On the way to work, pushing through teaming, standing masses on the platform, my train approaches while I am just clocking through the turnstile. I know it's my train because it is the littlest train in the stable, the runt of a fleet of iron steel siblings. Built for a population believed to be less significant it is small, run down, unappreciated. I know it is my train because it sounds different than the others, falling apart as it often it is, on the rails. And I must run now. Because I will never make it half way down the platform unless I do, often even if I do, because there aren't enough cars to fill the whole length of the station, because this is the population that is less significant. And no one moves. No one steps away. Men in suits and women in pointy footwear, they remain, standing, eyes cast downward, paper in hand, diligently not looking up, not looking out, not engaging.
It's late already, I stretch out my mornings too thin, reluctant and weary to spend another day as I do. As I tack my path towards the open door, my bag--unusually empty, unassuming thin canvass--brushes against the back of a woman as I dodge through the significant population to make my way towards mine. And as I pass her, brief contact through canvas, she screams "fuck you you stupid fucking cunt! Fucking bitch!"
And in that instant so many things occur to me, crashing gracelessly through that last, closing door, slipping and lurching from the momentum.
I realize that I do not turn around, gesticulating dramatically, mouthing the words sorry sorry sorry sorry. I don't turn around at all. I don't pause, I don't, even for a moment, consider it. I realize that the words fucking bitch and cunt are so common in the ambient ether of the world I share in, the impact is all but gone. I realize too, that I've assigned in my mind, a set of expected accents and inflections that are associated with words like bitch ass cunt, especially when delivered in rapid fire. It occurs to me only later that the reason the incident stood out, was at all or in anyway unusual, was the accent. The kind of inflection that her words were contained in. The absence of a certain expectation supplanted with another, unexpected. It got stuck for a moment in my auditory nerve, rattled my cortex.
*************************************************************
I dutifully follow the resident. Walking unquietly behind him, clutching a clipboard to my chest like armor, my hard soles hitting the plastic tiled floor; the sound travels before me, a kind of echo and announcement, filling up the green and yellow halls. I walk with my head up and down, at once intent on living presently in this space, this place, this hospital, and desperately trying to claw my way out. We walk in, disorganized, a small collection of white fabric and ties, low heels and books in our pockets. I watch as the resident turns to his left--to check his pager, grab a pen, tuck a lab result into the fold of his jacket--and asks our patient how she is feeling. He does this in the same action: turning away from her, attention divided, asking her how she is, only to answer for her. In one swift moment all is lost. How are you feeling today Mrs So and So, better, no? She looks at him, he is not looking at her, focusing in instead on his stethoscope, rustling some pages. I am on the side, watching them both. Her eyes brighten, then dull, she turns away. I'm okay.
He says nothing more, pulls back her gown, listens to her lungs, her heart, her belly, places her gown, her only object, her thin something, back in disarray. Today you have the CT, ok? Today we will look at your belly. Ok? She has recently moved here from Trinidad. He is telling her, listen, we're really worried that you might have cancer. In your large intestine. Just below your stomach, in your guts. We are very worried that it has spread, maybe, to your liver. Or your kidneys. Or your lymph nodes. We hope that we will see nothing, but we are expecting the worst. Because you are in your sixties. And you have never been to a hospital. And by the time you came here, you could barely pass stool. And when you did it was black and tarry. This is a bad sign, we are very concerned about you.
That is what he is telling her. What he is saying, in an accent very difficult for her to sift through, sleepy, disoriented, afraid, is Today you have the CT, ok? And later, when we have rounds, he tells our Attending, patient understands what we are doing and she has given her consent.
I suck in on thick, pungent air, sometimes uncertain if I can keep up with this.
