Rumpus Original Fiction: Additional Skills Include

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DEPT. OF ONCOLOGY JOB DESCRIPTION:
RESEARCH ASSISTANT W/CLINICAL SUPPORT

EFFECTIVE/UPDATE DATE: November 2016

GENERAL SUMMARY:

This position requires knowledge of institute policies and practices and may be required to interface with senior management, cross-organizations, internal and external physicians, and government and community officials which require considerable tact and diplomacy.

Six months after you leave him, you start a job at a hospital. You sign a mandatory hiring NDA as a woman from Human Resources looks on. You get an ID badge that says MEDICAL EMERGENCY PERSONNEL, which means you get a police escort to work if the trains are down. You don’t know what this will ask you to conceal: the hours, the patients who lose clumps of hair mid-appointment, the mangled diagnoses, the deaths.

Here is what you know: your credit card company has been calling. No one told you how expensive it is to disappear. You left a cosigned lease, your fresh college degree where it hung next to his, your favorite velvet blazer, your mother’s hand painted glass lamp, filled with seashells.

You need a paycheck. You have good practice at staying silent. You uncap the pen.

 

This position provides specialized support to _________, MD, PhD

You pick up your boss’s coffee. You pick up his dry-cleaned scrubs. You pick up his son from kindergarten when he develops strep throat, while your boss is in a meeting with the Chief of Medicine. The kid asks, where’s my dad and your heart contracts sharply, like the first breath of cold air after a snowstorm. You get strep.

You culture cells and write up lab reports. You file patient paperwork. You hand patients pamphlets on grief and write letters of recommendation for people you’ve never met. You put your boss’s wife on his calendar for LUNCH. You put his girlfriend, a med student only a few years older than you are, on his calendar under CONSULT.

Your boss specializes in ovarian cancer and is infamous for taking cases most won’t. At first you think this is admirable. Later, you realize this is narcissism. When caught early, ovarian cancer has a ninety-percent remission rate. But sometimes insurance doesn’t cover a women’s health exam, or they’re too busy for a pap, or the technician misses something. By stage three, there’s less than a fifteen percent chance of survival. Your boss takes stage four patients. He earns a nickname from the nurses who mutter in the halls: the vulture.

Stage four is mothers that beg for an alternate opinion. Your boss says one more round of chemo and you know that they will never go home to their children. They will spend their last days in a hospital bed and when they’re done gasping from a URI or bronchitis or pneumonia—it’s always pneumonia, cancer’s grim reaper—there will be a call from accounts billable. Cancer is an industry. Hope is, too.

Your boss is the sort of man you’ve developed a sixth sense for. He likes to shout and wave his hands. He likes to silently point at his medical students in meetings which means: stand up and impress me. He smacks the wall, inches from your face, to make a point. You flinch so noticeably that he draws back, as if stunned by himself. He mercifully doesn’t bother you for the rest of the day. You know, deep in your belly, what he is capable of.

 

Skilled in time management and an ability to self-supervise.

The only room on the Oncology floor that locks in the decontamination shower. The hospital administration took the locks off the doors, sealed the windows with bulletproof glass, removed their cranks and screens, after a doctor was shot in an exam room. Now, you complete active shooter training every three months. Now, they have to say “life-threatening situation” instead of “code gray” on the intercom. The decontamination shower is the only room, now, with locks left on its doors—as in a TV movie, nudity trumps violence.

You waste hours locked inside, cross-legged on the tile floor, leaning your head on the chrome walls. Examining yourself in the slip of mirror above the skink.

At first, it was about vanity. After you’d left, you painted your face every day. You spent a fortune at Sephora. Left lipstick on every spoon. You flat-ironed your hair until it smoked. As if you were trying to check possibilities off a list of reasons why you deserved it: it wasn’t because I was ugly. Something else then. Your smart mouth, maybe. Your drinking. Your terribly splintered heart.

You give up on being beautiful. When you’re not working, you’re destroying your body. Chain-smoking American Spirits and menthols in the courtyard and downing piss-colored bodega wine. When you’re not in scrubs, you hide your body in sweatpants and those men’s tank tops with the terrible name.

 

May be responsible for the recruitment support of candidates, and offer additional support to Oncology staff and faculty. 

Your favorite doctor on the floor specializes in pancreatic cancer. He has a reputation for being a Good Man. He’s one of the only doctors who actually clocks all their free clinic hours. He cries when his patients die.

When they live—which no one expects—Good Man calls you into his office and you drink bourbon on the floor together. He calls it the survivor gene.

It’s like that thing, he says. That French saying that’s like “what the fuck?”

Je ne sais quoi?

Yeah, that. The X factor. Like it looks like they’re not going to make it, right? The writing is on the wall. But sometimes you get these people.

Good Man spends a little too much time at your desk for someone who is married with two kids. One time, when you’re sitting on his floor after a patient proves their diagnosis wrong, he says, I forget how young you are. He says it in a way that makes you grateful that the door is open.

Some days you want to sit on his desk and swing your legs and drink his expensive bourbon and test a Good Man’s resolve. Other days, you sob at the thought of being touched. Most days, where there should be desire there is only the merest of embers, burned and gray, fibers clutching together on the verge of becoming dust.

You feel coltish all the time, held up by trembling new legs. You no longer know where want starts and terror ends. Yes and run—threads on the same bit of twine, twisting. You want to bolt into the shadows. You want to hide your face behind your fingers.

 

Follows and implements the institution’s guidelines on handling medical equipment and supplies.

People don’t know what to do when you tell them what happened. You weren’t a battered housewife. He never broke a bone. You didn’t stay for the kids; there were no kids to stay for. You were young. You were summa cum laude. When people find out, they say, but you’re such a strong girl. They ask, why didn’t you leave sooner?

No one warned you about him. Sure, they said, don’t dawdle in the parking garages and don’t forget to hold your keys in your fist like Wolverine and don’t put your drink down or uncovered or into your mouth and don’t own a gun and don’t live alone and don’t live with men. But no warning about him.

You were young when you met him. All fresh cotton and ripe melon. Ready to disintegrate on the tip of the tongue. You grew up under his gaze: a teenage girl tugging her too-small shorts away from her thighs. Hopping into his car after school, wearing a push-up bra, smacking gum. Your backpack weighed down with keychains that clattered like church bells. The face of the driver hidden by the car’s tinted window.

You didn’t know about words like grooming, then.

People never ask, what happens next? No one ever warns you how you’ll revert back to feeling so young because all you knew of adulthood was him. No one ever talks about how exhausted you’ll be when you finally leave. How leaving everything behind means everything—means leaving behind his good dental insurance, leaving behind only paying half of the rent in a city itching to squash you under its heel.

At the hospital where you make too little money, you swipe anything that’s not nailed down. Sandwich platters meant for conference rooms, IV bags brimming with potassium and electrolytes, migraine medication, lidocaine patches, beer marked SURGERY DEPT HAPPY HOUR, coffee filters, bandages, suture kits. You fill your new apartment with stolen goods with the determination of a magpie—or maybe that’s the crow.

All those warnings were useless. They should have told you: Do not make a home out of a slaughterhouse. The butcher doesn’t love you. He will tan your skin for his hardwood floors.

 

May serve in a volunteer/stewardship capacity.

On Tuesdays, you work the free clinic. Did you come in last week? Have you felt feverish in the past twenty-four hours? Sign here. There are record snowfalls. There are missing hands and feet. When melted, the snow becomes moisture, the enemy of open wound. The sun sets at 4 p.m. all winter. It is dark when you arrive at the hospital and darker when you leave.

On Tuesdays, you work with your favorite nurse, Prince. Prince is a veteran, but you’re not sure from which war, because Prince has unblemished clay-brown skin and a mouthful of veneers. He says, I’m timeless! I’ll live forever, Sugar! That’s his special nickname for you.

You and Prince met in Oncology, but Prince got the boot to Urology pretty quickly after you started. How am I supposed to focus around all those dongs? Prince asks you. Prince consistently gets transferred from unit to unit but is virtually impossible to fire because he has protected employment status. The hospital receives a lot of money for employing Prince, and this outweighs the fact that he tells patients he keeps his dead dog in his freezer or that he once threw a urine sample at the charge nurse’s car.

On Tuesdays, you pass out flyers with directions for wound care. You notice how one of the patients lost a toe and keeps reopening her wound by trying to walk too soon. She came in bleeding from her foot, hypothermic. Her boyfriend locked her out with no shoes, she said. She stood in the salt-lined street all night, apologizing.

She tries to get up and the resident grabs her by the shoulder, presses her back into the bed. She starts to bleed through her gauze again and the resident gets frustrated and brusque. For the love of God, stay still.

You are trying not to be overwhelmed by the sheer ache of it all: the bloody foot, the overworked trauma residents, the free Dunkin Donuts coffee, now gone cold.

Alright, Prince says, pulling you aside and wiping at your cheeks. You didn’t realize you’d started crying. Why don’t you go take a nap, Sugar.

 

May also be responsible for the indirect supervision of other support staff members, providing work direction to interns, technicians, and mentoring junior staff.

There is a research technician. He’s middle-aged and consistently disheveled. You know he’s single because he walks around rumpled with a poorly shaved shadow: too dark too be stubble, too light to be considered a beard. You fight over space in the CO2 incubator without ever introducing yourselves.

Sugar? He says one day, like it’s taken him a lot of courage. He heard Prince or one of the other nurses call you by your nickname.

Walker, he says and extends a gloved hand, which you do not take. Like the Texas Ranger.

Texas Ranger starts bringing you coffee. Starts giving you dibs on the best centrifuge. Gifts you his Adderall, leaves blue pills lined up in your desk drawer. Hospital courting, if you will. Love in the time of private-sector health care.

Texas Ranger is the first man to look at you this way since you left. It turns out, you are starving to be seen.

You fuck him for the first time in the decontamination shower, with your scrub top still on, pants pulled down to your knees. It happens again and again. During lunch, during department meetings, when you’re feeling hopeless or bored. In his car, in the parking garage, in a McDonald’s bathroom, in unlocked offices, in on-call rooms. A relief: when you are with him, you’re not in the lab. When you’re with him, you’re not around patients. You’re nowhere.

It doesn’t feel particularly good, the act of it. Texas Ranger seems to know this and looks hurt and doleful. You don’t tell him about the man you left. He is intuitive enough not to ask.

He continues leaving you offerings and it starts feeling a bit sour, like he’s trying to take care in approaching a wounded animal. Chocolate-covered mints. A cartoon drawing of your boss with Satan’s horns and goat legs. Pink Post-its. A perfectly rolled joint.

 

Fluent in an additional language (Spanish, Mandarin, French preferred).

Sometimes, you do translations on the neighboring floors. You get paged: can we get Sugar in here? You are faster and require less red tape than the social workers and the sparse and notoriously shitty translators.

One time, you’re cutting through the ER when one of the white doctors gestures at a woman with your color skin and ink-spill hair. Turns to you and says, we have another one of yours. The patient speaks English, albeit accented, but the doctor insists that you stay. You lock eyes with the patient like don’t worry, I’ve got you—you are one of mine, like fuck this guy. Like I don’t want to be here either. Here is the hospital, but also this city, here where the hospital chapel has a blond-haired and blue-eyed Jesus.

In Spanish, the patient asks you to ask the doctor if she can still lift boxes despite the tear in her tendon. She keeps her voice clear, but you can hear the undercurrent of hope, like you’re eavesdropping on a prayer.

Once, you were stuck at a department happy hour, talking to an attending who they always put on hospital brochures about diversity.

Did you know, the attending asked, already drunk, why it’s mostly white people who get addicted to Oxy?

No, you said. This was not your idea of small talk. I guess Boston’s pretty fucking white.

It’s because white people get prescribed painkillers, the attending said. We get sent home with ibuprofen. They don’t believe us.

You know the ER doctor won’t prescribe her anything. He’ll say, she needs surgery, and they’re booking two months out. He’ll tell her to stay off her feet. He’ll say something like she’s a fighter or she’s strong or she can tough it out.

She’s asking if you can write her a note for her boss, you tell the ER doctor. And she’ll need her scan and records, so she can apply for workers comp.

You must look like a pillar of flame, because he grits his teeth and says, whatever she needs.

 

Assists in research laboratory experiments in the field of cancer biology, under the supervision of the PI. Conduct data recording and analysis, keeping detailed laboratory records.

The lab has a rotating cast of cancer mice. The undergraduate interns name one and announce it as the lab mascot. No one has the heart to tell them it’s replaced every few weeks with one of its brethren, each with tumor-filled ovaries. They must know.

You find a cancer mouse under your desk. Maybe this week’s mascot. You have no idea how it got out of its cage, but it did. It’s dead. You pick it up with a tissue, expecting it to be warm and soft, but its limp and room-temperature. It died, but it didn’t die in the cage, didn’t die in the hands of one of the researchers, wriggling as they shot it up with barbiturates.

You start to do things you know that Texas Ranger hates: lowering all the windows while he drives you both to his place, speculating loudly during movies, running the sink while brushing your teeth. He comes up behind you, quietly switches the tap off. You wait for him to leave the bathroom before promptly turning it back on.

He squints and pinches the bridge of his nose, as if he has a headache, says something like, sometimes you act like a child.

You respond, maybe you shouldn’t date twenty-five-year-olds, if you want more emotional maturity, and he exits to the porch rather than engaging.

Maybe you are trying to speed toward the ending but more likely, you are hungry for the kind of attention you have come to see as paramount to affection. No one is ever as intently focused, wrapped up, than when they are angry with you. You’ll believe this for a long time.

I found a dead mouse today, you tell Texas Ranger from behind the screen door. Do you think that’s some kind of sign?

He doesn’t turn around. He wouldn’t be able to see you through the mesh, but it stings that he doesn’t try.

I’m a scientist, he says in response.

 

Conducts literature searches and synthesizes Oncology literature using electronic, web based, and paper sources.

You read an article about phantom limbs. A perception that pain radiates from a limb or an organ that is no longer physically part of the body. Phantom limbs do not stem from the source. The pain is buried in the nerve endings of the brain, in a mind that knows it has lost something, that something is missing. The patient keeps scratching because they are looking for the source of the itch.

You often go to the hospital on zero sleep. You lie awake at night, adrenaline rocketing because you think you hear a man’s voice. You feel fingers at your scalp. You forget if you’ve deadbolted the door.

You are too tired to feel ill around the ill. With no sleep, you have no concept of morning or night. All you have is the creeping gray light that is pre-hospital and post-hospital; all you have is the glint of streetlight on snow while walking home from the train.

I think you need to get out of here, Texas Ranger says, in lieu of ending things properly. This place is toxic for you.  

I will, you promise. Another month.

When you read the phantom limb article you have to convince yourself: that is not your pain. And yet, you are still double-checking the bathroom window’s locks, still sleeping curled into yourself so as not to take up space. Sometimes, alone in your apartment, you succeed at something—you hang a curtain rod or cook a piece of chicken perfectly—and find yourself looking for approval. You were together so long. He taught you so much. Sometimes, you catch yourself missing him. A longing that feels as if it’s built into you.

The month passes. Your paycheck is a tether. You’re still on the Oncology floor come the first of the next month, yoked by need. You’ll be here the following month, too.

 

A certain degree of creativity, imagination, and latitude is required.

Sometimes, there is a softness to the hospital. Early in the morning, before the buses have dirtied the snow with their tire tracks. Before figures in white coats swap a first cigarette, a Jesus Christ, it’s fuckin’ freezing. Before the streets are littered with Styrofoam Dunkin’ Donuts cups and used condoms and needles.

Before any of that, if you get to work early enough, you can walk down Avenue Louis Pasteur by the new research buildings. See how their structures suck up the pre-dawn light. All chrome and reflective windows, set ablaze. It looks green as a glass bottle, and you can almost pretend it’s a lawn, freshly mown. Pretend it’s not winter, that the sun will soon emerge.

It always happens on a day in late February or early March, when it’s an unseasonably warm fifty degrees. When there’s sun. Everyone stops for a moment, blinking like underground creatures. You get so little light in Boston that mornings like this can make you delirious. Make you think that winter’s over. They call it false spring—the day that convinces you, maybe it’s not so bad here?

You used to tell yourself: I’ll wait until Monday. It will be cleaner to leave at the start of a week. I’ll wait until I finish college. I’ll wait until after his birthday. I’ll wait until I’m shoved up against a doorway. I’ll wait until a pillow over my face. I’ll wait until a kick in the ribs. I’ll wait until he promises, I’ll kill you. I’ll wait until I believe it.

Patience became your lifeline. You almost wrapped it around your neck.

False spring will leave you in disbelief—did the winter even happen? Was any of this real? But then, there’s a blizzard, or a polar vortex, or a train collision that brings patients flooding into the ER. Had it not been for the last lingering shred of self-preservation, you would’ve stayed with him and you would’ve died: the acknowledgement of this dizzies you, makes it seem impossible to lift your head. The temperature plummets, the news says, single digits in March! And the street named for the dead scientist is no longer quiet and the glass that was once green is clear again.

***

Rumpus original art by Lauren Kaelin.


Katerina Ivanov Prado is a writer from Florida. Her multi-genre work has been published in the Florida Review, the Nashville Review, Iron Horse Literary Review, The Pinch, Joyland, and others. She has won the John Weston Award for Fiction, the 2019 AWP Intro Journals Award, The Pinch Nonfiction Literary Award, and the Florida Review Nonfiction Editors' Award. She is an MFA candidate at University of Arizona, where she is working on a novel. More from this author →