TIME TO WAKE UP
Sleep while the baby sleeps. This is what Lt. Col. Jackson used to say during our long weekend shifts together. The baby, in our case, was the hospital—Wilford Hall Medical Center—the largest U.S. Air Force hospital in the world and a Level 1 Trauma Center for the city of San Antonio. When its halls were dark and still, when the trauma pager stayed silent, we settled into the quiet corners of our own domain, the operating room, and rested our bodies until the baby woke again.
Sleep while the baby sleeps. The phrase rang through my mind as I settled onto the couch in my boss’s office. The phrase for me was more personal. It lived inside my flesh, every moment of every day since my daughter had torn out of me eight months ago. I slept when she slept. I nursed when her mouth demanded. Every cell of my body was aligned to her body so that even when I wasn’t with her, the sting in my breasts reminded me of her hungry pink lips. My tightening bra straps signaled it was time again for the next feeding, so I took my place on the pleather couch in the private office of my commanding officer, which had become my official fuel station, feeding myself while filling the plastic bottles with warm golden milk until her tongue took their place again.
It was Sunday morning around 10 a.m. I wrapped a heated blanket from the industrial hospital warmer across my chest and took out the suction cups and bottles from my breast-pump backpack. Other than a case going in the general surgery room, the OR slept. This was what I loved about the weekend shift. No administration. No scheduled surgeries. Less politics, less people, less bullshit. A month ago I’d completed my four-year commitment to the military, but I decided to stay on as a contract nurse in the same exact job, working part-time on weekends. As I placed the plastic funnel over my bare nipple, Lt. Col. Jackson, a retired officer and my fellow weekend nurse, poked her head through the door of the office.
“Captain Kurz, we got a trauma comin’ up.” She threw the glowing pager into my lap and I read the alert:
CODE 3 TRAUMA, 38 YR OLD FEMALE, GUNSHOT WOUND, ETA 5 MIN.
Lt. Col. Jackson ran back to OR 2, where she was working a big open-belly case—an elderly ICU patient with a blocked colon. The two of us tag-teamed cases on the weekends. While one of us worked, the other would rest. We did this, back and forth, so we could sustain our energy throughout the twelve-hour shift in case things got crazy. I began to pack the empty milk bottles back in my vinyl backpack, wondering how long I had to get ready.
Sometimes the trauma pager was a false alarm. As in “The Boy Who Cried Wolf,” we didn’t always take it seriously. We’d learned to walk the tense line between being ready for everything and for nothing at all. Many trauma patients bypassed us entirely and went straight to the ICU. The nature of the weekend shift in the OR was like this. Feast or famine. We either ordered takeout and watched marathons of CSI: Miami in the break room, or we worked nonstop for twelve hours straight, trudging through blood or blocked bowels or broken bones with hardly a chance to pee or eat. The not-knowing produced an anxious kind of boredom. A perpetual sense of walking on eggshells. A superstition that our words or actions alone could rouse the sleeping baby.
I walked across the hall into OR 14, the suite solely designated for trauma patients. The breath of the room was hot and still. The equipment silent. Emergency drugs drawn up tightly in syringes, laid out in a neat row on top of the anesthesia cart. The anesthesia resident was already in the room, turning on his machines, checking his meds and supplies, pulling up a large syringe of propofol, otherwise known as “milk of amnesia.” I barely recognized him. Maybe I’d seen him once or twice before, but it was 2007, and our hospital was still in the thick of staffing Balad airfield, a military base in Iraq with the largest trauma hospital in-country. President Bush had just announced the Surge, hoping more pressure and more troops in Iraq would yield more control of the country. It would also mean more dead bodies, more limbless bodies, more broken brains. Our nurses and doctors had been rotating between here and Iraq like a revolving door. It was impossible to know them all.
The scrub tech moseyed into the OR, yawning. He was a tall, gangly guy, about twenty years old, and he looked like he’d just rolled out of bed, his dark, stick-straight hair spiking in all directions beneath his surgical hat. We called him Mac and he’d just joined our motley crew of weekend-shifters. I’d worked with him a couple of times and his level of confidence was wobbly, at best. I told him to start opening the instrument sets just in case the patient wasn’t detoured to the ICU. Metal trays clanged as he lifted the heavy spool of steel instruments onto the sterile back-table. I checked the cautery machine, turned on the suction, and poked around the room, making sure all of my basic supplies and medications were in place before heading back to the office to pump my milk.
As I walked across the OR corridor, the double doors at the end of the hall opened. A large team of ER staff winded around the dark corner, charging through the open doors, running and pushing the stretcher towards me. Forget about the breast pump.
Time to wake up.
Life is movement, but death has a motion of its own. In the beginning, the activity is erratic. The heart quivers, the pulse quickens, breathing grows shallow and labored. Soon the body tires. The pressure drops. The rhythm slows until it finally stops. When she rolled into the trauma room, our patient’s pulse was so slow it had stopped. Blood pooled and dripped down the sides of the stretcher. The ER tech sat on top of her, straddling her bleeding torso while compressing her chest, pumping, pumping, pumping. The patient was pale, her eyes closed, her expression flat. The ER nurse rattled off a brief report as we transferred her over to the OR table:
“Domestic abuse. Mother of two. Shot in the chest three times by her husband.”
My heart beat faster, my hands went cold, I grabbed a pair of gloves. This was worse, much worse, than I thought. Her naked body spilled off the narrow OR bed and I strapped her thighs down with the leather safety belt. Blankets off. All clothes cut off. Anesthesiologists surrounded her upper body like a pit crew servicing a race car, attaching monitors, getting IV access, hooking her up to the ventilator, flooding her veins with rescue drugs.
How quickly the switch occurs—that moment when adrenaline kicks in and the body and mind intuit the magnitude of a situation. The senses heighten. The world becomes focused and blurry. Time evaporates. My own body evaporates. Before I knew it, the surgeons were gowned and gloved and I was pouring Betadine over the patient’s bloody chest as the scrub tech passed the first blade.
The surgeon sliced through her skin. A long incision down the torso, not knowing which vessel was ruptured or where the blood was coming from. The three bullet holes spanned her belly and chest—two different body cavities. He searched the inside of the abdomen. Not there. He needed to crack the chest. Damn it. He called for the sternal saw and I opened the set and dropped the blade on the sterile table. I looked at Mac and he met my gaze. His eyes told me he’d never used a sternal saw before. His hands trembled as I explained how to load the blade. The surgeon started yelling to pass him the saw and Mac obeyed, relieved to have it out of his quivering grip. The surgeon loaded the blade himself and turned on the motor. It sounded like a chain saw, something you never want associated with a human body. Once the sternum was sliced in half, he spread the ribcage like Moses parting the Red Sea, but salty blood flooded the open chest. His hands were drowning in it.
Voices from the head of the bed pleaded for more blood products, more suction. I called the blood bank and yelled into the phone, “We need an emergency release of blood, platelets, and plasma, now!” They started telling me to fill out more paperwork but I’d already hung up. Mac yelled for more pads to soak up the hemorrhage. I looked into the kick-bucket at the thick pile of used rags, saturated in blood. I ran to grab more and figured we’d gone through at least forty of them already. The anesthesiologists had already infused every blood product they started with, throwing the empty bags to the ground like marathon runners tossing used water cups on the road. I couldn’t see their feet or the white tile floor beneath them.
A group of medical students walked into the room with shocked and thrilled looks on their faces, happy to see some action. I recognized that look because it used to be on my face when I was new to this. I wanted to wipe away their excitement with one of the bloody sponges. This was my patient and I didn’t want anyone watching her as a form of entertainment. Then the surgeon looked up, just as annoyed as I was at the group of them, and yelled, “If you’re not working this case, get out of the room. NOW!” The pack of sheep filed out as quickly as they came in.
“I think I found the bleeder,” he called. I overheard something about the internal mammary artery, the major vessel that shoots off the aorta and feeds the tissue of the chest wall and the breasts. Just as I called cardiac to get a heart surgeon to come assist, the OR pager went off to alert me of an emergency C-section upstairs in OB. Fuck. We’re gonna have to call in more staff. The surgeon yelled for more suture, anesthesia called for more plasma, the blood bank said they didn’t have any more thawed, the tech needed more irrigation, more silk ties, and all the commands streamed into one catastrophic run-on sentence: get a chest tube send off the blood-gas to respiratory where’s the suction we need another hemostat call the family we need more blood more blood more blood more blood.
There was no one left to run for blood. Our extra tech had been diverted to OB, so I left the room to go myself. It was never ideal for the OR nurse to have to leave, but it was a simple solution. If we didn’t get more in the room, the patient would die. I ran out of the trauma room, down the OR hall, and through the break room. Halfway down the dim corridor, my milk let down, that painful sense of pins and needles shooting through my rock-hard breasts, which could not hold the fluid any longer. What are we but salt and water and blood and milk, pumping through a body that nourishes itself, that nourishes others, filling up and pouring out again?
When I returned to the OR with the last cooler of blood products, the surgeons had isolated the hemorrhaging artery and were spinning suture through its severed wall. The bleeding leveled off. The Red Sea retreated. I charted whatever details I could get down and called the ICU nurse to give a report. After six hours of surgery, her chest was sewn closed, but I was unsure if her brain, deprived of too much oxygen for too long, was already gone.
After the surgeon broke scrub, after the anesthesiologists pushed the patient down the hallway, tracking sticky red footprints behind them, I stood in the center of the empty OR and breathed in the metallic scent of blood, tasted it on my tongue like warm liquid iron. Dark red splatters covered the bed and floor and one of the white walls. It looked like a war zone. It looked like a crime scene. Time was only a concept; six hours had passed like ten minutes. The anesthesia machine continued to alarm, the high-pitched beeps echoing into nowhere. The whistling sound of suction slurped the air, and a strange sensation tugged at me. The barrier between the seen and unseen world became disturbingly thin, like a tattered fabric I might slip right through.
My body started to come back online, emerging from its numbed state like a limb after it has fallen asleep. My armpits sweat through my scrub top. Breast milk soured inside my bra. The thought came to me that my military service was over now. I’d been discharged several months ago and yet I’d signed up to keep doing this job after four years of desperately waiting for it to end. My husband and my baby daughter were at home while I was here, my milk leaking away from the mouth it was meant to feed. I don’t have to do this anymore, I thought. I don’t have to keep doing this. And yet, for reasons I didn’t understand, it felt impossible to walk away. I’d technically separated from the war, but another war still raged inside of me. A war I could not see or name or reach.
Fatigue set into my legs, my knees about to buckle. I felt a wave of despair, like the horror of the day was for a moment able to penetrate the shield of adrenaline coursing through my veins. The dull teeth of grief gnawed away at a space deep inside of me, so old and primal that I couldn’t remember living life without it. This place was like a deep bruise, the kind you can’t feel until you press on it, and when you do, it brings a sort of pleasure. The pleasure of pain, of still being able to feel anything at all, a strange sort of violence that somehow soothed my body. My hand reached up and squeezed my breasts to feel how engorged they were. They felt like metal grenades strapped to my chest. They were about to explode.
THE SMELL OF THE SERIOUSNESS OF MEN
As much as I’d like to think that I’m guided by logic or intellect, it seems my most life-defining decisions have been influenced by the far more primal factors of sight and taste and touch and sound and smell. Especially smell. It’s what I remember most about my military recruiter’s office, as distinct and potent as a memory. Each visit I paid to that office, its scent infused the water of my body with a flavor I wanted to drink. Warm and bitter. A smell I loved so much that maybe, under the surface, it’s why I signed the dotted line.
It was that vacuous week after New Year’s, the clean slate of time feeling more desolate than full of possibility. Like most East Coast January days, cold misty rain coated the sky and streets, the whole world insulated by gray fog, the kind of weather that makes you feel like the whole human race is asleep, or extinct. The aimlessness of the atmosphere perfectly reflected my inner state. I was on the cusp of my final semester of nursing school with no plan in sight, depressed and doubting my decision to become a nurse in the first place. I was shuddering from a recent breakup with a college boyfriend and the residual heartache felt far more crushing than the short-lived relationship merited, though I didn’t understand why. I felt as confused and bruised as the weeping sky.
The recruiter’s office was in an old strip mall at the edge of downtown Charlotte, just a few blocks from the hospital where I did most of my clinical rotations. I’d driven by it countless times, but it wasn’t the sort of place you noticed unless you were looking for something. I pulled the metal door handle and realized it was locked. Shit. I’d just spoken on the phone with the Air Force recruiter the day before, a man by the name of TSgt Monday. I’m not kidding. Monday. Like the dawn of a new week. A dreaded day, but also a day of fresh starts. We’d confirmed our meeting time, but maybe I’d gotten it wrong. I tapped lightly on the glass, and a few seconds later a man emerged into the main foyer. My stomach lurched as I saw his body move toward me. He unlocked the door and held it open as I walked inside. He extended his hand and I reached to meet it, my damp cool grip inside his firm warm grip. We stood across from each other in the stagnant air, the air that smelled like an old office building, like paper and musk and a faint tinge of mold. My body recognized the cozy chemical smell of ink hot off the press, of machinery mixed with aftershave. It was the smell of the seriousness of men. A smell I’d smelled before.
“Well, come on back.” He led me through a doorway that opened into a large office space with several desks. “We’re the only ones here right now,” confirming what I suspected. My mind started calculating what I would do if he tried anything on me. If I screamed, would anyone hear me? Doubtful. It felt like we are on a desert island, and I didn’t recall telling anyone that I was here, meeting with him.
“Here, have a seat.” He gestured toward the chair directly across his desk. “You caught us during the holidays, so my colleagues aren’t in today.” I got the sense that he wouldn’t be here either if he didn’t have this meeting with me.
“So, why the Air Force?” Right to the point. I’d already told him over the phone that I was about to start my final semester of nursing school, that I was looking into options for what to do after graduation.
“Well, I really want to travel. I lived in England when I was younger, and I guess I’ve always wanted to live overseas again. I was thinking about travel nursing, but I’d need one year of experience before I could do that, and I don’t really want to wait a year.” The words felt dumb and hollow as they came out of my mouth, as though my own psyche was rejecting them.
“Ah. So, was your dad in the military?” I got this questions all the time when I told people I moved around as a kid. It always made me laugh, because my dad seemed like the farthest thing from a military man. He was a preppy and pedigreed golf player, a charming corporate salesman who wore Brooks Brothers suits and loafers with no socks.
“No. We lived there because of my dad’s job, but he was in computer software sales, not the military.”
Monday’s face looked flat, like he was still searching for something, so I continued. “But, my grandpa was in the military. He was a captain in the Navy, and he’s the one who kind of planted the seed in my head.”
His eyes lit up a bit, as if he’d finally found some traction in the conversation. “So, then, why not the Navy?”
“Well, I thought I’d rather be on a plane than stuck on a ship for months at a time.”
He laughed. “Well, you’re right about that.”
I decided not to tell him that the Marine Corps scared the shit out of me. So did the Army. The Navy didn’t interest me, and the Coast Guard never even occurred to me. But the Air Force—high-tech, high-priced airplanes, elite and intelligent modes of speed, weaponry, and reconnaissance—that seemed more appealing. Plus, the flight suits.
“So, what did your grandfather do in the Navy?”
“He was a PR officer,” I said. “He served in Vietnam for a while. He also lived in Japan and Hawaii and Annapolis.” The truth was, I had no real idea what my grandfather had actually done in the Navy. I didn’t yet understand all of the ways that PR officer translated to professional bullshitter. All I knew was what my mom had always told me—how they moved every eighteen months, and just when she was starting to make friends, it was time to move again. I knew my grandfather had his PhD and loved literature. He could put a linguistic spin on anything. I also knew that when I was about fourteen years old, I asked my grandfather what Vietnam was like, and it was perhaps the only time I saw him look human. As in, mildly broken and uncertain. Scared, even. Which made me want to know everything I could about the Vietnam War.
Up until that point, joining the military had never really been a blip on my radar. Not even a year ago, after the 9/11 attacks. The thought had only entered my mind the previous week, during a visit with family over Christmas break, when my grandfather asked me the dreaded question of what I was going to do after graduation. I told him the same thing I’d told TSgt Monday—that I wanted to travel but I didn’t want to wait a year for a travel nursing position. I didn’t disclose my sense of urgency to flee my current life in the aftermath of my recent breakup. We were sitting alone at the dining-room table after dinner, a college football game blaring in the background, the countertops littered with jugs of cheap vodka and wine, when Pop planted the thought:
“Have you ever thought of military nursing?”
I was probably the last kind of person someone would imagine in the military. Reserved and artsy and perpetually running late. But I also had an intense streak in me, and as a little girl, when I visited my grandparents in Florida and Pop took me to visit the naval base in Pensacola, I was enamored. It was an exclusive world that existed behind a gate, with its phallic jets and the hard salute and car decal you needed to gain access, a powerful language I didn’t understand. At their home in Florida, I remember watching Pop work in his back office, sitting at his dark wooden desk in the middle of the room, his walls adorned with military medals and fancy degrees. I was never allowed to cross the threshold of the door, but he’d let me stand just outside of it, watching him. The ribbon of cigar smoke swirling in the dimly lit room, leaving tracks in the air like a jet stream across the sky. The shiny sword he used to open important mail. The smell of ink and paper and aftershave. His blunt fingers pounding the typewriter keys like little hammers. The clack, clack, clack vibrating inside my body.
When I was a child, the seriousness of my grandfather and his military realm were always just beyond my reach. Look, but don’t touch. But there were also times he’d bring me in close, behind the closed doors of a bathroom, sequestered behind the foggy shower door, with no barrier but skin between us. I didn’t know how that concoction of power and sexuality and control over a child could cast such a strong and lasting thread of influence, how his legacy of abuse would pull my strings like a puppet for decades beyond my childhood interactions with him. And that night, sitting across from him at the dinner table, his suggestion seemed to lodge inside of me like an irretrievable piece of shrapnel, like a foreign body within my flesh that elicited an immune response, though in truth, the suggestion had already been planted in my body as a little girl, standing at the threshold and watching, standing at the threshold but not crossing unless he invited me in.
As Monday sat at the big desk in the middle of the room, I watched him like I’d watched my grandfather. Another threshold. He began to paint a beautiful picture, with opportunities for travel and further education. Since starting nursing school, I’d wanted to become a nurse anesthetist. The idea of putting people to sleep so they didn’t feel pain attracted me. I loved that numbness. Having someone’s life so thoroughly in my hands, knowing a body well enough to wield that kind of power and status captivated me. Monday told me that the Air Force had one of the best nurse anesthesia master’s degree programs in the country. He also talked about becoming a flight nurse, being stationed in Germany or Japan or even getting an assignment in Italy. Maybe I could go to a base in England, near where I’d lived as a kid. Plus, if I signed on for four years, instead of three, I would get a $5,000 sign on bonus, which seemed like a lot of cash to me at the time. It felt like the perfect solution to all of my problems.
I didn’t know anything about military recruiters, and I suppose I was too naive to ask. Monday was a military salesman, a linguistic spinner, like my grandfather. Perhaps even as smooth a salesman as my dad. Instantly likable. He sized me up from the first moment he saw me, and I was probably just as eager to join as he was to sign me. To be honest, I loved all the bullshit he told me. The bullshit was pure licorice, a long smooth line of sweet and chewy artificial rope I could nibble on all the way through that depressing winter of my senior year. Maybe Monday and I were such a great pair because we were both invested in fantasies. He was invested in selling one, and I was in the market to buy one.
Sitting across from him, I felt alive. There was a strain he carried in his body, as if he could snap at any moment but didn’t. I sensed a tightness within him, a stiffness, as if he’d taken a large breath but never let it out. He intermittently clenched his square man-jaw the same way Tom Cruise did in Top Gun. When I watched his temples flex, my body said YES. He wore his hair high and tight, like a Marine. And then there was the rectangular gold belt buckle, his shirt tucked into his pants just so, the blousing just right, the sleek navy pants and the shiny black shoes and the mosaic of bright ribbons on his chest. He was like an alien from another universe showing up during the post-Christmas, post-breakup, senior year apocalypse of my sad life. When he talked, his face hardly moved, and if he smiled, it was done with control. He swallowed like he was keeping something down. My body ran on that tight line of tension. My body knew that feeling, craved it even. Swallow it down, keep it together, handle it. Look the part, wrinkle-free. Hush hush hush.
Just outside the window, my little Honda hatchback sat at the far edge of the empty parking lot. It was mid-afternoon but already felt like evening, the atmosphere surreal, like a snow globe. The cool drizzle fell like flurries, an entire unknown world of possibility appearing on the other side of the glass, on the other side of the desk, the air smelling as it did.
I wanted in.
I didn’t know what I was wanting and I didn’t care. I wanted to feel something big. I wanted to like myself again. I wanted to want to wake up in the morning. I wanted to feel away. Far away. So far away from the black-hole shame in my body. Away from all of my wretched wants. Away from the dead-end suburbs. Away from the endless dark loop within my own mind.
Where do I sign?