A Tale of Two Patients


“You look familiar,” the woman smiles. “Have we met?” The woman’s husband and adolescent son are standing behind her, and the look on their faces says they recognize me too. Then again, I’d expect them to recognize me. It wasn’t that long ago.

“Can’t recall,” I mutter evasively. “I have one of those faces.”

I studiously ignore the woman and turn my attention to KatyBeth. We’re standing in a concessions line at the parish fair, and I pretend to study the menu board, as if the choice between the funnel cake and the cotton candy were of monumental importance.

“Your daughter is adorable,” she coos, kneeling next to KatyBeth and stroking her hair. “Are you having fun at the fair, sweetheart?”

“Yes, she is,” I tell her shortly, switching KatyBeth’s hand from my left to my right, putting myself between her and the woman. Both KatyBeth and the woman seem bewildered.

She straightens and looks at me quizzically, the smile frozen on her face as she fondles the big rock on the ring finger of her left hand. She is dressed expensively in fashionably ripped jeans and expensive boots, designer handbag dangling from her shoulder. No doubt these are her fashionably casual clothes, carefully chosen for a night among the plebeian masses. She paid good money to look this trashy.

Stay away from my daughter, you blackhearted cunt, my look communicates quite clearly. She recognizes the warning for what it is, and her smile fades as she wonders whether she has committed some faux pas.

“No, I’m sure of it,” she plunges on, “we’ve met before. I never forget a face, but I can’t put my finger on where…”

**********

The cops had brought her in, half-walking, half-dragging her with her hands cuffed behind her back. Her face was angry and inflamed, and long ropes of snot and drool hung from her mouth and nose, puddling on her expensive blouse. She was moaning pitifully.

“Room Three,” I told the cops, pointing to our Quiet Room, the one with the restraint bed and few furnishings. The Quiet Room is used for all sorts of things, but we try to reserve it for our psych patients because it has its own bathroom, and little in the way of things to destroy or use as a weapon.

“Good Lord, what happened to her face?” Favorite Nurse asked. “It looks like someone poured acid on her!”

“Pepper spray,” I answered for the cops, who nodded grimly. I forget that, despite her many years as an ER nurse, there are some things FN still hasn’t seen.

“Just put her on the bed, fellas,” I directed as I fetch a towel from the cabinet. I placed my hand gently on the woman’s back and leaned her forward, holding the towel to her nose.

“Blow,” I told her. “Let’s get your face cleaned up a bit, Ma’am.” Moaning pitifully, she complied, and then tried to wipe her face on the towel. I grasped her shoulder and pulled her back.

“You don’t want to do that, Ma’am,” I told her gently. “Rubbing it just makes it worse.”

“Please get this stuff off of me,” she begged. “I’ll do anything if you just wash it off…”

“Adding water just makes it worse. It reactivates the OC ingredient and it starts irritating all over again. The only thing that works is time.”

“Fuck you, miserable cocksucker!” she screamed, spittle flecking my face. “Get this shit offa me and take these fucking cuffs off NOW!”

“Well,” I observed wryly, checking my watch, “nice lasted for approximately three minutes.”

“What’s your name, Ma’am?” FN asked patiently.

“None of your fucking business, you twat-licking whore!”

“Is that your given name, or just what your friends call you?” I asked innocently.

“Fuck you, dickless! Fucking male nurse, probably fucking queer! I ain’t telling you shit!”

“Actually, the name tag says ‘Critical Care Paramedic’, but I understand your vision may be a little blurry from the OC spray,” I told her tiredly. “So once again Ma’am, can you tell us your name?”

“Fuck you, you miserable impotent little asshole! You’re probably getting a fucking hard on from holding me here like this! Probably the only way you can get a woman, from fucking pepper spraying her and putting her in handcuffs!”

“I’ve had about enough of your language, Ma’am,” the cop told her sternly. “Now you can calm down and cooperate with these people, or it only gets worse from here.”

“Fuck you, needle dick! You had no right to put your fucking hands on me! I was on private property! I was in my fucking home, you miserable cocksucker!”

“911 call for a domestic disturbance,” the cop explained tiredly. “She flipped out and jumped on her husband and both her sons. I got there, all three of them were bruised and scratched up. I tried to talk her down, and she attacked me. Kicked at me several times, so I sprayed her.”

“Fucking liar!” she spat. “You came into my home, and attacked me! I live in a $350,000 home, and I could buy and sell you fuckers ten times over! I’ll have all your fucking jobs! I DEMAND you take these cuffs off me!”

“That ain’t happening,” I answered flatly, rapidly tiring of her bullshit, “unless you calm down. There are two ways to do this: The easy way means you do what we ask and stop abusing the staff and the police officers, and the hard way means we do whatever we feel is medically necessary, even if it means strapping your high-dollar ass down on our low-rent bed, and doing it all by force. Your choice, Princess.”

Her reply is to hork up an oyster and spit at me. What with all the snot and drooling from the pepper spray, it was a sizable loogie that struck me in the chest.

“I guess it’s the Hard Way,” I sighed resignedly as I pulled paper towels from the holder and wiped off her love offering. I turned toward the door to fetch the restraints, only to find Laid Back Male Nurse walking in with them in his arms.

“This is not the way I wanted to begin my shift,” he teased, tossing me the arm restraints. “By the way, you still have some snot wad left on your shirt.”

“Thanks for noticing,” I replied sarcastically, “Want to help me get her restrained?”

“Be glad to,” LBMN agreed. “Let’s get her legs first.”

When we spread-eagled her legs to strap her ankles to the bed, her demeanor instantly changed.


“Please, please don’t tie me down to this bed,”
she sobbed pitifully. “I’ll be good, I promise. I just don’t want that cop in the room. Make him leave and I’ll do whatever you ask.”


“You’re telling us that you’ll cooperate if he leaves the room? I asked dubiously. “Is that all it will take?”


“Are you fucking deaf, motherfucker?” Make him leave the room NOW!”

“That is what is known as alcohol-fueled cognitive dissonance,” LBMN observed wryly as he strapped one ankle to the bed. “She’ll make more sense in a few hours.”

“Both you fuckers are getting off on this!”
she hisses. “Both your cocks are hard as teakwood right now!”

Teakwood?” LBMN wondered mildly.

“It’s an exotic hardwood,” I furnished helpfully, “often used as decking and trim on sailing vessels. Apparently, when Princess isn’t beating up her family and being pepper-sprayed by the cops, she spends a lot of time on yachts.”

“You wouldn’t know a fucking yacht if you were on one, Mr. Party Barge!”
she snarled. “You’re so fucking low class, this is the only way you can get this close to a woman like me!”

Show her how refined you are,” LBMN suggested. “When you fasten the arm restraint, stick out your pinky finger. That’s classy. That way, she’ll know you’re worthy of tying down a drunk of her social standing.”

“Fuck you, Teakwood!”
she snarled in reply. “You couldn’t even buy a woman like me! A thousand wouldn’t even get you a blowjob!”

“I think she means pesos,” I told LBMN, sotto voce. “And the OC residue on her lips would probably smart a bit, anyway.”

“Honey, let the men do their job,” came a plea from the doorway. “Please, I’m begging you. Just calm down.”

I looked over my shoulder to see a man standing there with a torn and bloody shirt, the scratches and bruises still livid on his face. Her husband, apparently. His presence had just the opposite effect of calming her down.

“GET HIM THE FUCK OUTTA MY ROOM!”
she screamed viciously, body arching and straining against the straps. Her face, already fiery red from the pepper spray, turned an ugly purple, the veins standing out on her neck and face.

I quickly turned out the lights and left the room, closing the door behind me. Even through the closed door, her screams echoed through the halls.

“I’ve been married to that cocksucker for ten years, but I’ve been fucking Bobby Vidor for three! You hear that, sweetheart? I’ve been fucking Bobby right under your worthless nose for three fucking years! Somebody call my boyfriend! I want Bobby here NOW! Somebody please call…”

“Sorry you had to hear that,” I apologized. “People say all sorts of horrible things when they’re drunk or high. Mainly they regret it terribly when they’re sober.”

Small consolation, I know. But it’s all I have.

“Yeah, I guess so,” the man sighed. He has the look of a man who has been through this before.

You want us to tend to those scratches on your face?” I asked. “Some of them look pretty nasty.”

“They’ll heal,” he replied absently, and something told me this was the voice of experience. “I’d like you to look at my son, though,” he went on in a choking voice, gesturing to the kid sitting quietly in a chair at the triage desk. “He got hurt in all this, too.”

I pulled up a rolling stool and sit next to the kid, who looked to be about twelve. I lifted his chin and examined the scratch marks on his face, and noted what would soon be a black eye.

“Your Mom do all this to you?” I asked him softly, and he nodded. What’s your name, son?”

“Mitchell,” he answered, almost inaudibly, his eyes red-rimmed from crying.

“Where you hurt, Mitchell?” I asked gently as I wrapped a blood pressure cuff around his arm. His Mom could still be heard screaming from her room.

“My knee, mainly,” he pointed, his lip quivering. “I skinned it on the concrete and it hurts to walk.”

“We’ll get that taken care of,” I assured him as I motioned him to a wheelchair. “Right now, let’s just get you in a room and finish the exam. You shouldn’t have to hear all this going on.”

“It’s okay,” he sighed, ignoring the chair and standing up. “I’m used to it. Which way to my room?”

I silently motioned him down the hall ahead of me, and watched him limp to his room as his drunken, high mother shrieked like a harpy from three doors down.

**********

“…so where have we met?” she pursues, flashing what I’m sure was her most charming smile. Behind her, her husband and son look like they desperately wished to be elsewhere.

Just walk away. Nothing good can come of reminding her of how and where we met. Katy is here, and so is her husband and son. Just let it go.

I remember what LBMN had told me about discharging her the next morning. “Normally, once they sleep it off, they’re embarrassed about the way they behaved,” he had mused. “Most drunks are remorseful, or go on a crying jag. Not this one, though. She was hateful and belligerent right up to the point I signed her out to the deputy.”

You are rotten to the core, lady. Doesn’t matter how rich you are, or how genteel you act in public. Trash is trash, no matter how nicely it’s dressed. You’re just an abusive, narcissistic bitch with no remorse for the torture you put your family through. You can’t even blame it on alcohol or drugs. They just happen to be your chosen medium for showing who you really are.

Finally, by way of an answer, I look down and tousle her son’s hair. “You’re looking good, Mitchell,” I tell him. “Not even limping, and the bruises have all faded. If she beats you again, just remember there are places you can go to get help.”

I meet her gaze and hold it, staring stonily at her. At first her face wears a look of shocked recognition, and then it hardens in defiance.

“Cocksucker!”
she spits at me, wheels around and stomps away, nearly jerking the poor kid down in her anger. Her husband flashes me an apologetic glance and trails obediently after her.

Great move, AD. You probably just earned the kid another beating. And now you’ll have to explain how your daughter heard someone call her Daddy a cocksucker.

**********


I brood for the better part of two hours over that malevolent bitch. Two hours better spent hearing my kid squeal in delight at the view from the top of the Ferris wheel, or watching her pet a pygmy goat at the petting zoo, and instead I spend them only paying half attention to KatyBeth, a child who could charm a smile out of any man’s darkest moods.

Even worse, I know it’s irrational, but I’m powerless to stop thinking about it. Knowing I give her the power to ruin my day, even away from work, makes me hate her all the more.

Why do you subject yourself to this? Every day, all day, you take care of people you’d rather avoid in any other setting. Drug abusers, drunks, whiners, malingerers and people just too damned sorry and irresponsible to care for themselves, and not a damned one of them shows the slightest bit of gratitude. You devote more time and energy to them than you do to yourself. Fuck them. There are better ways to make a living.

I’m leaning on a fence, watching KatyBeth ride around in a little pink jeep on a serpentine track, but my head is in another place. She yells and waves madly whenever the track brings her close to my vantage point, and I dutifully smile and wave back, but in my mind I’m replaying the conversation from two hours ago, wondering if she’ll drive home, smoke a rock and chase it with some vodka, and flip out again and start beating her kids.

And God help me, I find myself sincerely wishing that she’d just do everyone a favor by overdosing. I’m actually hoping she kills herself, and rationalizing in my own mind how that might be a good thing.

I’m so black and seething, so lost in bitterness and self pity, that I scarcely notice the man next to me, other than to nod absently at him as he takes a position on the fence next to me.

“You don’t remember me, do you?” comes the soft voice at my left elbow. I turn and look at the man, and he’s smiling at me, offering his hand.

“Sorry,” I apologize, shaking his hand. “Normally I just suck at names, but I can’t place your face, either.”

“That’s no surprise,” he replies. “I’ve gained thirty-five pounds since you saw me last.” Seeing the quizzical look still on my face, he chuckles and fills in the blanks. “Almost five months ago,” he reminds me. “I came into the ER, drunk and coked out. You took care of me.”

“Oh, now I recognize you! Nice to see you again,” I smile politely, not really meaning it. I don’t remember him, and I don’t really feel like talking, either. I let go of his hand and turn back toward the fence.

“One hundred and thirty-four days,” he muses, resting his forearms on the fence rail next to me. “That’s how long I’ve been sober. Kicked the crack, kicked the meth, haven’t even had a beer. Got my wife back, too.”

“Congratulations.”

“Anyway,” he sighs, straightening from his position on the rail, “didn’t mean to intrude on your family time. I saw you over here with your little girl and figured I’d thank you.”

“Don’t mention it,” I say automatically. “That’s my job.”

“Yeah well, it meant a lot. So thanks.”

“No problem,” I tell him, not even bothering to turn my head. We watch the cars navigate the track for a few minutes more, and my curiosity gets the better of me.

“So tell me,” I ask, turning to face him, “what did I say to you?”

“Well, first you told me that you always got the rectal and oral thermometers confused,” he laughed. “And you waited until I had the thermometer in my mouth to tell me that.”

“I say that to everybody,” I grin. “It’s my standard line. Eases tension.”

“Well, it worked,” he grins back. “I didn’t really want to be there. I was drunk that day, in fact. Scared, really. I didn’t want to admit I couldn’t lick it on my own.”

“That’s right,” I remember. “Your wife brought you in. You told me that she coerced you into rehab, said she’d leave if you didn’t.”

“Yeah, that was me.”

Yeah, I do remember you. You were drunk when you came in, but not so drunk that you weren’t scared. You didn’t put up much of a fight. You wanted help, you were just to proud to ask. And I also remember not wanting to deal with you. I told you that we didn’t do substance abuse rehab, and that you’d be better off going somewhere else. But something told me that if you left, you wouldn’t go anywhere else. So I didn’t try very hard to point you anywhere else, either.

I tell the guy as much, and he just nods. “Took a lot for me to even get in the car,” he agrees. “I had used and drank my marriage into the toilet, and I was about to lose my business. Even then, I thought I could handle it.”

“So what changed your mind?” I ask. “What made you get in the car?”

“Him,” he nods at a little boy in the red fire truck just behind KatyBeth. “I knew I’d die if I lost him. And I knew I wasn’t being much of a father if I kept using.”

The son waves at his daddy as the ride passes near the fence, and Katy waves at me. We both grin and wave back. The boy is the spitting image of his father.

“So what was it I said?” I press. “You still haven’t told me.”

“Wasn’t so much what you said as what you did,” he says seriously. “After my wife left to fetch me some clothes, I was sitting alone in that room, and I…”

You broke down, and I watched you cry on the security camera. And I waited until you were through before I came back into the room.

“…I just lost it. I remember telling you that if God wanted me to live, he’d help me kick it on my own. And the fact that I couldn’t just meant He wanted me to die…”

And I told you that God put me here to help stubborn-assed people like you get the help they needed.

“…and you said that God made you a medic to save dumbasses like me, and who was I to interfere with His plan?”

Yeah, or words to that effect.

“And you kept calling those rehab places, trying to find me an opening. Every time you took me outside to smoke, you’d update me on how things were going.”

“Twenty-one psych rehab and chemical dependency units,” I remember. “I got turned down twenty-one times before I found an opening…”

“The next afternoon when you came back on shift,” he finished. ” I was in the ER for almost 24 hours before you found me a spot. But what you said to me before I left was what stuck.”

“And what was that?”

“You said that the measure of a man’s strength is not how proud he is when things are going right, but how much he’s willing to humble himself when everything has gone wrong. And asking for help when you know you can’t do it alone is a mark of courage, not cowardice.”

“I really don’t remember that,” I confess. “But it sounds like something I might have said. My Daddy used to say pretty much the same thing to me.”

“Well, I remember it,” he assures me, “and I’ve reminded myself a lot of times since. So anyway, thank you. It m
eant a lot.”

No, thank you,” I offer, shaking his hand again. “It’s nice to hear a success story now and then. It came just in time.”

As I drove KatyBeth home from the fair that night, she dozed off not five minutes into the trip. Ipassed the rest of the drive in silence, alone with my thoughts and the drone of the radio for company.

And not once did I question why it is that I do this job.