Saturday, March 21, 2009


When the doctor called on Tuesday, it was to tell Samuel’s wife that the tests had come back positive. By Wednesday morning, she was in the hospital, ready to have the operation. Samuel went with her.

Before they took her back, Samuel’s wife had to sign papers. A woman in a blazer and silk blouse whose name and position Samuel didn’t quite catch made sure she read the right parts and signed in the right places. Then she put wristbands on her arm and smiled and said she needed to go back now, it was time, the schedule was very tight today, which was how it went sometimes.

Samuel studied the red rimming his wife’s eyes, the quivering at the corner of her mouth. "Don’t worry," he said. "I’m here. I’m going to take care of you."

While the surgeons opened up his wife and took out the things that shouldn’t have been there, Samuel sat in the waiting room. The waiting room had gray carpet and gray walls and stiff-backed chairs with gray upholstery. Almost all of the chairs were filled with people, some softly sniffling, some staring stone-faced off into space, some watching the TV mounted on the wall. It was tuned to a 24-hour cable news channel that kept cycling through the same stories. An explosion in the Middle East. Trouble with the economy. A man talking about Healthcare Reform. The news people must have liked that one, because they returned to it more often than the others.

"Healthcare Reform," the man said in a rich, resonant voice, "is about more than abstractions." He said the two words so that you could hear the capitals. "It has a face and a name. It is the single mother from Dayton who has lost her job and, with it, her insurance coverage. It is the retiree in Tarpon Springs struggling to buy medication on a fixed income. It is the entrepreneur in Philadelphia who can barely afford group rates for his growing business." The man looked directly into the cameras. "Healthcare Reform is too important to be anything else and that is why it must change."

Applause erupted, loud and extended. Then the TV blipped over to a rubble-choked street and a wailing throng of people.

Samuel wished he’d brought a book.

Eventually, a doctor came and got him. He told him a few things about the surgery, all the while scribbling on papers he kept clipped to a chart. Samuel asked him a number of questions. Still scribbling, the doctor murmured answers that didn’t quite address any of them, assured him that his wife would be fine and marched back towards the surgical suite.

Samuel had his wife’s room number, but when he went to it, a nursing assistant told him he needed to wait while they finished filling a few things out, the floor had a lobby, he could go there and watch TV if he liked. Samuel decided to walk the halls. Everywhere he saw men and women in white uniforms or white coats. They bent over binders stuffed with forms or stared into the screens of computers that lined the corridors, one for every three or four rooms. He circled the floor six times before the nursing assistant let him see his wife.

His wife did not look well. Her face had gone a peculiar shade of gray. A skein of tubes fed into her arm. When she tried to speak, only a cracked wheeze came out.

Samuel sat on the edge of the bed and squeezed her hand. "Don’t worry," he said. "I’m here. I’m going to take care of you."

They gave Samuel’s wife a button to push when it hurt. She pushed it a lot that night. She pushed it a lot the next day. She pushed it a lot the night after that. And the following day, the button stopped working.

"Sam," she croaked, "could you talk to someone?" A wince shuddered down her neck. "Please?"

Samuel picked up the phone next to the bed and dialed the nurse. It rang five times, clicked and went dead. He tried it again. And again.

His wife began to groan.

Samuel went out into the hall where he found the nursing assistant assigned to his wife’s room. She was alternately tapping on a computer and thumbing through the horoscope in that day’s paper.

"What do you need, baby?" she said.

He told her that his wife’s button had stopped working.

"You need to talk to the nurse, sugar."

He told her that he’d tried.

"Not my job, honey. Those are the rules. They don’t let me touch meds, certainly not nar-cot-ics." She drew out each syllable as if it were its own word.

Samuel wanted to ask exactly how then he should go about getting the nurse, but the nursing assistant had already gone back to the computer. He started checking each and every room, easing open closed doors and muttering apologies when irritable family members glared at him. In the eighth room, he found her. She had a length of blue rubber tied tight around the skinny right arm of an old man.

"Excuse me," Samuel said.

"I’m with a patient," the nurse said. To the old man, she added, "Mr. Turek, are you sure you’ve had chemo? It’s not in your chart."

The old man nodded. "Eight cycles of it," he piped. "Lymphoma."

"It’s just that my wife, she’s in room 312 --" Samuel began.

"I. Am. With. A. Patient," the nurse said. "Well, it would explain these veins are like threads. Ugh." She slapped at the back of his hand.

"There’s nothing left in that arm." The old man sounded nervous. "The chemo burnt it out. You have to use the other one."

"Her button has stopped working," Samuel explained.

The nurse rolled her head up to the ceiling. "Go to Mercy, they said. It’s got a great reputation, they said. But I didn’t ask about the patient load -- of course. I didn’t ask about all the documentation -- of course."

Samuel stood there.

"I’ll be there when I can," she snapped.

She jabbed a needle into the old man’s arm just below the blue band and began to wiggle it about, hunting for a vein.

Samuel went back to the room and paced a circuit back and forth at the foot of his wife’s bed, waiting.

After a long time, there came a knock. Samuel turned to see a small woman with gray-shot hair framed in the doorway. She was carrying a tray loaded with plates and glasses. She was not the nurse. The disappointment must have showed on Samuel’s face, because she drew up short and looked down at a paper on the tray. "Three-one-two? Full liquids? Tea? Apple juice? Broth? Popsicle?"

"I guess," Samuel huffed.

"Is something wrong?" the woman asked. The nametag pinned to her shirt read Magdalena.

Samuel explained about the button, how his wife needed it to work, but it didn’t, and he couldn’t get anyone to help her. "I’m worried," he said, glancing at his wife. Her breath came in short gasps, and sweat bathed her face. "I’m here. But I can’t take care of her."

"Did you know I’ve worked here for thirty years?" Magdalena said. "Did you know that there was a time when you got treated like more than a number? Like you had a face and a name? Before they told you that you needed a sheet of paper for every single thing? Did you know that?"

Samuel didn’t.

Magdalena looked at his wife. Her brow knotted angrily, and she set the tray down. "Will you wait here?"

Samuel nodded. He watched her march down the hallway toward the nurse’s station. Something in the set of her shoulders made Samuel glad she wasn’t walking towards him. He went back into the room to wait some more.

Soon after, things started to happen.

First, the nurse breezed in, muttering to herself, a rectangular, liquid-filled slab of plastic clasped in her hand. Then as she fiddled with the IV pole, the assistant scampered in with a thermometer and blood-pressure cuff.

"We’re going to get you feeling better soon, sweetie," the assistant cooed, sticking the thermometer under Samuel’s wife’s tongue.

The slab clicked into place. "There," the nurse said. She handed Samuel’s wife the button. "Press as needed. It’ll dispense every ten minutes."

Samuel’s wife pressed it. She sighed. "Thank you."

The nurse grunted and swept out of the room, the assistant on her heels.

Samuel wanted to thank Magdalena. As soon as his wife was breathing steadily through her mouth, he went out into the hall to find her. But she wasn’t anywhere on the floor. Eventually, he sat down on a couch in the lobby. The TV showed him a graph on which a squiggly line sloped downward. Solemn heads in Atlanta, New York and Washington, D.C., discussed credit markets and mortgages and consumer sentiment. Video began to roll, video of the man Samuel had earlier seen discussing Healthcare Reform. The man was saying how he planned to create agencies, institutes and bureaus not only to ensure the proper scope of Healthcare but the proper quantitative measures of Quality, too.

Samuel massaged his temples with thumb and forefinger, feeling an ache building inside his head. He stood, turned off the TV and went to the front desk, where he asked a harried-looking man in wrinkled maroon scrubs for an aspirin.

The man looked up from an inch-thick stack of flimsy, yellow sheets. "Okay. I’ll send the form down to the pharmacy, pending physician approval. Okay. Just let me find it." He hunted among the stacks, coming up with a lime-colored paper. "Okay. Name and room number?"

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