Intern Year

By Kristin LaFollette

On weekday mornings, we went to the classrooms behind the optometrist's office. The first months were spent in the practice rooms, instructor leaning against the wall with a clipboard, mannequins lying open-mouthed on the gurneys with the rose-colored sheets. In my gentlest voice, I asked for each patient’s history, carefully examined the bodies, collected basins of warm water & soap for the bed baths. With a sponge, I scrubbed the vinyl skins in a circular motion, rolled the mannequins to either side to pull the dirty sheets from the mattresses. During the CPR exam, a paramedic showed us how to perform precordial thump, force delivered fist to sternum, and I understood the order of things, the way I am truly myself with blood on the hands— This can only be described as flowerets in cardiac muscle, tension that is both desperate and intoxicating, bones unearthed and reassembled— --- Later, during a hospital rotation, a woman’s heart arrested & I felt it deep in my jaws and behind the eyes— A quickness, pressure in the ventricle, an ounce of zinc, an ounce of zinc.

After the accident, my mother and I drove to the hospital in the family van. On our way, she thrust her wallet into my hands, asked me to call the number on the back of the insurance card, to call my uncle and brother and grandmother— We passed my grandfather’s green Mountaineer on the way, the young boy’s head just visible over the seat & when we all met outside the parking garage, the boy told us about the fall, about the helicopter in the trees, about the officer who found him sitting alone in the grass— As our people gathered in the waiting room—my aunts and uncles, cousin, grandparents, best friend— we saw my father in the trauma bay and, while we talked with the neurosurgeon by the lightboxes, I thought only of his body, earth-rinsed, ecchymosis & hematoma expanding and leaking into pond and stream, fibrin rising to the surface to protect and seal the wounds— Later, I remembered my own training in first aid and advanced cardiac life support, recalled the steps, threaded my own body with enough vitamin K and calcium to share, enough to pass between us all.

The boy was 9. I was home with my mother when the officer called, but the boy was there, witnessed the impact and the blood, ran and ran & then waited— Here’s the thing: I didn’t ask for the details because I didn’t want to remind him, to conjure those moments and have them take hold like little fevers that could permeate both thalamus and thorax. I was the older one, I was the sister, & so I pressed our vertebrae together, collected interferon and stem cell for the threats I couldn’t see— In time, a social worker at the hospital asked the boy questions about the incident, wanted him to name what happened & sketch it out on a blank sheet of paper when he didn’t know the words— As we sat in the social worker’s office, my mother cried and the boy and I could only think of shielding her, of protecting her, of giving her flower and balm. The social worker said: It’s okay for her to cry It’s okay, it’s okay But the talking didn’t feel therapeutic and I kept wondering what would happen to the boy if our father didn’t wake up, or if he did wake up and wasn’t the same. I was 17, not quite an adult, my bones still warm like the unskinned body of a deer—

This is where I became caregiver and patient. In a field of chalk & grass, my bones became disconnected, a cycle of edema and heat deep in the soft parts of me— My fingers were still orange the day I returned to the hospital for work, a paramedic asking how I could push a gurney or collect seizure pads from the closet with all the plaster and wrap. With my arm just out of the sling, my skin was heavy, collection of extracellular fluid and betadine & I could only hold the heaviness above my heart as I navigated the emergency department, in and out of rooms to see patients with fever and pelvic fracture— At the nurses’ station, I was handed a bucket filled with fresh sponges and rags. I smelled the blood before I entered the room, bottomland of clots and formed elements, earth and pavement after it rains. Underneath my elastic bandage was new wound, a susceptibility as ingrained as the rod and plate and screws that would later be fixated in the bone—

The injury actually happened months before In the aftermath, I covered the hand and wrist in cold cloth, pulled the dislocations and damaged tissues together with floss and paper tape The doctor noted the necessity of new material, of a graft harvested & transferred to rootstock as living blood We tried therapy first, to step between the rows without crushing stem and leaf, the small fragments arranged like faulty dental work: inflammation in the sockets, breakdown of bone, tooth bolted in place by adjoining tooth

Occupational therapy is for women with an abundance of red cells, B antigens in the blood, skin abundant in hotness and morning water. Before his accident, my father often came along to the appointments, sat next to me as I arranged colored pegs or moved clothespins around on a wooden board— After the accident, I stopped going but tried to continue the exercises, to continue using the red and blue pieces of foam that made pens and forks fit in my hand, thumb & fingers held steady by adhesion and excess fluid— I watched my father go through his own rehabilitation, framework fractured in the lumbar spine, at C6, in the flat bones of the face and skull. The reformation of collagen fiber and inorganic salts was lengthy and I often got the boy ready for school while our mother was at the hospital, waited for him in the pickup line while doing math homework and memorizing anatomy flashcards, preparing myself for the rotations, possibility of blood, of trouble or dysfunction. Rehabilitation is for men without inhibition, so we collected the car keys in a basket and locked them in the safe in the basement and when he finally came home he could only sleep & sleep and so we let him— My surgery happened just before Christmas, two weeks before the start of clinicals, layer upon layer of antiseptic and gauze. The incision was still wet & soft the day the cast came off, black and purple marker and suture marking clear trails in the skin, anchor linking tendon and bone. A therapist dipped a piece of white plastic in hot water & wrapped it around the arm, gently bent it into shape. Splints are for women who must continue tending to the needs of others & so I took the vitals, dragged the bloody linens to the laundry, pulled supplies from the closet, cared for the boy, held the arm higher and higher above my heart—

This is a reorganization, an assembly. You’ve heard about the accidents. 1: When the swelling overcame me, I tucked the arm into my chest, sheltered it behind breastbone and intercostal space, felt it fill with water until a surgeon relieved the pressure, lines drawn in purple and black marker to indicate the boundaries, to insure the right arm was placed under nerve block & washed, sewn, immobilized— 2: The other involved the ventilator & the scans showing the careful pooling of blood. I could easily recognize the edema in my father because of the expanding of my own skin, my arm still elevated, still patched into safety. When he woke up after several days, he didn’t know me, was only able to recall the young boy’s face and his own birthdate— -- I prayed for all our parts to realign, for dissipation of gathered blood, for the forging of compact bone and red marrow— What I knew but tried to ignore: The unpredictability of the body, complexity of cranial and spinal fracture, underlying softness & the brewing of new trauma from the old.

About the Author

Kristin LaFollette is a professor at the University of Southern Indiana where she teaches courses on writing, rhetoric, and gender/sexuality studies. In addition to her role as a teacher and scholar, Dr. LaFollette is a poet and essayist. She is the author of Hematology (winner of the 2021 Harbor Editions Laureate Prize), a collection of poetry about the body, blood, family connections, and identity. Click here to learn more.