Sundowner

by | Jun 28, 2016 | Fiction

 

 

The rural hospital where her father languished was brand new, a sparkling edifice improbably situated like some medical temple in a cow pasture. It was such a young building to house the old. Dr. Christine Hartford hurried to locate her dad’s room. She’d been given directions in the social worker’s melodious Outer Banks drawl. Finding Joe would be easier for Christine than accepting his condition.

Christine the daughter wanted to preserve his life, but Christine the microbiologist knew the limits of over a thousand organisms. Elderly and struggling with sudden illness, her father wasn’t likely to survive.

Still, unlike many of the patients in the ICU ward, Joe Hartford was conscious when Christine entered his room’s bleak light. He was breathing precariously on his own. His athletic fireman’s physique was condensed down into a prune-like shrivel, but Christine wanted to believe the desiccation was normal and due to the 75 well-lived winters on him. Joe’s sagging skin hung down his frame like beige blankets about to fall off the bed to the floor. Sickness appeared to be peeling him, whole. The old man lay weak and perplexed on his back in an attitude of wondering how the hell all this happened.

“Dad, it’s Christine,” Dr. Hartford whispered to the old man draped in plastic tubes. “I’ve come to be with you. You’re going to get through this. It’s going to be all right.”

Joe Hartford raised an eyebrow as if he had his doubts. “Don’t know,” he murmured.

“Can I get you a cup of ice chips?” Christine asked softly. The fetching and pouring out of water would become a routine that developed between them. Christine thought it brought a kind of friendship to herself and her dad, a type of communion, even. Joe gave a wan smile and a little nod. “Sure,” he said.

The daughter scooped out the ice and placed a cube into her father’s wrinkled mouth. She stood by the old man’s bed, stroking his thin-fingered hand. It was a small gesture, offering a cup of water to the sick, but Christine wanted the ice to taste of her love. She wanted to put her mercy into that cup and share it with Joe.

“Chrissy,” the old man said, struggling to communicate. According to the social worker, Joe was made frail by an unexpected surgery on a nest of twisted organs when he had thought he was going downtown to load up a new window air conditioner. If he had been in his right health, Christine knew Joe would have laughed at the idea of dying in the act of lifting a household appliance. After all that her father had endured and escaped, a fireman being snuffed out by an air conditioner would’ve been too ironic. “Chrissy,” Joe whispered again, “lemon chess pie would be better.”

Christine Hartford didn’t chuckle. It wasn’t humor her father had meant, she felt. She thought it was more like a preference requested for a last meal, one she couldn’t fulfill lest she defy the doctor’s orders. Christine reached again for the handful of icy slivers, wrapping her fingers around their slippery shapes melting in the bottom of her cup. There was no way to make them taste like her dad’s favorite pie, and that was the reality. She placed a few cold chips on her father’s dry, coated tongue. Joe sucked them like tasteless lozenges, not especially grateful for their presence. They didn’t do a lot to quench his thirst, and nothing to slake his appetite. They were icy chunks of medical compliance that allowed his body time to heal, and that was all.

“Soon, dad,” Christine comforted. “Soon you’ll get all the pie you want.”

There was a rustle of skirts at the door. An energetic nurse came into the hospital room, immediately fluffing and tidying. “Good morning, Mr. Hartford,” the nurse called officiously. She didn’t look directly at Joe and she ignored Christine. She was focused on making order. The woman seemed intent on tackling something.

The nurse’s voice annoyed Christine. Her cheerful tone seemed forced and mechanical, a professional voice she used for every patient. The tone would have sounded the same in a greeting for a Mrs. Jones or a Rev. Martinson, or in a command to get out of ICU and don’t come back. Joe wasn’t just anybody to Christine, and she would’ve preferred a more personal introduction. Personalized preferences were niceties often lost in a health crisis.

The nurse picked up a marker. “Can you tell me where you are, Mr. Hartford? What day is it?” She erased a name on a white board screwed to the wall and quickly wrote in her own, complete with a little heart as a flourish that squeaked as she drew it. This patient was her turf, now, her responsibility for the next few hours. There would be no nonsense, cute heart on the wall or not. The nurse turned briskly on her heel to watch Joe answer her questions. Christine watched, too.

Joe Hartford’s spotted hand fidgeted on his top sheet. His lower lip quivered, working for words. This nurse was making demands of him. Joe looked to Christine for help, quizzically, as if he’d been presented with a lock he couldn’t open. “What did you say?”

“We know we are in Cantonville, North Carolina,” Christine said helpfully. “We are in the hospital on Milos Road, and it’s Tuesday morning.” She patted her father’s hand.

Joe refused to fail this test completely, though. He glanced at the numbered, round object hanging on the wall. “I know it’s seven o’clock,” he whispered with satisfaction. His voice sought approval and affirmation of his effort. “I could swear it’s seven o’clock.”

“Right, but you cheated,” the nurse said, smiling now. “This young lady helped you out with most of it.” The woman’s demeanor relaxed. She adjusted the old man’s pillows under his head and checked his tubes for leaks and knots.

“Listen, ma’am,” Joe continued faintly. He wanted to impress with everything he knew about his situation, with one goal in mind. “I know I’m in the hospital. It’s been a few days. Now, please, bring me something good to eat.”

Joe pleaded to no avail. “Why are you here, Mr. Hartford?” The nurse looked steadily at her charge, waiting. She moved closer to place her hand on Joe’s chest, pausing to gauge his awareness. “Why would you be in the ICU today? Can you answer that?”

Any desire to be affirmed vanished in Joe. He lashed out angrily, stretching his mouth into a disapproving grimace. “I don’t know why I’m in this damn loony bin. This is all a joke. You’re playing a game on me. I want to go home right now. I’m fine.”

Joe sounded better, he really did. Major parts of his body had been clipped and carted away, but his personality was intact. Christine ran her fingers through her father’s soft hair. She hoped the stroking would ease his temper. “Dad, you had emergency surgery. You went into shock and almost died.”

Joe stared at his daughter, listening. “OK, good, so they fixed me up,” he said testily. Then, a change of mood set in. The old man gleefully smacked his side with his hand. He was like a cowboy bursting with bravado because of a holster on his thigh. “I need to go on back home,” Joe said amiably. “I need to light the charcoal grill.”

“Now, dad . . . .”

Suddenly, the old man moved to get out of bed, lurching enough to yank the fragile machinery attached to his body. The IV bag dangling on a pole whipped with a jerk past the bedside tray table. An alarm blared loudly throughout the ICU ward.

“Nope, nope,” the young nurse commanded. She wrapped her arms around Joe’s middle. “You have to stay in the bed, Mr. Hartford. This is where you’re going to get better.” She eased the old man back between his sheets. “If you don’t stay in the bed, I’m going to have to restrain you, and I don’t want to do that.” Quickly, the nurse tapped in a code to stop the alarm. With her free hand, she held her patient in place.

“You just try to tie me down!” Joe Hartford yelled. He was strong now. “You’ll never keep me here against my will. I was a fireman! I know how to get out of places!” The old man raised his finger to point violently at the nurse, lifting his voice and his bushy eyebrows together in a threat.

“Dad, please!” Christine cajoled. “What’s the matter with you?” She spoke to the nurse apologetically. “I’ve never seen him like this. He’s a different person every five minutes.”

“It’s called Sundowner’s Syndrome. It’s ICU psychosis. We see that in elderly folks.”

Another nurse came running into the hospital room. She’d heard the alarm that warned a patient was climbing– or falling– out of his bed. “You all right, Deb?” this nurse asked her colleague. She came in and looked around. “Anything I can do?”

“Check that IV line, would you? I think our gentleman pulled it loose.”

The nurse examined Joe Hartford’s tender, swollen wrist, turning it over and gingerly pulling and tugging the long, plastic cord that dripped with food and medications. “I think he’s all right,” she said to her friend. “You don’t do that, Mr. Hartford! It’ll hurt even worse if we have to put all that in again. You hear?” The woman touched her fellow nurse on her shoulder. “I’ll be at the desk if you need me, Deb.”

“Thanks, Cheryl.” The primary nurse faced her patient, hands on her hips. “You lie down and get some rest, Mr. Hartford. The cardiologist is going to be here very soon to check your heart.” The nurse gathered a pile of wet towels, threw them under a sink, and moved deftly, efficiently, around the room. “Can I get you anything, Mr. Hartford? Are you warm enough? Let me check that bandage on your abdomen.”

Joe turned away and began to mutter. “I don’t know what kind of a place this is. See, they send a heart doctor to a man who don’t need him!” Angrily, the old man yanked his sheet up over his head like a petulant child. Christine saw the fabric settle in the hollow nape of her father’s neck. She was reminded of shrouds.

“Can you get a hold of your call button? Is it lost in the sheets again?”

“Yes, yes. I mean, it’s right here,” Joe said drowsily. He was sleepy, fading away. In an instant, he snored.

“Just call me if you need me,” the nurse requested of Joe. To Christine, “Can I see you in the hall for a minute?”

Christine met Nurse Deb by the door to the room. “Listen, if he keeps getting out of bed, we’ve got a real problem, you know? Please try to convince him he’s got to stay put to get better. Usually one of the family is better doing that than any of us.”

“All right,” Christine said meekly. “I’ll try. He’s got an iron will.”

“It’s very important.” The pretty nurse pushed the sanitizer button mounted on the wall and rubbed sticky foam over her hands and forearms. The doorway instantly smelled of antiseptic.

“It just ruins my day when I have to restrain them.” With a finger, the nurse drew an imaginary frown on her face as she walked back to her station in the middle of the bustling ward.

Dr. Christine Hartford, a respected member of the team that developed the Fallor Disease vaccine, took up her post once again at her father’s bedside. She wanted her mother badly.

 

At noon, Fireman Joe Hartford fought a conflagration. He had to, for his room filled with smoke. In his mind, he was on an orphanage rooftop in Cantonville, his back straining under a sky of Carolina stars, with a hundred panicked children thronged inside at his feet, each screaming to be raised above the swell of the crowd for a life-saving lift away from the blistering flames. In his memory, Joe turned away from the grownup minders also screaming for help and reached frantically for the children. Choices had to be made. “Hang on, hang on!” he shouted.

Christine had thought her father was resting. She had fallen asleep in her yoga pants and sweatshirt, the top’s enveloping hood pulled over her face. Christine rose abruptly from her chair, confused by her father at first, and then she realized the source of his terror. With sad compassion, she did her best to join Joe in the blaze.

“Just a few more, take this one, too,” Joe cried to a phantom helper. The old man was panting. His heart raced. “Shine the light through the smoke!”

“Dad, it’s all right, it’s all right,” Christine said. “Let me help you, dad.” She reached out to hold the folds of her father’s hospital gown together. She had never seen so much of her father’s naked body. She soothed him as best she could, with cooing reassurance. “You’re safe now, dad. You’re not in the fire anymore. You’re not a fireman anymore, dad.”

Joe stretched out his arms wildly. “Can’t you see the smoke? Can’t you see the kids?” he yelled. “They’re burning up! They’re burning up!”

Christine looked out into the ICU bay. It was serene and awash in bright light. “What kids, dad? There aren’t any children out there.”

“The burning kids! The burning kids!”

“Where are the burning kids, dad? What are you seeing?” Christine asked grimly. Her eyelashes dripped with tears at her father’s painful recollection.

Joe Hartford’s eyes widened at Christine’s questions. “Why, they’re jumping out of the windows!” he raved.

An announcement came over the intercom. “We have a code blue,” the female voice intoned, “We have a code blue.”

“What’s that?” Joe whispered.

Christine watched from her father’s doorway as a team of doctors and nurses sprinted to a shadowy room directly across from her father’s. Only their sturdy, ridge-soled shoes prevented the healers from careening into one another and their blinking, rolling equipment. In the sick room, furniture and visitors were shoved aside. Voices were tense. Then, after clamorous haste, all became quiet, noiseless, still.

A piercing wail filled the ICU.

“Oh, God, no!” a woman’s voice shrieked, “Please, please, wake up! Don’t be dead!” Powerful sobs echoed through the corridors. Screams bounced off the walls. Joe came to stand by his daughter to peer out of his window. Christine gripped its curtain, unable to turn from the drama of loss.

Three Asian women stumbled into the hallway. They formed a serpentine line. The two on each end held up their friend, a middle-aged wife who had fainted from grief. The two petite friends struggled to drag the widow over the shining, newly buffed floor. Their faces were blank but determined. The waiting room doors opened and closed with a whoosh of finality as the threesome passed through. Nothing remained of the trio except reverberating sobs.

“What happened out there?” Joe asked, barely breathing.

Christine had no idea how to respond. The widow’s pleas were still in her ears. But Joe’s distraught face caught her eye. Her father looked out into the ICU ward, his narrowed gaze following a slow-moving, rattling conveyance. Together, they saw a gurney. Two somber orderlies walked down the hallway, toward the elevator, pushing a draped corpse, passing so close to Joe’s room he could have stretched out his hand to touch them.

As the body rolled past the broad glass in Joe Hartford’s window, he reached for his daughter. “See, I told you,” he said. “The burning kids.”

A selection of mid-afternoon exams kicked in. The cardiologist arrived, followed by a nephrologist, a respiratory tech, and a fresh batch of nurses. Joe’s body fluids, crevices, folds, and corners were measured with extreme precision. He submitted himself to tucks of enormous pills into his mouth; to checks of bulbous bags that collected his urine; and to pinches with lookalike clothespins on his sore fingers to record his mercurial oxygen levels.

The medical attention was high-tech and state-of-the-art, until the abdominal surgeon came in, who simply placed his ear on his patient’s belly to listen for gas.

The doctor was tall, pale and mysterious, smoothly oiled and perfumed, a man not native to rural North Carolina. He was impeccably dressed in a silk suit and tie. His thinning, blonde hair was neatly combed, with his scalp surprisingly white at the part. His long, gaunt face was enlivened by brilliant blue eyes, which were not dulled in the least by the spectacles framing his face. The man moved with a confident lightness. He seemed to believe problems would part at his arrival, or else he would remove them.

The surgeon was pleased with his earful of intestinal squirts. He rearranged the bandage on Joe’s belly, failing to conceal his opinion that the nurses had put the dressing on wrong. He stood up, admiring his touch. Then, the doctor casually placed one delicate hand into his suit pocket and stood, self-assured, not at all in a rush, quietly thinking. Several minutes passed.

Christine was at a loss. “Is everything all right?” she finally blurted. Somebody had to ask. Joe was occupying himself by picking imaginary berries out of the air. He couldn’t care less. “How long before dad stops doing that?” Christine queried. “He’s in another world.”

“A few more days. It just depends on the person.” The surgeon stepped back from Joe to take a hard look to appraise him. “Mr. Hartford, as soon as you have a bowel movement, we can start thinking about moving you to a different floor. You’re very stable now.”

“Oh? That’s good,” Joe answered, picking blackberries. He was a boy again on the family farm. Grandma Kate needed berries to bake a fresh pie.

In the background, the television on the wall next to the clock was vivid with a special report. Footage was shown of terrorists burning healthcare workers alive in cages, with cuts to interviews of the victims’ mothers and wives who cloaked their female, Caucasian features in scarves and tearfully begged for mercy. Joe put down his invisible bucket of berries to watch the news. The battles of race, religion, and class still raged.

The surgeon tapped through Joe’s computerized files by his bed. He typed in a few comments and turned to Christine. “I notice in his records that you are mentioned as being a doctor, yourself.”

“I’m a microbiology Ph.D., not an M.D.” Christine clicked off the grieving families begging on the television screen. She had enough grief of her own.

“Any specialization?”

“Virology.”

The doctor closed the computer records, impressed with Christine instead. He began an odd observation. “Well, the apple fell far from the tree,” he said. “I would never have thought that a man with this background could produce a woman such as you. Was your mother an educated person?”

The doctor seemed to want to shake Christine’s hand, as if she were a successful escapee from a low social caste. Christine was insulted. Her father was a common, flawed man, yes, but not somebody to “fall far away from.” She looked at the doctor directly. “And the descendants of storm troopers have come a long way, too,” she said.

The surgeon pursed his lips and registered no emotion. He felt no need to explain himself, but he walked away immediately from Christine and Joe. Outside in the hallway, he upbraided a nurse about sloppy bandages. “If you cannot even apply a simple dressing, you need to get out of my hospital,” he scolded imperiously.

After the prodding of tests, Joe slept. Except for the clarinet-like squeal of a ventilator on a patient next door, the ICU ward was quiet. Death was taking a break, too.

At six o’clock in the evening, Christine’s stomach growled. She’d been subsisting on vending machine fare, and her body needed better food. Her unwashed hair hung in greasy strings around her face, and she was self-conscious about the ripe-melon smell under her arms. She needed a shower followed by a good meal and a full night’s sleep. Christine went out of her father’s room to talk to the first nurse she could find. She approached the ICU desk and said she’d return shortly to sit with her dad.

“We’re going to bring in the commode chair,” the nurse reminded. “If he can just go to the bathroom, we’ll release him out of ICU. Keep your fingers crossed.”

“I’ll be back to find out how that went,” Christine replied. “Oh, boy, what a treat.”

As she drove her rented car to the Rowdy Welcome Motel near the train station, the winter dusk was obscuring visibility. The motel was little more than a series of tarpaper sheds that had been nailed together, a dilapidated structure from the 1970s that someone had tried to spruce up with paint the color of pink after-dinner mints. Artificial geraniums crammed into sagging window boxes were covered in ice crystals and dirt.

Christine slipped off a leather glove to fit her key into her motel room’s door, and before she realized it she’d plopped down on a plaid sofa that had squatted for years under a bedraggled spider plant hanging from a water-stained, paneled ceiling. The microbiologist in Christine stood up, turned over the plant’s withered leaves with the tip of a pencil she found on the tattered carpet, and decided that the spores she saw fluffing off in every direction probably wouldn’t kill her, so it was safe to sleep in the shed.

At midnight, Christine was startled awake. She realized the hospital was calling her phone, which glowed with a radioactive eeriness. The nurses in ICU finally left her a text. “Come back right away,” Christine read, sitting up.

She returned to the hospital in just 15 minutes. She dashed through the parking lot in the coat she’d never taken off, and she was up a towering flight of looping stairs in a time very good for a 40-something. Wringing her hands, Christine waited for the doors to the ICU to swing widely open to give her entry into the ward, where she instantly encountered a band of stern-faced nurses fluttering about in uniforms the color of Easter eggs as they chased her father’s shockingly naked body, including the tattoo of warring dragons on his chest.

A trail of blood like paint spatters drained behind the old man, his body fluids and nourishment oozing from the wrist that had held his IV. Wet, vermillion footprints the texture of jelly were everywhere. An alarm rang so loudly that Christine covered her ears, but she joined the chase.

“I want to go home! I want to go home!” Joe Hartford bellowed, running at large in the pandemonium. His face was full of terror, as if he faced his execution.

The nurses tracked the old man in collective, organized pursuit, each with a blanket or a sheet they intended to cast over him like a butterfly net. One called the surgeon to urge him to phone in a script for sedation. Joe was captured like the booby he feared he was, a wayward soul who had to be put back into the hatch that was his room.

When Christine saw it, she recoiled at the sight. The attempt at the portable toilet had failed miserably. The whole apparatus was tipped at an angle, as if rapidly, forcefully abandoned. The terrified old man would have nothing of it. Christine picked up the dripping toilet and pushed it into the hallway. “I only wanted a little sleep,” she whispered to herself. “All I wanted was a little rest.”

Joe was marched back to his bed and freshened up. He hung his head in humiliation. He had never been restrained before in his life. A specialist was brought in to mend the old man’s damaged wrist and IV. Joe was stoic. If he had the chance, he’d try again to escape.

The nurses advised Christine that her father would soon return to a stable state. This spectacle was typical of old folks just trying to get better, they said. One seasoned nurse disagreed, however. “The sun going down is hard,” she said. “They know when their light is fading.”

“Dad,” Christine said. She had to begin a difficult conversation. She had to return to New York, if she wanted to keep her job.

Joe looked at his daughter, furious. “You let them bring me back here. I don’t want you to visit anymore,” he snarled. “I don’t want to see you again.”

“Dad, do you know what you’re saying? You need me. I love you.”

“Get out of my room.”

Dr. Hartford was speechless. The nurses discreetly lowered their eyes. Christine walked to a little office nearby to sign a big stack of forms, to read permissions, review disclaimers, and accept obligations. She wanted to feel anything but the betrayal that ached at her father’s livid rejection. As a scientist, she knew that a situation had reached a tipping point. As a daughter, she knew that she had to let go of her father’s hand.

Christine returned to Joe’s bedside for only a minute. She kissed the old man’s forehead and fondly pressed her cheek against his. She hoped there would be time for reconciliation. “I’ll come if you need me, dad.”

Fireman Joe didn’t bother to respond.

His heart stopped a week later when he was released for rehab care.

When the call came, Christine was in the cafeteria at ViraCombin, eating a lunch of tuna fish salad. She’d already fed her Ebola vaccines for the day. Christine listened as Mrs. Jeremiah, the social worker, described her father’s last moments. Joe had not asked for his daughter.

“Thank you for everything,” was all Christine could say to the case worker. Silence followed, but Christine didn’t conclude the call. She stayed on the line.

The woman sensed that Christine waited with longing for a sign that her dad’s anger had subsided. “I just want you to know, they’re never really themselves at sunset,” Mrs. Jeremiah said. It was the small support she could offer. “Dr. Hartford, remember a happier time.”

Christine made arrangements for Joe to be cremated.

He was a man who had always been found among the flames.

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