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Slum is a place I have dreamt of for more than thirty years. It is nightmarish, hellish. The dream I've written about below details my latest visit there, which took place a couple of years ago, and will appear in the next edition. I thought I'd include it now given that Senate Republicans are desperate to give us health care that is in many ways no less nightmarish.
The Health Clinic
THE MOST recent visit to Slum couldn’t have been mistaken for anything else. I knew I was there the moment the vision began.
I’m trudging up to the summit of a bluff. A wide, long white building is there. It looks like a huge warehouse. It’s not brick or wood but aluminum siding and windowless. Its roof appears to be green.
It’s night. I don’t know what time it is, but it feels late. I’m walking on loose dirt. A quarter mile behind me is a circular parking lot. It’s freshly paved and brightly marked. Several cars, all of modern make, are parked in it with their lights on. I see no sidewalk leading from it to the building. It’s as though the builders ran out of funds before they could put one down.
Just as I think that, I spy one. It’s a hundred paces ahead and begins between dead bushes.
The air is dry and cool and smells of a slaughterhouse. There are thick columns of orange-light-illuminated steam rising behind the building, which appears to sit at the edge of the bluff. The lights seem to be coming from below it, as does the steam.
The loose dirt under my feet occasionally gives way to harder, cracked earth that looks like it hasn’t seen rain in months. Both are hard to walk on. It’s apparent many have judging by the shoe prints everywhere. I spy what looks like bicycle tracks as well. Lots of them.
I gain the sidewalk and stop to catch my breath. The sidewalk looks brand new and sits on the dirt like a stone tapeworm. It’s virgin-white and well groomed and two yards wide. It winds haphazardly towards the building, passing through more scrub on the way. I stop to catch my breath once I get to it.
Stairs are just ahead. I start for them after another minute.
I stop when I reach them, and stare down them. The sidewalk continues at the bottom, where it crosses a gully. A gate is in the middle of the bridge, like one of those you’d see at a subway terminal. There are lights on it. They glow the same cold orange as the light shining up through the steam.
I descend the steps. Abandoned and wrecked wheelchairs are at the bottom. There are scars of tracks in the hard earth to each side, as well as oxygen bottles and tangles of plastic tubing.
The gully looks deep. It’s more like a gorge. It’s no more than sixty feet wide and runs in both directions into sightless night. I listen for sounds of water, but hear only the distant grind and hum of machinery, and the rusty creak of what sounds like wheels spinning weakly on axles. I look back. None of the wheels on the wrecked wheelchairs at the bottom of the stairs are spinning.
I turn back and start across.
I study the gate when I get to it. It was designed to admit wheelchair-bound patients. On the other side is a large, square metal platform with a big red symbol of a wheelchair on it, along with unavoidable black block letters:
I push partly through the double turnstiles and hesitate. The platform is mounted over machinery that has been neatly integrated with the structure of the bridge itself, making it nearly invisible. I wonder what it’s for.
Without warning the turnstiles come alive. The orange lights on the gate switch to red at the same moment a pleasant female voice announces: “Time expired … time expired … time expired …”
The turnstiles are pushing me onto the platform. At the last second I yell and leap as far as I can.
I land just on the other side. How I managed to clear the platform is a mystery: it’s at least three feet wide, maybe four. I gawk down at it, and then look over the metal railing of the bridge into the darkness below.
It takes a minute for my eyes to adjust. I back up, horrified, and hurry on my way. The mystery of the spinning wheel sounds has been solved.
On the other side are more stairs. I climb them at a run. At the top I gaze ahead. The warehouse is still a quarter mile away. It must be positively enormous. I hear a high-pitched whistle and then a long bell, and then the grudging grumble of heavy machinery. I can feel whatever it is in the bottoms of my feet.
I catch my breath and continue, walking fast.
There are signs posted every couple hundred feet. They’re circular, yellow, and bordered in black, with the same black block letters.
PATIENTS MUST HAVE INSURANCE CARDS READY
URGENT CARE PATIENTS: TAKE SOUTH SIDEWALK
TALKING IS FORBIDDEN ONCE INSIDE
INCOMPLETE CLAIMS WILL BE REJECTED
PAYMENT EXPECTED UPON ADMITTANCE
PATIENT PACKAGES MAY BE COLLECTED AT WEST ENTRANCE
I look up. This … is a health clinic?
There were health clinics in
Diego that were awful-looking, but none as nasty as
this one. I think of the gully and what I saw at the bottom of it, and shudder.
I’m standing at the last sign and find myself staring at it. It confuses me. What the hell is a “patient package”? Is it some sort of admittance package meant to expedite processing? Do I need to go to the west entrance to pick one up before coming back to this entrance? Which one is this entrance? Which way is west?
I try to get my bearings. I know I’m in Slum. Perhaps I can find my way if I can find Slum itself. Try as I might, though, I cannot spy the skyscrapers of the metropolis no matter which direction I turn. The night is ink-black and starless. The only light comes from the building, the orange glow of the steam, the cold white circles over the sidewalk, which begin here, close to the building, and the negligible yellow glimmer of headlights on cars in the parking lot, now a fair distance off.
After a long time trying to figure out what to do, I continue on.
At the entrance I try looking in, but can’t. The sliding glass doors are tinted and impossible to see through.
I take another step and the door slides open. I look.
An abandoned counter is fifty feet ahead. A single light shines down on it. I look for a sign on the sliding doors for the clinic’s hours, but can’t spy one. Frustrated, I walk in.
A three-inch-wide bar of fading red masking tape is on the floor next to a sign on a stand that reads: WAIT HERE. So I do.
I’m at the edge of the light. I glance around to get my bearings.
To the left and right of the admittance desk is the waiting area, but it’s shrouded in darkness. As my eyes adjust I can see that many of the chairs are occupied. I can just see people’s silhouettes. No one is moving.
I can hear them breathing. There are at least a couple hundred of them, and they are all breathing in unison. It’s barely audible but unmistakable.
There are big double swing doors to the right of the desk. I decide not to continue waiting when it occurs that they are watching me. I walk quickly to the desk and look down. The scheduling notebook is open. My name is on the bottom.
I turn to leave, but when I do the shadows stand and turn to face me. The noise of their breathing gets much louder and sounds very close.
I hurry to the double doors and half-walk, half-jog through. I stop to calm myself when the noise stops.
The corridor appears endless. At the far end is only darkness.
It’s patchily lit by bright, white corporate lights and has a white tile floor so common to hospitals, and white walls. There are blue doors on both sides, spaced at irregular intervals. All are closed. I hear the murmur and mumble of machinery and decide to walk on.
There are people behind the doors. They’re screaming or puking or cursing. I see no medical personnel anywhere. At one door I hear nothing, so I cautiously open it.
A man is on his back on the examining table. His arm hangs over the edge. His hand has been amputated. The stump is spurting blood into a drain. He appears dead. He’s wearing a hospital gown, his big belly tight pushing up against it, his eyes staring unblinkingly up. Flies buzz around him.
I quickly close the door and walk on.
I approach a section of hallway that’s dark. It isn’t entirely lightless; maybe one in ten of the lights have been left on. The half-gloom is more menacing than total darkness.
The sounds in this part of the corridor are more gruesome: drilling, sawing, and loud thudding splashes. One of the doors on the left has a blue LED light on the doorjamb just next to the doorknob. It’s flashing. As I get closer I hear what sounds like a recording. It’s a woman’s voice, calm and reassuring. She’s repeating:
“Code blue, code blue,
Fuck you, fuck you …”
I hurry on. I don’t want to imagine what’s inside. As I pass a beep sounds and the voice starts laughing hysterically. Just out of earshot I hear the beep again and:
“Code blue, code blue,
Fuck you, fuck you …”
The corridor goes on and on.
A small section a hundred feet up is well lit. As I approach, a young doctor steps out of a room on the right and turns to face me. He’s a good-looking man, with curly brown hair and a strong chin and sharp eyes. He’s wearing the expected white lab coat and a fashionable tie. He’s holding a clipboard which he clasps with both hands behind his back as he waits patiently for me to get within range without having to shout. The machinery grumbles to life again.
I motion over my shoulder. “There was no one at the front desk, so I thought I’d—”
“Don’t worry about it,” he interrupts congenially. “Come on in …” He sweeps his arm towards the door and gives an impersonal, professional smile.
I open the door and step inside. He’s close behind.
“Go ahead and sit,” he says.
I go to the examining table and sit. The fresh white paper on it scrunches loudly beneath my butt.
The room smells of detergent and death. There’s a sink to the left, and a cabinet above it. He opens it, reaches into it, and extracts a pair of white latex gloves.
“Forgive me,” I say, “are you a nurse or a doctor?”
He snaps the gloves down to his wrist. “Does it matter?”
He studies the document on the clipboard, which he picks up after setting it next to the sink. He grabs the blood pressure cuff hanging on the wall. “Roll up your sleeve.”
I unbutton my left cuff and roll the sleeve up. He wraps the black band about my upper arm with professional ease and starts squeezing the bulb with smart rapidity. The band inflates and squeezes my arm, tighter and tighter. He keeps going.
“Excuse me,” I complain when I’m no longer sure I can contain a groan of pain, “isn’t that enough?”
He stops, puts his stethoscope against my wrist. “Shhhhh …” A moment later the pressure of the cuff releases.
“Elevated, I’m afraid,” he says. “One forty over eighty-five.”
“Clinics make me nervous,” I tell him as he yanks the cuff off and hangs it back on the wall. “I also get performance anxiety.” I shrug.
He watches me with professional concern, then snatches the clipboard and starts writing after removing his gloves. “You’re a fuckin’ pussy, then. Is that what you’re telling me?”
He stops, stares. He isn’t smiling.
“I … I’m sorry,” I say. “What did you say?”
He tosses the clipboard. It bangs loudly on the cabinet, hits the wall, and falls to the floor. He gives my arm a companionable slap. “It’s nothing to be ashamed of. You’re in the right place to get it treated.”
“To get what treated?” I demand.
He smiles understandingly.
“It’s all in fun, Mr. Montaigne. I was just trying to make you feel comfortable. Now roll that puss-ass sleeve down and let me write you a prescription, you fuckin’ faggot—”
He pulls a small pad from his coat pocket and begins writing. The calm, professional demeanor is gone. He’s scribbling madly.
The pen starts pulsing blood—or what looks like blood. It drips off the pad and covers the pen and his hand.
He keeps scribbling. It spatters his clothes. Finally he turns and heaves the pad at the sink and rages, “You FUCKIN’ PUSSY! You didn’t bring your patient package, did you? DID YOU? I’ll get one. Here!—”
He jerks the top cabinet drawer open and yanks out a shiny silver package. It’s the same size as a package of ramen noodles. He bites a corner and violently tugs. The package opens down the middle. Shit oozes out of it, and maggots, and trash. What looks like an infant’s hand is in it. The hand is alive; it reaches weakly for him. He spies it and licks it and then stuffs the package down his unbuttoned trousers and begins masturbating.
The pen, on the floor, is still pulsing blood. There’s a sizeable puddle of it between me and him and the door.
A baby is crying now …
“Oh … oh, yeah,” he moans, his arm jerking up and down with steady severity. “Fuck yeah! …”
I get control of my disgust and jump the puddle for the door. It’s unlocked. I throw it open and hurry into the hallway. I hear a deafening whistle and long bell very close by, and then machinery rumble to life. I wheel about to look—
A huge tractor is growling down the hall from the waiting room. It has no driver. In front of it are shadows—what have to be those who were sitting in the darkened waiting room. They’re stumbling towards me like zombies. I can’t make out their features.
“Oh yeah,” grunts the doctor through the closed door. “Oh fuck yeah!”
Blood seeps under the door. I step back and gawk at the oncoming silhouettes and the tractor looming up behind them.
As I watch they start changing. The closer to the front they are, the faster they get younger, the more I can make out individual features. Soon the frontmost ones are nothing more than crawling babies, each horribly visible. The devolving silhouettes step on them mindlessly as they hurry to avoid the machinery advancing on them. But the faster they hurry, the faster they devolve. The hallway is filled with screaming infants in perfect detail and the stumble and crush of the faceless shadow crowd, and the grumbling, roaring tractor, which is now only fifty feet away and greedily shoveling blood and guts and writhing babies up.
I back away. Double doors are suddenly just behind me.
The lights go out—
—I’m standing on a high scaffold of some kind. The warehouse is forty feet above and to the left. It was built at the edge of a cliff. I’m looking at the double doors, but from outside. As I watch they burst open. The tractor’s big scoop suddenly appears. It’s filled to capacity. The scoop turns down and a great bloody mass falls into the maw of a rusty funnel labeled in chipping yellow letters: NUMBER ONE. The tractor roars and the scoop disappears back into the hallway. The doors slam closed.
There are many other double doors. Beneath them are rusty funnels: NUMBER TWO … NUMBER THREE … and on and on. As I watch, double doors burst open at random and dump great globs of red writhing flesh.
The funnels lead below a geometric tangle of pipes of all sizes and shapes. There are workers down there. They glare up at me with hate. They man huge cylindrical tanks like water heaters. Some work over what looks like troughs. Steam hisses angrily; still, I can hear babies crying just beneath it. I try to see where the funnels lead, but can’t. The tangle of pipes and troughs and tanks makes it impossible. It’s all lighted by harsh orange lights and confused by steam.
At the far end isn’t an orange light, but a yellow one. It illuminates a large sign, one that I can see clearly:
FORM A SINGLE LINE!
REPORT DIRECTLY TO ADMISSIONS
AFTER COLLECTING YOURS!