CODE 21
The microwave rings, and I dash across the seventh-floor lounge in a few jaunty strides. When I pull off the lid of my Tupperware, steam from leftovers of the meal my mom made last Sunday carries an aroma wild with savory bliss. I close my eyes and inhale. It’s Friday and most of my thirty-minute breaktime lies ahead of me. The injera inside the bowl is spongier than it should be. When my mom made it from scratch, it was as supple as uncooked pizza crust she might have tossed into the air. No matter. I mash it with a plastic fork as I stare out at the vista of treetops and the last of the evening’s sun.
“Attention, attention: Code 21 seventh floor.”
It’s Virginia, the ward’s evening administrative assistant. Her voice is weak and breaks a few times on the hard consonants. But she repeats with emphasis, “Attention: Code 21 seventh floor.”
There’s a full second of tinny feedback from the hospital’s P.A. system before the speakers go dead. A Code 21 means a patient is violently agitated. Against the panels of windows in the lounge my reflection mouths an unbecoming curse.
Staff are supposed to rally to “encourage” the patient to calm down through soft words and the strength of numbers, which usually works. But on the occasions when this isn’t encouragement enough, it becomes unpleasant. Staff must wrestle the patient onto a stretch board and apply restraints. Sometimes this requires six or seven staff, one for every limb and two or three for the torso and head and to secure the wrist and ankle locks.
My grad-school texts mentioned the need for physical touch might include an occasional hug without any references to sleeper holds or defensive grappling, nor the possibility I might be “touched” back. Faces have been spit upon, eyes gouged, fingers bitten, teeth kicked out, genitals yanked, ribs cracked, and femurs broken. One poor soul’s skull was fractured. I’ve never been in a fistfight before.
The HR policy clearly states that staff doesn’t have to respond while on break. And, I’m giddy with the desire not to. The mashed injera in my bowl has become a mouthwatering orange from soaking up the doro wat, the spicy chicken stew my mom makes when there’s a special occasion. You see, the leftovers are from the going-away meal she made us for her return to Ethiopia last Sunday.
I could sit back down and eat it in peace if Virginia’s voice weren’t still ringing in my ears. When I first started my externship at the hospital, I dropped whatever I was doing and ran, breaktime or not. I was intoxicated by the notion that I could help people overcome their problems through the sheer power of words. But people seldom get better, no matter how much I talk to them or how hard I work. Never is this clearer than when we tie them down and pump them full of drugs.
I go back to my seat, despite my misgivings, and eat the leftovers anyway. The urgency recedes a little after my first bites. Freshly cooked doro wat is rich and tangy from berbere red chili paste, onions, garlic, and ginger. It caresses your tongue, like a runny risotto. The days-old doro wat in my bowl has the clumpy consistency of chow mein sauce without the noodles. But it’s even richer for its thickness.
The taste recalls the image of my mom on Sunday, hovering over me as I sat and chewed. She watched as I swallowed. She smiled only when she saw me smile. Her food said “I love you” in a way that bypassed the need for words. It was how she said goodbye to me. The visit gave us a couple of weeks together, after years apart. I have no idea when I’ll see her again. The leftovers in the Tupperware are all that remains.
“Haile?” Christie’s voice snaps me back down to earth.
She’s pronounced my name “Hail-ee,” like the comet, and not “Hi-lay,” like my namesake, legendary Ethiopian emperor, Haile Selassie. How I’ve wished it were some run-of-the-mill name. No American would trip up on Jack or Bob.
Christie stands in the entrance to the lounge. Dusk has fallen. Her mussed-up hair and wide rounded shoulders are cast in silhouette against the light from the hallway. She is one of the patients assigned to my care for the shift. My plan was to hide away to finish the last of the leftovers while everyone else was down the hall for evening group session.
“Hey, Christie,” I say, my voice ringing low somewhere deep in my throat, from thwarted hunger, although it’s more than that. The very sound of her breath, rasping loud and through her mouth, sets me on edge. The P.A. system can be heard in most places on the unit, even in a closed bathroom stall. It may be my breaktime, but her presence suggests how flimsy my justification for not responding could seem.
I look back at the Tupperware and my fork. “Aren’t you supposed to be in group right now?”
“No one’s there.”
“Well, just go sit around a while. People will show up eventually.”
“No one’s coming.” She is somewhere nearer to my shoulder than I’m comfortable with, but I can’t bring myself to turn toward her.
She steps closer. Her breath rattles through my ears like a tornado. “Lonnie will be there,” I lie. “Just go back and wait.”
“No, she won’t.”
“Sure, she will.”
“Haile!” Christie grabs my shoulder.
The Tupperware flies from my hands and bounces against the floor. Sauce from the mash spatters against the carpet and leaves a reddish-orange wake. The carpet is white, which is a ridiculous color for a lounge. A few pieces of the mash soil my loafers and the bottoms of my khakis.
Christie hasn’t noticed at all. She points down the hallway in the opposite direction of the mess toward the front desk. Her finger stabs the air. Her pudgy cheeks have pockets of flesh that go ruddy along the cheekbones, like a schoolgirl’s, although she’s fifty years old. Her skin is almost wrinkle free. Her IQ is seventy-eight, which leaves her on the borderline between normal and slow.
I groan as I drop down from the chair to kneel on the carpet. My hands splay over the chunks of mash in a pathetic effort to salvage some of the meal. It’s as if my mom is spattered there. A memory comes back from when I picked her up from the airport on the first day of her visit.
She looked the same as when she left years ago—short and hunched from a series of jobs, bending to clean floors or shivering in tiny booths in parking lots, earning the money to send her son through school to live the American Dream. But her voice carried a staccato that twenty years of living in America never softened, regardless of her accent’s thickness, which only grew thicker during her time away. It was so dense that I told her to stop talking. I had to sit her down on a bench near the automatic doors and ask her to repeat herself.
She spoke again, slower so I could follow. She told me I looked like a giraffe. She speculated it was because I wouldn’t cook anything that didn’t come in a box. She scolded me for not having found an American bride to cook for me. She complained this country makes everyone crazy, before catching herself. She recalled I worked on a psych ward. She smiled and winked. She said the craziness was contagious. Maybe I should come back with her to Addis Ababa. She asked again why not, even though she knows the answer.
It’s a non-starter for me. We emigrated after a famine in the 90s claimed my father’s life. She and I spent more than a year in a refugee camp across the border. But I have no memories of him or any of it. I was only a toddler. She’s insisted life is better there now, and it could be. But it’s still a foreign country to me. I don’t even know the current prime minister’s name. My Amharic is so bad she refuses to address me in any language but English. I’d feel no more at home in Ethiopia than a non-Ethiopian.
She laughed as I opened my mouth to protest. “We must face it, you are no longer my little boy, Haile.” She would’ve patted me on the cheek if I were sitting closer to her. “You are an American.”
I let the chunks of doro wat mash I scooped up from the lounge’s floor fall through my hands. Salvaging them is useless. I glare up at Christie. I spent months driving Uber and saving to pay for my mom’s discount round-trip ticket from Addis Ababa, and now the last of the meal is spoiled. I try to imagine the sensations of ocean waves and rivers, of calmness learned from training manuals. When this fails, I close my eyes and simply clear my throat.
Christie turns around and, when she sees the mess, her hands go to her mouth. “I didn’t mean to…”
She stares at me with giant bug eyes. A dollop of snot is at the corner of a nostril. Her head bows with a deference so disarming there’s no use chastising her. She has no contact with family, no friends. This is her third admission this year. I shouldn’t have become so angry. She couldn’t possibly understand what I’m going through. Besides, no amount of doro wat is going to bring my mom back.
I avert my gaze, ashamed by my anger. “Don’t worry about it, Christie.”
She points down the hallway again, a waft of the berbere sauce lingering in the air between us. “They need you back there.”
Her insistence chills me. “Was Lonnie asking for me?”
“They were scared of Kurt.”
“What did Kurt do?”
Kurt is six foot three and at least two hundred pounds. When he takes his Risperdal twice a day, he manages to hold down short-term temp jobs on construction sites. If he doesn’t, he hears his brother calling him names or his father berating him for failing to take out the trash forty years ago, and he ends up back on the ward.
“They dragged him out of my room,” Christie says. “I tried to stop them.”
Her nostrils flare and her fingers tighten into fists. She’s going through her own crisis.
I rise from the carpet with apprehension for what Kurt might’ve done. I mumble something about needing to go up front to investigate and nod to assure her things will be okay, whether or not they will be. I backpedal away, turn, and hurry down the hallway, leaving her and the mess behind.
Over a breakfast of spicy genfo porridge one morning during my mom’s visit, I’d griped that the patients’ problems are endless, even if the problems are “just in their heads.” She thought of my career prospects and said not to worry, in her practical, Ethiopian way. “With all these problems, you got a job for life!”
The hallway keeps on going until it ends at the locked entrance to the ward. I veer away from it and, instead, follow the more trampled path to the front desk. I come to a stop when I don’t see anyone.
“Look what the cat dragged in.”
It’s Virginia’s voice coming from inside the nurse’s station. She scoots out on her swivel chair, clutching a mound of paperwork to her lap. Her bifocals hang from a chain against her collarbone. Her gray hair is tinted an old-lady shade of blue.
“Is the Code 21 over?” I ask.
“Not for me,” she says. She slams the paperwork onto the desk. “My excitement has just begun.”
“I was busy calming Christie down.”
She nods towards my clothes. “Looks like you she made you work for it.”
“Is that Haile?” comes Lonnie’s voice from somewhere back inside the nurse’s station. Its steeliness carries the authority of her position as the ward’s lead nurse. She also reports to my externship supervisor.
Virginia covers a giggle as I step around her and face Lonnie, who stands at the rear end of the station and stares through a wall of plexiglass at the four rooms in the back unit. It’s where we put the patients deemed a harm to themselves or others. Light from the perpetually running TV illuminates the padded, vinyl sofa and the rest of the cramped commons area. The doors to the first three rooms are open. Room four’s door is closed.
Lonnie looks up and glowers as I approach. Her long blond hair frames a face that might seem young if it weren’t for the dark rings around her eyes, probably from never turning down a double shift. My regard for the intensity of her work ethic runs the gamut from admiration to aversion and, in the mood I’m in tonight, bewilderment. I don’t know how she runs that hard when so many patients never get better.
“I’m sorry, Lonnie,” I say. “But I was on break.”
“This is a hospital. You leave your break behind when there’s an emergency.”
The employee manual would say otherwise. But there’s no use arguing that point with her. “Okay, in retrospect, I probably should have—”
“—no, not ‘probably.’” She breaks eye contact to look me up and down. “What happened to you?”
My hands go to my shirt and leave a stain to join several others from the doro wat mash. I forgot to wash up in my haste.
She tilts her head akimbo. “That’s not somebody’s blood, is it?”
“No, it’s spaghetti sauce,” I lie.
“While we were handling things back here you were eating spaghetti?”
We lock eyes for a moment.
Hers are blue and bloodshot. Her bottom lids tighten. She’s a head shorter than I am, and maybe ten years older, but her gaze locks onto me and tugs as if she were grabbing my shirt.
I tense up, ready to shout back, or to cry, if she says another word. I could burst with frustration for how upside down this shift has turned.
Lonnie sees something wound tight in me and presses her lips into a smile before shaking her head and returning to the bank of room monitors on the wall. Room four’s monitors show opposing angles of a man lying on his back on a stretch board. A band of gauze covers his nose. It could be almost any man but for the buzz cut and receding hairline, which unmistakably belong to Kurt.
“We’re short-staffed tonight, Haile.” Lonnie starts in again. “If a couple of orderlies from Geriatric didn’t run up here…”
“I already said I was sorry.”
“Sorry doesn’t cut it.” She turns again. “We had trouble wrestling Kurt down. One of the orderlies needs stiches. The other one had to drag Kurt away, but Kurt’s nose got broken in the process.”
“That’s horrible.” The news bends my gaze to my shoes.
I should’ve been shoulder to shoulder with the orderlies helping restrain Kurt. Maybe my presence would’ve prevented the Code 21 from getting too physical. Or maybe not. In the state I’m in, I could’ve been the one to break Kurt’s nose, and then I’d be more ashamed than I am now.
“I’m going to need you to go in there with him soon.” Lonnie picks up a hypodermic needle and a vial. She glances back to me and says, “Not now, though. You stay put.”
Then, she exits the nurse’s station and enters room four. She walks inside as casually as if the room were empty. The tragedy and horror of it all drips right off her. When Kurt wakes up, no matter what she or I or anyone does for him, he will eventually gripe about how we don’t let him smoke cigarettes or drink alcohol or pursue all the other self-destructive habits that accompany his schizophrenia. He’s strong enough to break his restraints. The whole cycle will play out again and again, whether we restrain him or burn countless hours at his bedside.
Virginia rises out of her chair and waddles in through the entranceway. She grabs a stack of Code 21 report forms and begins stamping Kurt’s ID number onto them.
I use the opportunity to step away from the monitors. Kurt’s chart lies open on the front desk. He admitted himself to the ward voluntarily earlier in the week so his doctor could stabilize his meds. I flip through the pages and guess that Dr. Keyes has prescribed Halcion or double doses of Ativan, drugs that will keep him knocked out. The prescriptions are there, and also something unexpected.
“All this is because of Christie?” I ask Virginia as I look up from the chart.
“No, it’s about Dr. Keyes putting him on a seventy-two-hour hold, and the weekend doesn’t count,” Virginia says, walking away from the stack of forms so she can lower her voice. “Given it’s Friday, he won’t be leaving until Wednesday night.”
“Christie didn’t mention anything.” Not that we had much of a discussion. I should’ve asked her.
“You know how he is, Haile.” Virginia sits down next to me. “Cussing. Pacing the hallway. He’s a talker, that Kurt.”
“Voices again?”
“He’s been cheeking his meds.” She rolls her eyes.
“But it says here Keyes thinks it’s more than that.” I point to the most recent doctor’s note in Kurt’s chart. “It says Kurt’s in ‘love’ with Christie?”
“Well, he found Christie with her hands held out, and Kurt was kissing them, crying about how much he ‘loved’ her.”
This could explain why Christie was so upset she spilled my doro wat, although I have trouble believing she’d think Kurt loved her. Then again, she’s quick to warm up to people, whether or not they respond.
“So, Keyes put him in lockdown just for being in love?”
Virginia leans toward me and whispers, “Kurt told Keyes to get the F out of here, lifted up a chair, and threw it. Keyes didn’t waste any time. Walked out of the room and rattled off orders faster than I could pull out a pen. Before I knew it, he was on the phone to Pharmacy to mix up a nice little cocktail.”
The nurse’s station door opens, and Lonnie streaks back through and asks to speak to me alone. Virginia mimics zipping her lips shut before she moves out of the nurse’s station with her stamped Code 21 forms. My eyes follow as she leaves.
Loathing for what’s coming next triples my weight. I can barely keep up with Lonnie as she leads me out the other way to a tiny meeting room. Inside, it’s dark and reeks of air freshener. An oblong plastic table separates her from me. The air-conditioned metal from the foldout chair is like ice.
I meet Lonnie’s scowl and wait for her to say something.
“You let us down, Haile,” she finally says. “We needed you back there.”
She’s looking for an explanation from me. She deserves one, too. All I can mutter is a wimpy “I’m sorry.”
“There were injuries,” she goes on. “Management’s going to need a full report. Maybe an investigation.”
An investigation? I open my mouth to say anything that might sound more investigation-proof than being off the clock because it was breaktime, but nothing comes out. I can’t meet her eyes anymore.
Her scowl relaxes a bit. “Haile, you don’t seem like yourself. Talk to me. Tell me what’s going on.”
I flash her the smile, the open-lipped one that reveals a glint of white teeth but softens up the edges of my cheekbones, shrinks the bigness and wideness of my eyes into something more cute and cuddly. I’m told it makes professors and teachers, sweethearts and childhood friends, do me favors just so they can see it. It comes to my lips reflexively and deflects questions I don’t want to answer, like where I “come from” or what my “nationality” is or why I “don’t have a father.”
But Lonnie sees it as a distraction to avoid giving her an excuse, and in a way it is. “This is a unit full of people overcome by their problems. You are not serving them when you can’t get a handle on your own.”
I nod. I know she’s right. This whole shift I’ve been working with my patients, but all I see are memories of my mother and the distance between us. One of my professors says it’s like when you’re on a plane and they tell you to secure your own oxygen mask before securing someone else’s. But my problems aren’t as easily solved as strapping on a mask. Instead, it would be like chopping off an a
I shake my head. All the solutions I’ve found have fallen away eventually, like scabs. A half hour ago, the choice not to respond to the Code 21was between the last of my mom’s food and everything I’ve hated about this externship. But there’s the emptiness of a bigger loss the size of the gulf that separates me from my mom, a connection that’s in my DNA but seems utterly foreign to me.
I slide the chair with the backs of my thighs as I stand up. I reach into a closet and grab my backpack.
“What?” Lonnie reaches across the table. Lonnie shakes her head rm.
“What if there’s no working out my problems?” I ask.
“Haile.” Lonnie looks down into her lap before she begins to answer. “There are ways to cope with our problems as we search for the solutions.”
and leans in, as if she didn’t hear me. “Where are you going?”
“Home. I don’t belong here.”
“Don’t do this. Let’s talk it out.”
She might want to help—and the offer softens me up, makes me wish I’d seen this side of her sooner. “I know you mean well, Lonnie. Really.”
Whatever else she says bounces off my back as I open the door and leave the room. It’s more like the room leaves and I’m drifting in its wake. There will probably be consequences. I could turn around, talk things out, pretend she helped me. Blame everything on having a bad day. Maybe it would be excuse enough to avoid the worst. After this externship, there’s only my thesis and its defense. Then graduation and two years of residency.
But it seems meaningless now, all the research and the papers, the years of endless education. My dorm room walls are crowded with quotes from Carl Rogers and Maslow, pictures of Erikson, Freud, Jung. All those dazzling box-and-arrow diagrams of cognitive theory. I’m going to go home and tear it all down. There are problems in life that no studying, no talk therapy or medications can solve.
Instead of heading down the hallway toward the exit to the unit, however, I turn back the other way toward Christie and the mess I’ve left in the patients’ lounge. I’m curious. It’s dark inside when I walk in.
“Christie, are you in here?”
“Haile?” She sits up from the carpet, where she seems to have been sitting since I left.
“Do you mind if I join you?” I move to flip on a light switch, but she waves me off.
As I move closer, I see she’s tried to clean up. But she’s scrubbed the doro wat mash into a smear. Crumpled towels with a red-orange tint lie to one side of her in a heap. To the other side lie chunks of mash in another heap she’s unwittingly placed on an untouched section of carpet.
There’s no cleaning this up.
Some twilight is still left in the sky. She is staring wide-eyed out the windows. “Pretty,” she whispers.
“Yeah, it is.”
I sit down on the bench of an out-of-tune piano adjacent to where Christie sits, but I’m not facing her. I don’t want to threaten her by being too close. I set the backpack down. “I’m glad to see this day end.”
“Me, too.”
“I heard about what happened with Kurt earlier,” I say, after a while.
“It was the doctor’s fault.”
I think of the note in her chart. “Why did Dr. Keyes come into the room while Kurt was with you?”
She folds her arms. “Because Kurt was hiding from him.”
“Keyes said it was because Kurt had been touching you.”
“Kurt said he loves me.”
“Do you believe him?”
She shakes her head.
I was expecting her to think he did love her. I’m chagrined to see I’ve underestimated her. It makes me curious about what else I’m not seeing.
“Why do you think he told you that?” I ask.
“He wants me to love him.”
“Do you?”
“No.”
“But you weren’t upset about him kissing your hands?”
“Doesn’t mean I love him.”
“I didn’t say that.”
“It’s pretend.” She lifts her hands, palms facing her.
We both stare at them. They start to tremble.
“He believed these hands could love him.” She pounds her chest with them. “My hands. My hands!”
She sucks down a breath.
I hold mine tight. “It’s okay, Christie.”
“No, it’s not.”
She is looking for me to say something, but I can’t figure out what. My mind is scrambling. Her hands are still in the air in front of her, moving quickly up and down with her breath. She pulls them to her mouth and rocks back and forth.
“He was so scared.” She is whispering.
“Scared of what?”
“Of losing the voices.” Her glazed eyes look out through the windows at the lights from the freeway. One or two stars are emerging. “He doesn’t hear them when he’s on medicine.” She pronounces medicine as a two-syllable word.
“But the voices are supposed to go away, Christie. They’re not real. They’re in his head.”
“What’ll he do without them?”
“He’ll get better, be normal.”
“He’ll be all alone!”
She is challenging me to say something comforting. But I resist. The moment brings to mind the flatness of weekends during the first months after my mom left America a few years ago. I would spend mornings in my kitchen drinking coffee with one random girlfriend or another, passing the time with small talk until she left, disappointed that not even the most intimate connection with someone else could make things all better.
I wish I could make it all better for Christie or for Kurt, but some things can’t be fixed. They can only be accepted. I sit there with this.
There’s a crackle as I hear Christie’s weight shift onto her legs. She sighs as she stands up. A whiff of armpit odor reaches my nose, but it doesn’t keep me from facing her. I get up, too, and move to stand beside her, watching our reflections in the window—our skin, our differences, the stillness—as the minutes pass between us like rain.
Paul Bachleitner is a creative writer of multiracial, Ethiopian American descent who lives in St. Paul, Minnesota. His short story “Old Man Austin” reached the final ten of the Nelsen Algren awards. Other pieces appeared in online publications for the 92nd Street Y in New York City and the Loft in Minneapolis. He is a recent alum of the Kenyon Review Writers Workshop. A graduate of Harvard University, he works as a communications director for a nonprofit institution. He spends his free time with his wife and child, delighting in film and video reviews, and enjoying the outdoors, as long as there’s electricity and running water to return home to.