Bleeder Read online

  SEPTEMBER 1993. I PEDAL THROUGH DUSK, MY BIKE GLIDING SWIFTLY along the campus’s flat sidewalk. Crickets chirp. Cicadas sing. The fall wind blows and puffs up my loose-fitting shirt. And the fading sun makes silhouettes of trees whose outlines I steer over as I coast. The evening sunbeams flicker through the longleaf pines as a strobe light, and I squint when my eyes water, loosening my grip on the handlebars to swipe a hand over my eyes; and when I can see again, it is too late. My front tire jams into a pine cone the size of my forearm. The wheel locks at ninety degrees and the bike jerks to a stop, throwing me from the seat. I fly over my handlebars and yell in pain when my right foot lodges between the wheel’s spokes and twists my knee.

  My body pounds on the ground, and the concussive force thrusts a gasp of air from my lungs and flattens my round heart against a hard mat of earth. Then for a moment, the world softens as if in a dream: the swaying trees and the freshly cut grass are chimeras of green, and the autumn air drifts with the perfume of fall wildflowers. I gulp a tentative breath. My heart fills again with blood and returns to beating. Then the pain comes piercing and unrelenting as if slivers of metal are stabbing at my knee from the inside out. I rest against my elbows, catch my breath, and slide myself backwards along the grass to dislodge my foot, still anchored to the bike tire, and as it drops to listlessly rest upon the ground, an intense agony rises from my knee joint. Wrenching my mouth in anguish at the great pain, I labor to breathe as I cup my hands against my knee and feel the swelling. The skin stretches tight against my jeans and presses at the seams, the bloom of swelling restrained only by my patella—a cap upon a boiling radiator of blood.

  Turning onto my stomach, I place my palms into damp grass and attempt to lift myself, but a fiery spasm wracks my body, and I grit my teeth and practice slow breaths again. When I regain myself, I muster all my mettle to endure pain and push off from the ground with my arms. It is a great and fierce thrust that lifts me and lets me hoist myself up, where I shift my weight to my left leg to lessen the pain in the injured right one. But still the hurt rages. I bite my tongue and displace the pain to the roll of tasteless skin now gripped between my teeth.

  I hobble toward my bike and place a hand upon the frame and ease my injured leg over the seat as if slowly mounting a saddle, and when it dangles above the ground, I push forward with tentative kicks. The wheels move. My leg cries out. I clamp my teeth into my tongue. A whistle of painful air leaks out of the corners of my mouth. I kick again.

  When I arrive at my suite, I pull myself up to the second landing and drag my leg through the suite’s corridor using the furniture and walls as balances, and then I drop onto my bed, gripping both hands around my kneecap and crying out in pain. I rock back and forth; tears spill onto my shirt; and with my hands still locked around my joint, I try to summon those magical potions from my childhood. Abracadabra. Make it go away. Abracadabra. Make it go away. But it does not work.

  I phone Kaitlin, who arrives and quickly gets the Vicodin that most hemophiliacs keep handy. Then I show her my knee: the kneecap lost in a globe of expanding flesh. Her hazel eyes widen and then start to water.

  “Are you going to be okay?” she asks, marveling at my knee’s size.

  “Yes. But I need to go to the emergency room, and I need you to drive me there. Get Sean to help. He should be in his room.”

  She hurries away in silence and from the hallway I hear her fist laying into Sean’s wooden door. “Wake up,” she yells. “We need your help.”

  I hear his door fling open and then they return to my room.

  “Holy shit,” Sean exclaims when I exhibit my knee.

  “You gotta help me get to the emergency room.”

  “Holy shit,” he repeats.

  He leans down toward the bed, and I shift so that I can reach around his stout neck. “Okay. Put your arms around me.” And when he raises me, I pretend that the pain is not real but comes from a phantom limb, one severed from my body long ago. My breath is heavy and winded.

  “Go easy,” I breathe out. “We have to go slow.”

  “Okay, okay.”

  Sean eases me down the stairway and out to the curb while Kaitlin goes for the car, and when she pulls around, I collapse into the backseat, inhaling heavy sucks of dust and heat and letting my knee calm.

  At the emergency room, Kaitlin retrieves a wheelchair, adjusts the leg rest, and rolls me into the lobby. We hurry past a woman comforting her sick child, a man cradling his hand in bloody gauze, a lady bent double in stomach pain. At the check-in window, the lady takes my information and my insurance card.

  “Blue Cross and Blue Shield?” she asks.

  “Yes.”

  “And you live on the UNCW campus?”

  “Yes.”

  “Any medical conditions?”

  “Yes. Hemophilia.”

  She types. “Anything else?”

  “Umm . . .” I pause. I lean in and whisper: “I’m also HIV positive.”

  “Okay, then. HIV positive,” she repeats, typing. “You can have a seat and the specialist will see you momentarily.” She points to the lobby where Sean already waits, so Kaitlin and I join him. Kaitlin taps her foot, twists her hands round; Sean shifts in his seat; and I rub my hands on my knee to soothe its pain.

  “A pine cone?” Sean questions after I’ve related the story of my accident. “Jesus Christ, man. How fuckin’ big was this thing?”

  “Huge, man. Monstrously big.”

  “Damn. I think I’d go with another story like a raccoon or a deer jumped in front of you. A pine cone just sounds kind of lame. Nobody flips over their handlebars because of a lousy pine cone.”

  In an hour, a nurse appears, calls my name, and carts me away. She leads me through a succession of double doors that open into a larger room where nurses swarm and where doctors hover near a central desk. They scribble onto charts and rapidly dial numbers on phones the size of mission control centers.

  “Do you want me to help you onto the bed?” the nurse offers as we sidle next to one, but afraid to move, I decline. “Well, you should probably remove your pants so that the doctor can look at you,” she suggests, tossing me a backless gown with a faded blue flower print dyed on it.

  I change, gritting my teeth, and soon lower myself back into the chair where I wait. The clock’s hands click off circles. When a sudden pain shoots from my knee, I throw my head back and dream of cutting it off at midthigh and imagine the happiness and relief such an act would bring. Abracadabra. Make it go away. My knee is plump, and it feels as if it may split my thin skin in a shower of red, bloody pulp. I close my eyes and try to sleep, but cannot. The clock continues to tick time.

  When the young doctor enters, he immediately asks me questions about my HIV and my hemophilia. He wants numbers, figures he can turn over in his scientific mind, so I provide the answers. His team stands behind him, jotting notes and nodding their heads as I explain my situation. When I’ve run out of things to say and when the young doctor has run out of questions to ask, he adjusts his spectacles along his thin nose and runs a slender hand through a receding hairline, swiping at a tassel of blonde hair. Then he washes his hands and places their cold, clean palms to my joint. I flinch.

  “Tender, huh?”

  “Extremely painful is more like it.”

  He feels around some more. “You need your factor,” he declares. “I already checked with the hospital pharmacy, and it will take several hours to get here. They don’t keep it stocked and will have to order it from another hospital. I wondered, however, if you have any with you?”

  “No. But I could get my girlfriend to get me some. It’ll probably arrive faster.”

  He gives a little laugh, a small wind pushing out his lips. “I think that’s probably a reasonable assessment. That’s fine by me. The nurse can help you infuse.” He makes notes in his folder. “So that takes care of the first order of business. Second is the X-ray. We should make sure there’s nothing going on in there beyond a bleed. I’l
l set that up. And third, we should aspirate. Your swelling is severe, and it needs alleviating. Have you had an aspiration before?”

  “Yes. When I was little, it was done on both knees. Several times.”

  “So good. This is old hat to you. You know we’re going to insert a needle into the joint and drain as much fluid as we can.”

  “I know it’s going to hurt like hell.”

  He laughs out again. “Well, we’ll give you a local anesthetic to help out, but, yes, with swelling like that it probably is going to hurt some. I won’t lie to you there.”

  I fidget my hands upon my knee, feel pangs of throbbing pulses twitch within and realize that more pain is being prescribed. The doctor leaves and the nurse comes in with water and another Vicodin that I swallow.

  “That should help you out,” she says, as I pass the empty container back to her.

  Then the nurse sends Kaitlin to me, and after explaining the situation, she agrees to drive to campus for my factor.

  “But I still can’t believe they don’t have it here,” she grumbles, taking down the list of supplies I call out. “Isn’t this a hospital?”

  “Well, they weren’t prepared for me. I’m just special that way.”

  When Kaitlin leaves, an orderly wheels me to X-ray, where the heavy machine aims at my knee, clicks, and sends invisible beams of radiation into a mass of bleeding tissue. By now, the pain has eased a bit, but I still bite my tongue as I am helped back into my chair and returned to the emergency room. When Kaitlin arrives with my factor, I mix the bottles, and the nurse infuses me, fortifying me with my clotting agent. Then later as the room’s clock approaches midnight, the young doctor and his team return.

  “Ah, I see we have good timing,” the young doctor says. “You’re all factored up and ready to go.” He presses my X-ray to the light-box and considers it with a lone finger resting upon his bottom lip. “The good news is that your knee looks fine. It’s just a severe hematoma. The bad news is, of course, that we are still going on with the aspiration.”

  He and his team move me into another, more private room. They lift me onto the table, secure my leg into a stirrup, and then begin yanking on their gloves as needles and syringes are spread out along a tray rolled close by. An attendant swabs me with a sterilization fluid the color of blood, and I watch as it runs from my kneecap, much as the cherry syrup glazed atop an ice-cream sundae. When they shift my knee around for a better angle, pain jerks me; my breath quickens, and my palms sweat.

  “I’m going to inject a numbing solution into your joint,” the doctor explains while holding the needle above my flesh, “but given the amount of swelling it may only do so much good.” He leans over and punctures my knee underneath the patella. I wring my hands together, avert my eyes, and brace against the pain that yanks a cry from my throat.

  “Hold his leg still,” the doctor commands, and a volley of hands straps me down. I thrash and slam my fists against the bed while the doctor coaxes, telling me to hold on, it’ll all be over soon. Then, momentarily, the seething hurt eases and my tears dry up as the doctor waits for the anesthetic to take effect. I grow anxious, anticipating the next needle, which is twice as long as the first one.

  “Oh, Jesus,” I call out.

  “Okay. Hold still.” He looks to his team. “Hold him tight.” They get into position. The needle comes at me. And this time, it is worse. Pain blazes as the needle jabs into my joint, and when I close my eyes, I see thickets of red and black. My body becomes fluent in pain: rasping breath, trembling hands, thrashing head. Even my heart is a compartment with a burr of hurt lodged within. When I clear for a moment, I see the doctor pulling on the syringe’s plunger and sucking fluid into it, as if bleeding nectar from a ripe fruit.

  When the doctor says he is done, I lift myself to view my poached knee—a red, unpulped mass. The attendants apply gauze padding and begin to encase my leg in a cast. The modern-day bloodletting has ended.

  The nurse comes to me with water and another Vicodin for later while the doctor writes a prescription for more, and then I am passed over to Kaitlin and Sean, who’ve fallen asleep in the lobby.

  “Are you okay?” Kaitlin asks, rising to hug me.

  “He doesn’t look okay,” Sean answers.

  “I’ll live.”

  They wheel me into the late night, a world now lit by the hum of electricity and a thumbnail moon. Sean comes with the car, and he and Kaitlin slide me into its backseat, and later lay me to rest in my bed, atop the sheets, and with an ice pack pressed gently on my bandaged knee. My eyes glaze over, and as I give into the darkness, I recognize the weight of Kaitlin’s body settling beside me. She kisses my face, tells me it’s going to be okay, and eases an arm across my chest. The throbbing pulse in my leg dulls so that sleep, for a time, envelops me.

  Near dawn, light strains through my window; the sun is rising. My leg lies unmoving and thrumming with pain. I slowly raise my hands to shift the pillow underneath my head and watch as sunlight paints my room in familiar colors. Kaitlin rouses and runs a hand along my chest. “How are you?” she asks.

  “Okay, I guess. But it still hurts like hell.”

  We lay together until Kaitlin rubs sleep from her eyes and slips out of bed.

  “I can run to the pharmacy for your pain meds if you want. They should be open soon.”

  “Yes. I think I’m going to need it to get through today.”

  She dresses and leaves. For a time, I lie still watching the red glow of morning. An hour or so later, she returns with the medication and sets it at my bedside along with a bottle of water, and then she ensures that my crutches are close, and asks if I need anything else.

  “No. Not for now. I can make it.”

  “Okay, then,” she says. “I hope you don’t mind, but I think I’m going back to my dorm to get some rest. I’m glad it’s Friday and I don’t have any classes.”

  “No, sure. Go rest.”

  I sleep. Watch TV. Read. Sleep some more. In the afternoon, Kaitlin returns with food and then after eating, we watch more TV and try to sleep. On Saturday, it is the same. And on Sunday, I attempt a shower. We duct-tape a garbage bag over my cast, and I crutch into the bathroom, biting down the pain as gravity drains blood into my joint. I prop in a plastic lawn chair, and the hot water revives me and soothes an endless ache pumping from my knee.

  The following week, I heal. Daily, I treat, my arms becoming pock marks of bruised injection sites. Kaitlin visits my professors and brings my assignments, while she and Sean tag-team the transportation of my meals from the cafeteria. Daily, however, the room closes in upon me. I sleep, read, study, eat, sleep more; in the evening I don the protective garbage bag for my daily shower, and in the night, I sleep again, sometimes with Kaitlin at my side, but not always as she needs her escape from this, from me. By the end of the week with the pain tolerable, I crutch to a table in the campus dining hall. It is good to get out. The leaves are beginning to fall. A handful of sparrows flutter in the treetops and in a sky purpled with whisper-fine streaks striating the horizon.

  The next week, I walk a few steps without my crutches, but soon fall back into my bed—the pain shooting through me—but each day I make progress—first to my door, then down the hallway, the bathroom—until eventually I only need my crutches for the long hike to the cafeteria. Two weeks later, the doctor removes my cast, and wraps me in an Ace bandage. In another two weeks, this is removed and he approves a handicap parking pass so that I can return to classes by parking nearby. And so I reenter the classroom, leaning hard against a cane, but glad to be returning to normal.

  Several weeks pass. Then on a Tuesday in my philosophy lecture, the professor comes to me before class begins and passes me a sealed letter.

  “The administration sent this to me earlier this week,” he says. “It’s for you.”

  When I see that it is from the North Carolina Division of Public Health, panic rises. My face whitens.

  “Everything okay?” the profe
ssor asks.

  “Yeah. Sure.”

  “Okay. Good. This seemed most odd.”

  He returns to the lectern and addresses the class while I read the letter, which, with words like “urgent” and “pressing importance,” demands that I contact the division ASAP. My imagination unreels scenes of disease and horror: I have TB; I require quarantine; my life is ending. Hurriedly, I limp to the handicap parking space, and, back in my room, I call.

  “Yes, Mr. Smoak,” says a lady on the other end. “I’ve been trying to get in touch with you but have been unable.” Funny, I think. I have a phone and an answering machine, and I have been readily available having been grounded by my injury. “We need to talk,” she continues. “How’s this afternoon, say three o’clock?”

  “Umm . . . Okay.”

  “Great.” And she hangs up before I can ask any questions.