1977, August: Like many others before him, Dominic Fonderini's odyssey began at home with a sudden paralyzing weakness of his right side. Rendered speechless, he listed to his right and slid from his chair to the floor. The sound of the fall and Dominic's initial struggle to get up brought his wife running. As she reached him, her terror matched his. Yet, she maintained enough presence of mind to call for help. By virtue of Dominic's entitlement through service to his country, he was taken to the local Veteran's Administration Hospital. He was evaluated in the emergency room and stabilized. After examination by medicine and neurology residents and a consultation with the respective senior staff physicians, the transport crew took Dominic to the Neurology Ward, Building 21, a quarter of a mile from the main hospital, down a gently sloping protected concrete walk.
The entry to Building 21 was not unique nor was the entry hall with its pale yellow tiled walls, divided in two by a brown line two-thirds of the way up. Yellow tiles punctuated the faded green linoleum floor, marking the way to the ward. Along the way, the litter, upon which Dominic lay, negotiated three turns, passed through four fire-doors, and traversed five different corridors. The way was bright; the corridor's smell, antiseptic. The final stretch on the way to the ward led past the resident physicians' night call room that was small, sterile, and Spartan. The conference room was next, its desks cluttered with books and papers. Then, there was the nursing station, almost always in order. The transporters pushed the litter through a final turn at the nursing station and entered another corridor, lined by rooms, patient rooms, private and semi-private, containing young and old derelict bodies, some with derelict minds. These patients represented the ravages of stroke, alcohol, Alzheimer's disease, and amyotrophic lateral sclerosis, more commonly known as Lou Gehrig's disease. The hall ended at the open ward, a large bright room with windows on three sides. Four-foot walls partitioned the ward and defined twelve areas, each with a bed and nightstand. The open ward lacked privacy; but from the entrance, the staff could observe and attend the patients in an efficient manner. Dominic's physicians had assigned him there.
Although this ward was to serve as an acute care facility for the neurologically impaired, many of the patients who sojourned here were far from acutely ill. Some, like Old George, had resided on the floor for years, and were considered residents rather than patients. Those with "resident status" actually helped with transport of specimens and laboratory results that had to be run between the ward and the main hospital. Old George claimed to be a direct descendent of general U. S. Grant. He frequently related, to those with the patience to listen, that, as a result of some family disagreement, the general had banished certain of his descendants, and all of their progeny, to the VA Hospital system. As a result, Old George took up residence here, in 1937, bed number seven, Open Ward, Neurology Unit. His was the bed with the western window exposure so he could watch the sunset over the coastal range each night. This was his major pleasure in life. George's chart said syphilis, general paresis; but, in spite of the best attempts by any of the recent neurology residents to find documentation on the chart to support that diagnosis, none could be found. To keep his chart current, the physicians would examine old George once a month. But, no one looked for the stigmata of his supposed illness, for if none were found, hospital administrators could challenge George's right to live on the ward. Aside from occasional entry in his chart describing a sore throat or ingrown toenail and comment on the state of bowl or bladder function, the entries read as follows:
06/04/77: This is a good man.
09/12/77: May neither rain nor snow nor dark of night keep this man from his appointed rounds.
Bill occupied bed number three, an eastern exposure on the other side of the ward from George. Unfortunately, Bill had contracted Lou Gehrig's disease in his early forties. Even more unfortunate, he had reached a state of stability, too incapacitated to care for himself or even communicate effectively without his letter board, but able to breathe and consume just enough sustenance to maintain his cachectic, cadaverous appearance just beyond the limits of starvation. Inside this shell of a body, he somehow maintained a positive attitude and sense of humor. The residents and nurses took time each day, as tedious as it was, to sit and converse with him through his letter board.
Next to the entrance of this ward, bedded Mr. Johnson, a World War I veteran who had fought at Verdun. He was a tall, thin, kind, old gentleman whose Parkinson's disease made him stiff and shaky. His medicine made him confused. He would actively hallucinate at the peak of his dose and had vivid nightmares at night. He had visions of dead people lying in his bed. These visions were so real that he could touch them and feel their cold lifelessness. Yet, so distressing was the state of his rigidity and the annoyance of the shaking when he didn't take his medications that he preferred the medicine's side effects to the symptoms of this disease. In deference to the other patients and to preserve his own dignity, he learned to suffer his hallucinations in silence. He never fussed or created a disturbance except to occasionally pace by his bed until its occupants were gone.
Between Old George and Bill, resided Tom. Tom had lost his right leg; well, not truly lost, for he knew where it had been taken and by whom. His diabetes and alcohol had ravaged his arteries and his nerves. His nerves had responded somewhat to optimal control of his diabetes, abstention from alcohol, and vitamin replacement, but his arteries remained in a disastrous state of occluding. Minor injury leading to infection resulting in amputation had led to the slow whittling away at his right leg over the years. The doctors had taken the toes first, then the forefoot, and so on, until all that was left was a stump of thigh. A minor stroke lead to further disability, but he had recovered almost completely from that. His most recent event was a spinal cord stroke. His arms still functioned well, but he was left with an anesthetic shortened-by-medical-necessity right leg, and a weak, though still feeling, left leg. Unable to stand, he nevertheless continued to wear his wooden prosthesis for cosmetic reasons as he slowly convalesced.
With nowhere to go, these patients formed the prevailing population of the open ward. The daily census of the ward would rise and fall, but it was seldom full. New patients would appear, slowly recover, and be discharged. Regulars, many with alcohol related problems, some with seizures, in various states of evaluation or treatment, would make their appearance, often briefly, at least relatively briefly, as nothing happened very fast at the VA. And so, the ward existed, yellow tiled walls, green floor, antiseptic smell, and quiet. This serene atmosphere would only rarely be disrupted by the sudden disorientation of one of the patients, or even death, which pervades all hospitals no matter how hard the nurses and physicians try to stave it off.
Some of the occupants of the open ward had family, although many, like Old George, Bill, Mr. Johnson, and Tom, had none. Some families were devoted, caring, and appeared daily. They would want to help with feeding and grooming of their loved ones and to know what was happening to Uncle Al, Dad, or whomever. For some of the more chronic patients, such visits might be weekly or even less frequent.
Life on the ward varied little over the years with few events to mark time. If unsure of that fact, one could always ask the ward historian, Old George, not that his history was very reliable. With the admission of Dominic Fonderini, however, life on the ward was about to change. Poor Dominic, years of smoking and poorly controlled hypertension had culminated in a devastating stroke that left him densely paralyzed on his right side and unable to speak. When he arrived that fateful day, there had been hope for a quick recovery, but days dragged into weeks as he achieved only the smallest of gains. It wasn't Dominic's presence on the ward that changed things, nor was it his illness, which was, regrettably, all too common. It wasn't his attentive loving children or even his many grandchildren that changed things. They were a pleasant group, as they arrived each Sunday to encourage their grandfather, hoping for a speedy recovery. For Dominic, a speedy recovery was not meant to be. Among the many grandchildren of Dominic Fonderini were the parents of two children, Luke and his younger brother, Duke, great-grandchildren of the patriarch, Dominic. It was Luke and Duke who would alter life on the ward.
Although their exact lineage was not clear, it was widely held Luke and Duke had inherited the moral turpitude and temperament of Attila the Hun. Further, it was believed that the genetic composition from Attila had somehow become amplified, appearing in its fullest expression, undiluted, unmodified, in these two dark-eyed, dark-haired Vandals. They would hit the floor like two cyclones, running and spinning. The smooth, wax, pale floors made exquisite slides as they dove headfirst, arms extended, or feet first, legs spread, to see who could slide farther, hooting and shouting all the while. They would visit each bed to awaken and harass the occupant with questions.
"And, how are you?" They would shout at Bill as if he couldn't hear. Then, they would delight, as the startle would set his spindly cadaverous limbs into spasms, arms and legs beating the air. They would stand and stare at Mr. Johnson, whose confusion was only heightened by the presence of these two strangers before him. Were they really just another apparition? They would accost Old George, who guarded his space with sentry vigilance, fore and aft, as the two hellions would dive under his bed and from there emit shrill banshee war cries. This behavior would reliably cause Old George to spring from his bed and grab his walking stick with which he'd attempt to chase them from the ward.
"Damn kids!" He'd call after them.
"Boys will be boys," the mother would reply, apologetically, embarrassed, but unable to effectively intervene.
"Don't run," their father would scold, but to no avail.
Old George's stick would serve as some deterrent. Often as not, at least temporarily, he drove them from the ward. Through the windows, the ward occupants could see them. They jumped on each other in the grass, threw stones at each other, and hit each other with sticks. These behaviors continued until one Sunday they discovered Tom.
Tom often sat outside behind the ward in his wheelchair, his bladder catheter bag, half full of urine, hanging just below his seat. He sometimes sat in the sun. More frequently, he sat in the shade. During the months of convalescence, he had taken to whittling. He started with soap, initially, and subsequently graduated to wood. As he lacked skill and his various diseases had robbed his innate abilities, he often passed the time of day sharpening sticks. He slowly reduced them in length, much as his doctors had reduced his right leg. On Sundays, Old George would wheel Tom to the chapel to pray. Tom always wore his best clothes, not the hospital's garb that those sicker than he wore. He sat with his shoes shined, one on the right foot, artificial, and the other on the left foot, paralyzed and useless. After chapel and lunch, George would wheel Tom to a spot behind the ward where Tom would sit and enjoy the day. Luke and Duke had interrupted many a Sunday's peace inside, but not outside in this safe place behind the ward. That was until Luke and Duke discovered Tom there.
The two approached Tom menacingly and stared at him. Tom stared back, his snake-eyed stare locked on them, as he anticipated the worst. There was a devilish gleam in the boys' eyes, out of sight of any others. There was defiance and determination in Tom's. Tom sat still, attention focused. He showed no fear as he continued to follow Luke and Duke as they began to circle him slowly like two coyotes stalking a stray lamb. Tom emitted a low growl, deep, guttural, and resonant, as they came closer. Puzzled by the sound Tom generated, Luke and Duke stopped close enough now to feel the air propelled by Tom's increased breathing. The three tensed their muscles, statues poised in readiness. Suddenly, the boys jumped back as Tom raised his knife above his head with the point directed at them. They gasped audibly as his arm fell, driving the blade into his right, artificial, leg without the least show of pain. He growled ever the more terribly as he continued to reach into their souls with his vengeful stare. Luke and Duke looked at each other, horrified, as if they were confronting the devil himself. They screamed, and ran.
"That should teach you!" Tom shouted after them.
With the arrival of Luke and Duke each Sunday, chaos reigned for the patients on the open ward. Old George's chasing Luke and Duke from the ward became a ritual, but they never harassed Tom again. When they would find him outside, they would not approach closer than 20 yards and never to menace him. If they ventured closer or looked in his direction, Tom would stop his whittling and stare his snake-eyed stare and growl softly. With that, they would quickly retreat and look away.
However, one Sunday in early spring, sun high in the sky, full of that welcome warmth that is absent from the winter bright cool light, Luke and Duke, having been chased from the ward by Old George, found Tom sitting in his wheelchair. He was dressed in his Sunday best, bathed in the warm inviting spring shine, asleep. The two hooligans approached Tom slowly and crossed the imaginary twenty-yard barrier. They walked with the stealth of Cheyenne worriers approaching their quarry. Tom slept peacefully; on his lap was his trusty whittling knife and a stick, the top of which was sharpened on one side.
Luke and Duke reached the foot of Tom's chair. There, they stood and stared. Luke spotted the knife in Tom's lap and a curious mischievous grin crept over his face. He waved his hand in front of Tom's face and got no response. He looked at his brother. Duke had a puzzled look, unable to discern what his brother might be thinking. At the same time, Duke resigned himself to watch and be entertained. Duke motioned to his brother to proceed. Luke carefully removed the knife from Tom's lap and examined it. It looked real, hard, and sharp. There was no trick switch. He then looked at Tom's legs and without hesitation drove the knife into Tom's left leg just as he had seen Tom do to the right leg. The sudden searing jolt of pain aroused Tom from his peaceful, tranquil slumber, and the long shrill cry that followed from the depths of his lungs filled the still Sunday air, shook the grass, and rendered poor Luke and Duke wet in front and soiled in the rear.
Their reign of terror ended that day as the deeply embarrassed, remorseful, and profoundly apologetic parents, dragged those two criminals home, never to return to the open ward again. They punished the boys severely, something to which neither had been accustomed, though both sorely needed. Tom's leg healed well without infection, lucky for all. He proved more forgiving and understanding than either of those two boys deserved. Dominic Fonderini never walked again, and his speech remained limited; but he was able to go home after many months on the ward.
According to Old George, life finally returned to normal with Dominic's departure. Although the Fonderini extended family promised to return to visit from time to time, Old George thanked them but assured them that it wasn't really necessary even without Luke and Duke.
"You see," he said, "General Grant never meant for me to have a lot of guests."