I don’t want to brag, pride comes before the fall, but I’m very important. The CEO makes eight million a year. I make thirty- four G’s with no retirement plan and shitty health insurance. But without me, the 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 the janitor. I’m proud. I’m needed.
I try to help everybody and make sure that no one gets hurt, patients or staff. I’m an enforcer. The 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 must 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 so long until the commission catches on, or you get sloppy and get tagged. I got tagged.
This kid was out of Spokane and was being promoted by gamblers. I was 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 Ali, I had 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 turned out to be a lucky break.
I spent six weeks in the 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 that 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 surgical cap
You can’t 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 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.
It’s pretty stressful. 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. I always paid child support. 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 and 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 disappeared behind a surgical mask. Dr. Dee, the surgeon, was 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’s knows some guys I know, but he shouldn’t.
I stood on a step stool to watch the operation. “You need to open the wound more,” he shouted 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 pried the wound with the steel retractors. Her gloved, bloody hands shook. “Not so much, you’ll rupture the spleen. What’s the matter with you? You could kill the patient.” She relaxed the traction only to hear, “now I can’t see, damn you.”
He kept operating and shouting. Brit cried. He took a swipe at the wound and almost cut her. That was too much for me. If he had cut her I shake when I think what I would have done. Like I said a hospital can be a very violent place especially against women.
“Keep your hand away from the incision.”
Brit shook her head. I heard sobs coming form underneath her mask. Her shoulders rocked.
Dee looked up from the operation. “Oh, you are 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 said. She let go of the retractors turned away from the operation and headed out. “I don’t have to put up with this.”
Dr. Dee yelled, “Get out of here now. Bring me somebody else. Quick, hop like a bunny.”
Brit turned around, pulled off her mask, and shouted, “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 left. The operation stopped dead. It was silent, like the morgue. The only sound was the “ping” of the heart monitor, and the “whoosh” of the ventilator. I focused 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 resumed operating. That was good. Let’s get this operation over and go home. I have an internal radar, I know when trouble’s coming.
Dr. Silva, the anesthesiologist, stood. He was a big, tall, ex-football player. He cast a shadow over the operative field. Dr. Silva said, “Doctor, if you don’t have a scrub nurse, I’ll have to stop this case.”
He was right. You can’t complete the operation without a scrub nurse. I could scrub in, some of the other doctors let me. But Dee would not allow me to help him because I was 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 said to Dr. Silva. “I can’t continue this operation unless you sit down.”
“I will 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 threw a clamp on the floor. It clanged and banged and came to rest at my feet. I picked it up and placed it with the dirty instruments.
“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 raised 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 ran the surgical recovery room, entered.
“I will take over,” she said.
She looked at the surgeon, then Dr. Silva. “Get back to the operation or I’ll write you both up.”
I liked Grace. She was 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,” the surgeon said. “I have cases scheduled all day. Time is money.”
The only talk was the commands of Dr. Dee for clamps, scalpel, and Bovie. The operation completed. The chief resident was allowed to close the patient.
The anesthesiologist had the nurse anesthetist take over. Dr. Dee left the patient but Dr. Silva blocked his exit like a fighter cutting off the boxing ring.
“Just a minute,” he said. “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 have been in his late fifties but he had old man muscle.
Silva moved toward Dee. The surgeon looked for a scalpel, but I removed the sharp surgical instruments. Violence is violence, civilized or not.
We watched hoping Dr. Dee’s time had come. He looked like a foreign field goal kicker coming face to face with a missed blocking assignment.
Silva’s face was red and the blood vessels snaking up the side of his head throbbed in time with his fast heartbeat. He raised his fist at Dr. Dee, then opened it, and slapped the little surgeon. It made a loud stinging sound. Dee went down and Silva fell on top of him.
I thought Silva slipped and waited for him to get up. Silva did not move. Dee was pinned underneath him, his arms and legs flailing like a bug’s. He finally rolled out and retreated to a corner of the operating room. Silva remained motionless on the tiled floor. I kneeled down and turned him to his side. His face was purple, his eyes open and sucker punched glazed. His jaw hung open. The blood vessels at the side of his head no longer moved.
“He’s not breathing,” I shouted. “Call a code. His heart stopped.”
I ripped the EKG leads off the patient and placed them on Dr. Silva. I shouted again, “call a code, I need help.”
“Dr. Dee breathe for him, you caused this,” I said.
The surgeon smiled, shook his head, and stepped over Dr. Silva like he was a dead dog lying in the street.
The staff in the O.R. could not move. Resuscitation time passed. There are only a few minutes before the brain withers.
I left Silva and slapped the red panic button to bring a platoon of doctors, nurses, and medical students. Dr. Silva remained blue. I fell to my knees and breathed into his mouth. Silva’s huge chest rose up and down and color returned to his face.
The CPR team arrived.
“It’s Dr. Silva, he collapsed, stopped breathing.”
I stopped breathing for Dr. Silva. A doctor put a tube down his throat and attached a black Ambu bag. The doctor squeezed the bag forcing air into Silva’s lungs.
I pressed on his sternum, pushing it down to force blood through his body.
The intern put a large needle into the vein running under Dr. Silva’s collarbone.
“Running the fluids. Wide open Watch the monitor.”
“Ventricular arrest. You have to shock him.”
Electric paddles were placed on Silva’s chest.
The team pushed away from the body. The cardiologist hit the switch on the paddle. I pray it works. THUNK. The body rose up then flopped down.
The resident looked at the monitor.
“He’s still in V-Tach. Shock him again, more juice.”
The body rose higher and crashed down harder.
Ribs cracked as I pushed his breastbone down.
“Stop. Let’s see his rhythm.”
“Nothing. Flat line.”
“How long has he been down?”
“Thirty five minutes.”
“He’s dead. Call it.”
“There’s nothing to save now.”
The resident looked at the clock.
“I pronounce death at 4:46.”
* * *
Dr. Dee walked 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 remained on time.
* * *
Brit was crying, breathing real fast.
“He tried to help me,” she said. “And now he’s dead. I caused all this. I caused all this. Dee is a monster.”
“Yeah but that monster is the head of the department.”
“Will he get away with it?”
“He always does.”
I took 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 will 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. I feel bad too.”
Brit continued to cry. Grace hugged her and brought her a valium.
“Now go lie down in the call room, and lock the door.”
* * *
All the cases were done. I was the only one remaining in the surgical locker room. I needed to clean up. Straighten things. When tragedy strikes people needed order and reassurance.
I placed the laundry in the hampers, and brought in clean scrubs for tomorrow. I stacked them in neat rows arranged by size. I laid out towels and washcloths. I cleaned the showers and toilettes.
At the foot of Dr. Dee’s locker was a dirty adult diaper. He won’t take time out to pee or shit. I put on latex gloves, and placed his diaper in the trash.
* * *
I had to figure out a way to get back at Dee. I would have to be careful because he was very powerful and could get away with anything.
It took six months but my chance came. During the summer the government gave the hospital a ton of money and forced the doctors to use computers rather than charts. The hospital put all the patient’s records on the computer. It was a disaster. The doctors and nurses complained. There were many mistakes and accidents.
There was no security because the computers are usually left on. There was no automatic shut off. With the computer left on you can go on line and find out anything you want. All you had to do was find an open computer. Now we all know which administrator drinks too much or can’t get a hard on. Every body was curious about the big shots. Nobody cared if I could get it up. But I can, anytime I want, and sometimes when I don’t want.
The computer breach was always traced back to some intern too sleepy to remember to turn it off. The violators got away leaving no DNA or fingerprints. For now it’s the perfect crime.
I wait for a computer to be left on. It took about five minutes. A doctor was at the computer but gets called away to a cardiac arrest. He forgot to log himself out. I moved in and pull up Dr. Dee’s computerized patient list and found the perfect patient.
The guy was eighty-five and had large ulcers on his legs. Both legs needed to be amputated. First the right, then after the right leg heals, the left would be removed. This should work.
I talked to the OR tech the day of the operation and asked if I could help prepare the old guy for surgery. Everybody knew me so there was no problem. Brit was in on it. I got the patient ready. They wheeled him out. I waited.
As usual Dee was fast. He never took time to read the OR permit. Amputations don’t take long or require much skill but this was faster than most.
The patient returned to the recovery room. He was still asleep. On cue Brit pulled back the sheet, looked at the results of the operation and covered the patient. She examined the post-op check- list and the OR permit. Then said loudly, “Oh my God, he cut off the wrong leg.”
She was a great actress.
The recovery room went silent.
“He cut off the wrong leg,” Brit said.
“Dr. Dee amputated the wrong leg.”
Dee walked over and grabbed the operative consent from Brit’s hands sending one of her fingernails 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 removed the sheet. “The right leg is prepped. Who prepped both legs?”
I walked across the recovery room and said, “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 looked at me and screamed “You stupid..” And then he slapped me. I laughed. I continued to laugh. I pointed at him “You cut off the wrong leg.” I laughed, slapped my thigh. I watched him ball his hand into a fist. He swung at me with his right. I slipped and stepped into the punch. I heard the crack of at least two bones. He swung with the left, but this time I’m ready, my internal radar was on, and I stepped into that punch. Three bones crack. Crack, crack, crack. I fell to the floor, pretended to be KO’d. The dive is an art.
Cutting off the wrong leg will get most surgeons kicked off staff. Dee was well connected so it may not be enough. But still he can’t operate with his hands in plaster casts. I got him pretty good. It’s fifty-fifty he’ll never be able to operate again.
It’s fifty-fifty he’ll lose his license. I pressed charges for assault. The hospital commended me for showing restraint. The hospital can’t do much to me because I’m faking a closed head injury suffered at the hands of Dr. Dee. My CAT scans showed lots of brain injury.
I remain the undefeated janitor of the operating rooms.