Stitches

Christopher Bryanhospital-1802680_1280-version-2

A fat drop of blood trickles down my leg and I worry it might drip on Irene’s floor-mats. Her car is much nicer than the others on the road and I hear that she is something of a “Kennedy” to Nicaragua. So I cup my hand below the cut on my shin and ask how far it is to the hospital.

“There’s a public hospital forty-five minutes away — we can try that. But the big hospital is in Managua. That’s two hours away. It will take much longer there to give you … uh … como se dice puntos?”

“Stitches,” I reply.

“Stitches?” she says with an accent.

“Yeah.”

“Okay. It will take longer to get you stiches in Managua. Are you okay with the public hospital?”

“Yeah, that sounds fine. Stitches aren’t that hard. It’s like sewing.”

“Sewing?”

“Never mind,” I tell her.

Irene has dyed-blonde hair, big sunglasses and is wearing suit pants. She is the director of our program and her English is very good, but specific words like “sewing” and “stitches” aren’t in her repertoire. We drive through the city, past stray dogs, wild horses, and old colonial homes painted in pastel colors with gated doors and low doorknobs. By Parque Central, there are horse drawn carriages, trees, fountains and statues. Vendors sell meat, peanuts, pastries, drinks, clothing, pottery, and cigarettes. Children run around, attempting to sell flowers, artistically folded palm leaves, whistles, and sunglasses, and a wrinkling-old man pushes a cart of ice cream, ringing a bicycle-bell for attention. As I look out the car window, donkeys drag carts, bicycles carry three people at a time, and the city feels more like an amusement ride for tourists than a place where people live.

This haphazard viewing is my first by daylight; I arrived the night before. So now, instead of walking through the streets, practicing my Spanish and tasting the local cuisine, I’m being chauffeured to the hospital in Irene’s Japanese SUV. I apologize repeatedly for being clumsy enough to trip and scrape my leg on the very first day, but she assures me, it’s fine — but I’m not so sure. The cut isn’t making me fear for my life, but it’s still the deepest I’ve ever gotten. We hit a bump in the road and another drop trickles down. A small puddle forms in my hand and I decide to stop trying to catch it. I wipe the blood on another part of my leg. Coagulating in my leg hairs, it looks much worse than before. More comes from the wound.

We get out of Granada, find some dirt roads, and the bleeding seems to slow down. Dust fills the air and metal shacks and shanties line the streets and backroads. People of all ages sit in plastic chairs by their doors, many shirtless. Some lie on the sidewalks outside their homes. The sun beats down, but the car has air-conditioning. Looking out, I catch glances from these people. They’re different from the tourist-appeasers in Granada. The more eye contact I make, the more dreadfully self-aware I become. I see a boy drinking water from a deformed plastic bottle with dirt and abrasions. I remind myself that parts of this country are fighting over clean water. Then I stop looking out the window.

Irene maneuvers around the natural speed bumps and avoids the car-totaling potholes, all the while asking me questions about my hometown. I tell her, “Well, my family is from Texas, but my parents moved to Washington DC, so that’s where I grew up.”

“Ohhh” she says with excitement. She likes the idea of Washington DC.

“Yeah, I love DC. But I have one brother in Philadelphia and I go to school in Ohio.”

We hit the highway after long and Irene asks me more questions about my brother, about girlfriends, about aunts, uncles and cousins. She’s curious about my family, and I get the impression that familia means something different here. Families in Granada sit together to eat lunch at home every day. Most businesses shut down for an hour; not everyone does it but most do. Retirement homes don’t exist here either, at least not for locals. Most places you pass have little old ladies living in them. I try to imagine my whole family getting together for a meal like they do, spanning three, sometimes four generations — it’d involve plane tickets, road trips, and a sufficient amount of topic avoidance.

I look down at the dried blood on my hand. Some of it has settled in the cracks of my skin, spreading across my cells like an infectious disease. I rub it but it won’t come off. I lean back and try to relax, try to forget that I am actively bleeding. Then we hit another bump and I feel a drop roll down my skin. This time it dribbles onto my sock.

“Estamos aqui,” Irene says as she pulls off the highway and onto another back road.

Her tires crunch over the gravel, throwing dirt on the back windshield. We park by the entrance and the only other car in attendance is an old ambulance. I open my door and the hot air pours in like smoke. Breathing suddenly feels like eating and I remember where we are. I brace myself for the tall step out of the car, putting my good leg down first, cautiously bringing the injured one after it. I start sweating and limping my way through the dirt. Irene notices my irregular walking and lets out a sympathetic sigh.

“We’ll see what it’s like. If they are busy, we’ll go to Managua.”

We reach the reception area outside the main building, which consists of one desk, a walkie-talkie, a clipboard, and a small girl with polished black hair. She couldn’t have been older than nineteen. She’s wearing a flowery T-shirt and white jeans. Irene takes off her sunglasses and leans on the desk with both hands. They start talking at a rate much faster than I’m accustomed to hearing, so I stand off-balanced about ten feet away and look around. The hospital is similar to the colonial homes in Granada. Concrete walls and large brown doors form a grassy enclosure. In the center, I see puddles with lizards and frogs. I see butterflies and mosquitos flying around palm trees and flower pots. I try to imagine an American hospital having a courtyard like this but all that comes to mind are sterilized linoleum tiles. Their conversation pauses for a moment and the receptionist peeks around Irene to look at my leg. Then she asks a question into the walkie-talkie.

Irene says to me, “They aren’t too busy. We should be able to get in.”

“Bueno,” I reply.

I’m relieved.

The walkie-talkie makes a noise and Irene leads me through the double doors to the ER. Two beds sit on the right with pale blue sheets, one doctor resides behind a desk of paperwork in the back, lots of male nurses are scattered around the room, and off to the left is a frail gurney with a white cover. Yellow curtains hang in the corners, ready to be drawn to divide up the room. I’m the only patient. Irene walks over to the doctor and begins to explain my injury, but a man in scrubs approaches me and gestures for me to get on the gurney. The doctor tells another man something from behind his desk and resumes his paperwork. The man in scrubs walks to the other side of the room, washes his hands, puts on gloves and gathers tools. Irene comes to my side and says, “They will take care of you.”

My attendant ventures back and forth across the room a few times, forgetting items as he goes. When he finally settles by my side, I see he has short black hair, a thin mustache and anxious eyes. He must be training. Using a syringe, he draws fluid out of a small vial.

“Voy a darle un anestético tópico. Dígale,” He says.

“Claro,” I tell him before Irene can translate.

“Entiendes?”

“Si. Está bien,” I tell him.

I use my left foot to steady my right foot and he injects the topical anesthetic around my cut. He goes to work and I see beads of sweat on his brow. I watch as he starts, noticing that he’s tying a knot for each stitch. The other men in scrubs come by to watch and comment. I decide to lie back and let them work, trying to put my mind somewhere else. I think of my study abroad group and my host family. I think of everything that was planned for the day. It’s not bad, I tell myself. Scars are fun and it’ll be a good story. Then the orderly mumbles curse words to himself and cuts out a fresh stitch. The man next to him told him he didn’t do it right and needs to replace it. I close my eyes and wait.

A minute passes and the walkie-talkie on the doctor’s desk begins to whisper distorted and gargled Spanish. My orderly stops mid-stitch, rests his tools against my leg and turns towards the doors. I raise my head to look around. All the attendants have turned to face the door and seem to have widened their stances, as if they’re waiting to catch something heavy. I look back to my orderly, and his eyes are significantly wider, spilling out more panic than before. The doctor stands up and I feel the room swell with anticipation. A gurney slams into the double doors, popping them open and setting off frantic movements about the room. The man is wheeled in beside me, about a foot and a half away. Without a moment to comprehend what’s happening, I see him on an identical white pad — head to head, foot to foot. His clothes remind me of the people lying on the sidewalks in the outskirts of the city. His left hand has long fingernails filled with dirt.

My orderly rushes to his side and checks his pulse. He puts both hands on his chest and begins compressions. The man bounces up and down off the gurney with each push. I take a moment to look at his face, and it reminds me of a fish I caught once — his eyes are grey, all the way through. He’s been dead for a while. Irene yells to me from the other side of the room, “Don’t look!” but I can’t pull myself from it.

The orderlies gather round and the doctor comes out from behind his desk to get a better look. Nurses rush to put on gloves and grab instruments; some preemptively bring gauze to help stop the non-existent bleeding, but the chest compressions begin to slow. The time between each push grows by milliseconds and everyone’s hands slowly drop to their sides – except my attendant. His hands come to a halt on the man’s chest. After a moment of silence, the words, “Ya … muerto,” dribble out of his mouth. He returns to his work station to take off his gloves and wash his hands again, and there’s a moment before they wheel the man away, when all of the nurses and attendants have turned around, and it’s just me and this man on gurneys beside each other. Something inside me wants to reach out and touch his arm.

Irene apologizes profusely about the dead man on the drive back and commends me on how still I stayed. I tell her it’s fine, that I’ve seen things like that before, even though I haven’t. We stop by the pharmacy in Granada to pick up antibiotics and she tells me to stay in the car. I try to relax but the heat thickens the air. Irene talks to the clerk for a few minutes and I feel the humidity getting worse. Sweat rises from my pores. I see the pharmacist disappear into the isles of medicine without any sense of haste.

“Sorry that took so long. He didn’t have the right antibiotic but he had another that should work. Here is some gauze and tape. He said you should let it breathe when you can, but put on a bandage at night and when you’re working with the kids.”

“Thanks. How much did it cost? Can I pay you back?”

No, no, no, no. Esta bien, no te preocupes.”

“¿Estás seguro?”      

“Si, si,” she said.

Gracias.

Irene drops me off back at Parque Central and I’m sad to see her drive away. You tend to know people intimately after going to the hospital with them. Particularly if you bleed in their car on the way. But now that I see the park, it feels more like an obstacle than a tourist attraction now. I make my way through the plaza, past a fountain, past children playing soccer, past the vendors and an outdoor restaurant, until a stray dog finds me. He undoubtedly wandered here hoping to get a piece of food, given or discarded. My pockets are empty so I reach down to pet him instead, but the moment my fingers reach underneath his thin, frail fur, they jerk back with disgust. Mange. Tics, fleas, and insects cover his skin like a plague. I rub my hands together, trying to scrub off whatever might have jumped from his fur to my hand, but he inches forward and looks up. A polite begging comes over his face, as if that were the first time a human has touched him — and it probably was. I want to pet him and take care of him but I’m afraid. By the look in his eyes, it seems that he knows.

“Yo!”

The noticeably loud and American “hello” comes from across the street in front of me. I look up and see Ryan, one of the other students on my trip.

“What’s up?” he says.

I forgot we were planning on hanging out and exploring the city.

“Hey, sorry I’m late. I had to go to the hospital.”

“Seriously? I didn’t think it was that bad. Did you get stitches?”

“I didn’t think so either, but when I took off the bandage, the cut opened up again and started bleeding worse than before.”

“Damn, how many did you get?”

“Nine.”

Damnnn. What was the hospital like?”

“It was fine. The guy did a good job.”

“Yeah, what was it like? Were there other people there?”

“Not many.”

“Was there only one doctor?

“Yeah, but a bunch of nurses and stuff.”

“See anything crazy?”

“I mean, kind of.”

For some reason, I don’t want to tell him. Ryan isn’t my best friend, in fact, I’ve only known him for a couple weeks and so far he hasn’t been my favorite person. One of the first times hanging out with him, he said he thought New Englanders were better people. Smarter, nicer, wealthier, and healthier people than the rest of the country. Judging by that conversation and his Boston Bruins T-shirt, I’m guessing he’s the type of person that spends every summer in Nantucket. Why he wanted to volunteer and learn Spanish in Nicaragua escapes me, but he’s been following me since day one so I figure I might as well tell him.

“What happened?”

“They wheeled in a dead guy.”

“What?”

“Yeah, right next to me.”

“Did he die there or was he already dead?”

“Already dead.”

“Shit.” Ryan looks down at the ground and reaches in his pocket, grabbing a pack of cigarettes. With more curiosity than disbelief, he says “Seriously?” and offers me one.

““Yeah, my guy was mid-stitch when he came in. They tried CPR but he was gone.”

I take the cigarette.

“Who was the guy?” he asked.

“I don’t know, they put a sheet over him and wrote Juan Perez on it.”

“Juan Perez?”

“It’s the Spanish version of John Doe.”

“Oh — what did he look like?”

“I don’t know, older, dark hair. Why?”

“I might have seen that guy.”

“What?”

For some reason I feel defensive. An itch rises beneath my skin, blood pumps through me, and I feel my leg throb. There’s no way he could have seen him.

“Yeah,” he replied.

“What are you talking about?”

“After we all got back, Abbey and I walked together to find our houses. You know, we live next to each other.”

I nod.

“So yeah, we decided to cut through the market and go around the city ‘cause it’d be faster, but we got a little lost. Then on this one street, we see this guy on the sidewalk, just lying there.”

“I mean I’ve seen a bunch of people lying on the sidewalk. They were fine. That doesn’t mean anything.”

“But he was lying face down,” he says, “like in the gutter.”

I’m not sure if Ryan is making up a bullshit story to try and impress me, but the fact that Abbey was there as well makes me think it’s true. I remember the man’s eyes. His was skin losing pigment already.

“What did he look like?”

“Dark hair, older. I didn’t see his face.”

“What was he wearing?”

“Brown pants and a dark shirt? Maybe blue? Real raggedy.”

I rub the back of my head.

“You might be right.”

The stray dog walks up to us, but we keep talking.

“You guys just walked by him?”

“Yeah, we kind of had to step around him. He was on our side of the street. Abbey and I both thought he was dead.”

“That’s unbelievable. … You saw him?”

“Yeah.”

“Shit.”

We smoke our cigarettes. In my head, I think Ryan’s an asshole. How could he have just stepped over this guy and kept walking? How could he not have at least checked on him, maybe gave him some water if he was still alive, or told someone nearby … but then I realize I don’t know the Nicaraguan version of 911. Or who I would have gone to, or what I would have said. I imagine myself walking up to someone, telling them there’s a dead man in the street and them ignoring me —somehow that seems worse than stepping over him. My cut itches and I look down at the bandage.

“Can I see it?” Ryan asks.

I peel the bandage off and the rush of cool air feels good. We look at it. The dark blue stitches protrude through the antibiotic gel. I rub the skin around it, lightly touching the stitches themselves. The topical anesthetic is still working. I think about how easy it would be to rip them out.

“Well, do you want to get a beer?

“Yeah, sure,” I tell him.

And we walk to the most American bar in the city, leaving the emaciated dog in the street.

 

Christopher Bryan is a writer, editor, photographer, and researcher based in Washington DC. He likes punk music, horror movies, and Don DeLillo. His work has been described as “gritty” and “visceral” with moments of “dark, philosophical tangles.”