Chapter Two
Casey
He’s, to be clear, a difficult patient. He treats the call button like a direct line to management.
On the first night he uses it to ask whether the coffee they bring him is the same coffee the doctors drink, and when I tell him no, the doctors’ coffee is worse, he seems genuinely pleased to have caught the system in something.
“You’re going to wear that button out,” I tell him, restarting the IV pump he has silenced by unplugging it, which patients aren’t supposed to be able to figure out.
“And then when you actually need something, no one will come, and you’ll die alone in a private room with excellent water pressure. Is that the plan?”
“I need to make a call and no one will bring me my phone.”
“You’ve made nine calls this morning. I counted. The unit clerk counted. Your assistant has probably counted.” I note his vitals on the flowsheet, all of them stubbornly, annoyingly stable.
“They were short calls.”
“They weren’t short calls. One of them lasted long enough that I intubated a patient two doors down, came back, and you were still explaining something about a term sheet.
” I get the pump beeping its indignant beep again and lock the cover so he can’t reach the plug.
“Rest is part of the treatment. I know that offends you. Rest offends you. I can see it offending you right now.”
I set the incentive spirometer on his tray where he can reach it. “And you’re going to use this every hour you’re awake, because shallow breathing with cracked ribs is how you earn pneumonia on top of everything else.”
He almost laughs, then thinks better of it, because laughing pulls the ribs. “You think you have me figured out.”
“I have you medicated and monitored. Figured out is above my pay grade.” I check his dressing, which is healing cleanly, and note it in the chart. “Stop unplugging the pump.”
Sterling can’t work, leave, or manage the room for once in his life, and by the second day, his attitude shifts.
The arrogance stays put. Apparently, it’s load-bearing.
Underneath it though, is a man bored down to the bone, in more pain than he’ll admit.
Boredom and pain are great equalizers. By the second night, he has read every pamphlet in the room, including the one about advance directives, which he critiques for me at length.
The formatting, he says, is hostile. He’s not wrong.
What surprises me is that he asks about me.
He’s not smooth about it, which is the only reason I answer.
A smooth man asking a nurse personal questions is a man running a play.
Sterling asks because he has decided the fastest route through a long, boring night is to learn something real, and he cares more about the answer than sounding charming.
“Where did you train?” On the second night he asks it while I change his linens around him, since he refuses to sit in the chair and I refuse to leave him in a bed I can’t straighten.
“Charlotte. Community college for the prereqs, then the university for the degree. It took me longer than it takes people whose parents pay for it, if that’s the follow-up.”
“It wasn’t.” He considers that. “How long have you done this?”
“Six years in the ED. Two on a med-surg floor before that, which taught me I’d rather be busy than bored.”
“You’d rather be busy than bored,” he repeats. The strange part is that the next night he uses it.
“Busy or bored tonight?” he asks when I come in to check his vitals.
“Busy. Two MVAs and a guy who tried to open a beer bottle with his teeth.”
“Did it work?”
“He’s missing part of a molar and all of his dignity. So, no.” I hang the new IV bag and check the drip rate. “You’re asking about my night like we’re friends.”
“We’re not friends. You won’t give me your number. I’m making conversation with the only person in this building who doesn’t talk to me like I’m dying.”
I chuckle. “You’re not dying. You have cracked ribs.”
“Exactly. Everyone else treats me like I’m made of glass. You treat me like I’m being difficult.”
I give him a look that is in full agreement. “You are being difficult.”
He grins. “See? That’s why I ask about your night.”
He asks other things, always bluntly. I’ve heard he’s charming from the other nurses, but he doesn’t show that side to me. “Do you like what you do, or do you just tolerate it?”
“I like it.”
He sounds skeptical. “You answered that fast.”
“Because it’s true. I’m good at it, I’m useful, and the hours mean I never have to go to brunch. What’s not to like?”
“What do you have against brunch?”
I mock shudder. “It’s wishy washy. Is it lunch? Is it breakfast?” I shake my head. “It needs to make up its mind.”
He laughs before asking, “What’s the worst part?”
“The paperwork.”
He looks at me. “You’re lying.”
He’s right. The worst part is the families in the waiting room and how their faces change when you walk toward them instead of past them. I don’t tell him that. He catches the lie and leaves it alone, which earns him more credit than I want to give him.
“Where did you grow up?” he asks the next night, while I check his dressing.
“Small town you’ve never heard of.”
“Try me.”
“Hickory.”
“I’ve heard of Hickory.”
I snort. “Congratulations. Your geography prize is in the mail.”
“Family nearby?”
“No.” I peel back the gauze and check the edges. The lac is healing nicely. “No family nearby.”
He doesn’t ask the follow-up. Most people ask the follow-up. Why not? or Where are they? or the gentle, probing Are you close? Sterling lets the dead end be a dead end. By the end of the second night, he has figured out that questions will only get him what I choose to give.
He asks nothing that gives himself away.
I learn that he has an assistant, that someone named Martin Yoon, whom he just calls Yoon, handles things I gather are legal, and that there’s no one on the emergency contact line except a name and a number he recites without inflection when admitting asks.
He doesn’t have visitors. He spends three days in 412 without a single visitor.
The empty doorway says more than he does.
Early on the third morning, near the end of my shift, I find him awake in the dark.
Not reading, not on his phone. Just sitting up, looking at the window where the parking lot lights make patterns on the glass.
He doesn’t hear me at first, and I see him without the performance, no wit, no demands, and no control.
Just a man alone in a hospital room at 5 a.m. with cracked ribs and no one coming.
Then he hears me. The mask goes back on so fast I almost miss the transition. “The sunrise here is terrible. I’ve seen better in airport lounges.”
I don’t mention what I saw. He doesn’t either.
I don’t ask about it. He deflects everything personal without effort, a skill he has clearly spent years on, and I let him, because his personal life isn’t on my assignment either.
Then, on the third night, the overhead pages a code on the fourth floor, and I’m gone before I finish the sentence I was saying to him.
The room I run to belongs to a woman named Delphine who’s eighty-one, a repeat visitor I’ve treated on and off for a week.
She has a bad heart, a good attitude, and a habit of calling me sugar in a way that should be annoying but isn’t.
We work her for a long time. We’re good at what we do, but it’s not enough, since sometimes it simply isn’t, and the attending calls it at 3:22 in the morning.
I write down the time, because writing down the time is a task with a beginning and an end, and I need one of those right now.
I help with what comes after. There’s always an after. It has steps, and I follow them. By the time the equipment is shut down, Delphine is covered, and her daughter is on her way, forty minutes have passed where I haven’t thought about 412 once.
I go back because it’s my assignment. That’s the only reason. His pump is due for a check. I ignore the little bump in my pulse at seeing him when I enter the room.
Sterling is sitting up. He takes one look at me and sets down the tablet someone finally brought him. “Sit down.”
I open my mouth to tell him the pump is fine, that I’m fine, that I have four other patients and a routine to keep, and none of it comes out, because he’s not asking whether I’m okay.
If he asked whether I was okay, I’d say yes on reflex and keep moving.
He’s not giving me the reflex. He’s telling me to sit down, in the chair by his bed, the chair he has refused to sit in for three days, and I’m so tired all of a sudden that I do.
I sit in the visitor chair in my own patient’s room.
I concentrate on the dark seam running across the vinyl seat, and Sterling waits without asking me to explain why.
He doesn’t tell me I did everything I could, which is the sentence people reach for when they want your grief to be smaller so it’s easier to be near. After a minute, he starts talking.
He tells me about a board meeting.
It’s a terrible story, and I suspect that’s deliberate.
The meeting involved a vote on a real estate position.
Halloran wanted a different structure, which led to ninety minutes of tax implications before they arrived at the place they could have started.
He narrates it in full. He does the tangents.
He explains what a term sheet is, unprompted, because I mentioned one earlier and he must have remembered that too.
He’s filling the room with conversation that asks nothing of me.
Most people reach for reassurance after a death, then wait for you to perform being reassured.
Sterling explains a tax structure I’ll never need to understand, and for four minutes I get to sit in an ugly vinyl chair without taking care of anyone.
I didn’t expect kindness from Sterling Hollingsford.
When I stand up, the four minutes have done what four minutes can do, which isn’t much but is enough to keep me functioning. I straighten my scrubs, check the pump, and my voice comes out evenly. “Your pump is fine. You’ve been leaving it alone. I’m almost proud.”
“Casey.” He says my name without heat. He’s as gentle as I’ve ever heard, which makes my eyes sting with tears. “I’m sorry about your patient.”
I don’t ask how he knew it was a patient, or how it ended. He’s good at extracting information from a room, and from me, apparently. “Thank you.” I mean it, and I leave before it can become a conversation, since a conversation is just going to make me cry.
They discharge him the next morning.
I’m there when the paperwork clears before my shift ends. I go over his discharge instructions, with the pneumonia warning and the prescription he’s going to fill this time because I’ve frightened him appropriately about it.
At the end of it, folder in his lap, dressed in ostensibly casual designer clothes an assistant brought because the suit didn’t survive, he looks up at me. “Give me your number.”
There it is. I almost respected the three days it took him to ask.
“I’m not going to do that.” I say it kindly, since I’m not a cruel person, and part of me is sorry, which is its own kind of warning.
“I have a rule about it. Patients are patients. It keeps things separate, which is the only reason I’ve lasted this long. ”
He arches a brow. “I’m being discharged. In four minutes I won’t be your patient.”
“In four minutes, you’ll be a man who was my patient, which is close enough that the rule still holds.
” I set the prescription and the follow-up slip on the tray table and slide them toward him.
“Fill this. See ortho in a week. Keep using the spirometer at home until breathing deeply stops feeling like a bad idea. Also, try to go a full month without rolling a vehicle. You seem like you could use the challenge.”
He rolls his eyes but is smiling as he takes the papers, and he doesn’t push.
Everything about Sterling suggests he’s accustomed to turning no into a negotiation, but he lets mine stand.
He watches me a moment longer, and then he says, “Thank you.” He means it as much as I did yesterday, and I go find my next patient before the moment can turn into a situation I’d have to have a rule about.
My shift ends at seven, but I get out at eight-thirty, because that’s just how it goes sometimes.
The sky is doing the gray thing it does before it decides whether to be morning.
The parking garage is half-empty, and my Corolla is on the third level employee-parking floor, where I left it.
There’s a white envelope tucked under the wiper on the driver’s side.
I stand there for a second before I take it.
No one leaves things on my car. My car isn’t a car that gets things left on it.
I’m not the kind of woman who gets notes tucked under a windshield wiper.
The only exception is the parking ticket I got last year when I was called in for a massive MVA and left my car parked illegally.
It required a trip to court, and two patients whose lives I saved that night insisted on coming with me to testify, but that ticket was dismissed.
This isn’t a parking ticket.
The envelope has my name on the front in handwriting I’ve never seen, with black ink. The letters are neatly formed if a little impatient, like the person writing them had somewhere to be. Inside, there’s a single card. On it, a phone number, and under the number, one line:
You said you don’t give out your number. You didn’t say anything about taking one.—S