Good News at Fallbrook Hospital — a Short Story

By Kit-Bacon Gressitt


“Are you OK?” the surgeon asked her, out in the hallway.

What a question. I surveyed the faces in the institutionally furnished waiting room. No one else reacted. Not one focus strayed from the droning television. No sympathetic shrugs. Not a twitchy eyebrow on those feigning sleep. It was odd. Lack of compassion, maybe? Or perhaps they were too busy with their own fears and hopeful distractions. But I heard him. I couldn’t pretend I didn’t — because she was not the patient, because a busy surgeon bothered to ask, because the question was so miserably revealing.

At least he had taken her to the hallway. Not like the other nincompoops.

Earlier, emerging from the mighty O.R. to deign to a visit with the peons, one doctor strutted in, eyeballed the woman seated at the far wall (the one who had studiously avoided contact with the rest of us, securing her privacy in the depths of a large paperback book wedged hard against her abdomen), and he proceeded to hold court from the middle of the room.

He proclaimed, “Mrs. Bassini, you will be pleased to hear your husband is the lucky recipient of a successful hernia repair. He’ll be up and about in a few days, but, of course, you two should not engage in sexual activity for a couple weeks, maybe three.”

The wife’s tightly tidy appearance suggested she had not been inclined to engage in sexual activity with her husband since well before his little eruption; that, or behind closed doors she became a deliciously dangerous pressure cooker of raging corned beef and cabbage drenched in the salty juices of love. Either way, she now kept her eyes straight ahead, painfully avoiding the rest of us — a reluctant audience to the intimate details of her marriage.

“You can see him in recovery in about an hour,” the surgeon concluded on his way out.

“Thank—,” the wife began but didn’t finish as the last bit of green scrubs disappeared past the door jam. Her color rose as she bowed into her book, eyes unmoving.

I squirmed on her behalf. It was the least I could do.

The takes-the-cake doc, though, was the second one of the morning. He plopped right down in the seat between the young cowboy and me — the graying, sardonic female of our incidental family.

I had seen Cowboy on my way into the hospital. He and his gal were flirting in the parking lot by the genital-red pickup that was bigger than my living room. I assumed the truck was a tip that Cowboy was dangling something significantly smaller.

He sauntered into the waiting room after me, his lower lip swollen with chaw, a half-gallon milk jug for a spittoon, and his ten-gallon hat pulled low, demonstrating, as my mother would have said, that he had been hit by the uncouth stick. “A gentleman removes his hat indoors and in the presence of a lady,” she had taught us.

Cowboy did not honor that rule. Although in his defense, waiting room etiquette was ill-defined beyond pretending not to hear others’ conversations — a tall order around here. But I guessed Cowboy might fall short of any standard of etiquette, because the next thing he did was make a spitty brown deposit in his cuspidor, and then he plunked the ptooey container smack in the middle between his polished cowboy boots, spread his knees wide to reveal a noticeably worn patch of denim, and settled in for the wait.

I imagined an Old West directional sign dropping from the ceiling, hand pointing to Cowboy’s crotch. His confident posture caused me to rethink my original assumption about his endowment.

His little lady joined us shortly after the sign dropped, and she was packing a saddlebag of hostility. Levis you couldn’t have removed with a potato peeler, a homemade bleach job abusing her hair, and tattoos from head to swishing tail. The barbed wire encircling her firm biceps was a particularly nice touch. And, like Cowboy, Barbie’s bottom lip was packed as tight with chaw as her jeans with flesh. She, however, fancied a more feminine spittoon, squirting her brown spittle into a sports drink bottle.

Once again, however, my initial impression was squashed when she promptly settled in with the growing group of ambulatory care visitors to enjoy The Price Is Right with Drew Carey, applauding correct answers and commiserating over the failures.

“Sucks without old whatshisname,” Barbie said as another young woman walked in.

The newcomer smiled at everyone and cheered, “Hey, Price Is Right — cool! I love this show! And yeah, Bob Barker was great, wasn’t he? He seemed like a pretty nice guy.”

She sat down across from me laughing, apparently enthused to find kindred fans. Her olive skin and ebony hair shone in the room that had been doused in tones so bland they could not be identified. In the friendly village of Fallbrook, she was probably pegged as Mexican, but she appeared to hail from more Caribbean climes.

I smiled, mumbled something encouraging about the good old days, and figured Puerto Rico, maybe, as she chattered on with Barbie, laughing about past shows and special guests, about the time she took her mama to see the show’s taping — and they’d had so much fun in L.A.

And that’s when the second surgeon came in, plopping his well-fed derriere in the seat buffering me from Cowboy.

“Your wife’s doing fine,” he said, curling his lip at the jug. “I cleaned her out, got it all — uterus, tubes and ovaries.” He relaxed into the seat, looking pleased, and threw his arm across its back and into my space. I leaned forward, but he didn’t seem to notice. “Everything’s gone, and that should help with the pain. She is going to have some bleeding. If she saturates more than two sanitary pads in six or eight hours, call my office. Otherwise, she should be just fine.” Cowboy spit into his jug and the idiot doctor leaned into my lap without dropping a beat. “No worries — I did a good job, so I’m not expecting any problems. She’ll be in recovery a few more hours, but you can probably take her home by dinnertime. We like to get them up and running pretty quickly. I’ll need to see her in one week — and no sexual activity for four weeks, maybe more.”

I couldn’t help myself. I looked over to Ms. Puerto Rico, and — glory be! — she looked back, pursed her lips and rolled her eyes, nodding in Idiot Doc’s direction.

“The nurse will let you know when you can come in and see her,” Idiot Doc finished and rose, bumping my shoulder as he swept his arm back into his own space. He didn’t seem to notice that, either.

While we attempted to stifle our reactions to Cowboy’s barren news, a sweetly fragile voice trilled from an elderly woman in the corner, opening her eyes for the first time. “It’ll be OK, young man,” she said, pushing a tendril of white hair back into her loose bun and patting the wrinkles in her frayed housedress.

“Yes, Ma’am,” Cowboy nodded in her direction.

“I had a hysterectomy fifty years ago, before they knew what they were doing down there,” she chuckled, “and it wasn’t too long before I felt just fine.” She leaned over to pull up a tube sock, rumpled round her bruised and withered ankle. Her slant revealed an unfettered bosom as flat as the plates of a mammography machine. “You thank God you still have her, and you adopt. That’s what I always say.” She chuckled herself back into a doze.

I wondered if adoption was a good idea, given Cowboy’s Barbie. Then I figured the biological drive to procreate was a lot stronger than any social convention. And then I decided it was time to take a break. I headed out for caffeine.

The way to the tiny cafeteria was lined with a rogue’s gallery of former community hospital board members, some of them, familiar faces — the brilliant, Jewish lesbian neurologist who finally left town because none of the local practitioners would refer to her; the community gadfly whose penchant for Bermudas without underwear left his elderly gonads notoriously flapping in the breeze on the boardroom dais; the unwed deputy sheriff whose tanned, lean body inspired a generation of hopeful beauties into civic involvement; the recovered cancer patient who abstained from attending meetings, but gobbled up the free healthcare benefits he couldn’t buy if he wanted to. Typical small town fare, each mug shot was a fading scandal.

At least they led to coffee.

“Where are the coffee cups?” I asked at the cafeteria’s counter.

“Next to the coffee machine,” a slight figure facing the grill said without turning.

“Oops, sorry! Didn’t see them. My eyes took a hike with my youth.” No comment from the grill, as I poured some coffee into a Styrofoam cup just large enough for Holy Communion. Then I searched for half-and-half, couldn’t find it, searched again without success, and reluctantly asked, “And the cream?”

A skinny arm, doubled in length by a spatula, pointed to the far end of the counter. “In the ice,” she said from the shadows of the grill’s hood.

I followed the cafeteria tray rails to the ice, where yogurt, milk cartoons and a stainless steel tub of coffee whitener laid half buried. Whitener, not cream, a distinction it seemed unsafe to make under the circumstances, so I whitened my coffee and asked, “How much is it?”

The short order cook looked over her boney shoulder and peered up at me. She was all hairnet and sorrow, pressing a grilled cheese sandwich into submission, maybe the only power she had. “Never been here before?”

“Just to wait, not for coffee.” I smiled, a paltry cover for the fact that I knew I was annoying the hell out of her.

But then an amazing thing happened. She released the sandwich and turned straight to me, her hands resting on her semblance of hips and a smile usurping her unhappy face.

“Well then, here’s your good news for the day, Sugar,” she said, suddenly animated and beaming. “It’s free!”

“Free? Really? That’s nice!”

“Yep. Coffee, tea and ice water,” she said in a singsong voice, “all free, all the time!” as though it was the most important — the happiest! — damn message she had ever delivered.

I wondered if I should take her home with me and fatten her up in front of Fried Green Tomatoes, give her a chance to discover greater pleasures in life. But having done her duty well, she returned to subduing the grilled cheese. And she was whistling.

I wandered back to the waiting room, reading the signs along the way that repeated every ten steps or so, directing me to cough into the crook of my arm and wash my hands obsessively to prevent the spread of influenza.

With the image of a germ-riddled milk jug in mind, I stepped into the room to find all the same faces, some reading, some chatting, some dozing at the TV, some staring off into a fearful distance.

Ms. Puerto Rico said, “Hi,” as I returned to the seat that had become mine.

Cowboy welcomed me back by spitting into his  jug and placing it in the empty seat between us. He had apparently tired of bending over to reach the floor.

Ms. Puerto Rico cleared her throat and looked at me, her nostrils flaring in disgust, and I had to laugh despite the brown muck perched twenty inches to the right of my thigh.

“Hey, who’re you here with?” she asked.

“My daughter, but it’s a simple procedure, no biggy.” I shifted as far left as the chair allowed. “And you?”

“My mama. But she didn’t tell me anything, just that she had to have a little procedure and needed a ride home.”

“Wow! That must be disconcerting.”

“Oh, it’s the way she is. She says God has more important things to do than listen to us complain, so she never shares any of the bad stuff. What can I do? I just wait for her to nudge out her stories in little pieces, but she’s always pretty cheerful anyway.” She laughed and shook her head.

“Is that where you get it?” I asked, and she laughed again.

“Yeah, Mama’s Puerto Rican. She says Puerto Rican women are resilient — and they love to laugh.”

“And they love to cook,” I offered. “At least my former in-laws did. They made the best Puerto Rican food — pasteles and fried plantains are my favorites.”

“And chicharrones — we’ve got to have our fried pork skin!” and Ms. Puerto Rico was laughing yet again when another surgeon came in the door.

“The daughter of Mrs. Santiago?” he asked.

“That’s me.” Ms. Puerto Rico turned to smile at him.

He gestured toward the hallway and said, “Let’s talk out here.”

Everyone looked at Ms. Puerto Rico.

Her laughter stopped. Her smile stopped. She stood and followed him out.

The doc said something about “bronchoscopy” and maybe “sooner” and “Are you OK?”

There was a pause, and then, “Yes, thank you, I’m fine,” and after a silent moment, she was standing in the doorway. “Hey, where’d you get that coffee?”

“I’ll show you.” I jumped up and walked into the hallway with her, my arm around her shoulders. “It’s down this way.”

“At least he didn’t say she couldn’t have sex,” she laughed, and then she turned into me, and she wept. And when she could, she whispered, “She never told us, not a word. … And she’ll just say that Puerto Rican women are resilient. … And they love to laugh. … We do love to laugh. We do. …

“Hey,” she stood straight, “I could use that coffee.”

“Well, the good news is it’s free — coffee, tea and ice water — all free, all the time, Sweetie. I’m Patsy. What’s your name?”

©2010 Kit-Bacon Gressitt

Comments (16)

KimJuly 25th, 2010 at 7:18 am

A very touching story, brings so many things to mind. First, I must call my mother this morning! Second, all the doctor horror stories I’ve experienced. Too bad they can’t all be like Fallbrook’s Dr. Hisey – now retired. Once, when I was in the ICU, Dr. H spent hours with me, seeing me through a bad patch. When I was finally lucid enough for conversation, with no seating available, he pulled up the commode, sat, took my hand and talked to me – not at me. K-B, please submit your story to JAMA. Maybe a few docs will get a clue.

EliseJuly 25th, 2010 at 8:12 am

What can I say. I love how you can take an everyday experience that for most of us is skeletal, and then put flesh and a face on it. Very inspiring for a novice like me.

WarrenJuly 25th, 2010 at 9:17 am

Hi……the word “compassion” strikes a most responsive chord…..my daughter is a social worker who does hospice work and it is this very absence of compassion that she encounters ……as opposed to the one dimensional aspect of “sympathy” …… Which is so lacking not only in times of crisis but in our every day shared struggles………

LisJuly 25th, 2010 at 9:22 am

I love this K-B, love the human voices, the endearing character sketches, the details of food, laughing, rumors in the hallway. I think of how Gam walks down a hall to Dr. Clements eye appointment and sees a chefallara tree and comes home and paints a pair of mot mots with the backlighting of the chefallara leaves in it and I just drove there and back. You go to a routine visit and come back with a description of our health care, our society, our family roots and communication. It is truly art when you take the ordinary and create a lesson, a creation, an insight. Thank you!

K-BJuly 25th, 2010 at 9:27 am

UPDATE: I suppose I could have persisted with muttering that some docs are dickheads, but the story seemed a more adult response.

KimJuly 25th, 2010 at 9:46 am

UPDATE: Yeah … well … those docs are still dickheads!

CarolJuly 25th, 2010 at 10:22 am

Thank God for humor, be it: Peurto Rican or dry, when it comes to O.R. , E.R. or any DR, for that matter, that has lost their passion and compassion for ‘life’s’ work. Quit!
Our best healer lies within….listen and trust…or get a good referral.
Love your passion, K-B.

MarcyJuly 25th, 2010 at 12:32 pm

I’m with Elise . You are so wonderful at this.
I love the part about the pictures in the hall.
This was a searing comment on the lack of humanity in medicine done on a slow sizzle.

Sometimes I think our healers take too many “God: classes in medical school. They are so removed from the very people they are supposed to be treating. It’s more a “process” than a “treatment”. You get the idea that the process is more important than the patient.
Not to mention that many have the bedside manner of a cement truck.

john gordonJuly 25th, 2010 at 6:33 pm

A lovely story and one that should be circulated as a reminder, not because most doctors don’t take the time or have compassion, but because we all can use a reminder every once in a while and doctors, like the rest of the human race, are not perfect.
Having been one of the ‘dickheads’ for 35 years, I have always prided myself on my compassion and empathy and the time that I spend with my pts. I have made mistakes to be sure, but hopefully they were never at the expense of the pt’s privacy or humanity.
While stories of waiting rooms and the various people crowded into an inadequate space for the most part, makes for good copy (rather like a story about ‘boy scout helps lady across street’ is less exciting than ‘boy scout trips lady into street’), I suspect that there are more Dr. Hiseys in the world than this story would indicate. Ref. Kim.
I also suspect that even those who consider all doctors to be dickheads have stories about a dickhead that got up at 2 AM to treat her problems or calm her fears, another who spent a little longer than usual answering questions or who called her at home long after office hours to tell them about some test result that was important to them.
Obviously, I take umbrage at the broad painting of all physicians, medical and surgical, as having the bedside manner of a cement truck and, of course, having the corner on dickheadedness. I do know that I am not perfect, but I do try. I also know that I work harder and longer today for less than I did 15 yrs. ago. I often operate into the evenings and I get up at night for emergencies. I have 1 1/2 people in my office that do nothing but handle ins. forms. I am distressed that my pts. do not understand what is happening to them in today’s medical climate and do not understand that socialized medicine will lead to rationed and more expensive care. Physicians are retiring or leaving medicine because they can’t make a living (esp. in primary care) and pts., especially older medicare pts, can not find a family doctor. Until our pts. realize that Medicare rates are welfare rates and that soon, there will not be enough doctors to care for the older population, we are in for a lot of unpleasant surprises.
However, I apologize, I digress.
Thank you for a poignent story and a good reminder to all of us who try our best to take care of a lot of people every day that we need to take the time to stop and reflect every once in a while. I hope that lots of your readers can also remember some good experiences to relate.
Keep writing. I am enjoying them and your expertise.
JCG

kbgressittJuly 25th, 2010 at 6:43 pm

You, Jack, are a gem, and I’ve worked with some fabulous docs who also go well above and beyond. However, although the story is fiction it is based on an actual experience at our little hospital, where one morning’s anecdotal evidence suggests that one out of four attending physicians in our friendly village has heart. I’d like to think our Chamber of Commerce’s PR campaign would be embraced by our local healthcare practitioners, and I remain hopeful that it will be!
Love,
K-B

P.S. If I were ever to get my back fixed, I’d opt for you — take Tricare? (tee and hee)

HuntJuly 25th, 2010 at 7:14 pm

Yesterday between noon and midnight I took care of 37 patients, including, amongst others, two people having heart attacks, a man who was only barely breathing because of an anaphylactic reaction to a beesting, a 48 year old woman who was in agonizing pain, dying of widely metastatic cancer, a retired professor with a kidney stone, peeing blood, and a child whose mother spoke only Korean but did not want to use a translator. I spent almost 2 hours trying to find a psychiatric bed for my suicidal patient, after having already spent a half an hour getting information about her from her mother and from the police officer who had brought her in to the ER. Then I spent half an hour trying to find out the location and phone number of the boarding home in which my retarded patient lived, because she didn’t know her address and the home had not sent anyone with her who could tell us. Then I spent another half an hour trying to find her a ride home because the boarding home couldn’t spare staff to pick her up.

When I got off duty at midnight I was in the midst of a conversation with the partner of my dying cancer patient. I spent another 45 minutes with her as she sobbed out her grief and fear. Then I had to dictate all of the charts that I hadn’t had time to finish while I was busy caring for my patients. I left the hospital at 2:55 am, the earliest I have gotten out all week. I have not had time for a lunch or dinner break for over two years. I just got over yet another UTI born of never having time to go to the bathroom. One of my nurses recently told me that she is afraid to drink anything starting an hour before she comes to work because she knows that she is unlikely to get time to pee.

Almost every day that I go to the hospital, one or more of my patients starts off the conversation by telling me how much they hate doctors and hospitals. I talk with my colleagues, hear how they have fought with insurance companies trying to get them to pay for the medications their patients need, how they haven’t gotten home in time for dinner with their families in years, and how, after 20 years in practice, they are still paying off their med school loans. All of us are hospital employees, because in this day and age, nobody can afford to stay in private practice.

In the past month, I have gotten three thank you notes from greatful patients, and two complaints, one from an addict who was peeved because I wouldn’t prescribe narcotics for her bruised shin, and one who had come with a rash, and was angry because he had to wait while I cared for another patient who couldn’t breathe.

I have been thrown up on, bled on, and peed on more times than I can count. On a daily basis, my fingers go into place we shouldn’t (though sometimes do) talk about at the dinner table. I work nights, holidays, and most weekends. I often go three or four days not getting to see my beloved. I take care of patients at my dining room table or in the grocery store when they can’t afford to pay to get their care in the clinic or in the hospital; my life is not my own. I spend hundreds of hours studying and teaching and spend thousands of dollars every year for conferences, courses and certifications in order to help myself to stay competent.

Once in a while I get to save a life, or to make a frightened child laugh, or to help a patient by sorting out a difficult diagnosis, and then I remember why, many moons ago, I embarked on this carreer.

But then I read your piece, and the responses in which people are agreeing that “…docs are dickheads…” and I weep.

kbgressittJuly 25th, 2010 at 7:19 pm

Hmm, interesting. Those who are not the target of criticism take it personally; those for whom it’s intended are not likely to respond. I’ll feel complete the day I get a note from a target that reads “Yeah, I’m a dickhead, and I’m going stop that now.”

Love,
K-B

Anne-MarieJuly 26th, 2010 at 12:56 pm

K-B,

Loved your piece. I can relate. To the physicians, “heal thy self”.

Anne-Marie

EliseJuly 26th, 2010 at 5:01 pm

I don’t think doctors are dickheads. Personally, I’m glad they are around, no matter how sensitive or insensitive they are. I thought about becoming a doctor, but decided I didn’t like to be around sick people, so I’m glad there are people who do.

Patty CampbellJuly 28th, 2010 at 12:00 pm

KB,
They’re not all dickheads. When I fell in the airport and cut my lip and cheek badly, my darling doctor left his Sunday racketball game and drove twenty miles to me in Fallbrook to sew up my face–without a scar. And he didn’t charge me.

But the piece is wonderful. Your style gets better and better.

Patty Campbell

john gordonAugust 9th, 2010 at 2:52 am

Hunt’s reply is so much more expressive than I could ever hope to match. She is in the trenches and it brings back the thought of “walking a mile in my shoes before you critisize, etc.” Her final comment is what hurts us practicioners, that the comments were so one sidedly negative.
Until the us vs. them, have and have nots, rich vs. poor and class warfare practiced by our elected (and often non-representative) representatives is seen for what it is and ended, things like this will continue not out of animosity, but mostly out of ignorance.
Jack

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