It’s 3 am and I’m Awake....Again

Went to bed at 10, up at 3. Story of my life. Don’t sleep much between shifts anymore thanks to COVID related and capacity related stress. Thinking about what a resident once said after listening to me and my coworker talk about going to dinner after work, maybe thirty minutes after a bad trauma. It was probably his first grotesque experience, but for us it was just another Tuesday. And he turned around and said “Jeez, does anything ever bother you guys?”

He was only half kidding. And I thought something along the lines of ‘boy, you’ve got a long road ahead of you if you don’t learn to compartmentalize a little bit, bud.’ This isn’t even going to be the worst thing I see this week. Sure, they might be missing a few pieces, but they’re going to survive.

We talk about the stress of COVID and healthcare workers a lot, but the trauma is real all the time. There’s a scene from Scrubs where someone is upset that people are using dark humor to get through the day. And one of the doctors says this:

I can’t say it better than that.

There are some things that never leave you. I’m going to share something that I’ve never gotten over, never will get over, and never talk about.

Trigger warning for graphic content.

Turn away now if you’d like. It’s ok.

If you’d like to listen, pull up a chair. Names have been changed, obviously, and years have passed, and there are so many stories like this out there. But this one’s about my regular, Linda.

I saw Linda come in and out of the ER for about five years. It started when she fell down a flight of stairs while high. That was the first but not the last of many trips to the ER for alcohol and drug related trips. Her kid used to come pick her up. The first time I called him, you could hear in his voice—this wasn’t his first time being called to get his mother and he was annoyed. It happens. People get burnt out on addicts and alcoholics the same way I get burnt out on work. It’s a horrible disease that takes and takes and takes. The addict suffers, the family suffers, and no one ever wins. The thing about addiction is, it’s gonna kill you eventually but first it’s going to take every fucking you have.

This fall was when Linda lived with her son. That lasted maybe two years. Then she started the house hopping, all the while getting more and more hooked on the heavy stuff. She became emaciated, she began getting arrested. Shoplifting, then drug and prostitution charges. She went from all appearances an average woman I’d pass in a shop, to someone I’d pass on the street begging for change. It was sad, and it was scary. A couple years in, I had started seeing her so regularly she’d come check in and I’d see her and shout “Linda! How the hell are you?” She liked to give the new staff the business. She could be mean, aggressive, and demanding, and it would usually culminate with one of the oldies, probably me, going in the room and saying, “Linda! Knock it off! Stop being ugly to that girl, she didn’t do anything to you! Now I’ll get you a meal and a cab voucher, but you gotta act right when you’re here, know what I’m saying?” And she’d straighten up and interact without all of the bluster.

Maybe six months before the last time I saw her, she’d gotten assaulted on a work date, face all busted up, probably raped though she wouldn’t say, and I went in to have what was probably our fiftieth conversation about what resources we could offer her. I’ve had these conversations a lot, and I’m pretty good at them—I come from a long line of addictive personalities and I have a lot of life experience—one of my ex boyfriends is dead from alcoholism. Mostly I get a lot of nods and a few cussing outs, and people leave with a list of detox centers, inpatient treatments, and 12 step meetings. Lot of times, you find these crumpled up and blown across the parking lot on your way home.

But you still try. You never know when it’s going to click for someone. It just takes that one time where someone is in that place where they don’t want to keep going on like this and is receptive to trying something different, to change a life. It’s worth getting a Sierra Mist chucked at your head all those other times.

That day, I looked at Linda and I said, “Linda, here’s the deal. We’ve been here before, right? You and me, we’ve known each other for what, five years? You know I remember the first time I was your nurse? That time you fell down the stairs and dislocated your arm?”

She said, “Oh shit that was you, huh? Yeah, it was. Yeah, you and me are cool, but fuck these other bitches, I don’t like them.”

“That’s fair,” I said. “Don’t like some of them myself. But listen, Linda. I’m getting really scared for you. Because these last few years, you’re putting yourself in some pretty bad situations. I get it, you do what you gotta do, but I gotta tell you, I’m scared you’re going to come in real bad and it’s going to be late. I don’t think you’re gonna make it another five years, living like this. You’re gonna get killed or overdose or freeze to death or something.”

Linda laughed. She told me, look, she knew I had to say this bullshit, but if she could just get her discharge papers, and a cab pass, and maybe a sack lunch to go, she’d be on her way.

Man, Linda, I’m trying to help you here. I’m really concerned and scared for you. I want you to hear this—if we don’t change something here, you’re going to die.

And she said, ok, but can I get my fucking discharge lady, Jesus fucking Christ.

Ok, Linda. But I’m giving you all this shit anyway. You remember if you get in a bad place, you have chest pain, ok? Call 911, tell them you have chest pain, an ambulance will come get you and bring you here. You’re always safe here, ok? We won’t call the cops on you or anything.

Whatever it takes for me to get outta this motherfucker, ok, Jesus, I promise, I got the chest pain, damn.

You promise me if you get in trouble, you’ll come here?

Jesus Christ I promise get the fuck outta my face with this shit.

Ok, Linda.

And I gave her the sack lunch and a cab pass and she fist bumped on the way out and told everyone “this my motherfucker, right here, fuck the rest of y’all.”

She always did know how to make an exit.

Six months or so later, I took a call from a rural county EMS service. They said they were bringing an unresponsive woman. Said a couple things about her history, said they weren’t for sure on a name, but it was something like this. And I said, “aw shit, is this Linda so and so?”

It was Linda. EMS brought her in. They’d been called to a trailer outside a small rural town. There was a few people, no one could tell them how long Linda had been lying smashed between the wall and a metal bed frame. It was one of those places people come and people go, high as hell, and whoever put Linda there was probably long gone.

She was completely unresponsive, even to painful stimuli. Her blood pressure was dangerously low, her heart rate was fast, and her core body temperature was 89 degrees. She had been laying in urine so long her the skin of her thighs had peeled off. Large chunks of her hair had been pulled out. She had probably been dragged across a rough surface on her knees—both knees and shins had extensive rug burns. She was covered in animal hair and mouse droppings. She had bruises up and down both arms and on her thighs and torso. There were bruised fingerprints around her throat. One of her eyes was black. She had been pressed against the bed frame long enough to develop ulcers on her face.

I asked EMS where the fuck the cops were. Because goddammit, someone did this to her. Maybe more than one someone. And it wasn’t quick. I was furious. Another crusty old nurse was helping catalogue the extent of Linda’s injuries. One or the other of us kept saying, “Oh God. This is horrible. What happened? Something terrible has happened here.” We were shaken to the core.

Labs came back and Linda was in multi system organ failure. Everything was failing. We had already intubated her and put on her pressors to keep her blood pressure up, transfused huge volumes of warmed fluids up, but the warmer she got, the more blood pressure tanked.

I still hadn’t seen a goddamn cop from that county, so I called their dispatch and asked if someone was coming out. “For like assault?”

“It’s gonna be homicide,” I said. “She’s not going to make it.”

This deputy showed up. My good friend Stephanie was the other crusty nurse, we locked eyes when this guy ambled in. I get it’s a small area and this is probably the only detective, but JESUS. I pointed out the injuries and asked him to photograph them. I mentioned the fair amount of coarse white hair she came in covered with. I had already bagged the clothes she came in, in a paper sack, and I asked about chain of custody forms—they hadn’t been out of my sight so I could transition custody to him and swear in a court of law that no one had interfered with them.

“You gonna collect some of that hair or what?” I asked him.

“Don’t you do that?” He said. Not meanly—he was just genuinely baffled.

I locked eyes with Stephanie then. We had one of those silent conversations where we simultaneously were furious and sad.

The detective said best he could tell, Linda was with Rocky, another person I knew from the ER, and they had both gone to this town together to exchange sex for meth a few days ago. No one could tell them how Linda got where she was. Maybe she’s rolled off the bed and gotten trapped. Maybe she’d gotten in a fight and gone to sleep it off. Maybe she overdosed.

Dude, there are FUCKING HANDPRINTS in bruises all over here, the fuck you mean maybe she got in a fight? No, no, no, someone DID THIS TO HER. They tortured her and beat the shit out of her and left her to DIE.

I knew this case wasn’t going to be pursued very heavily. First of all, the guy fucking asked me to collect his evidence and he didn’t even have a goddamn bag. Or chain of custody form. Second of all, the addict thing. It’s very difficult to chase down which addict did what, and you can’t find half the damn witnesses anyway. Third, no one but Stephanie and I seemed to care that something fucking awful really happened here, over a period of time. Maybe because we were the women involved. Maybe because for some people, substance abuse comes with a certain measure of, well, shouldn’t have been there. Hard to say.

I’ve known Stephanie for ten, twelve years as one of my best friends. I’ve seen her cry twice. “No one should have this happen to them,” she kept saying.

“What the fuck?” I kept saying.

I cried the whole way home.

Linda passed away about four hours after I clocked out.

Stephanie and I talked for hours on the phone that night.

This is a hard story to tell, because I don’t feel like I can put into words how it makes me feel. Sad. Angry. Helpless. I also can’t adequately explain to you how hard it is to lose a regular. We might argue, the ER staff and the patients who are frequent fliers, but they’re still OUR regulars.

At some point, Linda had hopes and dreams and a family and she just got lost along the way. It happens. I saw it happen, saw her wander further from the path, and what if I didn’t try hard enough to bring her back? Was there a different way to have that conversation that would have prevented her from ending up there? Was I enabling her by always giving her sack lunches and cab passes?

Did she think about calling 911 when this happened? Did she think, that dumb bitch told me to call for chest pain, how I’m supposed to do that being strangled?

Where the fuck is the justice for her? Who did this? Where the fuck are they? I haven’t been able to locate any updates on the case, if it’s still even open.

Before I left the room for the last time, I held Linda’s hand. “I’m sorry your life was so hard, Linda,” I told her. “I’m sorry this happened to you.”

And then I left.

Because it was time to go.

I had a kid to pick up.

I had to come back the next day.

I had to keep moving.

I wish I would have stayed until the end. Not like I slept when I got home anyway.

So yeah, some shit does really bother me, many years later. It bothers me more than I would ever tell. I have a whole trunk packed with these kinds of stories. They’re not stories you tell at parties—that’s for the “remember the guy who was showering and fell on a broomstick and it went right up his butt?”—but they’re the stories that keep me up at night.

I had more, but that’s enough for one session. It certainly is for me—writing it makes it feel like it happened yesterday.

If you look at us, ER staff and EMS and first responders, and think how the hell can they be so dark? Why are they the way they are?

Not because it’s fun.

It’s that whole “getting by” thing.
— The Midwestern One