Outpatient Clinic

It’s a brick and concrete structure, rectangular in shape and nondescript except for the drain spouts that add a touch of art when the water coming off the roof freezes and forms into icefalls. It’s not an ancient building yet not new, built over twenty years ago. The air inside is kept too cold in the summer and too hot in the winter. This winter’s been brutal with the chill so the moment I walk in, freezing from the weather outside, I’m struck with a wave of heat that in the first instant brings comfort but in the second nearly makes me ill. Straight off the entrance, the main hall is wide and half the length of a football field. I can see to the far end past the security desk where the green institutional doors with their push bars stand closed and locked. The thick frost on the far side of those door windows keeps me from seeing through to what stands beyond. The northern wall, to the right, is lined with short brown wooden partitions that are topped with glass dividers not unlike a bank that scrimped on fixtures. Behind the partitions are the scheduling desks facing inward towards the hall and behind those are more desks facing any way but inward. Clerks are stacked three deep in this narrow space. They each have a computer and a phone but there’s one line for every two phones so the incoming calls are squeezed and stacked into a queue. This design gives the front-line staff time to belong to the people standing before them, and the folks dialing in a chance to find their limit. The clerks rotate chairs throughout the day to avoid burnout but they gain a different kind of insanity.

Opposite the scheduling desks, through the doors on the southern wall, are Dental, Optical, Service Officers, the Patient Advocate, Lab and X-ray. Pharmacy has its own little waiting patch with an electric overhead sign that reads out numbers for the next in line. At the little space for the Volunteers there’s a cutout window and a ledge where they’ve placed donuts and cakes.

Veterans, some quiet – others talking, wheezing and coughing – are lined up to take the nourishment. Paper cups and pastries in hand, they turn and leave their heavy breath behind. For a few of the visitors this is the morning ritual, a visit to the clinic to chum with their friends and grab a cup and a bite to eat.

Every space between the desks and the doors on both sides of the hall is furnished with plastic chairs for people to sit in while they’re waiting. Even this early, those waiting outnumber the chairs. The system struggles, the crowd grows, and the warmth does too. It’s easy to tell that the clinic isn’t shaped to meet the burden that’s placed upon it.

On the floor there’s a strip of white tapeline across a length of blue indoor-outdoor carpet that lies parallel to the check-in desks. There’s a sign taped to a partition that reads, “Wait here for your turn.” Most of them are good at waiting, it’s part of what they know. If the spirit moves them, some will grow tired and step out of line. There’ll be a shoving match that might lead to a boxing match and one of them might go down for the count. Along with learning how to wait they learned how to fight and even if it was a long time ago it’s still a part of who they are.

Many of them wear symbols of fabric: A hat, a patch, or a shirt that shows where they’ve been or where they want you to think they’ve been. Sometimes, along with the cloth there are other symbols and if those markings don’t show where they’ve been, they show where they are.

I look back and notice a fat, disheveled guy in shorts. His pale legs show bright against the grayness of the day. He’s standing in the space between the entrance doors making his choice from the offerings in the vending machines. I think to myself, “It’s too wintry for bermudas; you’ll freeze your skin. No-one cares how tough you are,” just then realizing that his legs are prosthetic and it’s not the temperature that matters.

“Morning Ranger,” someone voices as I walk by – I nod back.

I turn to the right, pass through a door and make my way to the little cave of an office, locking the door behind me. With the door shut, the temperature in this room is amplified more than most. If it’s hot out there, it’s fiery in here. The room’s got two glass openings that face out somewhat like the entrance to a movie theater. The ledge beneath each is cut to allow vouchers and cash to be passed; they pass travel vouchers in, and I pass cash out to cover the cost. One window’s high for those who can stand and the other’s low for those who can’t. There’s a bag of dog biscuits near the low opening. I keep the lights off and the room dark while I answer the phone and direct the calls. Occasionally, someone comes to my window and asks a question or passes paper.

A young, fit man appears at my window. In his twenties, there’s an attractive woman of his age standing beside him. With an even, firm voice and no trace of emotion, yet not with a dead voice, not with despair nor the sound of depression, not as if he’s asleep, he asks me a question and takes my answer. His companion smiles and say’s something to him. I catch her name, “Annie”, as he answers her back. They turn and go. I think she must be cut from the same cloth as he; they seem similar and well matched. There’s something noble about him, and about her too. For a moment I wonder why he’s here – he looks whole. He walks away with a stiff rhythm. A prosthetic leg replaces the real one lost in battle or lost in error. I think to myself, “He bears it well; they bear it well.”

My mind drifts back to when I was his age, retreating to parts I left behind and pains I no longer ratify.

I did it for God and country, our way of life, my brothers-in-arms. I did it for myself. It wasn’t a good war, but it was the only war we had. It could have been worse. Others paid more. I knew the risk; I have the reward.

A week or two later, while walking the hall I spot them again, sitting in chairs, waiting. Annie’s smiling and leaning into him, saying something. He’s listening, sitting straight yet relaxed. I have the same reaction to them; their strength and their quality but now I can tell that they are cut from the same cloth, likely brother and sister. This time I notice that both of his legs are prosthetic.

This is the protocol. We offer them glory, immortality, a purpose, a job. Most of them served and survived before their brains finished growing and the experience stopped them something like an athlete who reached his peak in high school and never got past it. Killing is hard and better suited to the young for many reasons. Of the seven percent who served, one-fourth have seen combat. Combat or not, one feels bitter, cheated, deceived – the other proud, humbled, at peace – but whatever their feelings, they mingle here in the clinic. So we try to treat them for what we did to them and what they did to themselves.

Months later, the clinic is being moved to a new facility better suited for the greater numbers that the continuous wars have generated. The old building is being offered in service to another need. The doors are open as I walk in to pick up a few personal items. Workers move chosen pieces of furniture, equipment and medical records onto trucks to be taken to the new space. The inside temperature is in balance with the outside temperature as I pass through the entrance and look beyond the empty main hall, past the vacant security desk and the green institutional doors.

“You coming with us, Sarge?” someone asks.

“Maybe. What’s coming in here after we leave?”

“More of that,” he says, pointing with a thumb towards the space outside.

I follow his motion to the opening at the far end of the ward. Out there, on the gentle lawn, magnificent oak trees looking like giant soldiers stand guard above the grass covered fields. In the midst of a meadow dotted with the grave markers of the Michigan veteran dead, a fresh hole has been dug in the earth. There’s a ceremony taking place. After a pause, I recognize Annie standing next to a flag draped casket. It takes me a moment to understand.

“You with us, Sarge?”

I turn back the way I came, my eyes watering, and my skin flush with newfound shame.

Several clerks stop their labors and stare my way, curious to hear my answer.

Maybe the best we can do is give them a place to rest – these people cut from the same cloth.

“Yes,” I say, “I’m with you.”

 

 

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