The Sound of Silence

by Jinryu

“I’m going to be about an hour late,” I said.

“Oh? You’re still at work? What time do you finish?”

“Supposed to be a half hour ago.  I should be home by six though. What time are we eating?”

“We’ll wait for you.”

I sort of lied a bit. I mean, I gave the impression that I was going to
be an hour late because I would still be at work, but as I called, i
was already outside of the hospital. I trod slowly down the street to
the bus stop.  Though Chinatown
was only a ten minute walk down the hill, I was exhausted and didn’t
feel like doing that today.  Walking felt too slow.  I
couldn’t get away from the hospital quickly enough, it seeemed, and
yet, it was almost as if the days events had made me feel as if I could
stand perfectly still and I’d be buried in it.  It? I don’t know
what it was.  I could guess.  I could try and explain that, but there’s no reason for someone to share it with anyone even if they could.

When I got to the YMCA, I changed quickly, not even heading to the
badminton courts to see who was there. I needed some time alone, or at
least, some quiet– I had my swimming trunks and cap in my pack, so
that’s where I went first.  I did about 10 laps of the pool. 
I wanted it to be a nice round number.  Ten laps isn’t really that
big a deal, and, on top of that, they weren’t continuous– but I’m not
a good swimmer.  Imagine doggy paddling 10 laps.

My mind wandered to what was on my mind throughout the laps– the
heaviness of the water, pressing against my chest.  The feeling,
when your face is under water, that unless you spend more energy to get
your head out of the water first, you won’t even be allowed to
breathe.   Was it fear? No, it wasn’t fear– it’s just that
sensation that was me, sorta hugging the line of helplessness.  I
mean, I can swim– but the point was to feel what it felt like to be
helpless.  Does that make sense?  A controlled experiment in
the sensation of helplessness, to try and understand what might not be

When I finished my ten laps, I was completely out of breath. My heart
was beating so hard that if I put my hand in front of my chest
underwater, I could feel the pulse in the water.

Ever since I started working at the hopsital, I’ve seen and been part
of events that have changed my life forever.  Today, I had a
reminder of what it was like to experience those events, and I was
reminded of a fear that I’d had since the first few days when I was
given the responsability of managing operations independantly. That
fear was simple: I was afraid, and always have been, that through my
actions I might get a patient killed.

Today, Mr. [X] was transfered my hospital, the MCI, to the RVH for what
was a routine echocardiogram procedure.  I had booked the
transport, made the arrangements with the RVH.  The medicar
arrived to pick him up at 8:00 in the morning.  He began his test
at the RVH at 9.  He was done by 9:30am.

But something happened– and his transport to bring him back to the MCI didn’t arrive.

I work in administration– I don’t get to clamp down bleeding arteries
or cut someone open.  I don’t shout “clear!” and then jolt someone
with a difribulator.  I don’t even put the gloves on the surgeon,
or cut open a person’s shirt with scissors.  I don’t even get to
put bandaids on a person after he’s had a needle prick.  That’s
not my job. 

My domain is the paperwork– the hundreds of little gears in the
machine hidding behind or between the big gears of the actual medical
practice of the hospital.  That is my domain– and I take it
seriously.  A little paranoia doesn’t hurt.  But nothing’s
gone wrong for so long a time, and as a result, I was mentally
complacent to take the brunt of what happened this afternoon.

I got a phone call at about 11:30 at my desk.

“is [Jinryu]?”

“Yeah,” I said.  I was about to ask the person to speak louder,
when I recognized the voice.  “Mr. [X]?  Are you done your
test?” I asked.

“i be done since 9:30,” he says with a heavy accent.  “i don not
know if I don something wrong, they leaveft me here.  how i get

“There’s no transport?  Did they call for a transport?”

“I here since 9:30, no one come see me!  Did I forget?”

Mr. [X] thinks it’s something that he did– he thinks maybe he forgot
something, that’s why the people at the RVH didn’t book him passage
back to my hospital.

“Mr. [X], don’t hang up okay? I’m going to use the other phone and find out what’s going on.”

“is very hot here. very hard to breathe.  i am very tired.”

I’m not sure if Mr. X even had breakfast this morning, because his test
was so early.  I call up the RVH, keeping my ear on two phones at
once to make sure Mr. [X] isn’t trying to say anything.

After ten minutes, Mr. [X]’s transport is booked, and he’s on his way
back to us. I didn’t think much of it from that point on, and that’s
later one of the things that would haunt me– that it was
routine.  Even the error in itself on the part of RVH or
transport, that was semi-routine.   I went about my tasks without
much more thought.  The hospital’s been a warzone for the past
week, ever since my tour of duties started up on tuesday.  The
smoggy weather has been really wrecking some havoc, with all
departments strained to the limits.  I thought it was bullshit
that I’d be booked to work an entire week with only a few days notice–
I was replacing someone who was on vacation, and I think it’s retarded
if the HR secretary thinks that she can leave a week of administrative
staffing empty until the last minute.  Top off the chaos because
of that virus that’s crippled a lot of systems.  Even if my unit
has internet back, a lot of sites are still blocked and we’re being
basically intravenously dripped access to what we need to get our jobs

I can’t even get on any internet radio sites, so I kept myself alive
the whole day by listening to the Greatest Hits of Lionel Ritchie on
loop.  I now know almost all the lyrics to the CD.

I ate my lunch during my 15 minute break so I could spend my one hour lunch  taking a nap in the break room.

I had taken about 50 minutes out of my 60 when the doctor came in
through the door, waking me up without introductions.  She’s a
nice doctor, so I don’t mind– I told her I’d be sleeping and that she
could wake me in emergencies.  Which has never happened before; I
usually just say that as a formality.  But well– something was
up, that I couldn’t be given my last ten minutes.

“It’s crazy in there, [Jinryu].  I need you to get the
cardiologist on the line stat, and I need archives to get me Mr. [X]’s
old ECGs.  Stat.”

“What’s going on?” I say, struggling to get out of the impossibly angled reclining chair.

“Mr. [X] had a heart attack.”

Mr. [X] is alright and stable at the moment.  But somewhere,
waiting in the hallways of the RVH after his test, hungry, on a day
so  humid and hot (hich is the reason why we’re so overloaded at
the MCI that we had to send him to the RVH for his test)– somewhere
there, between the time when he was finished his test and got back to
the MCI, Mr. [X] had a heart attack.

He might have even been having it while I was on the phone with him.

Why did this happen?  How did this happen?

Maybe it would have been different if I’d had the foresight to order
his breakfast early, so I could be sure he’d at least had something to
eat since supper the previous day.  Maybe it would have been
different if the RVH hadn’t fucked up by not ordering his return
passage.  Maybe it would have been different if transport wasn’t
so slow. 

Maybe it would have been different if it weren’t for global warming.
Maybe the hospitals could have used more air conditioning. Or heart
disease. Or myabe Mr. [X] should never have gotten chronic obstructive
pulmonary disease in the first place.

Maybe this, maybe that– but the bottom line is that what happened
happened.  I was on the phone with someone who was put in
conditions that taxed his system from every end, and who, as a result,
had a heart attack.  I might’ve been on the phone with someone as
he died.  He showed up at my hospital, apparently with a pain in
his arm, and looking a bit blue in the face, and being even more softt
spoken than he usually is.

For the next 3 hours, staff and I scrambled not to get done what needed
done, like a good bunch of worker bees.  Mr. [X] is okay. 
He’s scared, but he’s out of the woods for the moment.

I’ve known people to die at the hospital before.  I’ve even been
to a eulogy for a patient, before the patient died– the patient wanted
to gather everyone he cared about for one last party in his palliative
care room, and he guaranteed on the invitations that he wouldn’t kick
off until he’d shaken each hand at least twice.  Him– he’s still

And I know that nobody lives for ever.  But Mr. [X] is a special
person who I know personally– when it’s personal, fuck
professionalism.  I’m no robot– I care.  And frankly, when I
left work, I switching on my MP3 player, and when the tune (that’s the
background for my Xanga) came up, I found that I couldn’t breathe, I
had to stop walking because I was choking on the air itself or
something.  I didn’t cry– and you should beleive me when i say
that I felt that I wanted to– I just felt something, through my whole
body.  In the same way that I would expect electricity to run
through a body as it is being electrocuted, that’s what it was like,
except the only thing coursing through my body was cement, and my lungs
were filling with lead.  I felt so heavy that I almost wanted to
just sit down on the sidewalk, and not just rest, but be consumed by it.

I didn’t get anyone killed today; Mr [X] is stable.  But how close
had we come?  No matter how insifnificant my part in all this–
this is a reminder of the true nature of our workplace.  This shit
is real.

While I was underwater in the YMCA pool, I let it all out.  I
screamed, I shouted, as hard as I wanted to– nobody would hear with my
head underwater.  I turned the poison in my mind into a secondary
concern by working my body to exhaustion, to give myself something else
to think about.  At least, that was the plan.  I couldn’t
quite shake the sensation of dread out.  When my body was
exhausted, barely able to make the 10 laps, and refusing to take any
more, I went to the sauna.  I spent 15 minutes in there, just
trying to focus on my breathing, to feel the sensation of it leaving my body with the sweat.  Then I went to the hot tub, and just soaked, not saying a thing, trying to drown it.

It felt good to have a shower after it all– as clean as a hospital is
when you’re careful, there’s still some sort of mental acknowledgement
when you go through the motions of an actual shower after working all
day.  I slept off most of the dark thoughts on the bus ride home,
though I had to suffer through most of it while I was on the metro
since it was too crowded to sit.

I had dinner with my folks, not contributing much to the dinner conversation.

It was only after dinner with the acoustic guitar that I broke the
silence.  I started strumming out random chords at first… and
finally, got into it.  I sat out on the balcony, under the setting
sun and the cool breeze– that same, slightly wet and cool breeze that
only half a day ago had nearly ended someone’s life. And without words,
I just kept playing– an hour later, I was able to breathe naturally

The sunshine was once again some symbol of hope, and not a death star
of heat and ruin.  The humidity was a nice smell, instead of a
weight in my lungs. 

The slience, the space between notes,  complemented the music, instead of being moments of  it.

I feel better now.