The Duke

Photo by Ashley DeHudy

This ICU is a half-cylinder affixed to the east side of the hospital, each room fitted with big picture windows to drink in the sun. Rounds as usual start before dawn, and the purple-pink arc of the coming day forms a pleasant orthogonal to our slow crawl across the unit.

In the dark, the weight of these injuries seems to summate. They blur into each other as we visit them in sequence, but the individual stories are also told repeatedly: first in macabre shorthand to each other as we arrive; second more formally on work rounds, as we develop the day’s plan; and third with some polish to the attending physician, who furrows her brow and agrees.

So it is that the details of Earl’s car crash comes to be hashed and rehashed each morning, in view of the wreckage of his purple-pink body. He avulsed an eye and broke his ribs and has cuts and bruises all over his massive frame. Technically he’s in a coma and breathes on a ventilator, but still he thrashes when touched.

Everyday his plan is reviewed by system – from a neurological perspective, from a respiratory perspective, from an infectious disease perspective. The ten or so members of the multidisciplinary rounding team contribute in turn their scraps of data to the intensive project of the whole. Their voices are calm and efficient, except for that of the clammy nutritionist, in whom this routine seems to stir up an exasperated urgency, as finally, from a gastrointestinal perspective, he reminds us that Earl has not had a bowel movement in three days.

By mid-morning the pack has cleared, and one or two nurses remain at the station watching the monitors. I stand nearby, drinking coffee. Shadows lifted, the wounded seem much less monstrously so. Earl has received a Dulcolax suppository, referred to in casual parlance as Dook-o-Lax or more simply The Duke. It is around noon that this treatment proves efficacious. Earl’s room is closest to the ICU door, and for a while everyone who passes through it makes the same face.

A pretty therapist with painted lips says to a nearby tech, “Rustle up some clean sheets, Pete, we’ve got a Code Brown.”

“God it’s like walking into a wall,” says a young physician’s assistant, in a pencil skirt and heels.

Looking in at Earl, I see only his naked tree-trunk legs at the foot of the raised bed. He has somehow managed to cross them, in the masculine fashion, suggesting powerfully his exquisite repose. Everything is awash with brightness.



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