Dennis McBride, 3/13/2011
Former Occupation: Respiratory therapist for over 20 years in the Portland area.
Yard Work, Salal and the Kindness of Strangers
Even at an early age I knew that pleasure was serious, that it came way before the top ten of anything. When I was young it was just unavoidable, it was everywhere, my head on the pillow, watching a dog sleeping on a sidewalk in the sun, or the golden brown syrup pouring onto my waffle. When I was older and began to realize that the world meant business I learned to complicate pleasure out of all possibility. But a fugitive part of me always knew it was still here, so even when I grew up I did not “put away the things of the child.” Even a quick glance at the world of grown-ups told me they had nothing to compare with simple pleasures.
It is strange how beginnings never seems to begin at the beginning, just the way things don’t really seem to happen till a while after they have happened. My beginning, or rather the tardy recollection of my tardy beginning (since our real beginning, though ours, is denied to all of us) began with the sight and smell of sea salal. All of my attention shrunk to those thick, sharp, dark green, oddly lush bushes that surrounded the sidewalks of the small seaside town I found myself deposited in. Even my mother existed in their background. Whenever I recall her I see salal. I don’t know where she is now, she’s been dead for some time, that is, some time for me because for the dead it must be like you’ve always been dead, outside of time, which is why the peace passes understanding, all of life being so sudden and all.
I can’t remember my first life events though I know they occurred, that startling introduction to the world and then to myself. They are buried in the labyrinth of my neurons’ synaptic maze. My earliest recollections are but the third or fourth car in the locomotive’s long torn trailer. It is in those first few dim cars that the inscrutable instructions laid down the narrow tracks on which I traveled through the wide world, all the way to today, to two hours ago, when I buried the one I had lived with for eight years in my backyard next to the wood pile. The reason I did that was not, of course, a reason at all, but rather the result of the fugitive forces of those first forgotten filaments of being. I did it for the simplest purpose. I had an intrinsic disinterest in ceremony, in any proper, public or official method of disposal, again, not because of some reason but because of the force of those ghostly filaments whose form and frame remained, commanding, outside my intention, my every action: free will being merely the awareness of consciousness parading its action as choice. I just forced the shovel into the ground and displaced the earth and then did it again, and then again, until a grave, through the gradual disappearance of earth, appeared as cleverly as though it was the result of my complete, discreet choice, rather than a combination of unremembered influences which had accumulated as invisibly and effortlessly as lint.
If I tried to explain clearly from the beginning the how and why, it would be as ultimately unsatisfying as God’s was in Genesis, when, after all, the question is merely begged again. Philosophy, like prayer, is one of the final expressions and confessions of human powerlessness, but unlike prayer, the power of philosophy or explanation is limited to the reach of understanding, the way a walk on a fishing pier is limited by the length of the pier.
I always hated being paged on the way to the hospital cafeteria. That day I was particularly hungry and the “Jesus Christ” that slipped out of me at the sound of my pager going off was louder than usual—drawing disapproving glances from two nurses walking down the hall twenty feet in front of me. “Respiratory call 3 South intensive care 311.” I stopped at a wall phone outside the cafeteria and dialed. Susan King, the ICU charge nurse, commanded in language cleverly disguised as a request that I come right away and look at the girl in bed 2 who had been coughing up a little blood from her tracheostomy. It was queen to drone. I hung up the phone and headed to three south.
When I arrived I pulled her chart. She was a 19-year-old MVA victim who had been transported from The Dalles two days ago for multiple internal injuries. They had done a splenectomy yesterday and she’d had an unremarkable post op course and was expected to recover nicely. Home Health was already working on her discharge which was planned for the end of the week. I saw that she had had a bronchoscopy in the morning and I told the nurses that the bleeding was probably secondary to that. Then I called her attending, Dr. Elsin, and told him. He agreed but asked me to change her trach as they had put one of the old metal Morsch tubes in her at The Dalles. We agreed on trying a new plastic Portex.
I casually approached her bedside. Her mother was sitting in a chair beside her knitting. I told them that I was going to put in a newer trach tube that would be much more comfortable. Her mother rose and set her knitting down in the chair. She said she was ready for a stretch and would go down to the cafeteria for a quick bite. She looked at me, “How long a bite should I take?” “About 15 minutes including dessert,” I said. She gave a squeeze of her daughter’s foot as she passed the end of the bed and pointed at her knitting, “watch my masterpiece,” she said and sauntered out. I went and got the trach tray and laid it out on the bedside table. “You looking forward to getting back to The Dalles?” I asked. She nodded with a glad look and flashed me a thumbs up alongside a slight look of nervous apprehension. “You’ll like this tube a lot better, you can talk with it,” I said. Her eyes shined in a delighted smile.
I raised the head of her bed to about 35 degrees. “This will be real quick but it might make you cough a little when I put it in. I’ll just cut that string around your neck, and it’s out with the old, in with the new.” She gave a small anxious “whatever” sigh with her eyes then reached for her pad and pencil and wrote, “cliché’s make me cough.” I laughed and cut the string, then said, “Okay, I’m just going to put this suction catheter down for a quick vacuum job and bring them both out together.”
The suction catheter caused a strong spasmodic coughing spell. I pulled the trach tube out quickly and had the new one half way in when a sudden force of blood flooded through it and around it. I put the suction on “high” but it just kept coming in larger pulsating streams. My stomach tightened as the small alarm in my mind started going off. Her eyes quizzically monitored mine for signs of an “it’s nothing to worry about” reassurance. A sudden gusher of bright red blood forced the new trach tube out onto her gown. I tried to put it back but with the steady pulsating gushers of projectile blood I couldn’t even see the surgical stoma opening in her throat, but then caught a quick glance of it and finally forced the tube in with a frantic thrust. The suction couldn’t keep up with the rush of her blood. I avoided her eyes which had moved from a trust in me, in my white coat, in The Hospital, to a small sudden suspicion of “something wrong” then to an involuntary animal fear. The terrorizing thought “artery” turned the knot in my stomach into cement.
I kept inflating more air in the cuff of the trach tube but it didn’t even slow the rapid increase of rushing blood. I yelled out “Nurse, I need help now!” and two came running in, “Get another suction and get the house surgeon here stat.” then turned my head back to her again. The blood was flowing slowly out of her nose and ears and the corners of her eyes. I froze. We locked eyes for an instant, an accident, the panic in mine delivering a terrifying knowledge to her and through her back again to me, a knowing beyond comprehension yet, somehow, within it.
That was the last time I looked at her. I never saw her again. I can’t even remember her face now. The surgeon arrived and pronounced her. I went into the break room behind the unit and sat down on something. Fear. That was all I felt. Just fear, for almost the whole month afterwards. I forgot about the mother, didn’t even remember her for several years. Now she appears in the oddest places, at street intersections when I’m waiting for a red light, in the dentist chair, stepping into the bath, or raising a fork to my mouth.