The Roads to St Mike’s

Gilic, Filip

It’s a big city out there. In the core alone, two-odd millions from a hundred nations of the world. Talking, eating, crying, fucking, living, dying. It makes for a lot of stories. You can hear them everywhere. On the subways, in the bars, on the streets, in shops and restaurants, in the houses, at the parties: the city buzzes and vibrates with them. You can walk through it all day, catching fragments here and there. You can run your heart out meeting, talking, asking, listening. You’ll hear a lot. But there is a place that collects the stories of Toronto. There is a place where you can feel the city's beat at its most visceral, its joys at their most acute, its tragedies at their most poignant. The roads of many lives lead to one place.

They lead to St. Mike’s.

It is a vast place. You might walk in, or a friend may drag you in, or your family. Many announce their arrival with the wail of the ambulance sirens. You join the enduring masses out in the ER’s waiting room and you wait and wait. The numbers get called, too slowly to soothe your ache, but one by one, out of the undifferentiated mass of stories of human suffering, the triage nurses judge, classify and assign with the authority of St Peter to create manageable order. When they allow it, go left, through the swing door and it hits you:

A Yugoslav girl sits in one of the beds, after a heavy overdose of ecstasy and coke. The parents, both middle class and elegant, are there with her; crying for her stupidity, laughing that she lived through it. Tears streak her face, too.

In a closed room sits a woman. She is of mixed Mexican and Norwegian blood, and it shows. She is stunning- slim, dark skinned and fair haired. Her face is mask-like. She is manic depressive and going downhill. Her boyfriend is beside her, holding her hand. Last time she had a manic episode, she went on a string of sexual escapades. She came out of it a week later, with HIV and Hepatitis C in her blood. When she is well, he tells us, she holds a job, has a house, lives a regular life.

In another bed, an Argentinian lady in her seventies, sharp and spirited, comes with her large and noisy family, and an abscess in her ovary. She is lying down, too weak to sit up. “Get me out of here fast,” she says” and I’ll teach you how to tango.”

A Ugandan man lies near her, a school board social worker who covers the Jane and Finch area. He battles poverty and ignorance every day and now he has a new battle to fight. A cancer in his liver eats him from within, and he writhes in terrible pain. Despite it all, he is civil, patient, even graceful. Three months ago, he was completely well. He won’t live through the year.

In the trauma room, a young Chinese girl lies listless. The trauma team buzzes around her; they check her fingers, her toes. She does not move. She tripped and fell over a balcony railing, hitting the concrete four floors down. Spine fractured in many places, she will never move again. In the bed next to her, a guy screams. Snowmobiling drunk, he hit a tree. The ultrasound shows internal bleeding. Just then he vomits a geyser of blood. He is dead in minutes.

Go up the elevator, to the medical and surgical floors. The stories follow you. Here are the chronic patients and the truly ill. Some have been here many times; for some it is the first time. For some, it is their last.

A Hungarian lady dies alone from a cancer in her gut, vomiting blood and undigested food. She has no family; her friends are all dead. “I’ll leave everything to the hospital,” she says, “they were the only ones who cared for me.”

Another Hungarian man, homeless, desolate and with terrible ulcers on his feet, argues with the nurse who changes his dressings every day. The smell of long-dead fish permeates the room as he whistles and talks of walks by the Danube in the old Budim and of the joys of masturbating to German porn.
Down the hall from him, two ladies who lived through the siege of Leningrad, through nine hundred days of fire, famine and pestilence lay not twenty meters from each other, not knowing it. One tells of eating potato peels, of crying upon coming to Canada and seeing rows and rows of food in a grocery store. The other won’t talk about it at all.

Walk further still and a perky blonde lady welcomes you. She talks quickly, about the weather, about her family, about the family business. They own a camp and she needs to get out of here to help close it. Healthy as a horse, she says, and damn the sudden pneumonia that brought her here. Except it is not pneumonia at all. The fluid you drew from her lungs tells you it is cancer. You struggle to maintain a cheerful charade while you wait for the final confirmation. “How soon can I go home?”, she asks…”Well, it’s hard to tell,” you lie. And when you finally tell her, the shock is palpable. She looks lost like a little kid. She cries.

On the vascular surgery floor, a well known newspaper columnist paces through the halls, her father in bed with a gangrenous leg. The surgeon wants to amputate it above the knee, save his life. She can’t make a decision. She is tired and worried. She is there every day. She complains a lot. She wants to write a column about medical care. She looks nothing like her pictures in the papers.

Most days you don’t think about it much. It is a job and you go about it as such. Technical details absorb your hours, not the stories. You can go for months and feel like a manager, a carpenter, an electrician who works with a different set of tools. But there are nights when you are surprised, when you do something difficult, when you tell some really good or really bad news. It is mostly when you are on call, all alone, asked to run a part of the show. You look at the weather, recount the call karma, and wish for a quiet night. If the city sleeps well, you might sleep too. But when the city sleeps uneasily, you sleep not at all. Hearts will stop beating, lungs will collapse, vehicles will crash, cyclists will get run over, operations will go bad. Adrenalin will flow.

Mostly it drains you. Sometimes it goes deep and touches you. Then you come to where the elevators are, stand by the huge windows. You look down onto the city’s night lights, and see the people milling below. You feel the city’s beat. You feel its stories flowing into the hospital and you say: Give me your tired, your poor, your huddled masses yearning to breathe free, the wretched refuse of your teeming shore. Send these, the homeless, tempest-tossed, to me: I lift my lamp beside the golden door. You feel both very small and larger than life. Ellis Island we are not, but we are the Urban Angel and all the shit and drudgery and fatigue flows away and you say again: give us your stories, no matter how difficult, no matter how much they hurt, no matter how hopeless; give us your pain. We offer succor, relief, cure sometimes; at least shelter, a warm place, some food. Sometimes that is enough. And when it is not, when it is beyond us, the kind eyes of the angel will look and record and he will whisper before the dying breath “It was not in vain; you will not be forgotten. We will weave your story into the city’s tapestry. Your life was the life of the city and we will not forget you, even if everyone else did.”

Theme: Community | Communauté
Theme: Death and Dying | Décès et le mourir
Theme: Patients | Patients
Theme: Physicians | Médecins

Stories in Family Medicine | Récits en médecine familiale [Internet] Mississauga ON: College of Family Physicians of Canada. 2008 --.




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