Universal Table

Although her patient could hardly look away from her, Calla liked the way she made eye contact, as if she saw her as a real person, not just hospital staff.

"I'm Calla, your student nurse. Should I call you Mrs. Loom or Zandra?"

"You can call me Mrs. Loom." But she smiled at Calla, not like Mona Lisa because the smile didn't touch the corners of her eyes, but as if she registered an absence of pain, as if smiling didn't hurt this time. "I was flipped onto my neck and head off the hood of a hit and run car," she said, as if to get it over with.

She was dressed in a deep blue robe, and Calla wondered how on earth she could help her change her clothes without removing the harness. If she removed the harness improperly, then she might cause harm to the cervical vertebrae. That was some halo cast if it gave two people a head ache at the same time.

Because of her graying hair, Calla expected to be questioned when she said student. No one ever commented, and she almost wished that someone would. She wanted to tell someone why she'd decided to try for a better salary, more security, with the result that she had less security. If she could explain it to someone, maybe she'd understand it herself.

It was the second week of Calla's last clinical rotation in practical nursing, and she had five more days to go. During this final clinical, the student nurse was supposed to demonstrate that she had it all together, but already she'd made two mistakes. At the Frontenac Technical College, it was three strikes and you're out.

She hadn't almost killed a patient. The first mistake was a medications error. It happened when she'd felt high on her freedom from the close supervision of the instructor. She had busily consulted the pharmacist and Sue, her staff nurse (who was also assigned Calla's patients) about an innocuous antacid medication to be given as needed. The problem was that the doctor had failed to give administration time guidelines.

"You can give these four times in 24 hours," Sue said. "Don't bother the doc - they hate that! He'll clarify the order when he makes rounds tomorrow morning."

Not long after Calla gave the medication her instructor tapped on the glass of the chart room. For an instant, as Calla rose, she saw her own face in the glass, her olive skin and black hair superimposed upon and darkening the face of the instructor, who was fair haired and thinner. The instructor closed her eyes for a moment before pronouncing the verdict. "Weren't you taught to never give a medication unless you had the correct time?"

"Yes, I was," Calla said, "I was wrong. I forgot I was a student."

The instructor shook her head. She didn't like the implication that, out in the real world, it was okay for Calla to think for herself that way.

"If your primary nurse wanted to give the med, okay, but you should have said you didn't feel comfortable."

The problem was - she had felt comfortable. All along, all along there've been incidents and accidents (Paul Simon's song an endless loop in her brain), hints and allegations. Things she should know, although she hasn't been taught those things precisely.

The second mistake happened when her patient was taken off to physical therapy before she gave his inhaler. "Don't worry," Sue told her, "you can give it when he gets back." Nonetheless, Calla chased him down to P.T. because she'd been taught that every medication had to be given within one half hour of the time the doctor ordered it. The therapist had her patient in the whirlpool, so Calla waited. It was her lunch half-hour, but she took the old man's chart off the cart to catch up with her charting. At noon, he was still with the physical therapist, and Calla had meds to pass upstairs. So she left, feeling it was better to be damned for one mistake than six.

Fifteen minutes later her instructor arrived pushing Calla's patient in a wheelchair. The patient, an elderly man who had done nothing but complain about having a student, was grinning, and the instructor had a smile clamped to the corners of her lips. Both of their heads were turned toward Calla, who was late on a med and stranded her patient.

The head of the bed raised automatically and at the same speed - too fast. Only a faint wince on Mrs. Loom's perfectly oval face, a shivering of fine wrinkles. She couldn't have her head raised more than 30 degrees, and Calla double-checked before she wrung out the wash cloth and washed her legs, her skin, so papery fine that the terry cloth seemed too rough. It occurred to Calla that she'd seen her at the library, perhaps many times.

When she was a library aide she loved the books, except for Darby Coffey's intrusions. A year ago, when Darby was fired from the tenth job he'd had since they married, he had time to sprawl in the reading room of the library, looking at her with a sneer or scowl. Just when she'd brace herself to refuse to buy him lunch, he'd leave without a backward look. At the safe house, an advocate said, "get him out of the apartment, not you!" Calla collected evidence in a diary, but her fresh black eye did it for the judge, and they served him when he picked up his welfare check. She should have been relieved, but she knew he'd violate the order. He knew where she was at the library, so she quit her job. A student loan just had to tide her over and a loan from the boldest of her three old aunts.

The aunts already had Calla's nurse picture in the Carrio family album: white dress and prim French twist. Aunt Elana was particularly disappointed about the disappearance of the nurse's cap. "It got in the way," Calla said, but she was disappointed too. As if a winged cap would have conferred nurseliness.

Mrs. Loom was distant, not much like the aunts, who were bosomy and wept over soap operas. Calla returned with warmer water to finish her bed bath. It was hard to move in these hospital rooms. The wallpaper was the ocher of old contusions, and the walls, exuding a faint smell of antiseptic, pressed in upon the furniture.

Mrs. Loom's shelf had a cactus with purple flowers and a large sculpture: a jade (it couldn't be real!) mountain peak, bonsai trees on the tree line. Close to the top was a tiny hut and smaller human figure, peering out the door at the highest peak, as if wondering about the weather.

"My mountain - the air is thin up there." Mrs. Loom made a grating sound in her throat, and Calla realized that she'd made a joke; it was too late to laugh, so she smiled. "I dislike knick knacks, so she gave me the Himalayas," Mrs. Loom said. "That was my daughter's idea of a prank."

"Your daughter, does she..."

"She's dead," Mrs. Loom said, "of cancer, last spring."

"Mrs. Loom was in the news," Sue said. "Struck by a car while she walked in a counter-demonstration outside Planned Parenthood." In the clipping on the nurse's station bulletin board, the straggling line of protesting women were mostly dressed in down jackets except for Mrs. Loom, who wore a long black coat with a hood. Her face in the picture - high cheekbones all bone, the darkness in the sockets of her deep-set eyes - looked even older than she was.

"She's too old to be a woman's libber," Sue said.

"How old is that?" Calla asked. Every now and again, when she had an emotion other than fearful vigilance, she could see that nursing might be fun.

"Oh, you know - over fifty."

Sue was barely thirty. Calla, who was fifty-two, only smiled. She had mixed feelings about abortion. The Carrio sisters, all childless but Calla's mom, rest her soul, said women should make up their own minds, thank you very much, not men and the government! Calla agreed, but, childless as well, she thought of herself as a natural mother. If she and Darby had been able to have children, would things have been better or much worse?

Looking up at the ceiling, Mrs. Loom told Calla about her life. Not like confiding - it was more like overhearing her thoughts. "Seems just yesterday," Mrs. Loom said, her voice weak, as if through a narrowing in her throat. "My husband and I were looking at the last of our babies through the glass in the nursery, and then - in the glass - I'm seeing him walk onto the elevator. Now I can't remember when we divorced. That was the divorce for me."

"How terrible for you!" Calla said. "What a time for him to leave you!"

"He didn't want us to have the last child. I was forty-one. Still, my ex-husband was happier about having a big family than I was. Except for that last baby, my only daughter, and she would be my greatest - well, that's another story. I often wonder, if they'd had safe and legal abortion then, what my life would have been."

"Oh!" Calla flushed up to her forehead. "But you wouldn't wish your children not to have been born?"

"That doesn't enter in. It would have been an alternate life, you see, and I wouldn't have been their mother. If they had to be born, they would have been born to someone else."

Mrs. Loom's face showed no emotion that Calla could recognize. Mrs. Loom was waiting without expectation - did it feel like limbo? Or was that heaven - above your pain at last? Calla felt bruised from the inside with feelings.

"Do you have pain?" Calla asked again as she cleaned the last pin site, halo anchored in bone. Mrs. Loom mouthed 'No,' but Calla knew that she was lying because she wouldn't take anything for pain except an occasional Tylenol, though she seemed to hurt if she even wrinkled her forehead.

Alternate Lives. Nursing was another life Calla had strayed into. Sometimes she observed herself being a nurse. Who was real - the nurse or the one who watched? No bruises left on Calla's face or arm, her hand holding the cotton tip swab. Darby's hand was so fast it was back to his glass of Killian Red by the time she touched the swelling. You look like that, you get the back of my hand!

Calla shook her head, shaking Darby out. "Mrs. Loom, I'm concerned about the lack of stimulation for you. You don't seem to like television. I bet you're quite a reader."

"For many years, I preferred reading to thinking, but I didn't know that. I thought reading and thinking were the same thing."

Calla turned her just a fraction, keeping one hand on the halo cast. Reading was more like feeling for Calla. The library books used to make her feel enclosed, all the alternative lives in novels and safe to open.

After lunch, Calla walked past the nursery. A baby's mouth so wide its cheeks swallowed the eyes. In the glass, a ghost woman, her full lips a thin line. How did she look before he hit her? She'd cut her lunch break short to get some reading aides for Mrs. Loom, a book holder and a mirror and magnifying glass that reflected the page up to immobile patients. Mrs. Loom said, "No, I won't read, but thank you for your enterprise," biting off her words. Calla felt rebuffed. "I'm in another place, Calla," Mrs. Loom said, as Calla was about to leave. "So are you." It was the first time she'd called her by name, and Calla felt shy, pleased. Had she indeed seen her at the library? She had.

After taking her noon meds, Mrs. Loom said, "I'm sorry if I seemed abrupt after your thoughtfulness, but all my former lives are just at the edge of my vision. That reading glass - it reminded me of that sign on rear view mirrors - objects are closer than they appear. Reading would make me feel crowded. Do you see?"

Calla nodded, though she didn't quite see. Time bumped at her white-sleeved elbow. When they took away the date stamp at the library for a bar code scanner, she'd read until someone came through the line and she moved the spines of books across the glass. Books and time flowed past. Now she crammed tasks into the minutes on her neat work sheet, no room for the kinked drainage line, beeping I.V. Calla, crowded by the present. Mrs. Loom, crowded by her past - so much behind her that she had to wait for it to catch up to her.

As she waited, the elderly woman moved from dreaming to waking and back again, but what she reported to Calla wasn't like a dream though it seemed to come from the same nonlinear source. As Mrs. Loom opened her eyes one morning, she said, "Even people you love the most, they live in their own spheres - like those miniature houses that get snowed on when you turn the globe upside down."

Here she was, Calla thought, giving intimate help within another person's glass sphere, just that fragile.

While Calla was setting up an IV for the patient in the next bed, the patient asked Mrs. Loom if she had any grandchildren. "No. One son is gay, another's sterile from a mumps infection, and the oldest is unlikely to marry at this late date."

When her roommate was wheeled out to the visitor's room, Mrs. Loom told Calla that she was trying to think of her daughter's death as a snowstorm in a glass ball. "I can have sun in mine if I choose," she said, her voice so light and even, not breathless but produced without breath. Her head was lifted by the halo cast, even from the softness of the pillow.

Every hospital room looked like every other one until you looked out the window. Calla paused to look out at the frozen marsh bordering the parking lot. At the edge of the wetlands, a fringe of snow fell. How strange, Calla thought, a snow shower. Madonna of the winter fields, wisps of snow in the furrows, her halo worn down like a crescent moon.

On the fourth day of Calla's final clinical, the sky was leaking snow. It had been gray for weeks, the clouds so low and close it was almost as dark at three-thirty, when her shift was over, as it was at six A.M. when she arrived, her white sup-hosed legs tingling from the cold, the nurses passing her like they owned the place, laughing, joking, one with Christmas tree earrings. Instead of taking the elevator to her floor, Calla turned into the coffee shop. I have a right to some private comforts, she decided.

While the night shift nurses were finishing up, Calla called the pharmacy; one of Mrs. Loom's meds was missing. She scanned the lab reports. Loom's potassium was just below normal. Low enough so that with her heart med, the Lanoxin, she was in danger of digitalis toxicity? What were the signs again? Six forty-five already, would she have time to get her text book out of her locker? Sweat trickled between her shoulder blades, even though the regular staff nurses wore sweaters. Well, she had a minute to find out more about Zandra Loom. She flipped quickly to the social history page.

A widow. Mmmm, a good address. An address that went with the educated voice. Republican national committee woman in 1955. Donated to the west wing of the hospital. Republican, of course. She, Calla, could accept life's blows philosophically, if she'd been rich all her life like Mrs. Loom. She'd rather be a philanthropist any day than a nurse. A philanthropist in a halo cast? Yes - even so. Nursing put you in danger.

Maybe she was the only one who thought so. Calla took note of the way the nurses talked to the patients, flip and easy, joking. Too familiar, her mother would have said. It was taking care of her mother that last year that gave her the idea, gave her elderly aunts the idea, that she ought to go into nursing. "You're so calm, and you have a kind smile," they all repeated, as if it were settled.

Go away, Aunt Elana said, Calla's mother needs her, then she closed the door in Darby's face, but there he still was, standing so close to the window he fogged it, his hand making a cut across his neck to take away the door slam. Aunt Elana, showing her yellow teeth in triumph, didn't see, but Calla did.

She hustled into 618 with her small tray of meds in fluted paper cups. Temperatures normal, same for pulse, respiration, and blood pressures. Calla loved the word 'normal,' which the day proved to be. Still, she went home so tired that her legs throbbed. After unplugging the phone, she collapsed on the couch and dropped off for at least fifteen minutes before she sat bolt upright and remembered that she'd forgotten to record the I and O, Input and Output, on Loom. Important enough to call about? Everything seemed important, so she left a message for the P.M. nurse and the station clerk, sounding impatient and amused said, "Okay, I'll tell her."

Calla lay back down and was just feeling vague and floaty again when the phone rang. Darby at a bar, saying how he loved her and hated her at the same time. She had no time for his Irish maudlin shit and unplugged the phone again. After a few minutes she sat up. If he couldn't talk to her, he'd get mad and come to the apartment. Enough to drink and he wouldn't give a damn about the restraining order. No sleep for her. Then she was sure to make another mistake, and would have to go through the longest two weeks of her life again in a year - another life time away. There was a Budget Motel across from the library.

As she stepped into the room, she thought, all mine. She got into the bath tub and ran the water as hot and high as she could stand, so only her face and the tips of her breasts and the soft mound of her stomach were out of water. It took her an hour to finish her bath, then she dressed in jeans and a sweat shirt and went out for dinner at Denny's, the one she used to go to with her friends from the library, which seemed a very long time ago. When she left, they'd presented her with a nurse doll holding a threatening syringe.

As she got into bed, she remembered - no alarm clock! She'd have to depend on the desk. "I must have a call at five!" She woke on her own at 5:30 a.m., drugged with sleep, but she dressed in five minutes, the toes of her supp hose still damp.

When she arrived at the hospital something nagged at the back of her head, something she'd forgotten, something much worse than forgetting the I and O, but she made herself get a roast beef sandwich and black coffee.

Though room 618 was not officially hers before report, she checked on them. "Can I do something for you, Mrs. Loom?" The elderly woman's face looked minutely askew in the wire geometry of her halo cast, her eyes very wide, and then, as before, heavy lidded.

"You're back. I wondered all this time why you left and didn't say goodbye."

"I told you goodbye yesterday. Perhaps it didn't register - you were very drowsy."

"When you died, you didn't say goodbye."

"It's me, Mrs. Loom, it's Calla."

"Calla. The nursing student. I've been talking nonsense. I didn't sleep well."

"She threw up last night." The roommate reached for a quilted bed jacket. "I took care of her. She told me not to get the nurse, but I would have if she'd gotten sick again."

"They don't have to know everything," Mrs. Loom said, "a shred of privacy, please."

Calla felt the same way about herself, but it was her job to pry, and yesterday she'd neglected to ask important questions.

A knock and "Calla?" It was the instructor. "They started report without you."

"I'm sorry!" Calla let go of Mrs. Loom's hands.

In the hall, Calla, wanting to bolt in two directions at once, said, "my patient was telling me something important. I should go back. I could take report from the staff nurse?"

"And waste her limited time? Hurry, catch it now."

Report on 618 was routine. No mention of nausea. "Excuse me," Calla said, and the team leader stopped the tape. "Mrs. Loom's roommate said Loom was sick, uh, had an emesis."

Outside the conference room, Calla caught up with Sue. "Mrs. Loom was so disoriented when she woke that she thought I was her dead daughter."

"Keep an eye out for her doctor. Good work, Calla, smile. You're doing fine."

"Thanks, Sue. I appreciate your support." Calla's eyes filled and she turned away. Being late wasn't serious, so why this nagging feeling? Possible dig toxicity! Her fingers damp, Calla paged through the drug book. Nausea! Disorientation!

Her heart beating in her throat, Calla slid the bell of her stethoscope under Mrs. Loom's left breast. Her apical pulse, her heart beat, was only 50.

"Calla, do you feel okay?" Sue asked, "You're white as a sheet."

"I'm holding the Lanoxin on Loom. I think she might have digitalis toxicity."

"What was her potassium when it came up yesterday?"

"It was low but not very. I don't remember exactly."

"Oh boy, I wish you'd... never mind. I'm just glad you caught this."

The chart was there for all to read - two shifts of nurses, Mrs. L's doctor, but Calla felt she was the weak link. She reported to the resident, who looked bored and ordered various blood tests and an electrocardiogram.

Somehow Calla got through the day and it was almost two thirty - only a final half hour to go and she would pass - but Sue was talking to the instructor. Calla felt her stomach knot. Sue was saying she hadn't reported the low potassium yesterday. The third strike. She kept on walking toward them. Better to get it over with.

"Calla!" Sue couldn't maintain her smile. "I've just been telling your instructor what a great job you do, how you picked up on the possible digitalis toxicity."

"You have great potential, Calla, but there's something I have to talk to you about." The instructor turned and led Calla into the chart room.

"I was checking the medications record, and I noticed that you didn't record Mrs. Loom's twelve o'clock Tagamet. Did you forget to give it?"

"No, I'm absolutely sure I gave it because I had three to give her and I checked them off on my assignment sheet as I gave them. Then I went to record them on the med record and I must have overlooked putting my initials in that particular box."

"What if Sue had looked at the meds record when you were at lunch and thought that you had not given it and gave it? That's not so terrible with this anti-ulcer med, but what if it had been a heart med?"

"Yes," Calla said, "that's bad." At last it was over. She felt lighter in her center. Now she had all the time in the world. "Am I out?"

"I'm sorry, Calla, yes. But I don't want this to discourage you. You'll be just fine as a nurse." The instructor's large pale eyes looked pensive. "If only you could relax."

While she waited for the instructor to return with the necessary paperwork, Calla reported off to Sue, who said, "I tried to make her change her mind." A hand on Calla's shoulder. "Don't let this get you down."

Calla finished her charting, and the words just flowed - medical abbreviations came from her pen as if she were a twenty-five year veteran.

The instructor gave Calla a written report of events. "Do you think that's fair?"

"Yes," Calla said. The instructor had praised her observational skills and her patient communication and rapport. "This is fair, but I'm confused about the way things work in nursing."

"Please go on."

"There was something else I failed to do, something that might have had far more serious consequences than failing to record a med. I should have brought the low potassium to Sue's attention and checked for the signs of dig toxicity a day before I did."

The instructor looked at her without quite making eye contact. "If you hadn't made your third mistake, would you have told me this?"

"I don't know," Calla said, then, "Of course not! Not unless my doing so would correct something seriously wrong with my patient!" Calla could picture herself slapping the instructor's smooth pink cheek. Didn't the woman have any idea of anything?

The instructor shook her head. "It's all a part of nursing ethics, Calla."

Calla went to tell 618 goodbye. "Mrs. Loom, let me turn you slightly to the other side. You've got to stay off your tailbone as much as possible." She wedged a pillow at her back, another between her knees. "Don't forget to do your bed exercises."

"No, I won't forget." Mrs. Loom smiled. "When I get out of this cast, I don't suppose I'll be seeing you at the library any more."

"No." Calla's mouth felt very dry. "I made a mistake today. It wasn't serious - I forgot to chart something, but now I have to wait to take my final clinical again, and I guess the best thing to do is get a job as a nursing assistant."

"Yes. You mustn't quit. I think you will make a good nurse, much better than you were as a library aide. When I checked out my books, you were always staring into space. Maybe that's why you didn't remember me."

"Oh, but I did," Calla said, "but for some reason, I didn't think I ought to..."

"Remind us both of better days? I wonder. You, in any case -  you look alert now."

The window behind her darkened as the snow came down. Calla thought she saw the double hoops of the halo cast turn, black then silver, spinning in the opaque light.

What are Calla's gifts as a person?

Are they the same as her gifts as a nurse?

What makes her feel trustworthy to you?

Would you want her to be responsible for your care? Why or why not?