the healing muse

Volume 7, 2007

Night Duty

Eileen Valinoti

            At midnight, I reported to Marianne, the evening nurse, to begin my tour of night duty on Female Medical. I felt apprehensive. I was only in my second year of nurses’ training, and Female Medical was considered St. Mary’s unofficial psychiatric unit. Though most of the patients had heart disease or diabetes or cancer, some were borderline psychotics, dwelling in a never never land between fantasy and reality. At nineteen, I had little knowledge of psychology or counseling and my own host of fears to confront.
            The nurses’ station stood at the head of a staircase that led to the male surgical floor below. There I sat, perched uneasily at the edge of my chair, as Marianne gave me the report on the patients, beginning with a Mrs. Greene.
            “She’s off the wall,” Marianne said, rolling her eyes, “and somebody found her smoking the other day. No one knows where she got the cigarettes; she never has any visitors.” She paused, and then added ominously,
            “You’d better watch her. There’s an oxygen tank in the room.”
            I kept my face expressionless.
            “A nurse must appear calm at all times,” our student handbook read, but in my mind’s eye, I could see Mrs. Greene and me being blown to kingdom come. Everyone else was fine, Marianne said, or as fine as they could be under the circumstances.
            “Just make sure that no one climbs out of bed. Someone last night wandered on to the fire escape,” she added, gathering up her belongings. I had never met Marianne before, but now she seemed the most desirable companion on earth.
            “Shouldn’t we go over the narcotic count together?” I asked.
            “Everything checks,” Marianne said, glancing impatiently at her watch. She grabbed her purse and disappeared.
            I made my rounds, shining my flashlight into every room, relieved to find that my patients were still breathing. Her first night on duty, my roommate had found a patient dead in her bed and became so unnerved that a senior student had to take over.
            “Her hands were so cold,” my roommate said, “icy cold.”
            I shivered in the warm hall, thinking about it.
            “Hail Mary,” I prayed silently, clutching the rosary beads in my pocket.
            Mrs. Greene was wide awake, sitting upright in her bed. I saw at once that she was deathly ill. Her skin was dark with jaundice, her abdomen swollen while her arms and legs were as thin as matchsticks. She wore thick dark glasses and had fashioned a piece of black silk into a sort of veil that covered her head. She looked like a mad nun, and in the dead of night, she was a fearsome apparition.
            The room was bare except for a crucifix on the wall. I saw no cigarettes, no photographs or get well cards, no hints of a life before this dreary place. The oxygen tank stood in the corner.
            “It’s too close in here,” Mrs. Greene said in a hoarse voice. I opened the window.
            “Now there’s a draft.” She picked at the bedclothes with long spectral fingers,
             “Get me another blanket; my feet are freezing.”
            I covered her legs with a quilt.
            “It’s too heavy on my legs.” As I leaned to remove the quilt, she grabbed my arm.
            “Give me something to make me sleep,” she said. Her chart read: “NO SEDATIVES.”
            “I have no orders,” I said, looking away uneasily, afraid she would ask me why. I would have to say I didn’t know. But she only stared at me, her eyes glittering behind the dark glasses. I felt pity and guilt and revulsion.
            A patient’s buzzer sounded in the hall. Deliverance.
            “Someone is calling for me,” I said. Still Mrs. Greene held my arm until I had to pry her fingers away. She sank back exhausted on the pillows, muttering to herself. Her whispers followed me out the door, her murmurs impossible to follow.
            At two a.m., Miss Hoey appeared. Catherine Hoey was the night supervisor, an elderly Irishwoman who made her rounds once every shift, inquired briefly about the patients, and offered one coffee from the pot she always carried with her, an evil brew that tore your insides. Miss Hoey was never any practical help, bringing a Celtic fatalism to the care of the sick.
            “Sure the day shift will be here soon, love,” she would reply placidly when asked for advice.
            Once she left, I sat at the nurses’ desk and wrote my notes.
            “Patient agitated,” I wrote, or “Patient confused,” the same sad chronicle over and over. The room was hot. Beneath my feet, a radiator hissed and gurgled. Feeling drowsy, I got up to look at the calendar on the wall. I counted all the nights I had to go. Ten, I saw with despair. I opened the window and looked out at the barren view. The hospital stood among a warren of abandoned warehouses. I longed to see a neon sign or some indication of normal human life. Then I heard the sounds of music. Off in the distance, a band was playing. I leaned on my elbow, listening. Out there, not so far away, someone was dancing with someone. I closed my eyes for a moment, lost in a dream of strong arms holding me fast.
            I went back to my charts until once more, I was overcome with sleep. I ran to the sink to splash cold water on my face. Time to make my rounds again. And so the hours passed until I heard the clatter of the breakfast trays, the banging of the elevator door, the quick footsteps of the day nurses coming on duty.
            In the nurses’ residence, I couldn’t sleep. I would drift off and then be awakened by the noise of my classmates coming back from the hospital, laughing and slamming doors. When I finally slept, I was haunted by weird dreams in which Mrs. Greene appeared, clutching my hand in a vise-like grip.
            The days and nights seemed to blur together. It was winter, and I rose in darkness to go to the hospital and when I returned in the early morning, it was still dark. I began to feel jumpy, distant from the world.
            “You look like a hag from hell,” my roommate told me disapprovingly one night as I dressed to go on duty. I had given up curling my hair. It hung now in lank, dispirited strands on my collar, in bold defiance of the rules. A strange rash had erupted on my face which I had doctored myself with applications of Vaseline, making it worse.
            “Oh shut up,” I told my roommate irritably, banging the door as I left. She could talk, I thought bitterly, cozy in her pajamas, a blissful sleep ahead.
            One night, as I was writing my nurses’ notes, I heard footsteps on the
landing, followed by a loud “PST.” I looked up, and in the middle of the staircase stood my classmate Terri, who was working nights on the floor below.
            “Kelly,” she whispered, “I’ve got cigarettes.” She patted her uniform pocket and grinned.
            Terri and I were not friends; she was not my idea of a proper nurse. On duty, her cap was often askew, her apron untied. In the nurses’ residence, she went about in her brother’s old army pants, rolled up to her knees. She chattered and giggled constantly, holding court with other renegade classmates in her shambles of a room. Last week, she had been caught smoking in the hospital cafeteria. I had met her on her way to the Director’s office, scarcely recognizable in a navy skirt and a long sleeved white blouse. Her hair, which normally framed her face in an exuberant halo like Orphan Annie in the comic strip, was neatly braided across the top of her head. She looked like the orphan schoolmarm in Jane Eyre.
            “I want to look young and vulnerable,” she told me, eyes downcast.
            “I wish you well,” I said primly. In my heart, I thought her a silly, feckless girl who deserved whatever she got.
            Now she shifted restlessly on the staircase, looking anxiously over her shoulder.
            “Come on,” she said, pointing to the steps where she stood. “You can hear if anybody calls.”
            I hesitated. But lack of sleep and isolation had destroyed my willpower. Still, I hung back.
            “Hurry up,” she said. “Hoey might come back. Sometimes she forgets where she left her damn coffee pot.”
            Miss Hoey. I was sure that if she ever saw us here smoking, she would drop dead on the spot of a stroke or a heart attack or both.
            We sat together on the steps, inhaling deliciously.
            “I’m a wreck,” Terri puffed happily. A patient had just thrown all his pills at her and told her to go to hell.
            “I’ll get blamed for it in the morning,” she said. “Koch hates my guts.” Miss Koch was the day supervisor, notorious for her interrogations of the student nurses.
            We sat huddled together on the narrow step, our cigarettes glowing. I found myself confiding in Terri, telling her about Mrs. Greene, how frail she was but sinister at the same time.
            “O throw some holy water at her,” Terri said carelessly.
            Why was I even talking to this foolish girl? But I was unable to stop.
            “Look at my arm,” I said. The skin was mottled and red. “Every time I go near her, she clutches at me.”
            “What are they doing for her?” She might have been the chief surgeon inquiring about one of his charges.
            “Nothing,” I said. From one of the rooms, someone moaned softly. “They won’t give her anything and she never sleeps.” I knew now what it was like to be alone and to long for sleep.
             Terri eyed me speculatively from behind clouds of smoke.
            “You have to use psychology with her. Give her a sugar pill and tell her it’s a Nembutal.”
            Lying to a patient? I might as well consult with Miss Hoey. I thought disgustedly.
            A ritual developed. We met every night on the steps as soon as Miss Hoey left. Juan, Terri’s orderly, stood watch while I provided the paper cups of water to use as ashtrays. We never sat for long. A buzzer sounded or else we imagined we heard Miss Hoey’s heavy tread.
            Terri always had stories to tell from her unit—angry outbursts, nervous breakdowns, miraculous recoveries, all ending in the morning confrontations with Miss Koch. Terri told these tales with a theatrical intensity, acting out all the parts, puffing out her skinny chest as the bosomy Koch, shaking her fist as the angry patient. One night a large rat had appeared on the unit.
            “Just as I was changing dressings, I saw it scampering across the floor.” My hand flew to my mouth, to smother a scream.
            “Big as a cat,” she said, making a wide arc with her hands to show me its monstrous size. I cringed at the details—the beast’s twitching tail, its fierce fang-like teeth, its bristling nostrils. Juan had panicked, crossing himself and cursing hysterically in Spanish at the same time.
            “But I looked it straight in the eye and chased it away with a broom.” Terri leaned back against the railing, hugging her knees in delight.
            I looked over my shoulder. A new terror had been added to the night.
            “Don’t worry,” Terri leaned over and patted my arm, “it’s gone now. Besides, you can’t show fear,” she said, folding her face into stern lines, a soldier back from the wars.
            I was speechless with admiration. I knew that if it had happened to me, I would have begged to be relieved. Miss Koch, it appeared, was equally impressed. She looked on Terri as a heroine.
            “She calls it ‘the animal,’” Terri said, choking with laughter. “Every morning she asks, ‘Did you see the animal again, Miss Murphy?’”
            We collapsed into gusts of laughter, and we had to bury our faces in our aprons to smother the sound.

            My last night on duty, I was alone. Terri’s tour had already ended. A white robed nun took her place. From my desk, I could hear the soft rustle of her habit as she made rounds, the click of her rosary beads. Cozy chats on the stairs were now out of the question.
            I didn’t care. After tonight, I would join the real world again—I would go to the movies, dance alone in my room to the radio, eat hamburgers at the diner with my friends. When Miss Hoey made rounds, I gave her a dazzling smile. She looked astonished, accustomed now to my pursed lips and anxious frown.
            “Sure to God, love,” she murmured wonderingly.
            I thought about Mrs. Greene, how she would still be here, long after I was gone, like a prisoner in her cell.
            “No one ever comes,” the day nurses said every morning, clicking their tongues and shaking their heads. I wished she had a friend to make her laugh and share a pack of cigarettes with her.
            I went into the treatment room to get my flashlight. A battered tea kettle sat on the counter, one of Miss Hoey’s castoffs. I felt a wave of homesickness. Tea was a ritual in my Irish family, a cup of tea, the cure for every ailment—for headaches, for cramps, for shattered nerves—sometimes even offered for poison ivy and corns.
            I put the kettle on to boil. Rummaging in the closet, I found a tea bag. I carried the steaming cup into Mrs. Greene’s room. She was awake, the sheet pulled up to her chin, the blankets in a disheveled heap at her feet. It was stuffy in the room. There was a faint odor of disinfectant and the musty smell of the woolen blankets.
            What did she think about, I wondered, staring at the walls night after night? I fought back the dread I always felt in her presence.
            “I brought you in a cup of tea,” I said.
            She didn’t answer, her expression impenetrable behind the large dark glasses, glasses a movie star might wear to hide from adoring fans. Moving closer to her bed, I heard myself say,
            “It’s made from special herbs that will help you sleep.”
            She reached for the cup, but her hands shook so violently, I had to sit on the bed and hold it while she drank. After each sip, she had to rest, spent from the effort. It seemed to me an interminable time while she drank, the only sounds in the room the relentless drip of the broken faucet, the ticking of the clock. I was intensely uncomfortable perched on the bed, a forbidden intimacy.
            “A nurse must never sit on the patient’s bed” had been drilled into us. At last, she finished and sank back exhausted on the pillows.
            I was ready to hurry away, when suddenly she raised herself on her hands, reached up and took off her glasses. I saw that her eyes were a startling blue, the skin around them as pale and delicate as paper.
            “Turn off the light,” she said, blinking and pointing to the fixture on the ceiling. I flipped off the switch, she closed her eyes and once again, fell back on the pillows.
            When I looked into Mrs. Greene’s room again on the last of my rounds, it was dawn. A streak of pale sunlight fell across her bed. From where I stood in the doorway, I could hear the soft, slow rhythm of her breathing.

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