I pull up
outside the diner with the shitty coffee and good pie and pretty redhead
waitress with the too-short skirt and wry smile and slightly smeared lipstick,
let the engine idle, text my partner. I see him through the window and watch
him wince as he drinks his coffee, and I think briefly about what it is that
possibly possesses him to keep coming to this place. He doesn’t drive, so I
always have to pick him up. I see him take out his phone, look at it, put some
bills on the table, smile at the redhead waitress with the too-short skirt and
wry smile and slightly smeared lipstick, watch him give a two fingered salute
that looks a little military with his stocky frame and buzz-cut head to the
cook working in the back, who returns the salute, and I watch him push the door
open, walk up to my Camaro, open the door, and get in. He gives me the same
little salute he gave the cook and asks me where we’re going tonight. I tell
him-
“Pueblo”, and he says-
“If I’d had known we were going
to be burning the midnight oil, I’d have gotten another coffee to go, while
away the hours on the road.” He tries to talk like he’s a gangster in a Raymond
Chandler novel sometimes, words just hissed out between lips kept almost shut.
His name is Thomas, but he insists I call him Igor. Something about Shelley.
“The coffee here’s shit anyway.
We’ll stop at 7 Eleven”. This is not a story about coffee.
We mostly
work Colorado, particularly the strip of cities between Denver and Pueblo,
though we’ll go as far south as Albuquerque if we’re given a little notice.
Once or twice we’ve been flown elsewhere, Omaha, Tallahassee, someone else got
sick and we needed to fill in before the opportunity vanished. All in all it's
not a bad racket, usually don’t work more than three nights a week, pay is
good, work is easy. Can’t complain. Occupational hazards, of course, but same
as any job. I keep a Beretta in a concealed holster on my hip just to be safe.
Most guys, a gun that big would be dead obvious worn that way, but I’m a big
guy.
It’s a long
drive and the roads are quiet. I speed and we listen to some old jazz song on
the radio. It’s a clear night and Igor looks at the stars and doses off
occasionally, only to be woken when we hit bumps in the old highway. He’s a
light sleeper. I met him when I was working as a cabbie, he ran the dispatch.
Before I was a cabbie, I was a surgeon back in Bosnia, but I made more as an
American cabbie than I did as a Bosnian surgeon. This is not a story about
immigrants in America.
We get into
Pueblo and I look at the clock - it’s 12 am. We were told to show up at one. I
ask Igor if he wants to get something to eat, and we stop at a McDonald’s. Igor
orders a Big Mac and I get a salad. I’m trying to eat better - doctor said my
cholesterol is too high and it might put me at risk for a heart attack when I
get older if I don’t address it now. I finish my salad and tell Igor to sit
tight, I need to go find an ATM. I walk out of the McDonald's and my phone
tells me there is a Wells Fargo just a block down, so I head that way and then
I print out the money and put it in the padded envelope I have tucked into my
brown leather jacket that I bought from All Saints. I go back to the McDonalds
and get Igor because it’s almost one. We get in my car and drive the last few
blocks to the hospital.
I park in a
doctor’s space near the entrance. Igor grabs my duffel bag and a medical cooler
we filled with ice on the way from the trunk, and the two of us walk to the
doors of the emergency wing. They slide open with a slight hiss, and I watch a
brown leaf get blown in. Getting on to Autumn now, I suppose. I notice Igor
isn’t wearing a jacket. We walk up to the reception, and the admitting nurse
looks at us with a slight frown. I don’t recognize her, and I usually am good
at remembering faces. I say-
“Hey, how are you?” And she just
says-
“Surviving.” Then I slide her the
envelope, and she opens it slightly and looks hesitantly up at me.
“Count it if you want, I don’t
mind.” She looks back down at the envelope and then back up at me and says-
“That’s fine, I trust you. Room
237.” I think to myself that this is the hotel room from that old Kubrick film
and smile slightly. This is not a story about postmodern discourse. Igor looks
at me weird.
We get in
an elevator, one of those big elevators you only see in hospitals because they
are designed to accommodate stretchers, and muzac starts playing. It sounds
like a bubblegum pop re-arrangement of “Mac the Knife.” I smile again to
myself. Igor doesn’t seem to get this reference either - he’s always prefered
books to movies and music. I don’t think he even saw Titanic. I love movies, mostly romance movies. My favorite is Casablanca, though I do hold a soft spot
in my heart for Ghost. I’ve always
been a little sentimental. I say-
“I think this is meant to be ‘Mac
the Knife.’”
“Oh.” I start to say-
“You know, the song about... oh
forget it.” The doors open and they rattle slightly as they do so. Down the
hallway a light flickers. I think this is very funny, and Igor seems to get
this joke at least. He has, I think, read his share of bad Stephen King novels.
We walk down the hallway, and Igor’s cowboy boots click on the tile. I wear
sneakers, and they make only a slight squeak. I mutter
“Those boots. You’re going to
bother a patient one of these days.”
“Eh. Occupational hazard.” His
use of this phrase seems funny to me and I can’t put my finger on why. This is
not a story about odd coincidences of language.
We get to
room 237. I hold the door open for Igor, and he walks in. The man in the bed is
Latino, perhaps late 20s, early 30s. His face is heavily lined and he smells
like ammonia. I look at his charts absent mindedly. He’s listed as “John Doe.”
They usually try for John Doe’s, although that’s not always possible. They also
usually try for racial minorities, usually young men without families, usually
those in the hospital as victims, who are also perpetrators of violent crimes,
those who will go unmissed by so-called polite society. This is not a story
about socio-economic inequality.
“What are
we here for tonight?” Igor asks me. I take my phone out of my pocket and look
at it. I tell him-
“Heart.”
“God damn.”
I ask-
“What?”
Then he tells me-
“Novak
Djokovic has a match in Belgrade this morning. I wanted to be home in time to
see it.” I follow this with the obvious question-
“Why didn’t
you just record it?” He sounds dismissive as he says-
“You really
aren’t athletically inclined, are you?”
“How do you
mean?” Then he explains with an explanation that only makes sense to him-
“Results
are going to blow up on Twitter as soon as it's over. I don’t want it spoiled
for me.”
“Then don’t
check Twitter.”
“What the
hell else am I supposed to do on the drive home?” Once again, I suggest the
obvious
“You could
drive for a change.”
“Yeah
yeah.”
This
important topic discussed to a draw, I turn myself to the task at hand. I put
on a surgical gown as Igor opens my bag and takes out a plastic wrapped
syringe, a scalpel, retractors, bandages, sutures, and a few other tools. Then
he unplugs the heart monitor and hands me the syringe. I check the packaging
and glance again at the man’s charts.
“We might
want to go a little lighter on the sedative Igor... this guy isn’t very big. We
don’t want to send him into cardiac arrest... that might defeat the point.”
“Sorry.” He
hands me a different syringe out of the bag and I pass him the original. I
check this one and again his charts and decide it will do. I put on a pair of
surgical gloves and a face mask, then I pull out the man’s IV and carefully
insert the syringe into the hole it leaves behind. I press in on the lever and
watch the greenish liquid drain from the chamber.
Example of an occupational hazard
- I have to manually check his pulse to make sure he’s far enough out, but not
totally dead, because the heart monitor is unplugged. Tricky. But then again,
during the war I had to work under far more odious circumstances. This is not a
story about European ethnic conflict in the 1990s.
“Scalpel.”
“Scalpel.”
I make the
first incision and watch flesh rended from flesh, blood boil up as if called
forth from some dark chasm deep within the earth, the flesh sagging now under
its own weight, taking on a texture that is unique to cut flesh, seeming
somehow fundamentally undermined. I work my way down the chest and then I seem
to hit something I shouldn’t have, as a jet of red issues forth and splashes
into my mask. It is warm against my lips and chin and I taste it slightly,
salty, on my lips, where it soaks through. Igor says
“Fuck,
careful.” And I reply ironically
“Occupational
hazard.”
“Yeah
yeah.” Then I finish my cut and hand the scalpel to Igor.
“Retractors.”
Cutting slicing slipping sliding, flesh and blood and mucus and pus and veins
and arteries and bone. Shliickshlopplopplopschlopshcliick and blood and guts
and blood and blood and blood and it seethes and roils and moves about in
strange waveforms, transistors discombobulating and remade, sliding about
flesh, jelly squid tentacle reminds me of sex and flesh on flesh on flesh on
steel through flesh and blood and rust and veins and cut and cut and cut and
cut and retractors and pulling and popping and collapsing inwards and blood
rushes about trying to get where it's supposed to go but where it's supposed to
go isn’t there anymore so it just kind of rushes about and it pours onto the
floor and all over my surgical gown and the shapes it makes remind me a little
bit of some painter whose name I can’t remember right now, and also of that
movie I watched last weekend, blood looks like it’s not sure now what it’s
supposed to do as I lift and pull and then I hold in my hands a human heart and
it is truly an incredible thing and Igor holds up the cooler and I put it in
the ice and Igor closes the cooler. The man is dead now and he was alive but he
is dead now and will always be dead and with his heart went his life and the
heart shall give life but the heart is not alive and he is just flesh and the
heart is just flesh and I am just flesh and Igor is just flesh and the nurse is
just flesh and the waitress is just flesh and the man is just flesh and he was
just flesh an hour ago and he will be just flesh an hour from now and he is
just flesh now but he is dead now and will be dead an hour from now but was not
dead an hour ago. This is not a story about death.
I take the
sutures and the needle and I close, can’t leave a patient with an open wound,
leaves too much suspicion, and as I’m closing, pulling metal through flesh and
rending back together flesh, Igor finds a mop bucket and wheels it in and
cleans up the blood on the floor. Where the heart has been taken from the flesh
sags inwards and looking at it makes me a little sick - it just looks somehow
wrong. Then Igor hands me a trash bag and I put my surgical gown and mask and
gloves in it, and then he picks up the cooler and my duffell bag and we walk
out of the room, get in the elevator, and walk past the nurse, who waves at us,
and put the cooler and the duffell in the trunk of my car and throw the garbage
bag in a dumpster and drive towards the airport. This is not a story about
proper post-op procedures.
We save
lives doing this job. We take lives doing this job. This is true of many jobs.
This job pays well. However this job also has hours that don’t suit some
people. Once I had a gang banger’s girlfriend pull a 9mm on me when I walked
into his hospital room. That’s why I carry the Beretta. Igor had to slit her
throat with a scalpel. It was a type of scalpel designed for extremely precise
tasks, and the blade was permanently ruined, which was a shame, as I had
ordered the scalpel specially from Malaysia. It took me months to find another
one. The worst part of it was the gang banger’s girlfriend died before anything
could be taken from her. We could have gotten paid double if we had procured, for
instance, a kidney, which can be preserved for far longer than a heart, and
thus could have waited the time necessary to find a suitable paying recipient.
This job is
messy, but so are many jobs. I cannot count how many times I had to clean vomit
from the back seat when I drove a taxi.
Once I had
to go to a children’s ward and take the heart of a boy who can’t have been more
than two years old. He had been hit by a car while he was playing in the
street, and was in a coma from which he may or may not have awoken, if I had
let him keep his heart. He was white and suburban, but it is hard to find a
heart for a two year old, especially one that meets all the peculiar
requirements of organ transplant.
The
advantage, as far as I can tell, of taking the organs of hospital patients,
rather than those otherwise at large in society, is that, by accessing
electronic hospital records, the exact genetic information of individuals all
over the world, as well as their precise geographic location, can be quickly
searched in order to find donors suitable to the wealthy clients paying for our
services. This is not a story about information security.
Much of
this is guesswork on my part - I only see my portion of the supply chain - but
I’m smart enough that I consider my guesswork reasonably reliable. Some might
consider this job morally repugnant, but many of those people are lawyers or
businessmen or politicians or doctors who get paid hundreds of thousands of
dollars a year to save lives, so in my personal opinion, they don’t really have
grounds to criticize my behaviour. Of course, that implies a discussion of the
peculiarities of the capitalist system that delves far too technically into
micro and macro economics for me to concern myself with. Like I said, I like
watching romance movies in my spare time - I may be smart, but I’m not some
kind of intellectual. I leave the politics and ethics of this job to the people
paying me to do it, most of whom, I imagine, are rich enough to leave behind
all but the most basic vestiges of morality. This is not a story about Marxist
theory.
Igor looks tired as we pull into
a parking lot near the airport that is shared by a Hampton Inn (technically a
Hilton production, but a little more mid-market) and a Ruby Tuesdays. I text
the number I’m supposed to text, and after a few minutes an Escalade pulls into
the parking lot. A man gets out. He wears a suit. The shoulders are wide and it
has pinstripes and I think he looks like he fell straight out of the 1980s, his
hair slicked back like Gordon Gecko, but I see the Glock 20 he wears casually
in a shoulder holster (is the grip the same colour as his pocket square? Jesus
Christ these people) and I think better of making a joke. This is not a story
about men’s fashion.
Igor and I get out. I walk over
to the man, and Igor gets the cooler out of the trunk. I say to the main in the
suit-
“Hey.” And he responds-
“Hey.” I look back at the car,
and Igor is closing the trunk. I try to make small talk-
“Looks like it’s going to be a
hot one today.” But he seems uninterested-
“Yup.” Then the man in the suit
checks his watch as Igor walks towards us. Then the man in the suit takes the
cooler. “Thanks.”
He puts the cooler in the
passenger seat of the Escalade and drives away. I look at the Ruby Tuesdays and
think about breakfast, but decide it probably isn’t open yet, the sun just
climbing purple and pink over the horizon. Igor and I get back in the Camaro
and head home to Denver. I drop him off in front of his apartment and I tell
him to enjoy his tennis match - we made it back in time, despite his concerns.
We get another job that night,
but it’s just downtown at Rose Hospital. Igor says he was born at Rose. We pay
the nurse and we go to the room. It’s a black woman, gunshot victim. We take
her liver. Blood goes everywhere and I mess up when I’m closing and the flesh
of the wound is all torn, broken, but this probably won’t matter. We finish
early and drop off the liver with another guy in another suit (this one looks
stolen from Frank Sinatra - what is it with these people?)
Igor and I decide to grab a
coffee - diner of my choice - and on TV is M*A*S*H, the movie, not the TV show.
I watch the doctors pull and twist on the flesh, the blood boiling and surging,
the cutting and snipping and sewing. It doesn’t look quite right, but it’s
better than a lot of these medical shows and movies. This is not a story about
modern medicine as depicted in the media.
This is not a story about
clinical depression.
This is not a story about the
2008 financial crisis.
This is not a story about
cultural decay.
Pop quiz - what is this a story
about?
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