View From a Kite (22 page)

It seemed logical that the best way to get the diseased lung to heal was to collapse it, so it would stop inflating and deflating every time the patient breathed, and could get some rest. Pneumothorax— the collapsing of a lung—sometimes happened spontaneously and it occurred to the medical profession that they could make it happen artificially. They did this by sticking great big needles though the chest wall and pumping stuff into the space around the lungs. Pump enough stuff into its pleural cavity and the lung will flatten like an empty hot-water bottle. That was the theory.

Unfortunately the lungs tend to form adhesions, places where tissue from the lungs sticks to the ribs and the walls of the pleural cavity. The lungs won't properly collapse as long as the adhesions are there.

Hacking and burning away at the pleural lesions became normal procedure, although the profession preferred terms like “intrapleural pneumolysis by galvanocautery” to “hacking and burning.” They stuck in various sharp devices and twirled them around inside until they felt they'd cut everything loose. Or they cut holes in the chest wall, stuck in electrodes, and burned the lesions loose. Then they pumped air or nitrogen gas into the pleural cavity and down the lung would go, like a poleaxed steer.

Lungs, however, tend to be stubborn about reinflating, so they had to keep sticking needles into the patient and pumping him or her full of air, over and over again. There were, of course, accidents and complications. If a needle ended up in the wrong place—say, a pulmonary blood vessel—blood would spurt back through the needle into the tube that was to deliver the nitrogen, and could leak into the lung. If an air bubble got into the circulatory system it could end up in the brain and cause convulsions, blindness and paralysis. Needles, knives, tubes, and electrodes introduced germs into the chest. Most patients ended up with secondary infections—all before modern-day antibiotics. This generally hastened their demise.

Oleothorax was developed as a way to pack in something a little more substantial and long lasting than nitrogen or air. Strip the lung and both pleural layers away from rib cage and pack the space between with spare abdominal fat or wax. Piece of cake.

In their attempts to get those stubborn lungs to go down and stay down, the profession moved on to more exciting procedures meant to induce permanent collapse. Simple—but effective—was the crushing of the phrenic nerve. This partly paralyzed the diaphragm so the lung above it couldn't move. It was accomplished, quite handily, by crushing the nerve with forceps, or by picking it out of the diaphragm, reeling it up through the chest, and snipping it off.

If you've still got your lunch we'll move along to thoracoplasty, the removal of ribs. Ribs aren't the easiest thing to haul out of a person's body. Not to mention the fact that you sort of need them to stay upright. Thoracoplasty causes permanent deflation of the part of the lung over which it is performed. They usually took out eleven ribs and left behind the periosteum, a bone-covering membrane that eventually grew cartilage-like pseudo-ribs—so patients didn't completely collapse in a one-sided heap when they tried to sit up. The postoperative mortality ranged from ten to forty percent. These murderous procedures were the result of the need for doctors to “do something,” even when the results were terrible and the suffering was horrible.

Drug therapy eventually made thoracoplasty and pneumothorax obsolete. Re-section, the removal of the diseased part of lung, is still an acceptable procedure for holes that won't heal over. It's what they were going to do to me. In twenty or thirty or a hundred years, people will throw their hands up in horror at the thought that a doctor would take a scalpel and carve open a person, stick a couple of tire wrenches in to yank apart their ribs, and then chop out a chunk of their lung.

I can't remember where I read this last bit, but it seems a fitting quote to end with:

“A few surviving guinea pigs do not constitute proof for the effectiveness of a treatment.”

CHAPTER 47

Denise is relatively cheerful again, and Mark is ticked off because I spent yesterday evening with her and no time with him. I contemplate having nothing to do with either of them, but I know I'll never stick to that resolve. This afternoon in the sunroom was horrible, the pair of them sniping at one another. She asked him if he'd ever considered braiding his eyebrow so he could see properly and he suggested she might want to move to another chair, one with a heftier seat. They're both beautiful when they're apart, and when they're together, Mark looks skinny and beetle-browed and surly, and she looks bottom-heavy and mean-eyed and cranky. It's awful. I just want to get away. I went and had a long shower, until the day nurse chased me out and made me go to supper. There was a note on my table from Mark, which made Elaine gush and Evvie blush and Mrs. Driscoll say hush (sorry). He's invited me to join him on the stairwell and says he has a surprise. It had better be good.

I push against the bar of the fire door and slip through the open crack. Light from the parking lot comes faintly though the murky, cobwebbed windows that are set too high up to clean properly, and from the small blots of night lights recessed in the walls at ankle level. The handrail is painted black with hundreds of layers of enamel. I grip it loosely and slide my hand along as I slipper down the tile steps, my breathing softly echoing in the well.

“What's the surprise?”

He jumps. He's been listening so hard he hasn't heard me coming, his heartbeat deafening in his ears.

“Jeez, you scared me, Gwen.” He pulls me down beside him on the stair and unwraps the surprise. A pint of rye. Well, I guess it's better than generic jam jar, but I was hoping for a single red rose—or a bottle of champagne if we must drink.

“Did you bring any mix?”

“I forgot.” He's flustered. “I'll go get some.”

“Never mind,” I say and pull out two cans of soda from my robe. I wanted a rose, but I didn't really think I'd get one. The daffodil was it, I've realized. It wasn't an opener, it was the whole deal. I snick open the cans and give him one; we each have a long drink to make room for the rye. He drinks too quickly and brown fizz froths from the corner of his mouth. He wipes it off with his sleeve and hands me his can.

“Hold them steady.” He pours rye in each, replaces the screw top on the bottle and sets the bottle back in his pocket.

We clink cans and drank. I shiver.

“Too strong?” he asks.

“No, it's fine.” I take another mouthful and say, “Put some more in.” He leans over and mooshes his mouth on mine. I slop my drink.

“Wait,” I say, and he pulls back. I put my can on the floor and he puts his down and we try again. Soft. I move under his arm and we explore all possible combinations of upper and lower lip, tongue and teeth. Slow, fast, faster, slippery fish. We come up for air and gulp some more rye. In half an hour we have drunk almost half the rye and are getting perilously close to serious trouble. Mark's hands are getting bolder, and I am beginning to feel an occasional frisson of panic, but the rye makes it hard to keep in focus and I am much too distracted by swooping waves of horniness. We have just enough residue of paranoia left to jerk apart when we hear steps coming up the stairwell.

“Go, go!” I whisper and shove him to his feet. He scrabbles up a flight and I hear the door on the floor above swish shut behind him. The nurseprints click-clicking on the tiled steps stop at the floor below me and fade behind a second swishing door. She has gone into the Children's Ward. The stairwell is silent. I hang over the railing to be sure. Nobody there. I wait ten minutes or so, but Mark has gone to ground, so I pick up his can and mine, pour everything together, and finish it off. I just don't love him enough. I love making out with him and I love being his girlfriend. If I was totally, passionately, in love with him I wouldn't still be a virgin. It wouldn't be a point of argument between us. But I know what I want and, fun as it is, this isn't it. I want to make love with someone I'm willing to die for. But not in a stairwell, or a janitor's closet, or the laundry room. And not in the damn graveyard. Some people are beyond my understanding.

I amble up to my ward, sneak down the hall, and crawl into bed. My head is a muddle. Then it occurs to me that I haven't brushed my teeth and I probably smell like I've been half the night at a bar. I carefully collect my toothbrush and toothpaste and slip-slop to the bathroom. The night nurse is down the other end, drinking coffee and writing letters in the staff room. The black-and-white hexagonal tiles in the bathroom spin around, then right themselves. Sinks are handy things, for leaning on. I sing a bit, because I like the sound as it echoes off the tiles, as if there are two of me singing very, very close harmony. “Rock of Ages,” from my days of incarceration in the Junior Choir.

“Shush,” I tell my mirror image, “you're going to get us in big trouble.” I have a pee and sing a line or two of “Abide With Me” in the stall, but it sounds cramped, fish bowled.

“Get to bed, songbird.”

I jump a mile. She's snuck up on me.

“You're supposed to be drinking coffee,” I say, indignantly.

She's smiling. She's amused.

“You scared me.” I clutch my robe shut. “I almost fell.”

“Fall into bed or I'll put your name down for the Chapel Choir in the morning.”

“No, no!” I beg, “I can only sing in bathrooms.”

“They won't care. They're always looking for new recruits.”

I flee.

The next morning at breakfast I am a little slow. It's quarter to eight by the time I drag myself to Table 16. Denise has been waiting impatiently to tell me the news. She looks long-faced and serious, but it's an effort. Mark took sick in the night, coughed up some blood and is in intensive care.

I've killed him. He's going to die and it's all my fault. I've French kissed him to death, I've given him blue balls and they've backed up and blown out through his lungs. I am a murderess.

By mid-afternoon he's back in his room. He isn't supposed to have visitors, but the nurse at the desk relents.

“He's been asking to see you.” She taps a handful of files into alignment and puts them on the countertop between us. “Two minutes, no more. And don't say anything to excite him or upset him.”

I ease open the door and slide in. He's alone. His roommate, Michael, is gone for x-rays. Mark is deadly pale, there's a languid Keatsian aura about him. He doesn't raise his head from the pillow and I move closer to the bed, my heart twisting in my chest. At least he's still breathing. Maybe they'll be able to save him after all.

“Don't tell them,” he whispers. He must be delirious. Does he think I'd admit to anyone how much we've been fooling around? Wild horses couldn't drag a confession out of me.

“I won't,” I whisper. “I'm so sorry. It's all my fault.”

“It's not your fault. I'm the one drank all the rye.”

I remember it differently. I drank as much as he did, and what has that to do with…

“I drank half a pint with Michael before I left my room. When I got back I finished the pint we had. Puked it all up in the night and busted something.”

“But what about…we were messing around,” I remind him, uncomfortably.

He manages a weak grin. “Messing around with girls never hurt me before.”

Before? I'm one in a series? Of how many? Those tentative exploring fingers…they were practiced exploring fingers. He's bragging, the SOB. I feel like an idiot.

“Well,” I try to sound as casual as possible, “I hope you feel better soon. Have to go now. So long.”

“That was fast,” says the nurse.

“He needs to rest,” I tell her, primly.

It's amazing how ideas come to me.

“But you know, he looks a little yellow. He'd never say anything to you— you know how guys hate enemas—but he's been lying about his BMs lately. I wouldn't say anything,” I blush deeply here, quite credibly, “and please, please, please don't ever tell him I said anything to you, he'd be so embarrassed but, well, you know, he's been having a problem.”

“Is that so?” She reaches for his chart.

“Yes. For over a week now. Maybe longer.” I shake my head in fake concern.

“I see,” she says, flipping through the pages and frowning.

It's like they just drop out of the sky, slide into my brain, and blossom out my mouth. Later I'm sorry I've been so nasty. Somewhat sorry.

CHAPTER 48

GWEN'S RULES FOR THE TREATMENT OF
TUBERCULARS:

1. Patients must not be disturbed until ten a.m.; tea or coffee and hot buttered toast with black currant jelly or white clover honey should be served to the patient before she or he arises. A few grapes (seedless) or strawberries in season should decorate the tray.

2. A fleet of limos must be kept available at all times should the patients wish to drive out to view the countryside, visit family, or do a little shopping.

3. Nurses and attendants are to wear muted but cheerful colours and speak in soft voices. All nurses must past a personality test before being hired; no crankiness or bossiness or narrow-mindedness will be tolerated.

4. Dancing lessons shall be offered daily, in a variety of styles and techniques.

5. Each ward shall have a library, stocked with good books and magazines, and a music room with a wide selection of musical instruments. Regular concerts by rock-and-roll bands shall take place in the parking lot on Saturdays, followed by take-out pizza and beer.

6. Wine shall be served with dinner, champagne on birthdays—to be followed with chocolate cake with mocha fudge icing and rocky road ice cream. Lemon meringue pie for Evvie.

7. Dinner shall contain no item steamed or boiled to death. The following items are never to be served to patients, although staff may consume them if they so desire: consommé; eggs with runny whites; mush, of any kind or temperature; cream of wheat and Red River cereal; head cheese; beets; turnips; barley in anything; anything with barley; plastic cheese; canned peas.