Maureen Hirthler is a retired physician who holds an MFA in Creative Writing from the University of Missouri-Kansas City. Hirthler is the Managing Editor of Intima: A Journal of Narrative Medicine.
Sound, sight, smell, taste, touch. The most potent essays use sense experience to draw the reader into a particular story as a participant rather than an observer. In the introductory paragraph of his excellent essay “For The Old Man Buying a Stuffed Giraffe” (Intima, Spring 2022), Ben Goldenberg brought me back to a place of refuge, of safety: the hospital gift shop.
He writes, “It’s like stepping through an interdimensional portal; the frenetic, anxious atmosphere of the hospital gives way to the anodyne hum of small-stakes commerce so seamlessly it’s almost jarring. When I enter the gift shop, I’m suddenly in a world where I never have to hear bed alarms or overhead code blue announcements—only the soft rock offerings of 93.9 Lite FM Chicago. Tubes of every Pringles flavor climb the walls like ivy and nobody’s talking about vital signs. I can take in a deep, carefree breath of air that smells like greeting cards and tell myself that in this moment, there are no major medical decisions to be made; I’m just a guy on a little errand.”
The Emergency Department is a universe of sensory worlds. Most striking is the cacophony of sounds: shouted orders, screams, cries, laughter—in different languages, different volumes, different locations. Monitors beep, printers print, phones ring, and ambulances report over the radio. The quiet that exists in the rooms of the dying offers no relief: the sadness speaks just as loudly. And the Zamboni-like floor cleaner purrs on its mission.
The visual world is in disarray—blood on the floor, wastebaskets overflowing, empty stretchers, and people sitting or lying in the hallways. Staff moves swiftly, and patients head to x-ray or CT scan, then return. New patients arrive; old patients leave. Entering a room reveals unexpected sights—the bleeding finger amputation, the old man struggling to breathe, the young woman holding a floppy blue baby.
It's impossible to sort the smells—feces, urine, car exhaust, pizza, pus. No amount of disinfectant can hide the odors of gangrene or bloody diarrhea that attaches itself to your nose hairs so that you carry them even to the bathroom.
Emergency physicians are interrupted approximately ten times an hour—every six minutes. Everyone wants your attention—patients, nurses, families, consultants, the secretary, the radiologist—right now, this minute. Techs shove EKGs under your nose for reading in the first five minutes after a patient's arrival with chest pain. Stroke alerts, trauma alerts—drop what you're doing and go.
Touch. Time curtails the physical exam. Warm blood runs over your gloved hands; miscarried fetuses land in them. Sometimes there is the luxury of time to stroke an arm or smooth a brow, and occasionally you are slapped or punched or vomited on. There are no designated breaks, and people will follow you to the bathroom or the staff lounge. The occasional hug startles you.
How can you think clearly when you’re overloaded with sensation, with the needs and demands of others?
When things became overwhelming, I, too, sought the parallel universe of the hospital gift shop. The hospital lobby was a wormhole, a gateway to a clean, quiet, fresh, and shiny world. At its center was the refuge, the gift shop.
I remember low-pitched voices and elevator music; the rustling of wrapping paper. Colorful cut blooms dancing in fancy vases with fresh floral arrangements safe behind glass doors—the calming scent of candles and soaps—rose, eucalyptus, lemon. And the gift of chocolate. High-quality candy not stale from a vending machine. Godiva. The excuse I gave to "run down to the gift shop."
My favorite section was the stuffed animals. As I read about the man’s selection of his gift, I thought about how I would stroke and cuddle the soft creatures until the chaos in my head and the ache in my heart dissolved. Bears, dogs, monkeys, and, in Florida, manatees. It didn't matter. They were my comfort, my refuge.
This world was not my home, and I knew that I was needed elsewhere, back in the chaos, to do my best to help the sick, the injured, and the mentally disturbed. So I gobbled my chocolate and walked away, knowing this place would always be there.
Maureen Hirthler is a retired physician who holds an MFA in Creative Writing from the University of Missouri-Kansas City. She is the Managing Editor of Intima: A Journal of Narrative Medicine. Her writing has been published in Creative Nonfiction, The International Journal of Whole Person Care, The Examined Life Journal, and others. She resides in Florida with her husband and very sweet dogs. Her essay “Pandemic of Lights” was recently featured in the Journal of the American Medical Association.