What’s Needling Me, You Ask? I’m Not Really Sure

This is Part 3 in the “Stories from the ER” Series I have begun to write. While the details are entirely fictional, the event which occurs in the story is based on a story once told to me by an actual ER nurse. All names have been changed to protect the idiots who come into the ER with unusual sets of circumstances.

 

Because of the high costs of insurance, many people who can’t afford health insurance – the mentally ill, the addicted, the homeless or any said combination of those — tend to use their local ER departments as a doctor’s office. We get a lot of repeat customers suffering from lung ailments – homeless people catch colds and pneumonia much easier during the fall and winter months than the warmer months– who come to see us for a) a warm place to sleep for a couple of days, b) a free dose of antibiotics and c) scraps of compassion they don’t ordinarily get from those who walk by them in utter disgust as they sleep in alleys and over warm city grates, huddled into tight little balls so they don’t freeze to death during the night.

Since this area of DC has such a high percentage of homeless, and the winters can get really harsh, every year we ask for and accept donations of old coats, blankets, hats and mittens for the homeless to take with them when we inevitably have to kick them out of probably the only warm place they’ve slept in weeks. I must admit, the first few times I had to cut dead and dying blackened skin from the fingers and toes of some severe frostbite victims really had me rethinking a move to the Caribbean.

Unfortunately, I’d really grown attached to both the adrenaline rush and Buster, my five-year old labradoodle who patiently waits for me at home when I have to work double shifts due to high volume patient loads. He is also part of the reason why I keep coming back every time – he is my saving grace and the only one I reserve my tears for when I go home and allow myself to feel the pains and anguishes I bury all day long. He never judges or chides, he just sits patiently by my side, staring at me with big, brown eyes as I let the tears flow for the especially hard cases I never had the chance to win. It seems like lately, I’ve been losing more than I have been winning.

Anyway, I have another story for you. This one isn’t a story of loss, but more of a story about mental illness, and what weird shit mental illness can cause people to do to themselves over and over again. This is Shannon’s story.

Shannon wasn’t homeless. Well, okay, she had been homeless for several  years before she met and married her second husband. She  was taken to the homeless shelter one night by a good Samaritan who had discovered her huddled in the recessed doorway of his apartment complex, shivering and mumbling incoherently to herself. He had noticed she was clean, so he surmised she hadn’t been out on the streets for long. In between mumblings, he was able to piece two and two together and found out she had, in fact, a home – but had no idea where it was or, even where she was at the moment. When the good Samaritan summoned for an ambulance, he made sure to tell them she had spoken to him some and was most likely “not homeless just very confused at the moment”. My ambulance drivers searched through her large, expensive-looking leather purse but, unfortunately, she had no identification. When they brought her in, they weren’t able to tell me much more about her, other than her name. I guess it was up to us to figure out who she was, until she was able to speak for herself.

Bud and Gerry, my drivers, wheeled her in through one of the back door bays, and quickly called me over to her gurney. Assuming the worst, I peeled the gurney out of their hands, mumbled a quick “thanks guys, I’ll take it from here” and started rolling her down the long hallway to find an available room for her. I thought at first she might be another cardiac patient because she was a little blue in the face and lips. However, after further assessment, and hooking her up to the monitors, I could see the EKG was pretty solid, except for an occasional hiccup. The readout indicated Shannon was stressed, but certainly not arrythmic. I was relieved, because I was able to stall for time and leave her be for a few moments to attend to the screaming child with the broken leg who had just been carried into the waiting room, screeching and flailing about as his diminutive mom was trying her hardest not to drop him onto the hard, tiled floor as he tried to squirm out of her arms. It really never is a dull moment at work.

Once the chaos and confusion ended, I headed back to find Shannon fully awake, a little glassy-eyed as she tried to figure out how she got to where she was currently. Her hair was completely disheveled, but as she ran her hands through her hair, I saw something that told me Shannon was neither homeless nor even poor. In fact, my guess was that she lived in a very affluent suburb of DC, and ended up in my ER merely by a series of unfortunate circumstances. Shannon’s fingernails were freshly, manicured. And on the ring finger of her left hand, she was wearing the largest sparkler I’d ever seen – and most likely will never be able to afford. I put its value somewhere in the same price range as my first house.

She caught me looking at her ring finger, and immediately rolled the hand into a clenched fist. She must have assumed I was going to steal it from her. I approached her and said, “Hi! I see you’re awake now. Do you know where you are?” Shannon looked around the room, a baffled expression on her face, then looked back at me and squinted to read the words on my name badge. She grunted a little, crinkled her very perky buttoned nose in what I could only describe as “disgust” and, to my utter surprise, spat out, “What the fuck am I doing in this shit hole? Who are you? Why am I here? What the fuck is going on? WHERE IS MY HUSBAND! He would be appalled to find me here. Get me out of here. Get me out now!”

Something had set her off, and I think it was her less-than-first-class medical accommodations. And me – some lowly, barely blue-collar male ER nurse, whose only fault at the moment is showing compassion for someone whom I can only describe as “a high-maintenance, frigid bitch with cunt-like tendencies.” Yeah, I can’t write that on her medical chart, but I sure can think of her that way in my head.

Shannon sat up, took one look at her hospital gown, and went off on me again! “Doctor! Where tšhe fuck are my clothes?! Gimme my clothes back, you asshole! I paid five thousand dollars for that top — you had BETTER NOT had to cut it off me or I am suing  you, your hospital and everyone else I find out who is involved in holding me against my will! How DARE you put me in this piece of crap cotton – COTTON! I haven’t worn cotton anything since I was six! — get me my clothes!”

All of her screaming and scene making had caused quite a reaction from the rest of the staff. Suddenly, I found myself sharing a bedside emotional beat down with the ER doctor on duty and three other nurses – who were checking to make sure the bitch hadn’t decide to stab me with a pair of suturing scissors when I turned around to grab a pair of sterile exam gloves. Fortunately, we’re trained in nursing school to calmly continue and speak with a calm, soothing tone, for situations such as this. I maintained as blank a stare as possible, indicating I wasn’t going to cower or kowtow to her demands. I just paused and waited until she was calm enough, once again, to let her know why I was worried.

I proceeded slowly. “Hi, my name is Jeff and, no, I am not the doctor here, just the head nurse.” She opened her mouth to protest, once again, but I held up a hand and cut her off before she could lay into me. “As I said, I’m an ER nurse. You’re here in George Washington, because of a good Samaritan’s efforts. You had passed out, of sorts, in front of his apartment complex. He called for an ambulance and my drivers brought  you here. I’m just here to make sure whatever brought you here can be identified and treated, so it doesn’t happen again –” She bit her lip a bit, and was just about to lay into me when, again, I cut her off, “Ma’am, your safety and health is my number one priority at the moment. And honestly,” I paused for a moment, searching for the perfectly rude yet still professional thing to say that would cause her to drop the arrogant, self-entitled bitch attitude she was giving me. Unfortunately, I think I missed the mark. “Honestly, to be walking around in this area of the city wearing a rock the size of the one on your finger is dangerous. People kill people for that amount of extravagance.” Yeah, I can be a bit of an asshole myself when pushed too far.

That seemed to shut her up. At least she wasn’t demanding any special treatment any longer. I continued in my interview, “Do  you have any idea what you were doing before you passed out? Anything coming back to you?” I put my hands to her neck and checked her heart rate through her carotid. They seemed normal. I put the tip of the thermometer in her ear, and waited for the beep – normal temp, good. I used the penlight on her eyes – normal dilation, then I looked up her nose — everything checked out at first glance. Other than looking somewhat disheveled, I had no theories on why Shannon had ended up in my ER. The fugue state she had been found in, was a bit of a mystery as well. Only bits and pieces of it were coming back to her as well.

“I was out with my husband. We had just celebrated his second – and final step promotion – as CEO. He’s the CEO of World Bank — he worked himself into that position practically from the ground up, I’ll have you know…” She was going off on another self-congratulatory, high falootin, brag a thon, when I interrupted her again. I just didn’t have the time or patience to listen to such snobbery. “Can I see your arm for a sec? I’d like to get your blood pressure…”

She rolled her wrist over and offered it to me. That was when I noticed the large, blotchy patch of red that went from just under the bottom of the palm of her hand to midway down her forearm. Her skin was raw in spots — she obviously had been scratching at it for some time – possibly days. Regardless, it didn’t appear to be psoriasis, or ringworm, or any of the other thousands of potential viruses and skin ailments I’ve seen over my years. I was, however, alarmed at how red it was. It almost looked angry.

“What’s going on here?” I asked her – pointing to her rash. Shannon looked down at her wrist, grimaced and – almost disconnectedly, said, “That? Oh, that’s for when I’ve been a bad girl. That’s my punishment.” Her voice had changed. Gone was the angry, pushy, wealthy socialite with the loud, aggressive voice, hell-bent on ruining my career. Right before my eyes I saw her change. She pulled her arm out of my grasp and, furiously rubbing and scratching at her bright red rash, she squeaked out in a tiny, almost childlike voice, “My needles. Mine. Bad Daisy! Bad, bad, bad!” I couldn’t believe what I was seeing take place before my eyes. Shannon, this big, brash, larger than life woman, was regressing into a child. I watched as she started curling into a little ball on the bed — trying to shrink as far into the bed sheets as possible.

I suddenly had the impression that I needed to call in a psych consult for her. Perhaps a psychiatric evaluation can be of help here. I’d never seen anything like this before – and felt it was out of my depth. I could, however, help relieve her of the pain and itching coming from her wrist. I leaned in for a closer inspection. I place my two fingers on her wrist and felt a series of small ridges. I moved my fingers over the ridges and felt something under the skin move as well. Shannon had something stuck under her skin. I rushed her down to the X-ray lab and had the technician run some prints for me. Fifteen minutes later, I got my answer: sewing needles. Shannon had over forty of them, at end of count, shoved under her skin. How long they had been there was anyone’s guess. That was,  until the psych evaluation came back.

Shannon, as it turned out, had dissociative identity disorder. More commonly known as multiple personality disorder. Through picking apart and putting together bits and pieces of her story, we were able to locate her regular psychiatrist who confirmed her case.

What I had seen that night, other than the rash of course, were two of the seventeen personalities this patient has living inside her. That explains how she ended up in the doorway of an apartment complex in a bad area of town. It turns out one of those seventeen personalities decided to turn a few tricks that evening.

Who knows how things would have turned out  for her if it hadn’t been for that good Samaritan. I, too, might have cheated another date with death as well.

 

 

Change Partners

The following is a response to my writers’ group prompt: “Take two to three words from a song and write a story”. Change Partners is a song by Stephen Sills.

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Lately, I’ve been thinking a lot about setting up a menage a trois. Why? Maybe it’s because I lead such a vanilla life. How “vanilla” a life? I’m a CPA. And if that doesn’t sound vanilla enough, let me add a few other clues:

I drive a station wagon. Not just any station wagon, but you know the one with the fake wooden side panels? Yeah, that one. I’ve had it ever since I inherited it from my parents as they sent me off to college at, where else? Purdue University in Indiana. The heart of vanilla country.

Despite how absolutely nerdy I feel and look driving this car, it comes with a story too good not to share. And, it’s part of the reason I have it in the first place. If you were able to look in the back seat – all the way in the backseat,  you would find a couple of words carved into the faux leather seat covering. They’re all but faded now, with only a semi-perceptible outline remaining. After all, the car is over twenty-five years old. I’m twenty-three. So, if one did the math correctly – and trust me, as a certified, licensed, board approved, vanilla laced CPA living in the heart of nowhere, USA, you’d pretty much be able to figure out what those carved words actually say. Okay, so maybe you can’t. Let me fill in the blanks:

Stanley Norman Alexander Preston, 6-12-83

Yep, that’s good ol’ me, Stanley. Or, SNAP for short. You see, twenty-three years ago, on a warm summer’s night, in the back of my parents’ (now mine) very vanilla, very classic station wagon with the fake wood paneling, semi bald tires and gas guzzling tank, I was conceived – a child born of passion, lust, and the unfortunate by-product of a swingers’ party.

Six years ago, my mom and dad were struggling to get along. Mom had always been the happier one of the two. Dad, well, he was a bit of a prick to both mom and me. I never actually understood why until THE FIGHT happened. Oh sure, I’ve heard them yelling and snapping at each other often – what kid doesn’t grow up hearing their parents fight? Mine were no exception. They’d find the silliest things to argue about – the toothpaste cap was left off, there wasn’t enough gravy for the mashed potatoes, anything unexpected, out of order or just plain annoying to either of their perfectly boring lives was perfect fodder for an argument. But, after a few nits had been picked fairly raw, they’d usually run out of steam and eventually just head to their separate corners – mom to her sewing room and dad to his garage, to find something to dither over until the storm had completely passed.

So it was a bit of a shock, needless to say, when I was studying in my bedroom one night and noticed that the volume of their argument was much higher than any other one they’d ever had. I tried to shut it out the best I could and just cranked up my radio a bit higher. That worked for a while until I heard the crash and subsequent sound of glass shattering in the room across from me. I dashed out of the room to see what had broken, when I heard my mother screeching at the top of her lungs “YOU ARE STILL PAYING FOR  HIS COLLEGE, REGARDLESS OF YOUR PATERNITY, YOU SELFISH ASSHOLE!” My father was cowering in the corner, hands and arms covering his face, small shards of glass glittering in his hair. I wasn’t sure what to do so I just stood there – stunned to all hell, as both my mom and dad (what had I just heard? something about paternity?) rushed over to me and, fight forgotten, pulled me into the living room and forced me down on the couch.

“Son,” mom smoothed her mini-skirt down, crossed her legs and folded her hands in her lap, trying to regain as much composure as possible. Dad took a seat in his leather recliner, leaned back and began picking glass fragments out of his hair. His purpled cheeks said he would need a lot of time to calm down before he could speak, unless we wanted to witness a brain aneurysm happen right there in the living room of 4714 Vanilla Drive, Anywhere USA. Mom continued.

“Son, I am so, so sorry you had to hear what you just did. It was never our plan or intention to mention the subject ever again. We –your dad, er – um, George over there – and I promised ourselves we’d do everything we can to give you as normal a life as possible…um, uh –” Mom was trying, and failing miserably, to get through the story with as little discomfort as possible. Dad just sat there quietly as the blood continued to drain from his face. I, on the other hand, was growing increasingly confused. I begged mom to continue.

“Well, son…here’s the thing,” she stammered a bit, but held on long enough to offer a partial explanation. “When we–” mom pointed to dad, then back to herself “When we were newly married, we, um…kinda. Oh how do I tell you this? We –”

“For God’s sake, Norma, let me do this.” Dad was back to his normal cranky self. I turned to look at dad and, perhaps for the first time, saw that his features and mine didn’t quite match. I had brown hair, brown eyes, and  he had blond hair and blue eyes. I was short and squat, he was tall and thin. As for mom, she was a redhead and from what I know about redheads, they’re sort of a mishmash of genes. Mom was a mutt, so I could have come out anything but albino and mom would have been able to pass off her very differently featured son as hers. My true dad, however, was obviously not the man who I have watched fall asleep in his recliner every night at 8:45 since I was old enough to remember. I felt a little panicky, I must admit.

The man I no longer thought was my dad continued, “Stan, it’s like this. Your mother and I were in a real romantic funk. We had stopped having the kind of mind-blowing, roll your eyes in the back of your head, blow the top off –” “GEORGE!’ my mother interrupted, “I think he’s got enough of an idea…” she chided. She was right. I really did not want to, or need to, hear about my parent’s sex life. For all I had convinced myself, they hadn’t had sex since I was born. However, George insisted on barging forward with the story. I think he was enjoying the memory, to be honest.

“Norma was feeling a bit randy one day, and since it was so close to my birthday, I decided to toss out an idea so wild, so foreign to the both of us, that we needed a bit of time to get used to it. You see, we wanted to find another couple to join us in the bedroom.” I started feeling nauseated. Was I really sitting here hearing about my parents having sex with another couple? What the hell?

“We found the couple through a newspaper ad. Sure, it was a huge risk to take – we were worried they’d come over, hurt us,rob us blind, then steal the station wagon and drive off. The wagon was brand new and back then, it was quite the car because of the space in the back, if  ya know what I mean.” Dad winked at me knowingly. Even though I was seventeen, and knew exactly what he meant, my only thought was eww, eww, eww. I wanted to put my hands to my ears and roll into a ball on the floor. This was becoming more and more unbearable to hear. But of course, dad needed to finish because, we’ll he’s a guy and, now that I’m the age he was when all this was going on, I get how important it is that he bond with his son over sex. It’s a right of passage, so I’ve been told.

“Anyways, things were going along smoothly, Norma and John – that was the guy’s name, and me and Deb – that was his wife’s name, were flirting with each other. I had the booze out and was serving drinks all around. The alcohol was passed between us like a water jug. Then, things just got wildly out of control.” Dad paused a moment, the memory obviously right in front of his eyes. Mom, meanwhile was caught between awkward and titillated. I didn’t know. I really didn’t want to know anything at that point. I just knew things were about to get really uncomfortable for me.

“One thing led to another. Mom and I were together one minute, enjoying each other’s bodies, then out of the blue someone would yell, “Change Partners!” and we’d all shift positions like some kinky game of musical chairs.” Dad poured himself a bourbon on the rocks. Mom finished it up for me, but only after scrubbing the story clean.

“Stan, the man you think is your dad, really isn’t. John, the guy from Dad’s story, is actually your father. He and I had a wild romp in the back of the station wagon. Unfortunately, we didn’t think about protection until it was too late. And,” mom shrugged her shoulders matter-of-factly and finished, “here you are, years later, getting ready for college. We’re so proud of you, son!”

Mom had a way of finishing stories with absolute finality. I could hear from the tone in her voice that what they just told me was all they were going to say on the subject. It was over, done, and life was to go on. However, I had one final question to ask them. I wanted an honest answer, too.

“Mom, dad – can I still call you dad?” I sputtered out. “How do you know dad isn’t my father? After all, weren’t you..um, man this is awkward, all screwing each other at the same time?” There, it was out. “I was really hoping that dad–I pointed to the man in the recliner–THIS dad, I mean, was my real dad. But, now that I know what  happened, I was wondering if I could see a picture of my possible dad?”

Mom snapped her fingers together in an aha! motion and hopped up quickly. “Of course! That’s it! Let me go dig out one of the pictures we took. Geez, we were all so drunk, I don’t remember much about that night except for the other couple’s names. I’ll be right back.”

As mom was searching through her closet for a long ago picture of who might possibly be my real dad, the only dad I had ever known was drifting off to sleep in the recliner, empty rock glass still in his hand. Obviously that wasn’t the first drink he’d had all day. I was still trying to wrap my head around the whole story when I heard mom shouting from upstairs. She was whooping and hollering like crazy!

Dad was startled awake again, and rocketed out of his chair like someone had just set his hair on fire and his ass was catching up. Mom flew down the stairs, shaking an old Polaroid picture pinched between her right thumb and pointer finger. She was practically bursting with excitement. I, on the other hand, was a nervous wreck. I was about to see who my real dad was. I wasn’t sure what to think about anything at this point.

Mom came barreling into the living room and ran right to dad, holding the picture up to his face and grinning from ear to ear. Dad took the picture between his two fingers, shook his head back and forth a couple of times, whistled softly between his two teeth. He looked from the picture to me, then back again. Then, he started to laugh – a deep, belly laugh that practically shook the pictures off the wall. I watched the two of them as they huddled together and hugged each other, laughing so hysterically mom had tears streaming down her cheeks. I wasn’t sure what to do, so I just asked, “Well, can I see his picture?”

Dad caught his breath one final time, wiped the tears from his eyes and said, “Oh son, there is no doubt I’m your father.” I perked up, hoping of all hopes that he was being one hundred percent honest with me this time. I asked, “What makes you know for sure?” I challenged him. Dad took the photo between his fingers and chuckled one last time. He turned it towards me and said,

“Because John and Deb, well, they are both black.”

I guess I really am “vanilla” after all.