We rolled up to the ER on September 7, Jack pumped with steroids and I holding it all in, getting through it. An orderly appeared with a wheelchair and wheeled us into the triage nurse, who looked exactly like Jeff Daniels. The ER was a zoo—I was immediately reminded of the t.v. show Jack and I often watched to help pass the time. Jeff Daniels took Jack’s vitals while he told me there were absolutely no beds in the ER.  “He can’t sit for very long due to the pain,” I said, adding up the length of the 45-minute car ride in my head.  Daniels shrugged. “You can find a place on the floor for him,” he joked, pointing with his head to the mayhem outside his window. I did not laugh at his joke. Jack looked around, considering his options for some relief.

We were back out in the crowded hall, and so was Daniels, bandaging a bleeding neck wound. There was a woman who was bruised and crying, and other wounded people sitting on the floor. Cop cars were lined up outside. I leaned against the wall and sighed. Suddenly I felt a hand on my arm, and a nurse was taking Jack’s chair. She led us through the first room of the ER into a second room. There were four empty beds. Jack was put in bed 13.

Instantly I recognized Milan. She was the ER nurse the first time we came in for Jack’s brain cancer in early March. It was almost exactly six months later. I remembered her clarity, her directness, her supportive eye contact. I reintroduced us and she remembered. The other three beds were soon full with people detoxing and with one woman in extreme distress. She got the private room, but since they didn’t close the door, we all heard her intermittent screams. They were timed like labor contractions, except they weren’t. Her agony became the audio for the evening.

My plan was to get Jack’s diagnosis, get him into his room and settled for the night, and then head to my friend’s house in Alta Sierra (a nearby suburb) for a few hours sleep. From there I’d go teach my Friday morning class in Rocklin, and be back at the hospital at one.

They zipped Jack back for a CT Scan pretty quickly, and I watched the mayhem increase, realizing that now this ER made the TV ER look like Sesame Street. All this was going on in my little town? I was grateful to have become a hermit living out in the woods where it was quiet and safe.  I watched Milan and the other nurses navigate the beds with agility and finesse.

Jack became agitated and in pain again as the steroids wore off. The results of the CT scan weren’t back yet, and I began to fear that they wouldn’t admit him. I took some video of his agony, feeling bad about it but wanting some evidence.

Milan came over. “Are they going to admit him?” I demanded. She said they were waiting for the report. “I just took some video of him,” I declared, “And if’ we’re not admitted it’s going to be all over social media in five minutes.” She shushed me. “Be patient,” she said, “It will only be a few minutes.”

She was true to her word. “The scan is not clear,” she reported to me in a whisper. “Get ready to transport.”

It was just like last time. The admitting physician came in, the one Dr. Fratkin had made the deal with after our last debacle in this ER. “Can I speak to you in the hall?” she asked. That put Jack on high alert.

We slipped out.  “He has three tumors in different parts of his brain,” she said. “We’re recommending you go home on hospice.”

“I want a transport to UC Davis,” I said flatly. “I want to hear this from his oncology team.”

“That’s within your rights,” she said.

My phone lit up. It was Dr. Fratkin.  “You have every right to transport,” he said, “but in my opinion the outcome will be the same.” He had an idea.  “Why don’t I call and see if I can get ahold of Dr. Fragosa and we can look at the report together? If he says you should transport, you will.” I was relieved. Dr. Fragosa was Jack’s radiation oncologist, one of the few doctors we’d met there who was both competent and caring.

“Don’t let them talk you out of transporting if that’s what you want to do,” Milan coached in her familiar whisper.

Someone brought me a copy of the report. I read that the three tumors ranged in size from 2-6 millimeters. His brain was also off center by a millimeter. How was he even walking?

Dr. Fratkin called again. Dr. Fragosa had said the tumors were inoperable.

The hospitalist came in and said that one of the brain tumors was telling Jack’s body he had sciatica. There had been nothing wrong with his back the whole time—three agonizing months. As Jack and I would later joke, it was all in his head.

“Let’s arrange to go home on Hospice,” I said, accepting that we were nearing the end of our journey, feeling the deep coupling of relief and despair.

Meanwhile, we were told there were no beds on the wards. Jack was admitted but would remain in bed 13 in the ER, probably through the night. As things quieted down for us a little, I noticed a button Milan and the other RNs were wearing. It was a blue button with white letters that said “Safe Staffing NOW”. I studied it a moment, thinking first that I wondered why they would be allowed to wear such buttons. I hadn’t noticed them when I had been in the ER two days ago.

As the evening progressed, Jack went from a confused lucid to an outright psychotic. He was determined to go home, and at times believed we were in a killing factory, waiting literally for our number to come up. It was past midnight now, and my fantasy of going to work the next day was long past.

Those who know me know that my vision is not the best. I am blind in one eye and wear a hard contact lens in the other. That one tiny disc of plastic allows me to live a normal life since eyeglasses don’t correct my vision enough to be of any use. After midnight my working eye started killing me, and I knew I needed to take my lens out and close my eyes for a couple of hours. Milan brought me a recliner chair and put sheets and blankets up to darken my space. Jack dozed. I settled in with the warm blanket she brought and got a few moments’ relief. But then I realized Jack was no longer asleep.

He began taking his gown off, sitting in Bed 13 buck naked. He needed to examine the seams of the gown, he told me, since it had morphed into a shirt his mother had made him. He showed me the high-quality seams over and over again, stopping only to yank out an IV or tear off a blood pressure cuff. Alarms sounded but he did not notice them. “She also made some cake,” he told me.  “Would you like a piece?” He smiled like a kid and with expert pantomime cut me a piece, put it on a plate, got me a fork, and handed me the dessert. I pretended it was delicious. “I’ve got to get home,” he said and tried to get up. I stalled him and squinted at the alarms. Finally, Milan came, out of breath. She tried to reason with him, to cover him up. He’d have none of it. She grabbed the call button she wore around her neck and pressed. “I need help in bed 13,” she said, her adrenaline obviously pumping. No response. She tried her cell phone and then both devices, yelling “Help me!” into them.  “I need help in Bed 13!”  Finally, she was calling so loudly that they heard her in the other room of the ER, and a second nurse appeared. “I need a sitter,” Milan yelled, “I need a sitter now!” A sitter was not available, the other nurse said when she returned.

The Safe Staffing NOW buttons they wore were starting to make sense. I squinted to see what was going on the best I could. “Should I try to put my lens back in?” I asked. “Then I could help.” Milan motioned for me to stay where I was. Jack quieted down and they both left. “I’ve got to take a piss,” he said, language he would normally never use around me.  He began to pantomime a urinal.  I called for help, but it was too late.

When the nurses returned, they noticed the mess. “You didn’t tell us he was incontinent,” Milan said with wide eyes. “He’s not. He was hallucinating.” She and the other RN began to change his sheets. That’s when it hit me. Why were two RNs changing a patient’s bed? Where were the nurses’ aides?

Safe staffing NOW.

I guess they adjusted the meds. I guess I drifted off. Except for the labor-like screams of that one woman, it had quieted down in the ER.  I put my lens in and got some water. It was almost daybreak by my clock, but deep in the ER, there was no way to see it. Jack woke up, no longer as volatile but twice as paranoid about them calling his number.   Neither of us had eaten since lunch. I couldn’t leave him, so a friend brought me some food and a yerba matte from the nearby co-op. Jack got a hospital meal, but he wouldn’t eat a bite since he was sure that it had been poisoned. He ate a few bites of my eggs and potatoes and nabbed all the sausage. I emailed work and said I was a no show. The secretary forwarded to my dean, who wrote me back right away with support and concern. We languished in the ER until a bed was available, about 3 that afternoon. I remembered that Dr. Fratkin had made me promise that once Jack was stable I would go home and get some sleep. I ducked out of the ER as they were getting ready to move him. Utterly exhausted, Jack would remain in near coma until they wheeled him into our living room and waiting hospital bed 36 hours later.

I contacted Dignity Health about the Safe Space NOW campaign. They declined to comment. I contacted the California Nurses Association or National Nurses United, and the press agent told me only the obvious and was not willing to be quoted. I reached out on social media to nurses in my community. Some contacted me, but none were willing to discuss the issue on the record. Just this week a friend reported on Facebook that she was admitted to a ward in the same hospital for a short period. A fall risk, she was pretty much bolted to her bed. When she pressed the button so she could get up and use the bathroom, she waited twenty minutes and pressed the button again. She waited fifteen more minutes. Then an orderly came in and chastised her, telling her she wasn’t the only patient in the hospital.  That made me remember the day Jack was out in the ward, while we were arranging for Hospice. I was a Candy Striper at this same hospital back in the day, and I remember the bee-hive of activity at the stations: the aides, the LVNs, the RNs, the MDs.  But on that day the station was morgue-like, just a few RNs and a hospitalist or too busy at their computer stations. During the hours I was with Jack, no one entered his room to check on him or offer him any attention. (A bath would have been nice.) As my friend noted, the staff in the ward was primarily great, but far from sufficient.

Safe staffing NOW, indeed.

Friends of CC and Jack have been helping CC pay down the medical debt incurred from deductibles, copays, and alternative treatments. If you can help, here is the link to the fundraising campaign: https://www.gofundme.com/help-for-cc-and-jack?fbclid=IwAR0FemImlcgJG0UlgeSmuowKwsD9y8RqECFpzCcr-tzQ0HimmASXtIwyTSU