Chapter 9/ 2008
“When the writing grabs us in our throats, we don’t feel alone.”
Six months remain on the sentence of my lost year.
No possibility of parole.
The odds of flying free and living in my body quickly turned against me in the days after I left the hospice. The fear in the eyes of my last patient as he struggled to breathe and the muffled squeaking of his throat, fighting with hopeless machinations to keep pureed fruit from drowning his lungs, push me off of my black velvet couch and out of my apartment every day by noon. A soft wind blows down Beachwood Drive from the Hollywood sign in the hills above my apartment. I walk the streets of Hollywood for hours, watching branches sway above me, the worn down heels of my cowboy boots hitting Franklin Avenue, where my eyes are shocked by the unselfconscious abandon of umbrellas shimmying above the outdoor tables of au courant restaurants, their ashtray covered girth overtaking the sidewalk, the narrow windows of the Scientology building across the street arrogantly looking down on the smokers beneath them. I could feel the air on me the day after I left the hospice, but I never think to question its absence in the following weeks and months. It has been so long since my body has relaxed against the caressing breath of the City of the Angels, my skin has forgotten what a breeze feels like. When the lost year ends, the air persists in its refusal to touch me.
The ex drops by with the cliched “I fucked up” bowed head and sheepish eyes at 2 AM. We talk. Mostly I listen. For reasons not quite clear to either of us, his business, facilitating the placement of gift baskets and swag at high-end parties, has taken a dive. He is losing thousands of dollars a month. He is scared. Terrified. It is not the writer’s strike or high gas prices. Suddenly, Hollywood people have stopped shelling out money, even for the tackiest of Golden Globe after-parties. He tells me I am his best bud. I can not argue with him about his fiancee. He is the friend I can depend on in this airless city. The only one I have.
“Try to hang on until September,” he whispers. “You’re going to make the best teacher.”
The tip of his tongue licks my ear. I want to tell him he has taught me what it means to be strong. The mask I have worn since I was first called a faggot is early 70s sangfroid. I have not said what I feel since I was in college and watched Tuesday Weld walk the line in “Play It As It Lays.” The ex’s fingertips run along my neck. For a moment, I think his touch is a breeze from the open windows in my living room. As always, my mouth refuses to speak the thoughts I feel.
Before starting my two new nursing jobs, a private duty case and charge nurse at an assisted living facility, I spend a week learning how to be a substitute teacher at the Los Angeles Unified School District’s Teacher Training Academy on Wilshire. I have not been in a room like this in a long time, not since Tuesday showed me how hauteur worked. Despite the classroom’s windows having been sealed shut for years, my skin is alive, the impermeable windows eliminating any chance of cool air stroking my face or back as it floats up from the bones of the Ambassador Hotel across the street. My balls and gut do not hurt, my blood pressure idles at a low my body has not known since I was a teenager, but this airtight room is not about me being a lucky man. No one is whispering, rolling around on the floor, listening to gospel music or proclaiming “He is sovereign!” at the drop of a hat. The Academy’s facilitators smile as they seat Los Angeles’ future substitute teachers at long formica topped tables, where we spend the week brainstorming different teaching scenarios, talking nonstop about how to handle difficult students, the best ways to discuss current events and how to present ourselves to the students. No one eats four donuts before they speak. There are no forms to fill out, no disingenuous re-certifications to be sent to Sacramento. If we were presented with such trivia, everyone sitting comfortably at these banged up tables would, without hesitation, help the others complete the migraine inducing paperwork.
The facilitators ask us to come up with a way to introduce ourselves to our classes while, at the same time, getting the students to reveal who they are and what interests them. My table picks me to lead a mock class.
“My name is Mr. Epstine,” I say to the smiling faces in front of me.
All eyes are on me, like the nights when I stood onstage, alone in the light to perform my monologues. The eyes are waiting for the story, wondering what this scruffy old man has to say. I give them a moment to drink me in, their eyes focusing on every move I make. Gut twists a bit. I want to tell my colleagues a good tale.
“I’m a writer when I’m not teaching. One of my favorite authors is John Fante. He wrote about what today would be called marginalized or dispossessed people living here in Los Angeles. That’s what I like…getting to know the people we pass by, but really never see. As we go around the room, I want you to tell me your name and who your favorite writer is and why.”
“I like sports reports on TV and online. Is that the writing you’re talking about?” a Latino man in his late twenties asks.
“Sure is,” I answer. “Concise, clean, cuts to the chase. I like it.”
Our lead teacher smiles and nods at me to continue.
Next, I call on a quiet woman, who I take to be eastern European. She has not spoken in any of our exercises. I have to know who her author is. When I ask her, she looks out to the impossible to open window.
“You must like someone,” I say. “A play? A movie? A song?”
She smiles and says: “Romeo and Juliet.”
My plan was to work the room, like when I do stand up. The deep sadness in her eyes and the tentativeness of her voice stops me. The lead teacher straightens his back and steps forward.
“You look like a Juliet,” I tell her. “Can you tell us why she enchants you?”
“I know what that feels like,” she says “…what families can do.”
As a class, we are quiet. We breathe together with the same rhythm. This is a room to work in, not a room to be worked.
“When the writing grabs us in our throats, we don’t feel alone,” I tell her.
The lead teacher leans back against the wall. I walk between the room’s tables, listening to the dreams and fears of the people sitting at them, their voices touching my skin the way the air once did.
My gut is still. This is something I can do. I like it.
Maybe I will not need to get my balls fixed. Their throbbing pain has stopped, as has the swelling. April, the open enrollment month for my health insurance, has long since come and gone. I am a Virgo. How I could have let that slip by? Was it the thought of someone cutting into me? I do not want the knife on me. I want to know what is in the heads of the people in this room, who sit attentively with still hands and trusting eyes at scratched up tables, people I have passed by and passed over since the day I returned to this city.
“Good luck in the fall. The kids are going to love you,” the lead teacher tells me at the potluck on our last day. “They respond to adults who convey authority and are interested in them.”
That is why this room is different. The people at my table and the ones around me want to be right where they are sitting, our guts ache only to teach the young angels of our city.
I drive home down Wilshire singing along to “Spirit in the Sky,” tears coming out of the sealed windows of my eyes. When I get home, I will watch the usurper Obama debate Hillary, then dream up a lesson plan on how to discuss this with the kids.
Lucky man. Just hold on until September.
Feeling very much a teacher in my heart, I begin the first of my nursing jobs. My plan is to hold on to the more palatable of the two gigs when I begin teaching in September. For now, I will attend to the straight boyfriend. He has lost so much business his eyes sigh whenever his former heroine Oprah babbles about being your true best self. I should learn how to cook. My man needs sustenance.
The agency on Sunset has assigned me to relief shifts for a ninety-three year old Holocaust survivor. His caretaker is short, overweight, in his late twenties. This kid has literally lived at the patient’s bedside for the past year, sleeping next to him on a lumpy futon at night. He attends to our patient twenty-four seven. Kid chants the rosary every morning when I enter the room. I can recite the Sh’ma, but I choose not to, even though it would earn me cred with my patient. Within five minutes of meeting the kid, he informs me he was a nurse in the Philippines. Right. I am about to be signed as the star of an edgy HBO sitcom.
I have been hired to work Wednesdays and Thursdays, the days the kid goes to school. When I ask the kid what he is studying, he stares at the white carpeted floor. He is unable to tell me the location of the school. I divine it to be quite an eclectic affair, as every Tuesday evening the agency calls and informs me the kid needs to change my days. I rarely work a consecutive Wednesday and Thursday after my orientation. You do not play a Virgo from New York that way. The kid needs to learn this.
I was on to the kid from the get-go. The ambiguous schooling was the tip-off, so transparent, so easy to blow a hole through. Kid never once washes his hands. He is always barefoot. The syringe and needle he uses to draw up respiratory medications have been reused so often the lettering on the plastic shaft has worn off. I do not know if the kid thinks he is suctioning the trachea and bronchi, but you need to get the catheter in way deeper if you want to reach either. He is able to mimic back medical terminology, but he never once answers a question. He dissembles until I want to slug him and put him out of his obvious misery.
“Do we really want to give that medication?” I ask him on the first morning of orientation.
He proceeds to place the pill in the pill crusher. I remove it.
“His pressure is extremely low,” I tell the kid. “We don’t want to give him an antihypertensive. He shouldn’t get the other BP meds either.”
The kid breaks into a sweat. I pour the rest of the medications, shaking my head “no” when I touch the bottles containing blood pressure pills. I throw around the words orthostatic hypotension to keep the kid quiet as I pulverize the pills with a stone mallet.
Cancer ignited our patient’s decline. He graduated to a stroke, which knocked out all movement in his arms and legs. The ensuing respiratory failure moved him into the room he now lives in. He is trached and on a ventilator. A G tube sticks out of his round white belly. Three inches away, a J tube protrudes from deep in his small intestine. Neither work well. The J tube was once clear plastic. Small black spores have attached themselves to its insides. Both these puppies need to be flushed as routinely as one would say the rosary. My patient needs to be bathed daily, his hair combed, hygiene maintained, linens and bed clothes changed. To prevent bed sores, the bony areas of his skin must be massaged with lotion frequently. His tube feed is run every four hours. His trach is cleaned daily and changed weekly. I watch it closely as he is prone to mucous plugs, which can block off his airway in a matter of seconds. I suction him almost every hour. The administration of his medications is critical. He is a diabetic and has high blood pressure. He must be turned every two hours. He is over six feet tall. Two hundred plus pounds of dead weight. I watch his vent closely. It alarms frequently, signaling that its tubing has accumulated moisture, which must be siphoned off. I check his blood sugar three times a shift, his blood pressure every hour, as it bounces from low to high in a matter of minutes, requiring close attention to the meds which control it. His respiratory treatments are performed every four hours. He receives twenty-four medications during my shift, their names scrawled out in an indecipherable script on coffee stained medication sheets. I administer meds every hour, grinding them into a fine powder before heating them to make their instillation into the G tube easier. Medications tend to clog up an old G tube, which if blocked will require hours of repositioning my patient’s immobile body, along with constantly flushing the tube with Coca-Cola, whose obstruction dissolving powers can only be described as magical.
My patient’s daughters have billeted him in a room so narrow his hospital bed barely has room to stretch out, leaving a few feet in width around its frame. The room’s two windows look out on to a poorly paved alley in Westwood. His wife is in the next room, attended to by her caretaker, a woman who claims she was a nurse in Cuba. Again, I am the star of an edgy HBO sitcom. I was told by the agency the wife is wheeled into her husband’s room every afternoon for a short visit. I never once see this happen. The only face my patient has seen on a continual basis for the past year is the kid’s. The keeper of the flame has erected a shrine at the foot of our patient’s bed. Held captive under the glass of a cheap black metal frame is a nausea inducing poem the kid penned about his love for our charge. Surrounding this cheap sentiment are cell phones, rosary beads, remote controls and takeout menus. Our patient is suspicious when anyone unfamiliar enters his room. His eyes follow everything I do. He closes them whenever I touch him. If I make the slightest unscripted gesture, if he reads a trace of uncertainty or hesitation on my face, I will lose him.
He is a what we in the medical field, who have training and possess a license, call a nursing challenge. I like to work. I dig in.
Game plan is to wean him off of the vent and close his trach, allowing his family to hear his voice again. I will never hear this patient speak. The numbers on his arms tell me all I need to know. The days go by quickly. He settles into bed baths, foot massages, a dimly lit room and open windows on hot afternoons. When the kid leaves, I switch off the screaming Filipino soap operas and tune in TCM. My patient spends most of the day sleeping as I go about my work. He opens his eyes to stare at Rita Hayworth or Jane Russell before winking at me and falling back to sleep.
I do not foresee him getting out of this room any time soon.
My first day on my own, the kid calls me an hour before my shift ends. Can I stay late, he asks. In broken English, he whispers a mind numbing monologue about school, an RN he knows, a bus route and a bookstore. I can not leave the patient alone. The extra money won’t hurt. I stay. The second night, I get the same request an hour before I am to leave.
“Sure, but we can’t do this every night. I have things to do after work.”
The kid opens the front door ten minutes later. Guess the undisclosed location of the school is around the block. Trailing behind him is a thin white man in his mid-thirties. The kid holds a large bag from a Chinese restaurant. He refuses to look me in the eye.
“This the nurse who took care of her in the hospital,” the kid says.
The kid, like many of his Filipino brethren, has great difficulty getting her, I mean his, pronouns straight.
I give the kid report on the day’s events, peppering it with medical jargon I know he can not follow. Now, the kid wants me to leave early.
“I got hired for ten hour shifts. I’m working ten hours.”
I go into the kitchen to fold the day’s laundry. Dinner is laid out for two. Kid works fast. What I do not get, what I have never understood, is why dreamy RNs from Iowa like chubby Filipinos so much.
My fourth week in, the Cuban caretaker sees fit to talk to me, her opening salvo expressing her admiration for the way I fold sheets, washcloths and towels. I am only averaging a day a week at this gig, as the kid keeps changing my days. But I do seem to have a way with laundry. I do insurance interviews to make up the money I lose when the kid cancels my shifts. I make enough to pay rent and buy groceries. Sometimes, I have extra money, allowing me to take the boyfriend to a bargain matinee in Los Feliz. We sneak in bottles of Pepsi One and split a box of Milk Duds. What lucky men we are.
My new ally fixes us Cuban coffee. I tell her my blood pressure diet forbids it. Her eyes insist I drink. I sip. It is beyond wonderful. Its bitterness, darker than my soul at 3 AM, churns straight through my twisted Jewish gut. I have discovered the ultimate Master Cleanse. The Cuban looks like she herself has not shit in a week, but the coffee sure opens her up, she can not stop talking. In addition to my folding skills, she likes the way I suction my patient. Employing histrionics this side of Faye Dunaway in “Mommie Dearest,” the Cuban voices her disapproval of the kid’s supposed medical skills. The Cuban likes the stillness which comes over my patient’s face after I bathe him and massage his feet. The caffeine will not let her stop wailing on the kid. Seems the family led him to believe they would not only sponsor his citizenship when his visa expired, but claimed they would pay him off the books. No to both. The kid is going to school in order to stay in the country on a student visa while trying to figure out how to pay off his back taxes. The way the kid processes information, this will most likely take the rest of his rosary bead chanting life.
“Must me some school,” I say. “Different days and locations every week.”
The Cuban laughs. After a month of maneuvering my patient’s dead weight by myself, she offers to help me when I turn him.
That afternoon, my patient spikes a temp. I can not wake him up. Chest X-rays are taken in his room. Blood is drawn. The doctor makes a home visit and stays for over an hour.
These people are rich.
“He’s developed another infection,” the doctor says. “Most likely double pneumonia. Your thoughts?”
“Seems to me if I teach the kid about hygiene, show him how to clean equipment, suggest that he wash his hands, maybe things like this wouldn’t happen.”
“He’s hypnotized this family. I wouldn’t attempt to get between them.”
With death blowing in through the screen of my patient’s open window, his three daughters put in their first appearance, their tight lips smiling down at their father as their French manicured nails beat into their cell phones, their eyes gazing at their keyboards as they manage their businesses and talk over each other, telling their father how good he looks.
“How did that spot get on my rug?” the oldest sister asks me.
“The one before you did it,” she says. “I wouldn’t pay him for that day. Now, he’s suing me.”
“A white rug in a sick room isn’t ideal,” I say.
The youngest daughter looks up from her iPhone as her thumbs pound out orders to her employees in sweat shops throughout the Pacific Rim. She hates me. Every time I see her, she stares at me with such contempt in her oddly slanted eyes I feel like I am Ferapont in the all Botox version of “The Three Sisters.”
“Have you thought of bypassing the agency and working for us as an independent contractor?” the middle sister asks.
“The IRS would never know,” the oldest says. “It would be our secret.”
“I don’t think so…the kid changes my days every week.”
Silence. The wind coming through the window makes their preternaturally shining hair twitch. There is not one grey strand between the three of them.
“Besides, I’m going to be working as a substitute teacher in September.”
They stare at me. They never once blink or smile, all three are over sixty and are attired in skinny jeans and low cut cotton blouses. Their eyes are the same deep shade of green. Must be contacts.
“You have to be smart to be a teacher,” the youngest says, her eyes on the keyboard.
“You’re not flexible with your time?” the middle sister asks.
“I’m not a whore sitting in my apartment ready to be sent out on a call,” I tell her.
Their father laughs. It is the only time I ever see his pale lips form a smile.
It is hot outside, over ninety degrees. The air conditioning is off. The room is freezing.
The sisters are not lucky. White help can be so difficult, n’est-ce pas?