I said it.  Sorry.  Uh, can I have something for the pain?  And do you know how long all these tubes will be stuck in me?”

“The catheter will probably come out in a couple of days and the drainage tubes about a week later.  But I think you should get used to the IV lines with the antibiotics.  Your tibia is infected, and it may take a while to clear it up.  I’ll be right back with something for the pain.”

She had just returned and given me the shot when Dr. MacKay and another man came in.  “Hi Richard, how are you doing?” he said.  “This is Dr. Stark, the head of Plastics.  He examined your leg when you were in the operating room the day after you arrived.”

 “Uh how long have I been here?”

 “A week today,” said Dr. MacKay.

“Oh, I sort of thought I’d just gotten here yesterday.”

“No, we’ve had you down in surgery five times.  We can’t seem to control the infection and the severed ends of the bone are dying, so we have to keep scraping them clean.”

“Oh.  Am I going to lose it?”

“No, not necessarily.  The foot is still getting blood and you have some feeling in the bottom of it.  I’m sorry, but we had to remove the ankle joint.  The bone was too damaged and it died.”

“But will it still work almost as well as it did?” I asked.  “I won’t walk with a limp will I?”

“Richard, it will never be like it was.  There will be no ankle movement, and the best you can hope for is to walk without a cane.”

“What will it look like?”  I asked.

Dr. Stark answered, “Oh, no problem there.  It will look quite acceptable – a little enlarged perhaps, but not too bad.”

“What do you have to do?”

“Once we get the infection completely cleared up, we will use microsurgery to remove a large muscle from the back and graft it into the ankle area.  Then when that has healed, we will take the fibula, the small bone from the left leg, and graft it in place between the foot and the remains of the tibia in the right leg.  There will be the two major surgeries, and several smaller ones.”

“What are the chances of success?”

“I predict an 80% probability that we will save the foot,” said Dr. Stark.

“OK, let’s do it.”  I could see hesitation in Dr. MacKay’s face, but I looked away.  I had to believe this would work.  I’d only seen one amputee in my life.  When I was a kid, I’d seen a man on the beach take off his leg and hop into the water.  The sight of his severed stump had shocked me and I still carried that heavy memory around with me.  In my mind there was a cesspool of murky thoughts and images. I’d never met an amputee, so I didn’t know that losing a limb is a misfortune, not an unbearable tragedy.  I wouldn’t accept the possibility of amputation, but sometimes in unguarded moments I’d hear a secret, sneering voice hiss, “Cripple.”

I convinced myself that these doctors could make me whole again.  I’d been the sexy scuba instructor working at a fancy resort hotel.  I’d been skillful at turning on young tourist women and getting laid whenever I wanted.  My body had always been important and I was proud of my shape and physical abilities.  I couldn’t stand to think of myself without a foot.

 “Yes, anything, let’s go for it.  How long before I’ll be healed?”

Dr. MacKay answered me.  “If everything goes well, you will be here about three months.  Then you’ll have to use crutches and a leg brace for perhaps two years.  After that, you’ll need a cane for an indefinite period of time.  Richard, if we remove the leg now, you would be up and walking without a cane inside six months.  There would be less pain and you could be more active.”

“Forget it!  No, no way!  As long as there’s a chance, I want to try.”

“That’s the stuff,” said Dr. Stark.  “These are new and exciting techniques with great potential.  It will be difficult, but if we succeed...well, just think of it.”

But I didn’t really understand what he was saying.  The painkiller had taken hold and I was drifting off again.

*               *               *

The doctors stood silently, looking at the unconscious body.  Each of them was lost briefly in his own thoughts.  There was doubt written across the face of Dr. MacKay, but there was no doubt at all in Dr. Stark.  There was only professional excitement in the challenge that lay ahead.  As he looked at the leg beneath him, he was no more aware of the human being it was part of than he had been of the four hundred and fifty bored students in the lecture hall the previous week.  He was a great surgeon with skillful hands, and that was enough for him.

*               *               *

The days drifted by in a haze of pain, drugs, and infection.  My friend, Susan, came to visit as often as she could, and my mother and sisters called regularly from California.  They reached out to me, sharing their love and strength, and knowing I mattered to them helped me feel less lost.  But most of the time I spent with my new roommates.  One of them was crazy.  He kept getting drunk on the vodka his wife smuggled in to him.  Then, with his cigarette lighter, he’d burn through the ropes that held his leg in traction and it would fall and break again.  The doctors got pretty upset when they had to set it for the third time.

Phil was my other roommate.  He was there with a broken ankle.  His laugh could have chased the gloom out of a morgue, and some of his ideas were so exciting they stopped time in its tracks.  I connected with him as soon as they put me in the room, and I knew we’d be friends for life.  We were too.  But while he was focused on healing his ankle, cancer snuck up and took him from behind.  We sure had some good times in that hospital room.  It’s not often you find a friend like that.

 

 “God bless you, my child.”

“What?”          

“I am sent to you by the Lord,” she replied.

I woke up, and saw a strange, dumpy woman standing beside my bed.  She had a Bible in her hand and the gleam of a zealot in her eye.

 “I am Wilber Johnson’s mother,” she said.  “He called from the Dominican Republic to tell me a friend in need was here alone in Montreal.  I came to ease your burden.”

“Oh boy,” I said.

Wilber’s mother had recently found the faith, and it was so powerful that neither she nor the meeting hall could hold it in.  So she had come to the hospital to lay her hands on me and affect a cure through prayer.  That was OK by me.  I needed all the help I could get.  If she could hook my foot back on through prayer, I might find some pretty heavy faith myself.  So I told her to go ahead and pray.  But there was a catch.  Not only did she have to believe, but I had to believe too.  It’s not so hard to believe – after a miracle happens, but beforehand is a different matter.  You can want to believe, and even pretend to yourself that you do believe, but when you get right down to it, you either believe or you don’t.  I didn’t.

“Mrs. Johnson,” I said, “I believe you believe you can heal me.”

“Yes,” she said, “that’s nice, but it’s not good enough for God.  You must testify that you believe the Lord can heal you using my hands as His tools.

“No Ma’am, I’m sorry, I can’t say that.  It isn’t true.”

“Oh my son, just say those blessed words, ‘I believe,’ and you will be healed.  You will throw down your crutches and walk away.”

“I’m really sorry,” I said, but I can’t.”

She decided to try it anyway.  She laid her hands on my leg and started to call on the Lord to step down and hook this poor sinner’s foot back onto his leg.  She was crying and praying and creating a real ruckus there in our room.  I was still deep in pain and pretty far gone on the Demerol they were shooting into me every few hours.  I was, in fact, riding pretty loose in my slippers.  But this was juicy stuff and I was starting to enjoy it.  Phil was having a good time too.  He was a devout atheist, and he was flopping around over there nearly falling out of his bed with laughter.  But he didn’t want to offend Mrs. Johnson, so he kept trying to hide behind his handkerchief at the same time he was wiping the tears from his eyes.  My nurse, on the other hand, was not amused.  This was her hospital, I was her patient, and this holy-roller-faith-healing nonsense was too much for her to handle.  She kept marching up and down on the other side of my bed saying, “Madam, please!  This is not acceptable!  Madam, please stop.  I must insist.”

But Mrs. Johnson didn’t stop.  She kept right on hollering, “Lord, bring down your love!  Touch this man and make him whole.  Use me, Lord, use my hands.  Heal him, Lord, heal him!”

Nothing happened.  My foot didn’t hook itself back on, and I didn’t yank out the tubes and walk out of there.  I was one of the losers ‘of little faith.’

Before long, things got out of hand.  My nurse was getting frantic, and Phil was laughing so hard he started to shake loose the steel pins in his ankle.  Above all, Mrs. Johnson was boiling over with fervor.  She had given up on my foot, and having fetched a tambourine out of her bag, was whanging it against the end of my bed, waving her other hand over her head for glory and belting out the song:  “Jesus, Jesus, Jesus, sweetest name I know... fills my every longing, keeps me singing as I go!”

On the third Jesus, all hell broke loose next to me.  My lunatic neighbor, whacked out on vodka, had burned through his ropes again, and screaming “Praise God, I’m healed,” had leapt out of bed to dance.  He landed on his bad leg, fracturing it for the fourth time, collapsed onto the floor with a howl, and lay there foaming at the mouth like a rabid dog.

A crowd of orderlies, nurses, and other patients had gathered to watch the show, and the head nurse, noticing that activity had ground to a halt out in the corridor, came in to investigate.  She did not like what she discovered.  She politely told Mrs. Johnson to either put away her Bible and tambourine or get out.

A mortal soul can only bear so much of the holy fire.  The passion that had consumed her was now burned down to a glowing bed of coals, so Mrs. Johnson and I edged close together to warm ourselves at the embers and talk while the slow, sleepy afternoon slipped away.

 

The days drifted by, and after about three weeks, they moved me to a private room.  The infection had gotten worse in spite of all the antibiotics, and they were worried that the other patients might get contaminated.  I liked the privacy and the quiet, but it was lonely sometimes.  I got some posters for the walls and started collecting used paperbacks.  Somehow, I knew I’d be there longer than three months.

 

“I dropped my spoon!  I dropped my spoon!  I dropped my spoon!  I dropped my spoon!”

“Nurse!  Nurse!  Nurse!  Nurse!  Nurse!  Nurse!  Nurse!  Nurse!  Nurse!”

 “I’m finished eating now!  I’m finished eating now!  I’m finished eating now!”

“What did you say?  What did you say?  What did you say?”

From the open door across the corridor, the shrill, mindless chanting came beating on my ears hour after hour.  Like shrieks from an asylum, the cries from the four women irritated and frightened me as they scraped across my pain-jangled nerves.  I lay there unable to escape, unable, even, to close my door.  Teeth gritted and fists clenched.  I waited for the sound of footsteps in the corridor.  Then my calls joined the cacophony, “Please close my door!  Please close my door!  Please close my door!”  But no one came to close it.  I felt myself sliding over the slippery edge and started to tremble.  Was I the only one in the whole damn ward to be upset by the cries?  “Christ,” I thought, “if this keeps up, once they get my leg fixed, they’ll have to send me over to the mental ward to work on my brain too.  Why don’t they keep their door shut?”  I couldn’t take it anymore.

 “I dropped my spoon!”

“What did you say?”

“Nurse!  Nurse!  Nurse!”

And then, like a telegraph key sending a message of reprieve, I heard the impatient clicking of heels coming down the corridor.  “What do you want?!”  It was Michelle’s voice.  She was one of my favorite nurses, and hearing her irritation brought me back from the edge.  There was silence from across the corridor.

“Michelle,” I called.

“Hi,” she said, coming into my room.  “What can I do for you?”

“Would you close my door, please?”

“Sure.  The noise getting to you?”

“Yeah.  I can’t take it.  Why don’t you keep their door closed?  How can anybody stand to share a room with them?”

“We can’t close their door.  They can’t pull the call-bell cord if they need us, so we’ve got to be able to hear them,”

“Yeah, I guess so, but it sure makes it hard on the rest of us.  What are they in here for?”

“They’re here to die,” she said.  “There aren’t enough geriatric wards or retirement homes for the elderly, so each ward in every hospital takes its share.”

“There’s no chance they’ll improve?” I asked.

“None.  It’s only with continual treatment that they’re alive at all.”

“Why do it?  Listen to them.  They’re vegetables.  God, I hope I die before I get that way.”  But I wondered.  Once I had thought I’d rather die than be stuck in bed, but now I felt different.  I was nowhere near ready to die.  I wondered if I’d ever be ready, no matter how bad things got.

“I don’t know,” said Michelle.  “I don’t have the answers either, but it makes me wonder sometimes. Medicine is great.  It helps a lot of people who need help. But some doctors force people who don’t want to be here any more to stay alive.  People in pain, people who’ve given up.  There are three failed suicides on the ward right now.  Two of them are guarded to prevent them from trying again.  The third man was partly paralyzed from a stroke and couldn’t live with it, so he jumped out a window.  It was only the third floor though, and the fall didn’t kill him.  The doctors managed to save him, but now he is totally paralyzed. Do you think he wants to be here?  Maybe, but I doubt it.  We are so into controlling everything, we can’t even let people die when they want to. Oh hell, sorry for the sermon, but sometimes it gets to me.  I’ll close your door for you.”

Watching her leave, I thought again, “yum, what a nice ass she has.”

 I wondered if the stories I’d heard about patients and nurses might be true.  Then, in the quiet afternoon, I drifted off to sleep.

 

6:00 AM:

“Hey Richard, sorry to wake you up, but I’ve gotta take some blood.”

“Yeah, that’s OK, Lou.  Try to find a patch of vein with no holes in it, will you?”

Lou was a friend.  He worked for the blood-testing lab in the basement, but sometimes moonlighted on the vampire-run to earn extra cash.  When he had time he’d stay a while and bullshit me about life in the hospital.  He always wore a sad/happy face.  He seemed to know he would get shafted at every turn, but could still see the humor of it.  The extra forty pounds he carried turned him roly-poly and made liking him all the easier.

He jabbed me, sucked out a beaker-full, and then slouched down in a chair for a rest.

“Jees, what a night,” he said.

“What happened?”

“You know those four old ladies across the hall?  I’ve got to get blood from them once a week and they’re my worst customers.  They just don’t like me to stick them.”

“Yeah,” I said,  “I can understand that all right.”

“Sure, nobody likes it, but those women just won’t let me do it.  Usually I take some candy in and bribe them, but I just wasn’t up to it last night.  I figured I’d wait till they were all asleep, you know.”

“What happened?”  I asked.

“Well, I waited until they were all sound asleep.  It was about 2:00 AM this morning, and the whole ward was dreaming.  It’s kind of spooky then, you know.  The lights are turned down low, and all these people lying here close to death and no one making a sound.  So I crept into their room, quiet as I could, and very softly rubbed Mrs. Benedict’s arm with alcohol.  I thought if I was gentle enough, I’d get her blood and she’d never even know it.  Everything was OK until I just touched her with the tip of the needle.  Then everything went crazy.  It’s like all four of them are wired up together.  They all sat up in bed at the exact same time, hair wild and eyes popping out, and started hollering about dropping their spoons.  It was really weird.  Gave me the shivers.  I never did get any blood, just got the hell out of there.  Sometimes this job is so damn depressing.”

He sat there in the corner looking so down and sad in his comical way that I broke up laughing.  He heaved himself out of the chair with a hurt look and headed for the door.  That just got me laughing harder.  At the door he stopped and grinned at me.

“See you later, Richard, thanks for the blood.”

 

Time dragged on.  This world inside the granite walls was no longer just a place I had come to visit.  It was my home, as well as my prison.  I longed to be flying through the sunrise on my motorcycle or dropping gently down through cool, golden light to hang motionless over a coral reef.  But bound and drugged, I lay trapped in this sterile mausoleum.  I could only remember, and sometimes, alone in the night, I would cry.  Just outside my window, on top of the mountain, there was a cross.  During the day, it stayed there, but at night, alive with light, it would crowd its way into my window and remind me of my aloneness.  My cynicism faded through those long months, and, at times, I tried to believe.  How sweet it would be to have Jesus as my savior, but I could not escape myself along the path to Calvary

 

The knock on my door woke me.

“Come in,” I called.

“Hi Richard.  How are you feeling?”

“Oh hi, Mrs. Everest.  I’m OK.  C’mon in.  How’s everything in God’s country?”

“Like always, He’s looking after us.”

Mrs. Everest was a volunteer with the Pastoral service, and she dropped into visit once a week.  She was a beautiful woman:  steel grey hair styled toward elegance, tailored suits, silk scarves adding a flash of color.  She was, perhaps, sixty or sixty-five, and she had nine kids, but you’d never know it.  As she walked into the room and sat, it was apparent she was at ease with herself and the world around her.  Her face always looked smooth and young to me.  I guess she must have had wrinkles, but the warmth of her smile melted them away.  She was profoundly Catholic and, perhaps, the most tolerant person I’ve met.  An unusual combination.

“Well, next time you’re talking to Him, maybe you could tell Him that I could use some looking after too.”

“Yes, He heard you.  He’s already on the job.”

“Yeah?  It doesn’t much feel like it.”

She laughed.  “I can see how you might feel that way.  It’s hard to accept sometimes, but He’s here.”

“He in Ireland too?”

“Yes, He is there too.  Richard, if you ask me to explain Ireland, I can’t, because I don’t understand it.  I can’t explain your leg, and I can’t explain about my son either.  But I know God is looking after us.”

A shadow flickered across her eyes, and I could see the hurt there.

“Did he die, Mrs. Everest?”

“Yes, the doctors couldn’t save him.”

“I’m sorry,” I said, feeling helpless before her grief.  But the shadow had passed over and the light shone steadily again.

We sat for a while in easy silence as night fell and the Cross called to us through the window.  “Richard,” she said finally, “I must be going.  My husband and kids will want dinner before long.”  She got up and started for the door.  Her wound was invisible, but I knew the pain was there.

“Mrs. Everest,” I said as she reached the door, “if you could have chosen to lose one of your legs instead of your son, would you have?”

She looked at me and smiled, then turned and went out.

 

Time dragged.  The single thread tying events together raveled, and existence became a repeating pattern woven of pain and boredom.  When the boredom got worse than the pain, I looked forward to the next surgery which brought activity and drugs in its wake.  There was little progress.  The antibiotic poison I received every four hours was having no effect on the infection rooted deep in the bone.  The physical problems were bad, but more troubling and frightening was the mocking voice which whispered “cripple.”  Sometimes my leg seemed to improve for a while and I would ride high on a cloud of optimism.  But always, later tests showed the continuing spread of infection or the beginning of some other problem.  During those months I was emotionally wrung out and often considered giving up.  But I fought on through the long, hot summer, and finally, during the dog days of August, they beat the infection and grafted in the fibula.

*               *               *

The hot, humid August gave way to the cooler days of September.  After months of uncertainty, the infection in the patient’s leg had been eliminated, and the last major operation, the fibula graft, had finally been completed.  The twelve hour surgery left both patient and doctors exhausted.  It appeared to have been successful, but only with time and tests would they be certain.

 

Up on the ward, Dr. MacKay was talking with the head nurse about the patient.  “He’ll be up shortly,” he said.  “Here’s his chart.  He’ll still need antibiotics.  Change the dressing three times daily.  He can have a shot of Demerol every three hours.”

“How’s he doing?” asked the nurse.

“Well, twelve hours in surgery is a long time.  He was white and shaking like a leaf in the wind when he came out, but he’ll be OK,” the doctor replied.  “How is he as a patient?”

The head nurse thought for a minute before she answered.  “He’s not an easy patient because he’s so demanding and he doesn’t fit into the system here.  If everyone were like him, we’d have a problem, but he’s got guts.  He’s been through a lot and he’s still fighting. He needs so much emotional support that some of the nurses find him hard to deal with.  And he gets fresh with some of them, and they don’t like it.”

“Yes,” said Dr. MacKay, “he’s been here a lot longer than we’d expected.  But if everything goes well, he should be gone before too long.”

 

In the corridor, two temporary employees from the transport section were wheeling their load up to the ward.  They were the same students who had been delayed by the ambulance as they crossed Pine Avenue many months before, but they were unaware how closely they were linked to the patient.  This was the last day of their summer jobs, and they were eager to return to their studies. 

“I’ll be glad to get out of here and back to university where I can learn something.  This job is a dead-end.”

“Me too.  I’ve had it with wheeling these bodies around all day and getting lousy pay for it.  If I never see the inside of a hospital again it’ll be soon enough.”

“You got that right.  All these sick people really get to me.  I wonder how they get so messed up?”

“I think most of them are looking for it.  It’s some sort of death wish.  We studied this stuff in Psych. last term.  A lot of these guys are unstable, you know.  I sure can’t see something like this happening to me.”

The two young men were so involved in their conversation that they carelessly smashed the stretcher into the wall while rounding a corner.  A half-conscious scream from the patient, as the jolt of agony burned up his leg, caused them to hurry and finish their last day on the job.

 

When the surgery was finished, before the patient could wake up and ask to see him, Dr. Stark hurried out of the hospital and down toward McGill University.  He was elated by the successful procedure he had just completed and decided to describe it during his opening lecture the following week.  As he crossed Pine Avenue he was struck down by a speeding pickup truck.  Although the accident took place beside the waiting hospital, he died before he could be rushed into Emergency.

*               *               *

The death of Dr. Stark brought with it profound feelings of futility and disorientation.  Next to Dr. MacKay, he had been the most important figure in my life.  I had believed that only his skill as a surgeon could save my foot.  The sense of being at the mercy of random and uncontrollable forces was driven home to me the following week when more tests showed the surgery had been only marginally successful.  The grafted fibula was in place, but the spliced arteries were blocked, and without blood the bone was dying.  This would slow the healing process and it was probable that more surgery would be necessary.  But now, Dr. Stark would be unable to operate.  Also, Dr. MacKay felt the bone might never strengthen enough to support my weight without a brace.  Infection had become a problem again, and my body was reaching the limits of its tolerance for antibiotics.  My hair was falling out, and a ringing had developed in my ears.  I knew there was little hope of saving my foot, but when I thought of the months of pain and of the muscle and bone I had sacrificed in the attempted repair of  my ankle, I couldn’t bring myself to accept an amputation.  Together, Dr. MacKay and I decided to wait a while longer.

 

Early in spring, I had discovered a wild area behind the hospital where it backs up against Mount Royal.  Those days it didn’t rain, and I wasn’t confined to bed following surgery, I would go out for a couple of hours and read or just sit with the trees and the sky.  It seemed to me during those quiet afternoons of spring and summer that I had always been moving and had never sat still long enough to really feel the growth and change, which is the essence of nature.  Finally, I had time to watch the pale green spring buds darken and spread over each tree and bush to shade the entire hillside with summer leaves.  I watched, day by day, as birds returned and hatched their chicks, and as the young chicks grew and began their first hesitant flights. 

A family of groundhogs lived secluded beneath the trees, and, from where I sat in the sun, their movements seemed disconnected and meaningless as they ambled between pools of light and deep shadow.  A rabbit fed in the meadow.  It hopped and hesitated, nibbled, twitched, and hopped again.  It never seemed to plan its journey but always arrived where it was going.  Each thing went its own way and every one was related.  A flock of crows came by now and then.  For a while they’d clutter up the area with their cawing and flapping, and then wheel off over the mountain in a motley, screeching mass.  They seemed intelligent to me, perhaps wise, and when they cackled to each other, I heard black-humored delight in their raucous comments.  They appeared cynical and aloof, but they fit perfectly into themselves and into the world round them.  I sensed they never fell prey to dread by questioning their own existence.

But during that long summer I questioned, and I doubted what I saw.  And then in the Fall, with the death of Dr. Stark and the failure of the surgery, I spiraled down into despair.

Autumn was moving in from the North and dusting the leaves with a filigree of gold.  The vine maple laced the under story with magenta and scarlet, and the ivy that climbed the granite walls wrung moisture from the stone and transformed it into wine.  The miracle of life giving way to life surrounded me, but I was blind to all but the power of death which lurked in the shadows, waiting.

I would die.  Hell, I was already dying in pieces:  a leg here, some back muscle there.  Who could say what would be taken from me next.  I knew that I could never be again what I had been, and the loss of myself felt impossible to bear.  The pending amputation of my leg crushed down on me like a great weight.  Nothing else seemed important.

 

I had a book.  I’d had it for years, and during the winter I’d asked a friend to send it up from the Islands.  It was written in the third century BC by the Chinese Taoist philosopher, Chuang Tzu.  One afternoon as the autumn light was fading into evening, I sat in my wheel chair beneath the trees and for the first time understood what I read:

 

‘All at once Master Yu fell ill.  Master Ssu went to ask how he was.  “Amazing!” said Master Yu.  “The Creator is making me all crookedy like this!  My back sticks up like a hunchback and my vital organs are on top of me.  My chin is hidden in my navel, my shoulders are up above my head, and my pigtail points at the sky.  It must be some dislocation of the yin and yang.”

Yet he seemed calm at heart and unconcerned.  Dragging himself haltingly to the well, he looked at his reflection and said, “My, My!  So the Creator is making me all crookedy like this!”

“Do you resent it?” asked Master Ssu.

“Why no, what would I resent?  If the process continues, perhaps in time he’ll transform my left arm into a rooster.  In that case I’ll keep watch on the night.  Or perhaps in time he’ll transform my right arm into a crossbow pellet and I’ll shoot down an owl for roasting.  Or perhaps in time he’ll transform my buttocks into cartwheels.  Then, with my spirit for a horse, I’ll climb up and go for a ride.  What need will I ever have for a carriage again?

“I received life because the time had come; I will lose it because the order of things passes on.  Be content with this time and dwell in this order and then neither sorrow nor joy can touch you.”’

 

When I opened my eyes again, the world was still as it had been, but I was not.  My vision was altered and I no longer saw myself apart from nature’s cycles of change.  Why hold what will never stay the same?  Losing my foot would be hard, but it was, after all, just a foot.  Alive!  I was alive and aware of living.  No matter what the circumstance:  one leg, no legs, or paralyzed, the wonder of Life would fill me.  Ends and destinations have no meaning because there are no ends, nor true destinations.  We are alive only to live, and life has no favorites; not when pain and fear are as valued as pleasure.

As I turned to wheel myself back within the granite walls, I saw the cross through the changing colors of the trees.  As always, it spoke to me with words I couldn’t understand, but I’d heard the message in a different language.  There is no freedom in control or escape, but only through acceptance.  My dread was gone.  This world was my home:  friends, books and this tiny wilderness.  I would stay until it was time to leave, and then I would go.  I would go with my leg or I would leave it behind.  Trapped in my chair, I laughed at the gray granite walls and wheeled myself inside.

*

Out of the rank winter sky came iron bars of freezing rain.  Hunched against the cold, I knew the ice would melt in time.  On the shoulder of Mount Royal, beneath the cross, the Royal Victoria Hospital waited.  Its granite walls were heavy and imposing and they protected the world within from the falling wet outside.  Below the hospital, McGill University was doling out education to its students with a three-credit ladle.

Walking along Pine Avenue, I stopped to look South.  Far away, within the clouds, I saw palm trees standing motionless in the dying breeze and golden light spilling over brilliant coral reefs.  I knew that world was still there beneath the sun, but my life, for now, was here, so I turned and hurried into the lecture hall.

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