A Manual for Cleaning Women (13 page)

“Did he call?”

“Course not, honey. He ain’t gonna call.” Esther held her, rocking her. She had taken care of Bella Lynn since she was a baby. Didn’t spoil her though, like everybody else. I used to think she was mean. Well, she is, matter of fact. She greeted me with “Looka here … another empty-headed girl!” She held me too. She was a tiny fine-boned woman, but she enveloped you.

“Where’s that poor baby?” She went in to see Ben, came back and hugged me again. “Blessed love. He’s a blessed child. Are you grateful, girl?” I nodded, smiling.

“We can help you make tamales,” I said. “I just want to say hello to Tyler and Rex. And Aunt Tiny. Is she…?”

“She’s not coming down. She has an electric blanket, a radio, and liquor. No, she’s up there for a while.”

“Praise the Lord,” Bella said.

“Go fix some food for those men-children out in the shop. Plenty of shrimp for Rex.”

Tyler’s “shop” was really an old adobe house, with a big den and guest room, a gigantic room full of guns, new ones and antique ones. The den had a big fireplace, animal trophies all over the walls and bearskins on the tile floor. The bathroom was a carpet of breasts, rubber breasts of all colors and sizes. The carpet had been a present to Tyler from Barry Goldwater, who once ran for president of the USA.

It was dark now, cold and clear. I followed Bella Lynn down the walk.

“Hussies! White trash!”

I gasped, startled. Bella laughed.

“That’s just Mama, on the roof.”

Rex and Uncle Tyler were glad to see me. They said when Joe set foot on American soil again to let them know, they’d tear him limb from limb. They were drinking bourbon and making lists. The room was stacked with shopping bags. Every year they took presents to old folks’ homes and children’s hospitals and orphanages. Thousands and thousands, they spent. Only they didn’t just write out checks. The fun was picking out everything and then going to the places with food and Santa Clauses.

This year they had a new scheme, because Rex had a plane now. A Piper Cub he landed in Tyler’s south pasture. On Christmas Eve they were going to air-drop bags of toys and food over Juárez shantytown. The two men were laughing and carrying on about their plans.

“But Daddy,” Bella said, “what will we do about Mama? And Aunt Mary? What about Lou and me here? Tigers went and knocked her up, ran off with my husband.”

“Hope you two have knockout outfits for tomorrow’s party. Caterers are coming, but Esther will still need some help. Rex, how many candy canes you figure for them crippled children?”

Emergency Room Notebook, 1977

You never hear sirens in the emergency room—the drivers turn them off on Webster Street. I see the red backup lights of ACE or United Ambulance out of the corner of my eye. Usually we are expecting them, alerted by the MED NET radio, just like on TV. “City One: This is ACE, Code Two. Forty-two-year-old male, head injury, BP 190 over 110. Conscious. ETA three minutes.” “City One … 76542 Clear.”

If it is Code Three, where life is in critical danger, the doctor and nurses wait outside, chatting in anticipation. Inside, in room 6, the trauma room, is the Code Blue team. EKG, X-ray technicians, respiratory therapists, cardiac nurses. In most Code Blues, though, the EMT drivers or firemen are too busy to call in. Piedmont Fire Department never does, and they have the worst. Rich massive coronaries, matronly phenobarbital suicides, children in swimming pools.

All day long the heavy hearselike Cadillacs of Care Ambulance back up just to the left of emergency parking. All day long, just outside my window, their gurneys sail past to cobalt, radiation therapy. The ambulances are gray, the drivers wear gray, the blankets are gray, the patients are yellow-gray except where the doctors have marked their skulls or throats with a dazzling red Magic Marker X.

They asked me to work over there. No thanks. I hate lingering good-byes. Why do I still make tasteless jokes about death? I take it very seriously now. Study it. Not directly, just sniffing around. I see death as a person … sometimes many people, saying hello. Blind Mrs. Diane Adderly, Mr. Gionotti, Madame Y, my grandma.

Madame Y is the most beautiful woman I have ever seen. She looks dead, actually, her skin translucent blue-white, her exquisitely boned Oriental face serene and ageless. She wears black slacks and boots, mandarin-collared jackets cut and trimmed in Asia? France? The Vatican, maybe—they have the weight of a bishop’s cassock—or an X-ray robe. The piping has been done by hand in rich fuchsias, magentas, oranges.

Her Bentley drives up at nine, driven by a flippant Filipino who chain-smokes Shermans in the parking lot. Her two sons, tall, in suits made in Hong Kong, escort her from the car to the entrance of radiation therapy. It is a long walk from there, down a corridor. She is the only person who walks it alone. At the entrance she turns to her sons, smiles, and bows. They bow back to her and watch until she has reached the end of the hall. When she disappears they go for coffee and talk on the telephone.

An hour and a half later everyone reappears at once. She, with two flushed spots of mauve on her cheekbones, her sons, the Bentley with the Filipino, and they all glide away. Glisten and sheen of the silver car, her black hair, her silk jacket. The entire ritual as silent and flowing as blood.

She is dead now. Not sure when it happened, on one of my days off. She always seemed dead anyway, but nicely so, like an illustration or advertisement.

I like my job in Emergency. Blood, bones, tendons seem like affirmations to me. I am awed by the human body, by its endurance. Thank God—because it’ll be hours before X-ray or Demerol. Maybe I’m morbid. I am fascinated by two fingers in a baggie, a glittering switchblade all the way out of a lean pimp’s back. I like the fact that, in Emergency, everything is reparable, or not.

Code Blues. Well, everybody loves Code Blues. That’s when somebody dies—their heart stops beating, they stop breathing—but the Emergency team can, and often does, bring them back to life. Even if the patient is a tired eighty-year-old you can’t help but get caught up in the drama of resuscitation, if only for a while. Many lives, young fruitful ones, are saved.

The pace and excitement of ten or fifteen people, performers … it’s like opening night at the theater. The patients, if they are conscious, take part too, if just by looking interested in all the goings-on. They never look afraid.

If the family is with the patient it is my job to get information from them, to keep them informed about what’s going on. Reassure them, mostly.

While the staff members think in terms of good or bad codes—how well everyone did what they were supposed to do, whether the patient responded or not—I think in terms of good or bad deaths.

Bad deaths are ones with the manager of a hotel as next of kin, or the cleaning woman who found the stroke victim two weeks later, dying of dehydration. Really bad deaths are when there are several children and in-laws I have called in from somewhere inconvenient and none of them seem to know each other or the dying parent at all. There is nothing to say. They keep talking about making arrangements, about having to make arrangements, about who will make arrangements.

Gypsies are good deaths. I think so … the nurses don’t and security guards don’t. There are always dozens of them, demanding to be with the dying person, to kiss them and hug them, unplugging and screwing up the TVs and monitors and assorted apparatus. The best thing about Gypsy deaths is they never make their kids keep quiet. The adults wail and cry and sob but all the children continue to run around, playing and laughing, without being told they should be sad or respectful.

Good deaths seem to be coincidentally good Codes—the patient responds miraculously to all this life-giving treatment and then just quietly passes away.

Mr. Gionotti’s death was good … The family respected the staff’s request that they stay outside, but one by many one they went in and made their presence known to Mr. Gionotti and came out to reassure the others that everything was being done. There were a lot of them, sitting, standing, touching, smoking, laughing sometimes. I felt I was present at a celebration, a family reunion.

One thing I do know about death. The “better” the person, the more loving and happy and caring, the less of a gap that person’s death makes.

When Mr. Gionotti died, well, he was dead, and Mrs. Gionotti wept, they all did, but they all went weeping off together, and with him, really.

I saw blind Mr. Adderly on the 51 bus the other night. His wife, Diane Adderly, came in DOA a few months ago. He had found her body at the foot of the stairs, with his cane. Ratshit Nurse McCoy kept telling him to stop crying.

“It simply won’t help the situation, Mr. Adderly.”

“Nothing will help. It’s all I can do. Let me alone.”

When he heard McCoy had left, to make arrangements, he told me that he had never cried before. It scared him, because of his eyes.

I put her wedding band on his little finger. Over a thousand dollars in grimy cash had been in her bra, and I put it in his wallet. I told him that the denominations were fifties, twenties, and hundreds and he would need to find somebody to sort it all out.

When I saw him later on a bus he must have remembered my walk or smell. I didn’t see him at all—just climbed on the bus and slumped into the nearest seat. He even got up from the front seat near the driver to sit by me.

“Hello, Lucia,” he said.

He was very funny, describing his new, messy roommate at the Hilltop House for the Blind. I couldn’t imagine how he could know his roommate was messy, but then I could and told him my Marx Brothers idea of two blind roommates—shaving cream on the spaghetti, slipping on spilled stuffaroni, etc. We laughed and were silent, holding hands … from Pleasant Valley to Alcatraz Avenue. He cried, softly. My tears were for my own loneliness, my own blindness.

The first night I worked in Emergency, an ACE ambulance brought in a Jane Doe. Staff was short that night so the ambulance drivers and I undressed her, pulled the shredded panty hose off of varicose veins, toenails curling like parrots’. We unstuck her papers, not from her gray flesh-colored bra but from her clammy breasts. A picture of a young man in a marine uniform: George 1944. Three wet coupons for Purina cat chow and a blurred red, white, and blue Medicare card. Her name was Jane. Jane Daugherty. We tried the phone book. No Jane, no George.

If their purses haven’t already been stolen old women never seem to have anything in them but bottom dentures, a 51 bus schedule, and an address book with no last names.

The drivers and I worked together with pieces of information, calling the California Hotel for Annie, underlined, the Five-Spot cleaners. Sometimes we just have to wait until a relative calls, looking for them. Emergency phones ring all day long. “Have you seen a ———?” Old people. I get mixed up about old people. It seems a shame to do a total hip replacement or a coronary bypass on some ninety-five-year-old who whispers, “Please let me go.”

It doesn’t seem old people should fall down so much, take so many baths. But maybe it’s important for them to walk alone, stand on their own two feet. Sometimes it seems they fall on purpose, like the woman who ate all those Ex-Lax—to get away from the nursing home.

There is a great deal of flirty banter among the nurses and the ambulance crews. “So long—seizure later.” It used to shock me, all the jokes while they’re in the middle of a tracheotomy or shaving a patient for monitors. An eighty-year-old woman, fractured pelvis, sobbing, “Hold my hand! Please hold my hand!” Ambulance drivers rattling on about the Oakland Stompers.

“Hold her bloody
hand
, man!” He looked at me like I was crazy. I don’t hold many hands anymore and I joke a lot, too, if not around patients. There is a great deal of tension and pressure. It’s draining—being involved in life-and-death situations all the time.

Even more draining, and the real cause of tension and cynicism, is that so many of the patients we get in Emergency are not only not emergencies, there is nothing the matter with them at all. It gets so you yearn for a good cut-and-dried stabbing or a gunshot wound. All day long, all night long, people come in because they don’t have much appetite, have irregular BMs, stiff necks, red or green urine (which invariably means they had beets or spinach for lunch).

Can you hear all those sirens in the background, in the middle of the night? More than one of them is going to pick up some old guy who ran out of Gallo port.

Chart after chart. Anxiety reaction. Tension headaches. Hyperventilation. Intoxication. Depression. (These are the diagnoses—the patients’ complaints are cancer, heart attack, blood clots, suffocation.) Each of these patients costs hundreds of dollars including ambulance, X-ray, lab work, EKG. The ambulances get a Medi-Cal sticker, we get a Medi-Cal sticker, the doctor gets a Medi-Cal sticker, and the patient dozes off for a while until a taxi comes to take him home, paid for with a voucher. God, have I become as inhuman as Nurse McCoy? Fear, poverty, alcoholism, loneliness are terminal illnesses. Emergencies, in fact.

We do get critical trauma or cardiac patients, and they are treated and stabilized with awesome skill and efficiency in a matter of minutes and rushed to surgery or ICU, CCU.

Drunks and suicides take hours of time holding up needed rooms and nurses. Four or five people waiting at my desk to sign in. Ankle fractures, strep throat, whiplash, etc.

Maude, beery, bleary, is sprawled on a gurney, kneading my arm like a neurotic cat.

“You’re so kind … so charming … it’s this vertigo, dear.”

“What is your last name and your address? What happened to your Medi-Cal card?”

“Gone, everything is gone … I’m so miserable and so alone. Will they keep me here? There must be something the matter with my inner ear. My son Willie never calls. Of course, it’s Daly City and a toll call. Do you have children?”

“Sign here.”

I have found a minimum of information among the rest of the mess in her purse. She uses Zig-Zag papers to blot her lipstick. Big smeary kisses, billowing like popcorn all over her purse.