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CHAPTER 1
ONE
As I Unlocked the front door of the office I could hear the phone ringing. I hurried inside and stretched across the reception desk to answer it.
"Dr. Jourdan's office," I said, out of breath.
"Do y'all wash out feet?" a woman shouted.
I considered her question. Although I was accustomed to the local dialect and even to garbled medical terminology, I had no idea what she meant. I said, "Excuse me?" and quickly moved the earpiece a safe distance away from my head before she had time to respond.
"Wash out feet! Do y'all wash out feet?" she screamed.
"I ... I don't know." I sent up a silent prayer that we did not.
"Well she needs her foot washed out! How much do y'all charge for that?"
If I was unsure if we even did such a thing, how could I know how much it would cost? "I don't know," I said.
In the ensuing silence I managed to add, "I'd ask the doctor, but he's not here yet. I'll find out when he comes in and call you back and tell you what he says. Okay?"
I fumbled through the piles of paper on Momma's desk until I located a pencil and a blank scrap of notepaper, jotted down the woman's name and number, and then hung up. I stared at the phone warily. Working as a temp for Daddy might be a little harder than I'd anticipated.
I hurried around to the other side of the reception desk in an attempt to put a bit of Formica between myself and the medical world. But before I'd even gotten seated atop the wooden stool that was the main feature of my new domain, I heard the front door open and then the unmistakable sound of elderly ladies, their voices worn out from too many years of use. One squeaked like a rusty hinge and the other crackled in an unpredictable jumble of soft and then suddenly loud sounds, like a radio with bad reception. The ladies were advising and encouraging each other in an effort to negotiate a small step at the front door. I turned and saw that it was the Hankins sisters, Herma and Helma, and their friend who lived with them, Miss Viola Burkhart.
I'd known them all my life. They were in their nineties. The Hankins sisters had never been married. Miss Viola was a widow who had come to live with them after her husband died. She was ninety-eight, weighed about seventy pounds, and had an advanced case of what the sisters called "old-timers." Somewhere along the way she'd lost the ability or inclination to speak and now she wore a perpetual vacant smile.
Helma was ninety-five and also weighed less than 100 pounds. She was extremely stooped, bent almost double from osteoporosis, and her eyesight wasn't good. Herma was the baby at ninety-one and probably weighed more than both the other ladies combined. She was still sturdy but deaf as a post. So there was one who could hear and see, but not think or talk; one-who could think, hear, and talk, but not see; and one who could think, see, and talk, but not hear.
The ladies were inseparable. Helma did the cooking and talking on the phone and Herma did the heavy work and the driving. Both of them took care of Viola.
Helma wore a faded green polyester leisure suit with an oddly intriguing assortment of safety pins arrayed along the edge of one lapel, while Herma had on baggy sweatpants and a misshapen sweater. Miss Viola was wearing a demure flowered dress. All three ladies wore shiny brown Naugahyde coats that had been fashionable in the sixties.
When they moved, they shuffled along together, holding onto each other for support and navigational assistance. They made their way carefully to the reception desk and Helma said that it was Miss Viola who needed to see the doctor today. Herma said, "Hey there, girl," and smiled. "We was sorry to hear about your ma. How's she doing?"
"Pretty good. She'll be back Monday."
Herma looked at me in confusion. "I thought she had a heart attack."
"She did."
"Ain't she in the hospital?"
"Yeah, but she told me she'd be out by Monday."
I was relieved when Herma decided to leave it at that. The story sounded a little thin, even to me, but I desperately needed to believe it.
Then, without even a hint of foreboding, I made my first executive decision in the health care arena. "You ladies can come right on back to the examining room," I said. I figured it would be easier to get all of them up and down just once instead of twice; and waiting in the back would protect them from exposure to whatever germs the other patients might bring in. It seemed like a good idea at the time.
As I helped them through the door that divided the waiting room from the rest of the office I said to Helma, "You ladies are lucky to have each other."
She smiled. "Oh yeah, we got enough spare parts between the three of us to make one whole person!"
I took them back to Room 3 because it was the only room with enough places for all of them to sit down. Room 3 was used for surgery and contained Daddy's pride and joy — the hydraulic surgical table.
Thirty-five years ago, when he couldn't really afford it, Daddy had bought the special motorized table that would raise and lower, so he could lift patients to a comfortable height while doing surgery. Even now the table still occupied a special place in his heart, like his Leitz microscope. No one was allowed to touch either piece of equipment but him.
The table was controlled by four pedals that lay flat on the floor. The entire table could be either raised or lowered, or it could be tilted by raising or lowering either the head or foot.
I seated Miss Viola in the middle of the table and told the ladies that the doctor would be in in a few minutes. Then I returned to my post at the reception desk. While I waited, I retrieved my phone messages from voice mail in Washington, D.C. My boss, Senator Hayworth, was conducting a series of hearings on corruption in the nuclear power industry, and I expected most of the calls would be related to that.
There were eleven messages. I sorted them with respect to time zone and then numbered them to indicate the order in which they should be returned. First came the calls to people on eastern time: government affairs representatives for the University of Tennessee and Tennessee Valley Authority. The call to a huge nuclear power conglomerate in Chicago could be made after 10:00, to a colleague in Sedona an hour after that, and then after noon I could reach the Los Angeles offices of the lobbyists for the electric power industry. Tokyo Power Company would come last, after 8:00 tonight. No problem.
As I dialed the Director of Federal Relations for the University of Tennessee, Daddy came in carrying a cardboard tray with a Styrofoam cup of coffee and a McDonald's bag. He set his breakfast on the counter and I told him about the ladies waiting in Room 3. He nodded, fished his sausage biscuit out of the bag, and began to unwrap it.
Then he looked at me with his head tilted. "What's that sound?" he said.
"I don't hear anything," I said, trying to stay focused on the opening pleasantries of my phone conversation.
He laid his biscuit down next to his cup of coffee and walked down the hall toward the back. I heard him pause at the doorway of Room 3 and say, "Good morn —" Then he shouted, "What the hell's going on in here?"
"Gotta go," I said, hanging up on the Director while she was talking. Then I bolted for the back.
Things were not the way I'd left them. The surgical table's motor, normally a low-pitched, almost inaudible hum, had changed to an angry whine. The head of the table was tilted as high as it would go, over five feet in the air, and the foot was down, almost touching the floor. Miss Viola had slid into a little wad at the lower end. Herma and Helma were frantically struggling to keep her from falling onto the floor, but she was oblivious. She smiled serenely as Herma tugged on her arms and Helma hoisted her ankles.
I couldn't understand why this was happening. It sounded like someone was standing on a cat's tail. I looked down reflexively and noticed that Herma had somehow come to be standing on the floor pedal that raised the head end of the table. She clearly didn't realize what she was doing, nor could she hear the table motor running.
Daddy shouted a one-word accusation, "Carolyn!" and leapt forward to snatch up Miss Viola. As she slipped off the end of the table, her dress peeled up over her head. He tried to set her on her feet, but she was so dizzy she couldn't stand by herself. He told Herma to get her foot off the control pedal, but she couldn't hear well enough to understand what he was saying.
He made a series of shuffling hops sideways, crushing Viola tightly against his side, and startled Herma by lifting her bodily off the pedal with his other arm. He held one lady under each arm while he stomped on the "Head Down" control.
All of this confusion and manhandling sent the sisters into a tizzy. And Daddy was incensed that anyone would dare touch the controls of his table, much less put such a terrible strain on it.
"What'd you do that for?" Daddy shouted at Herma in a voice so thunderous that she finally heard him.
"Do what? I didn't do anything. Your table there is broken."
"It better not be!" he said.
When the table was level again, he set Miss Viola back down in the center and flipped her dress down over her legs. She seemed neither startled nor embarrassed. In fact, she seemed to have missed the whole ordeal.
Under the circumstances Daddy decided to go ahead and tend to Miss Viola's medical problems before normal office hours. He patiently listened to the health concerns of all three ladies and wrote prescriptions all round.
As the ladies drove away, Daddy went back to his sausage biscuit. He stared at me while he chewed and then said, "Don't ever do that again."
"Don't do what?" I said. "Don't leave any old ladies alone with any of your stuff?"
"Just don't do it again," he snapped and took his biscuit into the back to eat it in peace.
We were both under a lot of stress.
A few minutes later, Alma, Daddy's nurse, confided that during her entire twelve years with the doctor she'd never heard him shout like that before.
"Well, just stick with me," I said. "I've been with him for forty years and I've been hearing it the whole time."
Daddy was fantastic at handling medical emergencies. He was unbelievably cool under pressure if, say, someone had cut off their arm or leg with a chain saw. But he simply wasn't equipped to handle the kind of emergencies that seemed to crop up whenever I was around. He could cope beautifully with every kind of chaos, except the kind I created. And right now he was stuck. He couldn't work with me, and he couldn't work without me.
I felt for him. It was a good thing I was only going to be subbing in this job for two days. If I stayed a week, he'd end up sharing a room with Momma in the cardiac ward.
CHAPTER 2
I sat ignominiously on what now seemed like a dunce stool as my mind wandered all the way back to yesterday when I'd been a successful, competent adult. Daddy had called me out of a televised Senate hearing to tell me Momma was in the emergency room with a possible heart attack. I'd stuffed a jumble of clothes into a duffle in Washington, climbed into my car, and raced 500 miles home to East Tennessee.
During the drive I'd struggled to take in the shocking news. Momma had always seemed impervious to the blows of fate that sent other people reeling. I couldn't recall the last time she'd been sick. She'd been a cancer survivor for more than forty years and hadn't missed a day of work in decades. But as the miles passed, I kept coming back to the fact that she was seventy-two years old now, even though she didn't look or act anywhere near her age. Her hardworking, no-excuses personality had never allowed room for any of the infirmities commonly associated with getting old.
I'd torn through the Shenandoah Valley along I-81, blasting past Civil War battlefields and historic houses, numb to the beauty of the Blue Ridge Mountains. It was mid-October and the fall glory of the largest hardwood forest on earth should have been a rare treat, but I wasn't in any condition to enjoy it.
Momma was trailing wires and tubes in all directions and hooked up to a dizzying array of electronic boxes that beeped and chirped a medical Muzak and blinked with all sorts of numerical and graphic readouts. I scanned them until I found one that seemed to indicate her heart was still beating. The beat was erratic enough that it seemed unlikely she was being continuously paced, or "jumped off," by a computer. So it seemed her heart was still working, at least for now. That had to be a good sign.
Such a massive display of brute technological force was oddly comforting. Surely no one could die in this modern Frankenstein lab. If anything stopped working, they'd just plug in another machine.
I was scared to see Momma like this. It wasn't like her at all. To tamp down my panic I tried to think of the ICU as a sort of spa. A really, really expensive spa. For unconscious people.
An impressive platoon of professionals were doing all sorts of tests, trying to determine whether or not she'd had a heart attack. She'd had an "episode," a "cardiac event," the previous afternoon while out walking. A retroactive diagnosis seemed pointless to me, but I guess it gave everybody something to organize themselves around. Daddy was out at the nurses' station getting the latest news.
Daddy'd told me that Momma was blaming the whole thing on the gentle walking program she'd recently undertaken. Her theory was that a couple of weeks of light exercise had hurt her more than fifty years of chain-smoking. She made a good case. She'd never done anything remotely healthy for seventy years. Despite the knowledge you might expect a medical professional to have about such things, she'd smoked like a chimney, was completely sedentary, and existed entirely on a diet of iced tea, hot chocolate, orange juice, and Goldfish crackers.
I stood by her side watching her breathe until it became clear there was nothing I could do. Then I turned to leave. Without even opening her eyes, Momma startled me by grabbing my sleeve with the speed of a martial arts expert.
She said in an uncharacteristically weak voice, "Somebody's got to help your father."
I'd spent the whole drive preparing myself for bad news — but I hadn't seen this coming.
Daddy was a solo family practitioner. He had a full-time nurse, but Momma was his receptionist, bookkeeper, backup nurse, lab technician, and jack-of-all-trades sidekick. They'd worked together in his small rural office for my whole life.
For someone who was officially certified to be at death's door, she gripped my wrist with surprising strength. "You've got to fill in for me for a couple of days," she said. "Just till the week's out. I'll be back on Monday."
I did some quick calculations. It was Wednesday. That meant she wanted me to work her job on Thursday and Friday. Two whole days.
I was trapped. A possum in the headlights. I wanted to be a good daughter and lessen my parents' worries. I loved my parents very much. It was just too bad that what they needed right now was not an expensively dressed nuclear expert or a fierce lawyer. I had those two areas of expertise down. It was just that, to their disappointment, I'd turned out to be squeamish and high-strung — characteristics that did not make for a reliable health care assistant.
Although I wasn't bothered by any medical problems, such as exposure to contagion, and could happily sit in a small room and swap stories with people who had flu, TB, or even black plague, I was terrified of being exposed to other people's surgeries. I dreaded the on-the-job injuries like the crushings and maulings that Daddy attended to for the zinc mines, the slashes and gorings from the sausage factory, and the spatter burns from the rendering plant, not to mention the miscellaneous farming and hunting atrocities that popped up out of nowhere with alarming frequency.
The triage process may sound straightforward, but it can get devilishly tricky. Once, when filling in after school while Momma worked on the books, I'd registered a clean and especially fair-skinned young man who worked at the sausage plant. He didn't specify what he needed — he just gave his name — and because he had very little blood on him, I skipped asking him if he was bleeding. I let him take a seat and wait his turn. He sat perfectly still until Daddy happened to see him out in the waiting room and yelled, "Carolyn, what the hell are you thinking about? Look at that man's color, he's white as a sheet! Can't you see he's about to faint!" The man turned toward Daddy and said, "I got stabbed in the leg."
It turned out he wasn't naturally that pale. He was quietly bleeding to death inside his rubber waders. How tidy, and sneaky, of him. He got sewed up pronto and fully recovered. I, on the other hand, was permanently traumatized by the certain knowledge that I would've let a twenty-year-old man bleed to death less than six feet away from me while I filed my nails. Previously I'd overreacted only to visible injuries, but now I had a paranoid fear that the people who looked fine were the ones who might be in the worst shape.
(Continues…)
Excerpted from "Heart in the Right Place"
by .
Copyright © 2007 Carolyn Jourdan.
Excerpted by permission of ALGONQUIN BOOKS OF CHAPEL HILL.
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