don’t want to brag because pride comes before the fall, but I’m big. The CEO makes eight million a year. I make thirty four G’s with no retirement plan and shitty health insurance. But without me, this hospital would crumble.
I’m in charge of environmental services for the operating rooms. I make sure the instruments are sterilized, I make sure the masks, gloves, and gowns are in supply. I maintain the anesthesia machines. I keep the hand-washing area immaculate; you can’t have bacteria in the operating rooms.
I’m proud. I’m needed. I’m the janitor.
I try to help everybody and make sure that no one gets hurt, patients or staff. I’m an enforcer. A hospital can be a very violent place.
It took me fifteen years to get this gig. After the Marines, I boxed. I was number eight in the world, and I have the Ring Magazine to prove it. I fought Ernie, who could knock down a brick wall with his punch, and I realized, as did my corner, that I would never be champ. The short end money was for me.
I became a dive-bomber. At least it wasn’t Pro Wrestling. I would take a dive, go in the tank, fix a fight, and pad the career of some bum they were promoting—if the price was right. I was good at the dive. It’s an art.
You have to make it look good. You can’t get hit by a jab and fall down. To be good you have to time the cupcake’s punch and step into it. You use your strength and muscle to make the tomato can look like he has some serious power. I rode my number eight ranking down to number twenty-five making money all the way. Tax free.
You can only do this for so long until the commission catches on, or you get sloppy and get tagged. I got tagged.
This is how it went down. A kid was being promoted by gamblers, and I was going to launch him into the top ten where he would promptly get murdered. But I had to make it look good. He had some serious power in both hands but was so slow he couldn’t bob and weave away from a snail. So I’m fighting him, pulling some punches, but rocking him a bit for fun. I could have taken him out at any time. I time his right, carefully move to step into it, but the bum fakes the right and tags me with a left from nowhere. Like my hero Ali, I have always been a sucker for a left hook. It was the hardest I’d been hit. It all went white then black. I don’t remember hitting the canvass, but they say I bounced. I woke up in the hospital. It was a lucky break.
They had to drill holes into my head to let the blood out. I spent six weeks in this hospital, but they saved my life. I’m completely good except my left leg drags, and if I drink too much, or get really tired, my talking gets funny.
Hospitals usually don’t like anybody who can’t pay, but this one seems to have taken a shine to me. They took my house for payment, but they gave me a job as a janitor on the loading dock. They knew I’d fit in well with the roughnecks. I wanted to better myself, so when they needed a janitor to work in the morgue, I jumped at the chance—that was my entry into health care.
I found the morgue too quiet, the patients too dead, and the people working there a little weird. I am a people person and wanted to be with live patients. I wanted to interact. I moved on to the medical floor, then the surgical floor, the emergency room, and finally the most prized position—the janitor for the operating rooms. I get to wear scrubs, a mask, and a surgical cap.
It’s hard to tell me from the surgeons.
I take care of everybody, especially the nurses. Some of the doctors are rude to them, and I have to remind them to behave. But I do it in a real nice way, and then they realize that they were not being fair. If a tough guy like me can be nice, anybody can be nice. I show people being nice doesn’t make you a sissy. It helps us all get along. The most important thing is to work as a team. Surgeons, nurses, anesthesiologists all have a job to do. We become like family and we save lives. I love being in health care.
The surgeons, nurses and I are under a lot of stress. I can’t leave my work at the hospital. I bring it home. I’ve been divorced twice and I believe the pressure made things difficult for my marriages. My wives were jealous of the nurses. There are some very pretty nurses, but I would never get involved. It’s against my code of conduct. I love my work too much to do something stupid.
That’s not to say the nurses don’t appeal to me. It’s a good thing you can’t see a nurse’s face or figure when she is masked and wrapped in surgical scrubs. Only their eyes are exposed. The girls know it so they paint them like Cleopatra. It’s hard not to fall in love looking into a pair of mascara-lined, shadowed, spectacular, dreamy eyes. But I’m a professional. I stay on point.
Brit’s my favorite scrub nurse. She has wonderful, clear green eyes. With her eyes made up it’s game on. Surgeons have stopped working during an operation to stare. I remind them to get back to business, but like I said, in a nice way.
But today Brit’s eyes are a swirl of green eye shadow and black mascara mixing and streaming down her cheeks like melting ice cream. The swirling rainbow disappears behind a surgical mask. Dr. Dee, the surgeon, is tormenting her. He selects the pretty nurses to harass. I don’t know why he works here. He’s not a team player. He’s the chairman of the department, and I’m told he can get away with a lot because his assistants write a lot of papers. He’s also connected with the hospital’s board and a construction company. He knows some guys I know but he shouldn’t.
I stand on a step stool and watch the operation. “You need to open the wound more,” he shouts at Brit. His accent is Latino or Arab. Dee isn’t his real name but some shortened version of one of those real long foreign names. Brit pries the wound open with steel retractors. Her gloved, bloody hands shake. “Not so much, you’ll rupture the spleen. What’s the matter with you? You could kill the patient.” She relaxes the traction only to hear, “Now I can’t see, damn you.”
He keeps operating and shouting. Brit can’t do anything right. She cries. He takes a swipe at the wound, almost cuts her. That’s too much for me. If he cuts her I’ll kill him. Like I say a hospital can be a very violent place, especially against women.
“Keep your hands away from the incision.”
Brit shakes her head. Sobs come from underneath her mask. Her shoulders rock.
Dee looks up from the operation. “Oh, you’re crying. I’m supposed to stop and let the baby compose herself? Tears are going to fall in the wound and cause infection. A girl like you must get a lot of infections.”
Now I’m pissed.
“You’re disgusting,” Brit says. She let’s go of the retractors turns away from the operation and heads out. “I don’t have to put up with this.”
Dr. Dee yells, “Get out of here now! Bring me somebody else. Quick, hop like a bunny.”
Brit turns around, removes her mask, and shouts, “You tried to cut me.”
“You have pretty eyes my darling, and wonderful red hair, but your hands are big and clumsy. Now get out of here. And, if I wanted to cut you, I would have done it.”
Brit leaves. The operation stops dead. It’s silent, like the morgue. The only sound is the ping of the heart monitor, and the whoosh of the ventilator. I focus on the patient’s breathing and heartbeats. If they don’t stay regular I will step in. I’ve been through it. I can focus.
Dr. Dee resumes operating. That is good. Let’s get this operation over and go home. I have internal radar; I know when trouble’s coming.
Dr. Silva, the anesthesiologist, stands. He is a big, tall ex-football player. He casts a shadow over the operative field. Dr. Silva says, “Doctor, if you don’t have a scrub nurse, I’ll stop this case.”
He’s right. You can’t complete the operation without a scrub nurse. I could scrub in—some of the other doctors let me. But Dee won’t allow me to help him because I’m a janitor. If I’d had the chance I’d have been better than Dee, and more polite. But, I would not like to be in a position where he would try to cut me. I won’t let anyone come after me with a knife. I go crazy. There would be no bell to stop me.
“You’re blocking my light,” Dee says to Dr. Silva. “I can’t continue this operation unless you sit down.”
“I’ll stop this case and wake the patient up, if you don’t get a scrub nurse to assist you.”
“You think I will let you do that? The patient’s abdomen is open. The family and patient expect a good operation by Dr. Dee. They’ve waited months for me. Now sit down.” He throws a clamp on the floor. It clangs and bangs and hits my foot. I pick it up and place it with the dirty instruments. I’m getting very nervous.
“Now you’re throwing shit. You better pack that wound because I’m going to stop this case. You can finish tomorrow.”
“You stop and I will stop you.” He raises a bloody scalpel at Dr. Silva.
“What are you doing with that knife? You tried to cut that nurse, and now you want to cut me? You stupid bastard.”
Grace, the old nurse who supervises the surgical recovery room, enters.
“I’ll take over,” she says.
She looks at the surgeon, then at Dr. Silva. “Get back to the operation, or I’ll write you both up.”
I like Grace. She’s no-nonsense and stand up. We couldn’t wake the patient up with the belly open and packed with towels.
“All right Grace, as long as you’re here, I will keep the patient asleep.”
“That’s very good. Now, let’s get back to work,” says the surgeon. “I have cases scheduled all day. Time is money.”
The only talk is the commands of Dr. Dee for clamps, scalpel, and Bovie. The operation is completed. The chief resident is allowed to close the patient.
The anesthesiologist has the nurse anesthetist take over. Dr. Dee leaves the patient, but Dr. Silva blocks his exit like a fighter cutting off the boxing ring.
“Just a minute,” he says. “I will never do anesthesia for one of your cases again. You treat people like dirt. You should be ashamed.”
“And you should respect me. I bring you business. I’m the chief and I make the rules. You put people to sleep. Even a nurse can do that. I don’t know why they pay you so much.”
“To tolerate assholes like you.”
Silva must be in his late fifties, but he has old man muscle.
Silva moves toward Dee. The surgeon looks for a scalpel, but I removed the sharp surgical instruments. Violence is violence, civilized or not.
We watch, hoping Dr. Dee’s time has come. He looks like a foreign field goal kicker coming face to face with a missed blocking assignment.
Silva’s face is red and the blood vessels snaking up the side of his head throb in time with his fast heartbeat. He raises his fist at Dr. Dee, then opens it, and slaps the little surgeon. It makes a loud stinging sound. Dee goes down and Silva falls on top of him.
I thought Silva slipped and wait for him to get up. Silva doesn’t move. Dee is pinned underneath him. His arms and legs flail like a bug’s. He finally rolls out and retreats to a corner of the operating room. Silva remains motionless on the tiled floor. I kneel down and turn him to his side. His face is purple, his eyes open and sucker-punched glazed. His jaw hangs open. The blood vessels at the side of his head no longer move.
“He’s not breathing!” I shout. “Call a code. His heart stopped.”
I rip the EKG leads off the patient and place them on Dr. Silva. I shout again, “Call a code, I need help!”
“Dr. Dee breathe for him, you caused this,” I say.
The surgeon smiles, shakes his head, and steps over Dr. Silva like he is a dead dog in the street.
The staff in the O.R. could not move. Resuscitation time passes. There are only a few minutes before the brain withers.
I leave Silva and punch the red panic button to bring a platoon of doctors, nurses, and medical students. Dr. Silva remains blue. I fall to my knees and start breathing into his mouth. Silva’s huge chest rises up and down, and color returns to his face.
The CPR team arrives.
“It’s Dr. Silva, he collapsed, stopped breathing.”
I stop breathing for Dr. Silva. A doctor puts a tube down his throat and attaches a black Ambu bag. The doctor squeezes the bag forcing air into Silva’s lungs.
I press on his sternum, pushing it down to force blood through his body.
The intern puts a large needle into the vein running under Dr. Silva’s collarbone.
“Run the fluids wide open. Watch the monitor.”
“Ventricular arrest. You have to shock him.”
Electric paddles are placed on Silva’s chest.
The team pushes away from the body. The cardiologist hits the switch on the paddle. I pray it works. Thunk. The body rises up then flops down.
The resident looks at the monitor.
“He’s still in V-Tach. Shock him again, more juice.”
The body rises higher and crashes down harder.
Ribs crack as I push his breastbone down.
“Stop. Let’s see his rhythm.”
“How long has he been down?”
“He’s dead. Call it.”
“There’s nothing to save now.”
The resident looks at the clock.
“I pronounce death at 4:46.”
Dr. Dee walks to the control desk. “My room is a mess. I will not have my cases delayed. Get Silva’s body out of there, or give me another room.”
The bastard remains on time.
Brit is crying, breathing real fast.
“He tried to help me,” she says. “And now he’s dead. I caused all this. I caused all this. Dee’s a monster.”
“Yeah but that monster is the head of the department.”
“Will he get away with it?”
“He always does.”
I take Brit’s hand. “Calm down, honey. Calm down, Brit. I’ve seen guys like Dee in the service and hanging around boxing gyms. He’s an ugly man. He’ll get what’s coming to him. I’ll see to that. I’ve done it before.”
“But I feel it was my fault. I should have let him say what he wanted. They were only words.”
“Nobody has to be treated like he did you. I feel bad I didn’t step in. Silva would be alive if I had done something. It would have been easy for me, but I’d lose my job.”
Brit continues to cry. Grace hugs her and brings her a valium.
“Now, go lie down in the call room and lock the door.”
All the cases are done. I am the only one remaining in the surgical locker room. I need to clean up. Straighten things. When tragedy strikes, people need order and reassurance that tomorrow will come.
I put the laundry in the hampers and bring in clean scrubs for tomorrow. I stack them up in neat rows arranged by size. I lay out towels and washcloths. I clean the showers and toilettes.
At the foot of Dr. Dee’s locker is a dirty adult diaper. He won’t take time out to go to the bathroom. I put on latex gloves and place his diaper in the trash.
I have to figure out a way to get back at Dee. I would have to be careful because he is very powerful and can get away with anything. I will have to find the perfect patient that will ruin Dr. Dee. I didn’t want to hurt the patient too bad. This would be tricky and take time.
Lucky for me the hospital has computerized medical records. All patient information is on the computer, and there is practically no security. We can find out anything on anybody. We can snoop without fear of being caught. The computer leaves no evidence. You don’t have to be O.J. to get away with it.
For six months I’ve been tailgating. If a doctor or nurse leaves the computer screen I watch and wait. The computer stays on for ten minutes. If they don’t sign themselves out, I can surf the computer using their identity.
It’s like fishing. I waited but finally a doctor is at the computer and gets called away to a cardiac arrest. A cardiac arrest is the best time to find an open computer. The doctor does not log himself out. I move in and pull up Dr. Dee’s computerized patient list and find the perfect patient. My wait is worth it.
The patient on Dr. Dee’s list is eighty-five and has large ulcers on his legs. They both need to be amputated. First the right, then after the right leg heals, the left has to be removed. This should work.
I don’t want to lose my job. It’s everything to me. I don’t have to earn a living shooting at people like I did in the army or trying to knock them senseless in the boxing ring. My job is healing and caring. I’ve found my purpose. But this Dee thing has to be set right. I’ve found the correct patient and didn’t have to worry about being caught. The computer leaves no DNA or fingerprints.
I want to be like my hero Muhammad Ali, but since I took dives, I can’t. It’s over. He was world champion at the age of twenty-two and never had to go into the tank. But he did give up his title for something he believed in. I’ll do the same. This is my river of resurrection, my road to redemption. I’ll risk it all. This is bigger than me. It’s more important than my job.
I talk to the O.R. tech the day of the operation and ask if I can help prepare the old guy for surgery. Everybody knows me so there is no problem. Brit’s in on it. I get the patient ready. They wheel him out. I wait.
As usual Dee is fast. Amputations don’t take long or require much skill, but this is faster than most.
The patient returns to the recovery room asleep. On cue Brit pulls back the sheet, looks at the results of the operation and covers the patient. She examines the post-op check-list. Then shouts, “Oh my God, he cut off the wrong leg!” Then louder, “Oh my God, Dee removed the wrong leg!”
She’s a great actress.
The recovery room is silent.
“He cut off the wrong leg,” Brit says.
“Dr. Dee amputated the wrong leg.”
Dee walks over and grabs the operative consent from Brit’s hands. One of her fingernails goes flying.
“It says he was to have the right leg amputated, and you removed the left.”
“That’s impossible. I removed the leg that was prepped.”
He removes the sheet. “The right leg is prepped. Who prepped both legs?”
I walk across the recovery room and say, “Dr. Dee, I prepped his legs. They both looked bad, so I prepped them both. I believed you knew which one to cut off.”
Dr. Dee looks at me and shouts “You stupid…” He slaps me. I start laughing. I continue laughing and point at him, “You cut off the wrong leg.” I laugh, slap my thigh. “You slap like a girl.” His face gets red. I watch him ball his hand into a fist. He swings at me with his right, I slip and step into the punch. I hear the crack of at least two bones. He swings with the left, but this time I’m ready, my internal radar is on, and I step into that punch. Three bones break. I’m poetry in motion.
Cutting off the wrong leg will get most surgeons kicked off staff. Dee is well-connected so it may not be enough. But it’s a lead-pipe-cinch that with both hands in plaster casts he’ll not be operating for a long, long time, if ever. I got him real good. Like I say taking a dive is an art, and I made it look like he did all the serious hitting; and I showed remarkable restraint. I think my job is safe.
Olaf Kroneman graduated from the Michigan State University College of Human Medicine with an MD. He interned at the Mayo Clinic in Rochester, Minnesota, then attended the University of Virginia to complete a residency in internal medicine. Upon completion of his residency, he participated in a fellowship in nephrology at Massachusetts General Hospital and Harvard Medical School. He entered private practice in 1983. His interaction with patients and other healthcare professionals prompted him to write. Inspired as well as horrified by the things he has witnessed, his writing is influenced by actual situations but is fictionalized to protect people’s identities.
His work has appeared or is forthcoming in The Healing Muse, Left Curve, Quiddity International Literary Journal, and RiverSedge. His story, “The Recidivist,” won the Writer’s Digest short story contest. In 2010, he was nominated for a Pushcart Prize for his story, “A Battlefield Decision.”