Wound Care: The Musical

 I take a long weekend off and fly down with the Widder to Ashland to see some shows at the Oregon Shakespeare Festival. I take my scooter, and manage to get around the small but hilly town without much trouble. 

I fly back Monday afternoon, a few hours before my weekly wound care appointment. 

Curtain parts to reveal the WOUND CARE CLINIC. Seann wheels over to a chair and TIM takes his scooter away. Nurses can be seen bustling about in the background. 

NURSES:

This is wound care, 

where we care for all the wounds that will not heal, 

the holes that won’t close, the ulcers that won’t seal, 

we stop the sores from becoming more, 

give you bandages and casts, 

stop infection in its tracks,  

and if by chance it hits the bone, don’t be blue…

we’ll put you in the hyperbaric tube! 

TIM: Let’s see how the wound looks today! 

I’ll just fire up the saw and cut this cast off

S: I’m not sure what the wound is gonna look like

I went away this weekend and I kind of walked a lot

TIM: Well you’ve got to live your life. I mean, it’s not

(Saw drowns out the rest) 

This looks good. This looks good.

There’s hardly any drainage.

S: Would you say scant?

TIM: I’d say small. But it isn’t bad at all. 

(Takes out measuring tape)

The wound has shrunk from eight by three

to five by one. 

S: That’s fine by me.

TIM: The doctor will be glad to see. 

You really should be 

…haaappppyyyyy

Doctor Taggert appears, wielding her number three knife, and starts to sing The Callus Song, accompanied by a steel drum ensemble.

TAGGERT: Callus!

I love to cut callus. I don’t feel any malice

unless of course it’s towards a 

cantankerous callus. 

I’m a queen with a scalpel in a wound care palace!

I feel like Alice

in Wonderland, trimming the rim

of a rabbit hole. 

Off with her head? 

That’s not what I said!

Listen to me. I said:

 off with that callus!

S: Hey, I keep forgetting to ask, how was Panama?

TAGGERT: How was Panama? How was Panama? I’ll tell you how Panama was!

The people live in huts! 

They don’t have any furniture! 

They don’t even sleep on mats! 

S: They sleep on the dirt?

TAGGERT: On the dirt! Look, here’s our waiting room. (She shows me her phone. On the wall flashes a photo of a women sitting on folding chairs under a tree)

And here’s our ICU (flashes a photo of a man in a hammock) 

S: So you won’t be moving to Panama?

TAGGERT: To be honest, I don’t have the stanima! 

We went with a group called Floating Doctors

Who treat poor people on islands in the tropics

We ate plantains and we slept in hammocks

Removed their parasites and barraged them with shots

I took my son. He’s an EMT and dyslexic.

S: So a TME

T: Don’t be smart alexic.

NURSES: 

There’s so little you can do 

But you can do something. 

There’s almost nothing anyone can do

But you can’t just do nothing. 

You know that no one there has to live with diabetes?

S: Really? Why not?

TAGGERT: Because it kills them instantly!

S: That really puts the die in diabetes. 

NURSES:

There’s so little you can do

But you can do something. 

There’s almost nothing anyone can do

But you can’t just do nothing.

The canal’s hundred thousand dollar transit fees

have made so many investment bankers wealthy

while a short boat ride from Panama City

countless lives are lost to flesh-eating larvae

S: Investment bankers, eh? I’d rather take my chances

with the flesh-eating larvae.

It’s difficult not to look at these pictures and not feel a little sheepish. After all, here I am in this clean, sterile room, receiving… well, maybe not the best medical treatment money can buy. But I’m not sitting in a folding chair underneath a roof made of banana leaves, either.

Taggert finishes my cast and says, “Remember, it’s Memorial Day next week. When did they reschedule you for again?”

“They didn’t,” I say. “Wasn’t Dede supposed to call?”

Taggert looks annoyed.

“Because she didn’t call,” I say. 

“You’re coming in Tuesday,” says Shelley. “Is that okay?” 

“That’s fine,” I say. “Hey, did your kitchen ever get finished?”

Shelley is lit by a single spot as she sings a mournful song about torn-up floors and new cupboards that keep getting delayed. When she finishes, the audience gives her a standing ovation. 

S: So that’s wound care. It may not be the fanciest department in the hospital –I mean, they probably won’t be making a hit TV show out of it anytime soon- but there are some mighty fine folks working here, fine folks who really know a lot about taking care of wounds. They make you feel like you’re in good hands. More than that, they make you feel like family. 

Curtain

Pancakes for Supper

Once the guards at the metal detector have had their way with me, I speed upstairs. After using the restroom, with one smooth motion I zoom across the waiting area through the office door that Caitlin has just opened into room two and hop onto the chair and slip off my shoe. Caitlin wheels my scooter away. CK yips something. Caitlin yips back. Fires up the saw. 

“Thompson cast, I presume,” she says, digging in the drawer for the cracker.

The wound looks good but the skin of the foot looks like it's becoming macerated. Caitlin isn’t concerned, and chooses instead to fixate instead on a bruise on my shin, despite my assurances that it’s been there a while. I ask if she heard about the goat lady and she says no; like CK, she's off Thursdays, but I assumed they all would have been talking about it the next day. I tell her the story and she laughs and says, “So much for nurse appreciation week. The day before they brought in an alpaca but they only brought one which let me tell you is not enough alpacas for that many nurses.”

Dr. Taggert is also pleased with my progress. “Who knows, maybe it'll be healed up by next week!” she screams.

“It probably will!” I cry.

“That's the spirit! The power of positive thinking!” 

“I'm going to make it happen!” 

The little voice in my head grumbles but I can hardly hear it over all the yelling.

She slices the callus and the loudspeaker announces, “Code Gray in dialysis. Code Gray in dialysis.” 

Taggert laughs. “Who has the energy to cause a scene when they're on dialysis?” she asks.

“Maybe it's not the person on dialysis who's the code gray,” I say. “Maybe it's their jilted lover.” She scoffs and I say, “Wow, I’m sensing some real anti-dialysis sentiment in this room right now. Just because your kidneys are messed up doesn't mean you can't have a red-hot sex life. Maybe the patient's two baby mamas showed up at the same time and are getting in a pregnant catfight. You’re being blinded by your prejudice. Which, frankly, I find disgusting.”

“Don’t make me laugh when I'm holding a knife,” Taggert laughs.

As Caitlin wraps my foot, she says there have been more Code Grays than ever lately. “That's why we keep the door locked now. They put in a new bolt that we can hit with a button in case of a Code Silver.” I ask what a Code Silver is and she says it means there's someone with a weapon, or actively committing an act of violence. I mention that they've been using the metal detectors nonstop lately. “Yeah they’re finally protecting their staff, and not just talking about it.” I don’t tell her how distasteful I find them.

     She leaves and I hope that CK comes in to keep me company, but she doesn't. I can hear Taggert in room three, talking to an elderly couple about the wife's almost-healed wound. She goes on and on, not really giving them any information, just sort of hanging out. I wish she would hurry up and finish up so I could get out of here. 

     She finally comes in and pulls on her paper scrubs. CK comes in and starts to tell her the goat story. Then she stops and says I could tell it better, so I go through the whole thing again, embellishing only slightly.  

     ”Everybody is losing their shit,” Caitlin says. “The other night my husband was picking up pizza at this arcade we like to go to, where they have karaoke. This little kid gets up to do karaoke. He's wearing a helmet so there was definitely something going on there. He started singing so quiet you could barely hear him, and his mother took the other mic and started doing backup vocals. The kid suddenly started screaming ‘Fuck you Mom, shut the fuck up,' over and over again and she couldn't get him to stop. It really shook my husband up.”

“Didn't the karaoke machine have a kill switch?” I ask. 

“My middle one was like that,” says Taggert. “Once he started you couldn't stop him. This one time I was at Safeway with all three of them, the little one was still a baby and I had her strapped on my front, and my middle kid goes right behind the counter and smashes his hand  down on this cake, I mean, splat! I grabbed him and pulled him away and he had the nerve to ask if he could have a cookie, they always have cookies for the kids there. I said no and he started screaming like you wouldn't believe. Then my oldest starts in with wanting a cookie too and I told her, I'll make you pancakes for supper and she was okay with that. But meanwhile the other one is literally on the floor kicking and screaming, I had to pick him up and carry him out like one of those goats. I'm sure everyone thought I was the worst mother in the world. I left the cart when we left and called my husband to come get it. I couldn't believe it was still there. But I took those kids home and made them pancakes and my son didn't get any.”

     Between the old couple and me, it’s apparent that she really needs to talk today, so I just let her. By the time she finishes her tale, my foot is fully encased in fiberglass. Protected from the dangerous world, safe from harm. I roll out into the sunlight, up the hill, past scattered needles and a no parking sign that 's been flattened by a car, to the bus stop. The shelter is covered with advertisements for an AI money management service. An obese woman stands with a huge stroller and two rambunctious little boys leaping around and hollering. 

When the bus arrives, I get on first, and sit next to a banged-up looking Black man dressed all in black, with a black cap with the word DETROIT in black block letters across the front. He wears a black eye patch and sits behind an empty black wheelchair.

“Ain't enough space here,” he growls. As I squeeze in closer I tell him I’m making room for the woman with the stroller, who sits down across from us and tells her boys to sit still. 

As the bus starts moving, the man fishes around in his pocket and pulls out a wad of bills and holds it out to the older boy. 

“Here, buy your kids some ice cream,” he says. 

“Oh, that's very nice, but, no thank you,” the woman says. 

He shakes the money and says it again. “Buy your kids some ice cream,” but she again says thanks but no.

“I was on my bicycle when a car hit me,” the man says, tucking his money away. “Banged me up real good.”

“I'm so sorry,” the woman says. The man just nods and looks at the boys with his one eye and they stare back at him, fascinated.

“Kids should have ice cream,” he says, flashing a smile of crooked, gleaming white splinters.

Escorted from the Premises

 Everyone in the office seems low-energy, even Dr. Taggert. I can’t get a laugh out of anyone, and feeling my energy being sapped, I eventually give up trying. CK’s either off or hidden away in hyperbarics.

Caitlin cuts off my football and is pleased to report that, while the wound isn’t any smaller, no drainage has seeped through and the flesh looks pink and healthy.

Tom from Evergreen Orthotics shows up like we had arranged, and he tells me about how the AFO works. He looks at my foot and says that most of the pressure will be put on my shin, and on the front of the sole. “It’ll be a little like having toes again,” he says. “It takes some getting use to, but after all you’ve been through, I bet you’re up for trying something new.” 

He makes a mold of my entire foot up to my knee with some sort of quick-setting rubbery material, which he peels off and tucks into a satchel bursting with cloth and foam and a dozen pairs of specialty scissors. “They rummaged through it at the checkpoint downstairs and now it’s a total mess,” he says. 

“Remember when Dr. Thompson snuck her knife past the guards?” asks Caitlin. “She was so proud of herself.” I picture her wielding a huge bowie knife but Taggert says it was just a little thing. 

Tom says he’ll be back Monday with my brace, and Dr. Taggert applies my cast by herself. The nurses are all just kind of wandering aimlessly around the office.

“What’s with everybody?” I ask. 

“It’s been a day,” says Taggert. “Now remember, call if anything feels off.”

“I know, I know. And if it’s off hours, go to the ER so they can saw it off.”

“You can call here off hours but you won’t get anybody, so feel free to leave a long, rambling message like some of our patients do.”

Overhearing, Caitlin yells, “Remember that guy who would call drunk all the time and leave those, um, colorful messages?”

“Oh my god yeah. He’d leave long, rambling messages for some woman named Rhonda. That went on for months. The lesson being, don’t drink and hit speed dial.”

 

Three days later I’m back. I’m hoping the drainage remains low enough that i can go back to coming once a week. 

I set off the metal detector, but the guards don’t bother to wand me. The woman behind me says both her shoulders are made of metal but they don’t bother to wand her either. 

Upstairs, I wait a while for them to get my room ready. A large family sits around a table, evidently waiting for someone. “Hey look, it’s 4:20,” says the son.

“Ha, I remember when that meant something, and not just once a year,” the father says. “You kids don’t know how easy you have it. Used to be you had to journey all the way across town and find some guy if you wanted to get high. Sometimes you’d smoke up all day and realize it was ten at night and you were out and had to go searching for more. You kids don’t know how easy you have it.”

“We’re ready for you, Seann Patrick,” says Bridget. “We’re in room one, Jenny’s waiting for you.”

“Oh no,” I say. 

“Hi Seann!” cries Karen. 

“Hey! How’s Dolly!”

“She’s perfect. Want to see pictures?”

“How come you’re nice to everyone but me?” asks Jenny. 

“Because you’re my favorite,” I say, as Karen runs over with her phone. Her beady-eyed dog stares blankly from a log on the beach. 

“Then a bunch of us took the wieners paddleboarding, but Dolly couldn’t go because there were too many of us already.” She swipes to a photo of a bunch of lithe young women in bikinis with daschunds on paddleboards. Then Jenny fires up the saw and she dances off.

“Oh this looks good,” she says. “Let’s say moderate, though it’s really much less.”

“What does it measure?” asks Bridget, staring at the computer like she is trying to remember what it is. 

“Not today, we’re just casting,” she says. 

“God I can hardly keep my eyes open,” says Bridget.

The top of my foot has a row of bright red bruises. Jenny says it was from the Optilock, the foam bandage they put on the wound. “It’s great stuff, but it’s got this thick edge that you can’t trim.” I’ve never had this happen before, but she’s not concerned so I’m not either.

“So today was baby goat day,” says Jenny. 

“Ooh, are they still here?” I ask. I have warm memories of being here for baby goats day two years ago. 

“No. In fact they left early, we didn’t even get to see them. Apparently the woman who brought them freaked out and they made her leave.”

Karen says, “I had just got down there and she was yelling, ‘they don’t think I’m friendly enough so I’m being escorted off the premises!’ She was not having a good day.”

“I hope to someday be escorted off the premises,” I say. “Hey, what do you all think of the room makeover?” 

“I like the blue,” says Karen. “It’s like gazing out at the sky.”

“Bridget despises it,” says Jenny. “Don’t you?”

“Say what now?” asks Bridget groggily

“He wants to know what we think of the new room.”

“I despise it.” I tell her about my idea for a mural. She approves, and says, “I have a poster at home that reads ‘A wound neglected is a wound infected.’ You could put that in there somewhere.”

“You have wound care posters just hung up around your house?” 

As she wraps my foot back up, Jenny tells Bridget she talked to sally.

“How’s she like the new job?” Bridget asks.

“Well, you know Sally. I’m not sure she likes anything. And it’s an hour drive so she’s not even saving any time on the commute.” I hadn’t even realized she was gone; once they made her supervisor she rarely emerged from the hyperbaric room. When you first arrive at a place, you assume everyone had been there forever and always will be. I think about this at work a lot, where after a number of tumultuous years I am one of the few old timers left.

Jenny leaves to call Dr. Thompson, who comes in and squats on her stool. Bridget stands there looking down at the bucket of water.

“What’s wrong?” asks the doctor.

“I couldn’t get the temperature right,” she says. “It really bugs me.”

The doctor dips her gloved fingers into the bucket. “It’s fine.”

“You know what people mean when they say something’s fine,” says Karen. 

“It means they don’t want to tell you the truth,” I say.

“You probably know what it means in the Italian Job,” says the doctor, looking at me. “Freaked out, Insecure, Neurotic, Emotional. Speaking of which, I still can’t get over that woman with the goats,” says Dr. Thompson. “I could see that she was in distress and I asked how she was doing…”

“You actually talked to her?” asks Karen. 

“Yeah I was there for the whole thing. I love baby goats.”

“I thought with, you know, how you are about germs…”

“For the most part, animals are cleaner than humans. A dog’s mouth is cleaner than a human’s mouth.” 

“But the goats walk around with all that poop on their butts,” says Karen. 

“It’s cleaner than our poop. I asked how that woman was doing and she said, ‘I’ve got walking pneumonia, that’s how I’m doing! Do you need to know my whole life story?’ And then she picked up the goats, one under each arm, and kicked the gate open and stomped on out with them. She had to come back for the other two.”

“We kept hearing calls of a Code Gray at the west entrance,” says Jenny.

“She was definitely having issues. The attendants usually help people with the goats but she was just sitting there with her head in her hands. And then she screamed at one guy ‘Don’t hold them like that, you’ll break their backs’ But he was just holding it normally. The gaps seemed happy, anyway.” She shakes her head. “There weren’t any problems with the woman with the llamas yesterday.”

“I missed the llamas,” Bridget says.

“Are you running a petting zoo here?” I ask.

When she’s finished, Dr. Thompson tears off her smock and throws it into a bin in the new cupboard. 

“That’s for linens,” says Bridget.

“Where’s the garbage then? I can’t get the hang of these new rooms,” says the doctor.

“I despise them,” says Bridget. 

“Wound mural,” I say. 

As my cast dries, they all gather in the main room to continue to excitedly discuss the baby goat incident. The whole thing has reinvigorated them; there is none of the office ennui I sensed just a few days ago. 

“Oh shit, I keep forgetting,” I call from atop the chair, which no one has bothered to lower. “Doctor Thompson, can I get you to sign a form for a temporary handicapped parking permit?” Jenny brings my scooter and lowers the chair so I can fish the form out of my bag. The doctor signs it and Jenny makes a copy and I’m free until Monday. I leave by the side entrance and cross the parking lot, which was recently the scene of such goat-related melodrama. It’s quiet now, the only sign of life an old guy in a Primus t-shirt, smoking, who tells me I’ve got a sweet ride as I scoot by.