It’s been a while since I have shared a submission from the Relating to Humans feature and I so pleased to get things started again by sharing this hauntingly beautiful piece from our Philosophical Issues feature by Philip A Green.
As a quick update, on Wednesday evening we’ll have a much anticipated (certainly by me) Guest Post by author Manizha Sepas (bedvilledadventurer.wordpress.com) and next Friday evening I will post my review of our IABS&R Volume 3 pick HAWSER by author J Hardy Carroll (jhardycarroll.com).
THE GHOSTS OF THE EMERGENCY DEPARTMENT
by Philip A Green
I worked in an ER once with old wooden doors on the rooms. The patterns created by the grains in the wood became a Rorschach test for patients- some saw mountains, some saw animals, some saw nothing at all. But room nine, directly across from the trauma rooms, was different. Something in that door frightened patients.
It was the schizophrenics who first made me aware of it. God, they hated that room when the door was closed. I lost track of how many times the crash of that door being kicked open shook the department. The wall behind it had a fist sized hole from the handle punching into it. It finally reached the point where I had to make a rule, no psych patients in room nine.
I blew it off for years as a strange quirk until one morning, about three am, when I was interviewing a patient. In a sleep deprived stupor I sat on the stool next to the room nine bed, the gurney with the patient on it between the door and myself. The door was closed to give us some privacy. I was talking to the patient when the hair on the back of my neck began to rise.
There were faces in the door watching me. They wavered back and forth between a pattern in the wood and the Lost staring me down. I sat afraid, frozen in place, unable to understand what they could want from me. Finally, my patient on the gurney before me gave an awkward cough, and asked if I was ok.
That was a long time ago. I’ve moved on since then. Other ER’s, other towns, other stories. I never told anyone at work that I too, could see the faces. I’ve often wondered if a few of my nurses saw them as well. More than once during a trauma I’d catch a nurse staring off at the door on room nine across from us. The nurse and I would make eye contact, both waiting for the other to acknowledge the impossible. In the end, we never spoke of it, some things in the ER best being left alone.
The roughest part of what I do is getting out of bed each day, knowing an onslaught of suffering is barreling towards me. As I wake, so too are my patients. Perhaps we all drink coffee, sitting at our own breakfast table, chatting with our families about the day ahead.
I can’t help but think if only there were some clue, some way for me to warn them. Today is the day we will meet in the ER. Do not glance down at your phone on the way to work. Stay off Division Street. Wait, just one extra second, that’s all, just one second, before you step into the crosswalk in front of the school.
I imagine myself a ghost. Begging, pleading, screaming at them to stay home. Yet as a ghost, no one can hear me. My words have no meaning, my warnings no heed, my panic no justification. Nothing has happened yet. Today is starting out like every other day has started out, and those days were fine.
So instead we all get up, we go to work, and the day begins. I arrive at the ER, knowing my warnings have been unheeded. All I can do is prepare.
I walk through the department at the start of my shift. Airway equipment, check. Central lines, check. IV equipment, check. IV fluids, check. Room by room, item by item, I mentally touch and confirm each tool. As I see each item I make a quick practice run in my mind, so that when I need it I don’t have to think or feel. I can become pure action and resuscitation when need be.
Step by step I approach readiness, while somewhere, step by step, someone else approaches disaster. Like two planets whose gravitational fields pull them together, we begin on a collision course, gathering speed and momentum, neither of us yet aware of the other. I know a crash is coming but not who or what or where. My day is 10 hours of bracing for impact.
The buzzer on the radio squawks out through the department that a car has hit a pedestrian. The victim is unconscious on scene, rigs 7 and 12 are responding, and I know our planets are about to collide.
A hush falls over the ER as we listen to the call. They are on scene now, it’s bad. The victim is a child. She is critically injured. The car was speeding through a school zone. The quiet ding of a cell phone text has once again changed the course of the universe.
The medic phone rings and through the chaos and the static of the call there is only one thing I hear- the shakiness of the medic’s voice. ETA two minutes, he says, extensive facial trauma, chest trauma, maybe a collapsed lung. IV established, patient being bagged, not intubated.
My job now is to drain the department of all emotion. I become a human black hole. We cannot afford to feel. A child is dying. Feeling is for later. Now, we must focus. We must move. But we must not feel, or we will lose focus and fail.
My voice is calm, business like. As if we are getting a shipment of broken computer parts that require nothing more than reassembly in our shop. Part A will attach to Part B will attach to Part C. Nothing more.
I sound confident and ready, even to my own ears. It’s so convincing I almost believe it. Yet inside I feel it. The sheer terror. There’s no other word. The faces in the door of room nine show up in force for the show. They stare out at us, watching, observing, grading us. I try to ignore them as I prepare myself to once again bear witness to the horror of life tearing apart before me.
I take in a deep breath and push it down. Somehow I find a little space left inside to cram some more suffering. I shove one more round of fear into it, knowing at some point it’s going to break, but hopefully not today, not now.
We scramble to get the trauma room ready. There is motion everywhere. People run. Voices shout back and forth. Tubes are prepared, drugs are drawn up, machines are wheeled about through the department. Bright yellow gowns and blue gloves are handed out like bullets and helmets before a battle.
Everyone knows their role. The techs prepare the monitors and gurney. The nurses draw up meds one by one, laying the drug filled syringes out on the counter in a row, ready for whatever the enemy throws at us. Pastoral services arrive with a Bible. I stand off to the side, my head racing through protocols, doses, tube sizes, and back up plans. There is an excited buzz in the air as we prepare. Then it happens. We achieve readiness.
A silence settles over the room like a lens focusing us into existence. Nothing moves. Each of us alive and vivid and real and anxious and excited and terrified at what’s coming. The colors of the room seem brighter, my friendships with the nurses feel stronger, my mind feels sharper as I breathe air that suddenly feels cleaner. I can feel my heart in my chest, my hands, my skin, every part of me.
The medics come crashing through the door, CPR in progress, and once again motion returns. As they roll into the trauma room time slows. I focus all of my being onto the child sprawled on the stretcher before me. She is twisted and broken like a flower that has been stomped part way down into the soil. I know this battle has been lost before I even touch my stethoscope to her blood-covered chest.
The next several minutes are holy and private and terrible. And they shall remain that way forever. That is the one small power that I do have. Suffice it to say there is another face that stares out from the door in room nine, watching, waiting, perhaps remembering.
Weeks later, months later, years later, her face comes to me. I will be camping alone in the desert, as far from another human being as I can get. The door of room nine will rise in my mind, and I can feel the faces out here with me.
The desert, the stars, the heat, the desolation, the emptiness are not enough to keep them away. They follow me everywhere. That womb of stuffed down fear and horror inside me has to give birth eventually somewhere in my life.
I stare into my small campfire, the smoke twisting like ghosts rising to the night above. I wonder. Do the stars know? Does God know? Does the dirt know? What is this place, this life, this brief flash of light before we fall back into the darkness again from which we arose?
I watch the fire dance and the smoke rise for hours. The faces sit with me. I can feel it. They too wonder at it all. Finally, my fire burns out, the smoke stops, and the sun rises. In two days I have to go back to work. But now I understand.
The faces will always be with me.
Waiting. Watching. Making sure that I’m never alone when the next trauma comes.