After the Verdict, The Sentence

Dinner brought me back to the world of the living, as it always does, and then we settled in to watch Netflix. Sometime around nine PM, the phone rang: it was my internist. And the concern jumped over the telephone wires.

“Marc, you have to go, first thing in the morning, to the lab, pick up your MRI results, and go directly to Centro Médico.”

Centro Médico is famous on the island: it’s the teaching hospital for the University of Puerto Rico. The great thing about it is that the doctors there are often the finest in their field. The worst thing about it? It can take days or seemingly weeks to see those excellent doctors.

I was an innocent, the first time I had dealt with Centro Médico. I had called a friend, Clark, early in the evening, and was startled when he answered: he was howling with pain.

“What happened?” I asked.

“I just fell,” he told me, “running to get the phone…”

“We’ll be right there,” I said, and we drove to his apartment. Unfortunately, the pain was so severe that he couldn’t get to the front door to open it or even buzz us in.

It was in the early 90’s, in those quaint days before we had cell phones, and so I wonder now—how did we know that Clark had called his landlord? And so it was a wait for him to arrive, a wait for the ambulance to arrive, and then it was off to one clinic that was in his catchment area. All well and good—except that the X-ray machine was broken. So then we went to another facility, had the X-ray taken, and returned to the first facility. There, the resident took the X-ray, held it up to the light, and told the ambulance driver to take Clark straight to Centro Médico.

It was then about three or four in the morning: we had seen the orthopedic surgeon, and Clark was settled and stable. But what was he doing, lying on a gurney in the hall? Worse, it seemed that lying on gurneys in the hall was the norm, since there was a hook that the nurse casually hung Clark’s IV bag on. I had worked in hospitals for about a decade, and had I ever seen such a thing? No, and I was appalled.

It was very early in the morning—about five—when I left the hospital: how would I get home? I stumbled around in the dark, looking for a bus stop, which I never found. I did, however, see the little público as it emerged from the fog and the night: there was a distinctly Harry Potter feel to the whole thing.

So I clambered onto the público—essentially the first half of a school bus that had been decommissioned, sold to an enterprising Dominican, and converted into a little bus. (What had happened to the rest of the bus, I used to wonder—what is home for the Dominican? Nor have I ever found out….) Scorned by everybody who has a car, the públicos are hot, noisy, and always crammed—not to mention unpredictable. I virtually jumped in front of it, so desperate was I to escape Centro Médico. But I went back later in the day, to check on Clark.

He was in the same place.

And he was wet, since he had held his urine as long as he could, until he could no longer.

I was horrified: Clark was in his fifties, hardly incontinent, and where were the nurses? All he needed was a urinal…..

“They told me I had to provide my own urinal,” Clark told me. “And since I don’t have any money on me….”

I inquired further—had he eaten? Had he seen any other doctors? What about pain meds: he had a broken hip, and must have been suffering.

In fact, nothing had been done: he was simply lying in the hall, in his own waste, and nobody had paid any attention to him. Intuitively, I did the right thing.

“I’d like to speak to the nurse caring for Clark. I’d like to speak to the charge nurse, the nursing supervisor, the ER resident, the orthopedic resident, and the orthopedic attending—in no particular order. Oh, and I’d like to speak to the hospital attorney….”

Who was I talking to? I have no idea, to this day. But beyond proving that I knew hospital hierarchy, I was also speaking English, since I knew little Spanish at the time. Did that make a difference? Probably.

I had asked, as well, for a basin of warm water, soap, and a washcloth. I got instead wet—though warm—paper towels. So we were doing the best we could, when some white-coated person approached us, and told us we were ready to go.

“OK!” said Clark, who had been told there was no room on the orthopedics ward—nor did they expect there to be for several days. So where were we going, I asked.

“To your room.”

Since that experience, I have learned: every Puerto Rican has a Centro Médico story, and none of them are good. Nor was there any reason to believe that things were better: Montalvo, our adopted son, had six months ago been engaged in trying to make a wine bottle into a flower vase for his mother, in honor of her birthday. Instead, what had he done? Cut himself badly on his right thumb, severing the tendon. And so I had gone first to one hospital, and then to Centro Médico—and it was clear that nothing had changed.

Lady had called me earlier in the day, and very nicely chewed me out. Why didn’t she know that I had needed to go to the doctor? Why did she only find out when Lord (her brother, since if she is Lady, what else could he be but Lord?) dropped a remark casually? Dammit, Marc—keep me in the loop!

And so I called Lady, and asked her to find someone to take me to the lab and Centro Médico in the morning. We settled on ten AM—still early enough, but late enough for Mr. Fernández to sleep.

One of us, at least, should get some rest…..