No one in the big emergency clinic understood a word the old man was saying. They just knew he’d wandered in off the street in distress and collapsed before he could get to the reception desk.
A nurse, tech and Physicians Assistant rushed out into reception with a wheelchair and carefully placed the old man in it after checking his head and spine for injury.
“Let’s get him into Treatment 4,” Maggie Hennessy, the PA, said with the firm and confident voice of someone who’d worked at this East Side neighborhood clinic for five years. She’d seen it all, from overdoses to obstetrics, gunshot wounds to ears stuffed with gummy bears.
“Quick get me some vitals. Sir? Sir? Can you hear me? My name’s Maggie and your in the East 23rd Street Clinic. Can you tell what your problem is?” she said.
The old man rolled his head side to side and moaned, attempting to form words but all that came out was an unintelligible slurring in an accent no one understood. Hennessy leaned down so she could hear him, but said, “I’ve no idea what he’s saying. Sounds like an eastern European language, maybe?”
Nurse Angela Mezzanote asked, “Do we have anyone on staff who might know what he’s saying. It sounds something like Russian, but I’m not sure.”
“What about Joey Markov in maintenance? Isn’t he Russian or something?” Bret Nelson, the tech, said.
“Page him or fetch him, would you Bret? This guy’s looking pretty bad and I’d love to have a translator to help me make a damn diagnosis,” PA Hennessy said.
Within three minutes, Josip Markov rolled his maintenance cart up to Treatment 4.
“You need cleanup?” He asked Hennessy.
“No, Joey. I need you to help me diagnose what’s wrong with this guy if you can. I don’t even know if I can give him a sedative if I can’t communicate with him. Do you understand anything he’s saying? Is that Russian?”
Markov moved closer to the gurney and looked down on the sick man.
“What do you need to know?” He asked the PA.
“His name would be a good place to start, I guess.”
In Russian, Markov asked the man his name.
“Śeśpĕl Praski,” the old man whispered through clenched teeth. Markov moved closer, eying the old man as if he was the physician instead of a mop jockey.
“Good, now we’re getting somewhere. Translate for me, please, Joey. Mr. Praski, can you tell me what’s wrong?” Hennessy said.
“His name’s Mr. Śeśpĕl. He’s Chuvash, not Russian.” Markov said.
“Do you speak Chuvash, Joey?”
“Yep. It’s my native language.”
“Thank goodness. Would you ask him that question in Chuvashian?”
“Chuvash. Sure.” Markov said, and translated the basic questions Hennessy fed him and Śeśpĕl’s replies. He got closer and closer to Śeśpĕl with each question until his mouth was right up to the afflicted man’s ear. He kept speaking to Śeśpĕl and Śeśpĕl would reply, each time with more agitation and pain.
“He says he’s a hemophiliac and believes he’s bleeding in his gut.”
“Get me some bloods on this guy, STAT. He is showing symptoms of bleeding. Man, his spleen is frigging huge,” Hennessy said as she palpated Śeśpĕl’s abdomen. “And he’s got some nasty bruising on his ribs.”
“We’ve got a lead in, Maggie,” Nurse Mezzanote said. “Blood pressure 80 over 40, heart rate 134, respirations are 22. I think he’s gonna crash.”
“Shit. Okay, let’s slow push one milligram IV of TXA and see if we can get his bleeding under control. Call up to OR and let them know we’ve got bleeder down here on his way up.”
Śeśpĕl’s eyes frantically looked around the room until Markov one again whispered in his ear. Then he focused intently on the maintenance man, who smiled and said in Chuvash, “Epĕ Josip Markov jatlă. I’m Josip Markov. I know who you are, who your father was, what he did to my family in 1940. How he forced them to leave our home and move to that frozen hell in Karelia, just to be a human shield between his Muscovite masters and the Finns. My grandmother died on that trip. Our women were degraded by our own soldiers. My great uncle killed himself in despair. I know what your father did. Did you like growing up in our home? Oh, I see your time’s up. Tav sire! Good health to you, asshole.”
Śeśpĕl tried to speak, but he couldn’t. The stroke was instantaneous and massive. The clotting agent Hennessy had administered for internal bleeding was the worst thing she could have given someone with Chuvash Polycythemia. The condition made his body produce too many red blood cells, thickening his blood, slowing its flow, which alone could lead to a heart attack or stroke at his age. Markov was counting on the clotting agent to seal the deal.
“Out of the way, Joey,” Hennessy yelled. But it was too late. Śeśpĕl expired before the ER team could do anything to help.
“Okay, guys, let’s call it. Time of death, 14:20. Sorry we couldn’t help your old countryman, Joey,” Hennessy said.
But Dr. Josip Martinovich Markov, who was a physician back in Tsivilsk before his breakdown and immigration to America, was already pushing his maintenance cart toward the service elevator. He recognized the symptoms and the man from his name and the questions he’d asked.
“I’ve done my job today. I’ll let Julio or Brandon clean out the trash,” Markov said to himself with a satisfied grin. He pushed the elevator button marked B. The doors swished closed in front of him and he dropped one more floor closer to hell.
The idea for this first draft has been banging around in my notebook for months. Perhaps it should have stayed there. But I’m a hot streak of production right now and I couldn’t not push out the first draft tonight.