Crack The Spine (March, 2013)
When I was a young boy, grownups would ask me: “Are you going to be a surgeon like your dad? He saves so many lives, what a great man. Don’t you want to be like him when you grow up?”
“I’m thinking about it,” I’d say. What a stupid question. I mean, was I going to say no? “Maybe a brain surgeon.” Their foreheads would wrinkle and eyes open wide after that one. Most old people would then shake my hand with their big paws. “Terrific,” they would say and finally move away.
I really didn’t know much about my dad. Mornings he left for work before I was awake, and evenings he usually slept on the couch before and after dinner between phone calls. My friends knew what their parents did at work, but Dad never talked about what he did. Frustrated, one night before he sat down on the couch, I shouted: “Take me along with you!” He seemed surprised but maybe sort of pleased, I thought. That’s how we started seeing patients together in 1950, in the middle of Iowa, when I was nine years old.
Night emergencies, when most people were sleeping and voices had urgent sharpness, were the most exciting. Most often we went to see a patient in the emergency room. I would wait outside the operating room, looking through one of the small windows while they fixed somebody up. But it was like looking at a doctor movie from the entrance of a movie theater, showing distant people in white uniforms standing around doing something to the person lying on a table. I wanted to be in the surgical room, in the operating room, and see what really was happening.
“Andy, I’ve got to go see a patient in Monticello. She’s having a lot of pain in her stomach, may have to operate on her.” My dad was standing beside my bed. I rolled toward the Baby Ben on the table: 1 a.m. “Want to come along?”
Our old brick house faded away in the headlights as we backed down the driveway. We were soon racing along in my dad’s big, white Cadillac, way over the limit. Then he really opened her up on the narrow highway leading to Monticello, the center-line stripes rushing by in a blur. This car was new, with wide leather seats and those new electric windows instead of cranks. The front bumper guards looked like large bullets, and chrome stripes ran along the doors and fenders to the tail fins. A large, chrome V was on the front and rear. This was the champion of cars and it went like hell.
Dad floored it and soon the wind was screaming even louder than the engine. I watched the white speedometer needle move rapidly to the right—60, 70, 80, 90, 100. “There’s a three-mile straight stretch after this next curve,” he said, the red-tipped cigarette moving up and down as he talked. “Don’t be surprised at the bounce when we go over a little bridge a mile ahead.” I grabbed the seat edge and hung on. Foot to the floor, leaning forward, both hands gripping the wheel—90, 100, 110—we flew across that narrow, wooden bridge and through the black night surrounded by warm odors of farm animals and the sweet smell of freshly cut hay.
Being a doctor and driving a fast car seemed unreal to me then. How could you start as just a kid and one day become someone who could save lives and drive as fast as you wanted?
“Well, you’ll see, honey,” my mom would say when we talked about it, “not much in life happens suddenly. You’ll just figure out what you want to do and then work on it each day. You can do anything you want if you work hard.” My lips moved with hers. I had that last sentence memorized.
We slowed for the last curve before Monticello, passed a blinking red neon: Eat Gas 24 Hours, and coasted through deserted streets to a tall, white building on a hill, Henderson Hospital. The Henderson family had given their home to the town for a hospital after they croaked and the kids moved away. As we drove up the curving driveway, the headlights dimly showed a towering mansion with windowed turrets and dark balconies. It looked haunted, like the Hendersons might still be floating around inside.
Dr. Meyers was standing under the light near the front stairs. He was sort of stooped over with small, round glasses. He smiled.
“My God, that didn’t take long, Clyde,” he said, shaking hands. “Didn’t I just talk to you about half an hour ago?”
“No other cars,” my dad said as we walked up the steep stairs to the large, double entrance doors. “I brought my son, Andy, with me.”
“Glad you did,” Dr. Meyers said, holding the handrail, carefully taking one step at a time. “Can’t start them too early. You’ll have an interesting time tonight, son.”
“Yes, sir,” I said, still listening to the crinkling, cracking sounds of the hot Cadillac. Maybe I could just sleep in the car while they took care of the problem. There were very few lights as we walked up a winding staircase to the second floor and past a life-sized statue of Jesus with his arms reaching out, eyes staring up at heaven, folds of blue and yellow robes lit by several candles at his feet. I would have liked him better if his eyes had been looking down and following me along like in those old paintings where the eyes seem to move as you walk past. Dr. Meyers carried a flashlight along the dark hallway to the patient’s room. I followed along behind the doctors like a useless wooden toy being towed by a string.
I stopped at the doorway but watched closely. Looking over the tops of his glasses, Dr. Meyers introduced my dad:
“Here is Dr. Westwood. I called him to come up and take a look. Clyde, this is Marian Clark in bed and Jake Clark there beside her.” I could see Mrs. Clark, white as a wax candle, lying there holding her belly, and Jake standing there looking scared as hell, his white, wrinkled forehead contrasting with a deeply tanned face, his sun-darkened hands clasped together.
“Tell us what happened,” Dr. Meyers said.
“Well, I was just usual until yesterday. Then I had a little pain on the right here,” pointing low on her stomach. “It got a lot worse this evening, and when I got up from the chair after dinner, I fainted, didn’t I, Jake?”
“You sure did, scared the hell out of me, honey.”
“Any nausea or vomiting or diarrhea?”
“Just a little nausea.”
“Have you ever had these problems before?”
“Are your periods normal?” Dad asked.
“No. I’ve missed the last two.”
Dad touched her belly. She grabbed his hands and shouted: “Oh, Doc, that hurts like hell. Don’t press on it!” She turned on her side and brought up her knees.
I bit my lip and looked at the floor; never saw anyone in that much pain before.
Dad turned to Dr. Meyers.
“Well, Alex, looks like she’s got bleeding in her abdomen, don’t you think? Her missed periods make me concerned about a tubal or abdominal pregnancy.”
“The laboratory studies show severe anemia,” Dr. Meyers said. “I sent for some blood in case she needs a transfusion.”
“We need to look in there,” Dad said. “Shouldn’t wait for morning and we should do it here rather than wait for an ambulance. How about anesthesia and a scrub nurse?”
“We have two nurses on call and sterile instruments upstairs. I can give an ether anesthetic.”
The operating room was on the fourth floor. Mrs. Clark was carried on a stretcher up the two flights of stairs and down another dim hallway, Dr. Meyers holding the front handles, my dad at the rear. I walked behind again. Everything smelled like bleach and the old floor squeaked.
We came to a small, white room with a bright overhead light where two nurses were laying out instruments and opening packages of gauze sponges. Mrs. Clark was moved carefully from the stretcher onto a metal table in the operating room. Then Dad, Dr. Meyers, and I walked to the nearby dressing room.
“Alex, is it OK with you if Andy watches?”
“Hell yes,” he answered, pulling a white scrub suit over his fat stomach. I looked through the tall stack of uniforms for the smallest size.
“Oh, don’t worry about size,” my dad said, “we’ll just roll up the sleeves and pant cuffs and pin the waist so they don’t fall off. Here, put on this cap, I’ll tie this mask around your neck.” I stood there, trying to get enough air through the heavy mask, while the two of them began scrubbing their hands. They looked comfortable in their white clothes and masks. I could see through the window into the operating room as Mrs. Clark’s gown was removed, and she was painted with iodine. She was the first naked woman I had ever seen before except my mother once by accident. So pale and so quickly painted orange, her body didn’t seem real. Maybe it was her color or the fact she was lying down. I was a little disappointed at her flat breasts after looking at all the National Geographic photographs. White sheets were put over her, covering everything except the stomach. Dr. Meyers started the anesthetic. He motioned to me to come into the operating room. I loosened my mask a little and entered the room but stayed against the wall.
One of the nurses turned to me, eyes narrowed above her mask. “Don’t touch anything!” she said. I put my hands behind me and stood there in the bright-white room, fingers locked and sweaty, not sure of what to do. Another nurse and my dad stepped up to the patient’s side.
“She’s ready, Clyde,” Dr. Meyers said.
“Scalpel!” A nurse handed my dad this little, shiny knife, which he pressed against the patient’s skin. Blood flowed from the cut. “Hemostat, silk, sponge, hold the retractor like this,” Dad said, pulling on the handle and looking up at the nurse. Sometimes he talked to me like that, especially when I was trying to tie a knot or fix something that was broken. “That’s the wrong way,” he would say and then leave the room. Later my mom and I would figure out how to do it.
I looked away, thinking how great the trip home in the Cadillac would be.
“Andy, come over here,” Dr. Meyer said, again looking over his glasses. He was sitting on a shiny, metal stool near the patient’s head. “See how I pour this ether?” He was holding a metal can about the size of a Campbell’s soup can my mother used in our kitchen. He had cut off the small top and put in a cork with a small v cut in it. Ether dripped from a short piece of pipe cleaner stuck through the notch onto a soft mask held over Mrs. Clark’s face.
His wrinkled, hairy hand held the mask firmly. “She breathes it and it keeps her asleep. You just have to be careful not to drip too much or too little. You have to listen to how she breathes. Sit here beside me on my chair,” he said, moving to the edge of the round seat. “I’ll hold your wrist. You hold the can. There you go. Just go round and round the mask. Listen to her breathe.” He had a calm voice and explained things much better than my dad.
Mrs. Clark sounded like she had just been frightened by Frankenstein. You know how girls do watching movies, only she did it over and over. Her forehead started to frown.
“That’s not enough. See, she’s waking up.” I poured more out of the can, and her breathing deepened but then became softer.
“See, that’s too much!” Dr. Meyer said.
I tipped the can back but dripped some on my pants. It was real cold and smelled like mothballs. I liked it. I tilted the can and dripped a little more on my hand. Dr. Meyers took over.
About then my dad asked for the suction. I stood up and saw all the blood rushing through the plastic tubing into a large bottle on the floor. Sponges were soaked with blood. “Alex, you better start a unit of blood,” my dad said, looking through the cut into Mrs. Clark’s abdomen.
I didn’t know we had that much blood in us. The glass bottle on the floor was half full of Mrs. Clark’s blood! Jesus! In the movies people get hurt, bleed just a little, and fall over. But no one seemed too worried except me.
“I’ve got it,” Dad said. He had one of his gloved hands around something deep inside her. “Have Jake come in so I can show him what the problem is.” I had no idea people were hollow inside—that you could reach inside them to fix things.
In a few minutes Mr. Clark came wide-eyed into the operating room through a glass side door, his overalls and boots partly covered by a small, white gown a nurse was trying to tie around his chest.
“Jake, step up on the stool behind me,” my dad said. Silently, his wide eyes staring above his mask, Jake stepped up and put a hand against my dad’s back to steady himself.
“She bled quite a lot. See this red thing here?” Mr. Clark leaned forward; he was sweating. Dad turned his head to look at him.
“Easy, Jake, don’t push any harder. Don’t want you to fall into us. Is he OK, nurse?”
“Hell, I’m OK, Doc, just something you don’t see every damn day.”
“It’s about the size of a walnut. It’s a pregnancy that never made it down Marian’s right tube to her uterus. It got stuck in the tube and started to grow, got larger, and finally broke open and caused all that bleeding into her abdomen.”
Dr. Meyers was dripping the ether now; I was standing beside him so I could see what Mr. Clark was looking at. Dad had a red thing between his fingers of his left hand; small spurts of blood shot out with each heartbeat. He put two clamps just under his fingers and the bleeding stopped. He cut between the clamps and lifted the red thing out of Mrs. Clark.
“Here it is,” he said, holding the thing carefully before handing it to the nurse beside him. “I forgot to ask how many kids you have, Jake.”
“Two, Doc, a boy and a girl.” His voice seemed faint and he rocked back and forth on the stool.
“Well, you can still have more. The other tube is normal and she has both ovaries.”
I thought: Why would you ever have more kids after this?
“I gotta sit down, Doc.” Still holding up his gown, the nurse who had led him into the room grabbed Mr. Clark and helped him back out the glass side door into the hallway, where he slammed down on the nearest chair before the door closed.
So that’s kinda what happened my first time in surgery. Sure, I felt wobbly too, just like Jake. But I just sat down on the floor and stared at the small tiles for a while until Dr. Meyers wanted me to pour the ether again.
Mrs. Clark sort of woke up while we were still in the operating room after her bandage was put on. She started to moan and moved around before they tied her to the stretcher. Finally she answered a couple of questions and sighed when one of the nurses asked her to take a deep breath. I followed along while they carried her back down the stairs to her room. Jake gave Dr. Meyers and my dad bear hugs and everyone shook hands. Even me.
We pulled into that diner on the edge of town for breakfast just as it was getting light. A little bell rang as we opened the door. I was hungry. The only person in there was standing at the sink washing dishes and smoking a cigarette. “Come on in, boys,” she said, smiling. “I’m Esther. What’ll you have?” She was just a little taller than I was, her face wrinkled except for a strip of bright-red lipstick. We sat at the counter on those turning stools I like.
Esther put her cigarette down on the edge of the stove as she fried our bacon and eggs. About halfway through Dad lit another cigarette with his Zippo and leaned across the counter toward me. “Do you have any questions about what happened last night, Andy?”
“Oh, no, Dad. I pretty much understand it all.” That’s what I said. He had a little smile then. Really, though, I didn’t know what the hell had happened.
How much blood do we have inside us?
Do other naked women look like that? Wait until I tell my friends!
That night I learned that people aren’t just solid like trees. They look solid but you can drip some ether on their faces and reach into them with your hands to fix what’s wrong. I’ll probably reach into people someday too. And take Dad along on fast car rides.