The Patient (Day Five of Story A Day)

                                                        The Patient

Zama Army Hospital, Japan, 1968

    Mark Shapiro could hear the C-141’s rumbling overhead on their way to Yokota to discharge their broken human cargo. Fresh meat from the battlefields of Vietnam, to be triaged and flown continuously to the four Army hospitals in Japan. Here at Zama, you never knew what was coming, but tonight was a slow night.
    He slid his stethoscope around his neck and began to work his way through the ward. When he came to bed seven he took a minute to observe the boy who stared up at the ceiling.
    Mark picked up the chart stuck at the end of the bed. “How are you tonight, Anthony?”
    No answer. Mark flipped through the chart. “Is the pain bad?”
    “No.” Anthony’s lips were white and pinched together, his jaw tense. Mark watched him a little longer then shifted his eyes to the red and blue eagle on the Airborne patch someone had stuck over the bed. He hated those patches, but the higher ups said they boosted morale.
    Mark did the basic checks and made notes on his chart.
    “I’m going to have to roll you on your side a little so I can listen to your lungs,” Mark said, and he signaled for the corpsman. They eased Anthony over as gently as they could, but Mark didn’t miss the way the kid bit into his lip to keep from making a sound.
    “Deep breath. Take another. Okay, one more.”
    The corpsman rolled Anthony onto his back, and Mark began to probe his shoulder. This time Anthony grabbed the side of the bed with his left hand. His eyes filled with tears, and he squeezed them shut.
    “Can you move your fingers?”
    Anthony flexed the fingers on his right hand. They moved slowly, but they moved. Mark considered it a triumph that the kid had an arm at all.
    “Your arm’s doing well,” Mark said. “You should have close to one hundred percent mobility in a few months if you continue physical therapy when you get home.” Anthony said nothing, and Mark sighed. “Someone told me you’re a piano man.”
    For a second Mark saw a flash of emotion in Anthony’s eyes that quickly faded away.
    “You’ll be able to play again.”
    “You made your ten months and five days. You’re going home soon. Does that interest you?”
    “Beats going back on line.”
    It struck him that the kid had beautiful eyes, big and dark with long eyelashes. Mark had to fight the urge to smooth back his hair, and he wondered why this kid haunted him so much. Perhaps it was the vestigial sorrow that clung to him, or maybe it was the terror lurking in his eyes. But aside from that, any patient who fought against taking pain medication evoked curiosity.
    A fine sheen of sweat had broken out on Anthony’s forehead, and Mark saw the pulse pounding in his throat. This boy was in some kind of pain, and he was exhausted. But he was fighting it.
    He pulled back the covers to look at the dressing on Anthony’s left leg.
    “I have to change this,” Mark said. Anthony closed his eyes.
    A fifteen-inch incision ran up the front of Anthony’s thigh to just beneath the groin, but it was healing nicely. Six-and-a-half hours on the table, twelve units of O-negative, but Anthony still had his right arm and left leg. Not a bad day’s work.
    “Looks good,” Mark said and made another note on the chart. “I’m going to put a clean dressing on it. You want to tell me what you have against pain medication?”
    “I don’t need it.”
    “No?” Mark gave him a skeptical smile. “You’re feeling good enough to sit up and get moving? Maybe go take a piss?”
    “What do you want from me?”
    “I want you to answer my question.”
    “Pain builds character.”
    “That’s some bullshit answer. You got a problem you’re trying to beat on your own?” Nothing. “You need sleep, kid. If you don’t give your body a chance to rest, you’re going to screw up all that hard work I put into keeping you in one piece.” Mark sighed. “You want to tell me about it?”
    “Fuck off,” Anthony said, and Mark shook his head.
    “Wrong answer.”
    Mark held his hand in the air, and Anthony stared at him in panic when the corpsman came toward them with a tray. A syringe and little bottle sat on it. Mark filled the syringe and nodded to the corpsman who came to the side of the bed and took hold of Anthony’s left arm. The corpsman was a big guy and held him tight, but he was kind enough to place his big hand on Anthony’s shoulder and squeeze him, like a brother. Mark felt Anthony shudder when the needle slid into his thigh.
    “I’d put this through the IV, but I hear you pulled the tube out last night when Dr. Conroy gave you your meds.”
    “Go to hell.”
    Mark set to work replacing the dressing. He hated seeing the stark terror in Anthony’s eyes because he didn’t understand it. The kids who came through here were glad to sink into the oblivion afforded them by the drugs. Why this particular boy should be afraid he didn’t know.
    Anthony was one more in an endless line of damaged teenagers who rolled off the relentless parade of C-141’s, but this kid troubled him more than most. Mark could patch him, but he couldn’t fix him.
    The medication worked fast. Anthony was fighting to stay conscious, but Mark could see his eyelids weighing down. Anthony rolled his head back to stare at Mark when he finished with the dressing and pulled the covers back up.   
    “I want to help you,” Mark said.
    “Fuck you.” Anthony’s voice was blurry and indistinct. Mark looked away when he saw a tear slide down the boy’s cheek.
    “Get some sleep.”   
    Mark didn’t know the time when he walked out of the OR. After fourteen hours Mark wanted to get away from the smell of blood and suffering. When he jerked open the door to the stairwell, he heard a movement above him, and he looked up in irritation. He could see someone sitting on the steps, and he hesitated.
    “You aren’t supposed to be here,” he said. Then he felt his breath catch when he realized it was Anthony. The kid hunched over, holding his stomach, and Mark could see he was in a bad way. He walked up the stairs.
    “What’s going on, kid?”
    Anthony looked up at him, his eyes wide and bloodshot. “I didn’t know you had burn cases here,” he said in a shaking voice. His shirt was soaked with sweat. “I thought they all went to Kishine.”
    “We handle everything here. You know someone on the burn ward?”
    Anthony shook his head, and Mark watched the emotions pass over his face. He sat beside Anthony on the stairs.
    Anthony looked gaunt and sallow, and his right arm hung awkwardly at his side. When he could, Mark checked in on him at the medical holding company barracks to see how the physical therapy was going. He knew that Anthony sometimes came up to the hospital to visit with some of the wounded boys on the ward, but he had only seen him in passing. The kid was going home in a week, and while Mark was pleased to see him going back to the States, he felt like he had only done half of a job.
    “Does it hurt a lot?” Anthony’s voice was a shaking whisper. “I mean, I know it hurts to get burned, but does dying of it hurt much?”
    Mark shrugged. “In a major case, like when eighty or ninety percent of the body is burned, your body tends to turn septic. You die from the inside out because the bacteria overwhelms your cells. You generally lapse into unconsciousness.”
    “You go fast?”
    “Generally speaking, yes.”
    Anthony took a deep shuddering breath. “A friend of mine was burned. He died at Kishine.”
    Mark struggled to think of words that would comfort. “I’m not a burn specialist, but I know they deal with the pain. Was he a close friend?”
    Anthony nodded.
    Mark put a tentative hand on Anthony’s shoulder and kept it there when the kid didn’t shake it off. “You want to tell me about him?”
    “He was carrying detonators and got lit up by an AK round.” Anthony put his head in his hands, and Mark realized from his gulping breath he was crying.
    “I’m sorry.”
    “I couldn’t help him! He kept asking me to help him, but there wasn’t anything I could do. Christ, he barely looked human. I was a medic, and I couldn’t save him. I dream about it all the time. I see him burning, and I can’t stop it.”
    “And what were you supposed to do? If he went to Kishine where they specialize in burn cases, and they couldn’t do anything for him there, what were you supposed to do, Anthony?”
    “I don’t know. Something.”
    “You were his friend, and you were with him. I’m sure it was a comfort.”
    “I gave him M and M’s when I ran out of morphine. It wouldn’t have helped anyway, so I gave him M and M’s. I used to do that with the ones who were too far gone. ‘Cause you only have so much morphine. It runs out.”
    Mark said nothing. He ran his hands over the bony vertebrae of Anthony’s back and wondered at the ingeniousness of these kids who marched off to war. He was here stitching up children who were fighting in a war he hated. The casualties were poisonous.       
    Anthony rubbed the heels of his hands against his eyes. “It’s all fucked up now.”
    “What is?”
    “Everything. It’s all gone. It’ll never be the same again. I’ll never have my life back.”
    Mark wanted to find the words that would relieve the boy’s suffering and knew anything he said would be inadequate. He pulled Anthony’s head against his shoulder and let him cry.
    He could hear the C-141’s rumbling overhead. One after another. In the hall below someone was yelling. “We’ve got incoming. It’s gonna be a busy night.”

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