The Making of a Nurse (11 page)

“Am I in heaven?” Samuel asked.

Why not let him think so, if that would comfort him? I guess I had learned a thing or two from Hannah by then. I nodded yes. Was it lying? If so, I didn’t care. I bent down and kissed his dear forehead. I had never done something that intimate to a patient before.

I stood there and began to weep, for him, for Shaul, and for all of the patients that we’d lost and were going to lose.

“Nurse Teelda?” Tikva stood at the door. “Come now, please! Mom needs you.”

I hurried out of Samuel’s room and rushed past Yuri’s room where the
TV
was still on. It was 3:30 a.m. and despite himself, he’d fallen asleep, the remote control still in his hand. Abdullah’s mother watched me. I felt she wanted to help me but didn’t know what to do, so she stayed by her son’s side as if to indicate that she would tend to him if he needed anything and thus lighten my load by at least one patient. For the rest of that night, as I rushed from patient to patient, I felt the weight of each decision I made, of each
action I took or did not take. Each one held a practical implication, but also a huge moral freight, too. If I ran to hang another unit of blood for Geula, I might not get to Samuel in time to suction him and he would suffer and be afraid. If I stopped to readjust Samuel’s oxygen mask and comfort his wife, Geula’s naso-gastric tube might clot off. Talia was sleeping peacefully, but she was due for medications and they would have to be given late. I kept running as fast as I could in all directions, doing as much as I could.

Tikva was getting frantic. “When will Dr. Ben Cassis be here?” she asked.

“In the morning,” I said. It was almost 5:00. I imagined him in bed lying beside his wife.

“How could God do this to us?” the daughters cried, standing around their mother’s bed. The husband sat in a chair, sobbing. Geula’s breathing was raspy and heavy. They understood that her kidneys had stopped working. They saw the pools of blood all around her. “Do something!” Tikva shouted at me. “Do something!”

It was 6:00 a.m. In an hour everyone would be there. “The doctor is on his way,” I said to them. I looked out the window, scanning the horizon for the sun. The night sky was giving way to a violet sky with streaks of orange that promised that day would come. I looked at the mess I’d made. Empty vials and used syringes were strewn all over the counter. I had thrown a drained bag of blood at a garbage can and missed and I watched the last few drops drip onto the floor.

“You should have called us,” they all said when they arrived, but I could tell I had won their respect for having toughed out the night on my own. Aviva got straight to work tidying up, shaking her head at the disorder. Ben Cassis sat down and started grilling me about each patient. “What did you do then?” he asked. “Next? … What then?” He seemed satisfied with each answer I gave, but kept on going. Hannah went into the tiny on-call room, off of the nurses’ station and left the door open so that she could see and hear everything. She wanted to intervene and tell him to lighten up, but didn’t dare interrupt. Jamilla arrived with her friend Fredja and they were
chattering and laughing as they started up their little
finjan
on the stove to brew Turkish coffee and then began the morning
sponja
. Aviva wiped off the countertops. “Whose medication is this?” she asked. She held up a syringe filled with clear yellow fluid. I stared at it in her hand.

“How did Talia deal with the high dose of Amphotericin?” Dr. Ben Cassis continued his interrogation. “Did she have a reaction this time? Any chills or rigours? What’s her temperature?”

“A reaction?” I asked slowly, stalling, thinking it through.

“I hope you gave it slowly, with lots of fluid. Did you do that?”

No, I hadn’t given it at all. I had prepared it and drawn it out of the vial, but I hadn’t given it to Talia. I gulped for air, but my throat closed up tight. “I forgot to give it,” I squeaked. Aviva ran off to tend to Geula as I stood stock-still, quaking in terror, staring at that syringe on the counter.

“What? How could you be so stupid?” Ben Cassis pounded his fist on the tabletop. “Damn it!” he shouted. Hannah jumped up. I thought he might hit me, but words were his blows. “You could have killed her,” he screamed at me, switching to English, as if its foreignness might help him restrain himself from murdering me. Maybe he did it to even the playing field, otherwise it would be like crushing a bug. He was a powerful, intimidating man, but he was not a bully.

“I know, I know,” I cried.

“Surely you realize that a patient as immuno-compromised and vulnerable as Talia could quickly become septic!” he raged at me. “She could die from a fungal infection!”

I stood there taking it. I deserved it. It was part of my punishment.

“This is a matter of life and death here! Don’t you realize that?” I nodded and looked down at my blood-splattered running shoes. “If Talia dies, it is because of your carelessness.”

“That’s enough.” Hannah stood in between us. “Go home,” she whispered to me. “Talia will live or die regardless of one missed dose.” I couldn’t move. Hannah took my face in her hands. “Go home, sweetie. You need sleep. See you tonight.” She pushed me toward the door. Dizzy and exhausted, I stumbled out and onto the
dirt road at the back of Barrack Thirty-six Alef. As I began to make my way home, the wailing began. Geula’s daughters’ grief shook the old building.

I reviewed the night. I must have reasoned that Talia, the youngest and the most curable, could likely withstand more temporary neglect than the others. Although the others had less chance of survival, I felt certain Talia would make it through the night. And even though we were not actively treating Samuel any more, I had to ensure he was comfortable and didn’t suffer. Geula’s fierce daughters intimidated me and I was afraid they would blame me if she died during the night, while I was alone on duty. So, even though Geula had been closest to death, I had worked the hardest on her. My thought process was flawed because it was motivated by fear.

I made it home and didn’t even bother to shower before flopping onto my bed, still in my uniform. I tried to sleep. The phone rang and I jumped up. As I flew to it, I felt certain it was Ben Cassis calling to tell me that Talia had died. I answered the call and instead took a message for my roommate to call her mother. Finally, I fell asleep and when I woke up it was ten o’clock that night, barely time to rush back to work by eleven o’clock for another night shift.

That night new patients were in Samuel’s and Geula’s beds, now freshly washed and made up, completely innocent of the suffering they had recently contained. Yuri was watching the
TV
show
Top of the Pops
, the weekly hit parade of tunes, and waved to me as I walked past. Abdullah had been discharged home that morning. Only his mother and I knew what had gone on that night.

For months after that night, I avoided Ben Cassis. Of course, I worked with him and saw him every day, but I never made eye contact with him. I felt cowed in his presence and kept a low profile. I started getting headaches before going in to work and I checked and double-checked myself even more than ever. How could he ever trust me again? I asked Hannah for some time off, but she told me she didn’t have anyone to cover my shifts.

A FEW MONTHS LATER
, on another night shift, I had an opportunity to make peace with Ben Cassis. I took over from the day nurse and she gave me report about Dawud, a twenty-two-year-old man from Gaza, recently diagnosed with leukemia. He was coughing up blood and his blood pressure was low. Shortly after she left, I took my own reading and could barely detect it. His pulse was weak and thready. He was cool and clammy. I opened up his
IV
and let fluid pour in and called Ben Cassis at home and reported my findings.

“He’s gone into septic shock,” he said to me. “Damn it,” he said to himself. He began to outline exactly what he wanted me to do: give lots of fluid, plus two units of packed red blood cells, ten units of platelets, start him on a different, stronger antibiotic and a drug I wasn’t familiar with called Dopamine. “What’s that?” I had to ask him because there was no time to look it up as I was taught to always do. “Dopamine is a powerful drug that will constrict the vasculature,” he explained, “and it will raise the blood pressure.” I hung up the phone and got to work.

“Ya! Allah!” cried his young wife along with his mother and sisters, who gathered around his bed. “Ya! Allah!” they wailed and threw themselves upon his body. They had turned his bed around to face Mecca, in case he should die before the morning. As I hung the first unit of blood, I looked up to see Dr. Ben Cassis walking in the door. For the rest of that night we worked side by side. I gave the antibiotics and assisted him as he inserted a central line into the patient’s subclavian vein through which I could run the Dopamine faster and more safely. I took care of the other patients while he stayed with Dawud. At dawn, we took a break and sat down at the nurses’ station. I thought about Aviva and what she’d say when she arrived in the morning. She would look at the mess and exclaim, “You made all this effort for a guy who might go on to bomb us?”

He looked at me and, as if reading my mind, said, “We must never hesitate.” He raked his fingers through his dark hair. “The Arabs hate us and don’t want us in the West Bank or the Gaza Strip. I dare say they don’t want us in Tel Aviv or Haifa, either. The bottom line is that they don’t want us here at all. However, we
must have no hesitation whatsoever about what we do as doctors and nurses.”

I got up to make us coffee and when I returned I saw to my utter embarrassment that he was reading my journal that I had accidentally left out on the desk at the nurses’ station. Because he had opened it from right to left as he would a Hebrew book, he wasn’t reading about my wild adventures and fantasies (many involving him) but rather from the few pages at the back where I kept a running list of the patients who had died, along with a few details to always remind me of each one.

“Why do you do this?” he asked sadly. To him it was a list of his failures.

“It’s how I remember them,” I explained. He looked at me. He stood up and drew me into his arms. I could feel his breath on my hair. “Oh, Teelda,” he said in that ice cream way they all had of saying my name. Then he kissed me. The thought of war and enemies so close by was such a turn-on. (Funny how peace and reconciliation doesn’t have the same effect.) I wanted to stay in his arms as long as possible, but within seconds, I felt the kiss melting away and the hug petering out.

I HAD BEEN
in Israel almost a year to the day when I got home from work one evening to find a message on the answering machine from Pearl: “Your mother is sick, man. She had a stroke and is in the hospital, but she is okay. Good enough. God is love.”

It was spring and once again the sweet smell of the orange blossoms in the groves near the hospital filled the air. The hills in the cow pasture were covered in wildflowers. Just as everything was coming into bloom, I had to tear myself away from it all, and return to my dreary responsibilities back home. As I packed up to go, I thought back over the year. Talia was completely cured and in her first year of law school. Abdullah was in remission. Yuri was feeling great and came to visit us with his girlfriend to tell us they were engaged. Dawud made it through that difficult night, but died a few months later. Shaul was at home dealing with terrible bone pain. I didn’t inquire about any of the others. I was leaving.

Ben Cassis said goodbye. “You are a fine young woman and an excellent nurse. I’m glad we didn’t ruin you. We wish you well.” But he must have known what I felt for him because he tenderly touched my cheek as tears dripped down my face. He bent down to speak softly to me. “We’re friends,” he said, “and friendship is more important than love. Remember that.”

Aviva and Hannah hugged me and then I got into a taxi and headed for the airport.

S
traight from the airport, I took a taxi to my mother in the hospital. She lay in a bed, the side rails up around her, unmoving and unresponsive. I don’t think she saw me, much less recognized me.

“She’s beeyootiful.” Pearl fluffed her hair with a brush. “Getting better every day.”

My mother was now bedridden and paralyzed. She could no longer eat and had to be fed through a tube. Now that she required around-the-clock nursing care, the hospital had become her home, but Pearl continued to visit her. My mother spoke very little, but as I got up to leave, I heard her mutter, “I wish I had a daughter like her.”

My mother’s home had been sold, so that night I stayed at my friend Joy’s house. Her mother, Bunny, took one look at me and seemed to understand how bad things were.

“Just take it one day at a time,” she said, soothingly.

I couldn’t bring myself to tell her that I was so low I was going minute by minute.

The next day I went back to my mother and this time she was sitting up in bed and more alert, but was very agitated. “You and your friends are going to jail,” she said when she saw me.

“See, her head stay up when you’re here, girl,” Pearl exclaimed. “For you!”

“She’s not making any sense.”

“But when she open her mouth to sing, the voice is there, right there!” Pearl slapped the back of one hand into the palm of the other. “You can’t add to it and you can’t take away from it.”

“Don’t close that on me!” my mother cried out.

“Close what, my dear?” Pearl bent down and put her arm around her and leaned her dark head close to my mother’s colourless lips. “What is it, love?”

I fled from them both and descended into the subway and rode the train for hours. Those subway tunnels became my subterranean hideout. There wasn’t much I could do for my mother any more and I knew I had to start looking for a job, but I couldn’t face it right away. I needed to be alone. So, between short visits to my mother in the hospital, I rode the subway thinking things over. I tried to block out my grief over my family situation and the yearning I felt for the exciting life I’d left behind in Israel. I stayed underground, riding for hours, thinking things over. Sometimes I just rode, my mind completely empty. I would doze off for a few hours here and there, and manage to get enough sleep that I could walk all night through the city streets.