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E.R. Madness
by Margi Desmond

Pearl’s rotund bottom spilled off the sides of the hard, molded plastic chair, and its edges cut off the circulation to her legs. The tingling caused her great discomfort and would probably lead to a blood clot that would travel to her heart and kill her. Or when the nurse took her to see the doctor, her legs would be asleep, and as she stood, she would collapse and smash her head on the floor, causing a traumatic brain injury.

Where was Ralph, that stupid husband of hers? While she suffered in agony, he’d most likely gotten lost on the way to the cafeteria. All he had to do was fetch a cup of coffee. She hoped the caffeine might lessen her horrible migraine. The doofus probably got distracted by a colorful square of giggling Jell-O and decided to grab a bite to eat while she suffered alone in the filthy sewer of an emergency room.

Her eyes scanned the packed waiting room. An old man sat rubbing his chest, his face distorted in apparent agony. A middle-aged Mexican woman rocked back and forth in her seat, eyes closed, lips moving as she clutched a rosary with one hand, the other loosely bandaged with a dirty cloth and resting on her lap. A teenager appeared to be passed out while sitting upright in a chair. His head pitched forward, chin resting on his chest. A string of drool hung from his swollen bottom lip and puddled on the front of his shirt.

Pearl heaved herself off the chair and shuffled to the reception area. Two triage nurses sat at the counter, one typing on a keyboard, the other speaking on the telephone, and both focused on computer monitors. Pearl banged her knuckles against the glass partition, causing them to jump in surprise. The blonde, mousy little nurse stopped typing and slid open the glass window. “Yes, ma’am?”

“I’ve been waiting for hours,” Pearl snapped. She glared at the pale woman, dark circles under her eyes and hair askew. Pearl had no patience for people who wouldn’t make a little effort in their appearance.

“Mrs. Wallace, as I told you fifteen minutes ago when you arrived, we’ll call you as soon as possible. As you can see,” her eyes scanned the waiting room, “we are quite busy.” The nurse started to slide the glass partition closed, but Pearl blocked it with her hand.

“You could at least show me to a room so I don’t have to suffer in this grimy hellhole.”

“We don’t have any available rooms at the moment, Mrs. Wallace. Please have a seat until you’re called.”

“I hope one day you’re really sick and nobody gives a damn about you,” Pearl spat. “And as you suffer, think of me and how little compassion you showed a decent woman in dire need. Karma’s a bitch, lady.”

“I’m sorry you feel that way, Mrs. Wallace.” The nurse turned back to her computer.

“Mommy, I need to go potty,” a little boy said. He shifted his weight from one foot to the other and grabbed the back of his pants. His mother relinquished her seat on a worn and faded, yet cushioned settee and walked with the tot to the bathroom. Pearl plopped down in the vacated space. It was more comfortable than the plastic chair, but probably infested with lice and other critters. She started to itch at the thought.

A girl clad in frayed bell-bottoms, a stained peasant blouse, and flip flops rushed through the front entrance holding a tiny baby in her arms. “Please help me,” she said to the triage nurses. “There’s something wrong with my baby.” They both stood up and focused their attention on the child. The blonde nurse rushed from behind the desk and disappeared for a moment before emerging from the door leading to the examination rooms. She guided the girl and baby through the door.

“Now doesn’t that beat all,” Pearl thought, furious. “The damn kid wasn’t even crying. That stupid hippy is probably unmarried, unemployed, and enjoys welfare financed by my tax dollars, but still they see her before me!”

Pearl sat, fuming on the ratty old sofa, when the girl returned to the waiting area. She squeezed in the seat beside Pearl on the sofa. The girl stank of cigarettes and booze, long, greasy brown hair, and a pierced eyebrow. She looked at Pearl, then sniffed and wiped her nose with the back of her hand. Her only makeup appeared to be smudged mascara below her eyes. Pearl grimaced. The girl had blackheads across her nose and red splotches of acne pustules on her chin and forehead.

“My baby,” the greasy-haired girl said to Pearl. “They took my baby.”

“Yes, I noticed. I’ve been waiting here forever and you just waltz in and they see your kid. It wasn’t even crying.”

“They made me come out here to wait.”

“You can hardly be surprised. You stink like a gin-soaked honkey tonk.”

Greasy Hair began to cry. She bent forward and put her head in her hands. “Please, please God, take care of my baby.”

Pearl rolled her eyes. She shifted her weight in an attempt to move as far from Greasy Hair as she could, despite the small couch. The filthy trollop probably had herpes or some other revolting venereal disease.

Where was Ralph? Pearl couldn’t look for him because the nurse might call her while she was gone. Plus, she’d lose her seat on the couch and be forced to endure sitting on the horrid plastic chair again. Not to mention her headache. What if she started walking down the hall to the cafeteria and felt dizzy? Would anyone help her? Probably not, judging from the crowded waiting room. All concerned with their own needs, never taking a moment to notice her, Pearl Wallace, a woman of advanced age. She could have a stroke or a heart attack and they wouldn’t care.

The little boy and his mom emerged from the bathroom. They started toward the sofa, but spotted Pearl and Greasy Hair occupying it. With no other available seats, the mother and child stood against the wall.

Greasy Hair looked at them and said, “Hey, you can sit here.” She stood, allowing the other mother to sit beside Pearl. The little boy climbed on his mother’s lap.

“Thanks,” the mother said. “I’m exhausted. I’ve been up since yesterday with little Kevin here.”

“Oh, what’s wrong?” Greasy Hair asked.

“Diarrhea, vomiting, high temperature.” She felt his forehead. “He’s burning up.”

“I’m sure they’ll fix him up just fine.”

“Miss Trudeau,” the blonde nurse called from behind the counter. “You can come back with me now.”

Greasy Hair spun on her heel and followed the blonde nurse to the back.

“Son of a bitch,” Pearl muttered. “This is getting ridiculous.” She hoisted herself from the couch and stomped to the front desk. She pounded on the glass partition. The redheaded nurse slid it open.

“Yes?” She smiled, which caught Pearl off guard. The nurse had beautiful, perfect white teeth, porcelain skin, and the most captivating green eyes. Pearl composed herself, her anger softening.

“I’ve been waiting here for a very long time and have still not been called to an examination room.”

The phone rang at the nurses’ station but the redheaded nurse kept her attention focused on Pearl, which pleased her. “I apologize, dear. As you can see, we’ve been inundated by patients.” She ran her tongue across her bottom lip, shiny with lip-gloss. Pearl wondered if it tasted like cherries or bubblegum.

“I understand that,” Pearl said. “But first come, first serve.”

“I couldn’t agree more,” Red said.

“So why did your co-worker take that woman’s child before me?” She pointed to Greasy Hair. “I have been waiting longer.”

“Honey, if it was up to me, I’d have taken you back upon your arrival,” Red said.

The blonde nurse interrupted, “We have protocol we must follow, ma’am.” She gave Pearl what appeared to be a pained look.

Pearl pointed at Blondie. “You! You little condescending speck of nothingness. Keep your mouth shut.” Pearl turned to Red and said, “You should teach your buddy the fundamentals of customer service.”

Pearl stomped back to her spot on the vinyl sofa, currently occupied by the little boy. “Shoo!” She waved him off, much like she would wave a flock of seagulls off the deck of her beach house. “Sit on your mother’s lap.”

The little boy hopped off the sofa, just as Blondie called, “William O’Neal?” The lady picked up the child and followed the blonde nurse to the back.

“What the…” Pearl was flabbergasted.

The Mexican lady continued to mumble in Spanish, words Pearl assumed were prayers, since the woman was holding a rosary. The red spot grew on her bandaged hand. “Probably an illegal,” Pearl thought. “Another one sucking the teat of taxpayer funded government handouts.”

Pearl glanced at the triage desk and made eye contact with Red. The nurse smiled and nodded, as if she had read Pearl’s thoughts and agreed.

A hoodlum staggered in next, holding his side. He limped to the triage area to check in, and then took a seat in the chair directly across from Pearl. He sported shaggy hair, soul patch, and two teardrop tattoos below his eye. His jeans too big for him hung down low and exposed his skull and crossbones boxers. He glared at Pearl. She glanced away, but when she looked back at him, he continued to concentrate on her with eyes the color of coal, a murderous glare of the insane. She fought the urge to scold him for rudely staring at her.

“What you looking at, old lady?”

Pearl’s mouth dropped open.

“Yeah, that’s what I thought,” he said and harrumphed a wicked, disrespectful laugh.

“Mr. Yoakum,” Red called. “Come on back.”

His facial expression and groan upon standing indicated severe pain originating from where he clutched his side. On his way to the exam room, he jumped at Pearl, scaring her and causing her to jolt in terror. He laughed and limped away.

Pearl’s heart raced. She took a deep breath and tried to relax. How close had she come to getting attacked? That nasty thug probably had a gun under his shirt. She could tell by his appearance he was a gangbanger. Had to be. How many people had he killed, raped, maimed? Oh my, she was working herself into a tizzy!

Her head hurt worse. Probably the stress caused her blood pressure to elevate. Headaches were indicative of soaring blood pressure levels. First the headache, then the stroke. She had to get out to the waiting room. She couldn’t take it anymore.

An old man moved from a hard chair to the softer seat beside Pearl on the couch. “You don’t mind if I sit here do you?’ He smiled at her. “I’ve been here for quite a while and those plastic chairs get a wee bit uncomfortable after a while.”

“I’ve been her forever,” Pearl said.

The gentleman nodded his head. “I saw you arrive.”

“My head is killing me,” Pearl said. “I suffer from migraines but this one is a real doozie.”

“It’s chest pain for me,” he said.

“Now I’m nauseated.” Pearl rubbed her belly. “It’s probably low blood sugar. I haven’t had anything to eat in hours.”

“What a shame. I’d be glad to look for a vending machine. Maybe get some crackers and a drink for you.”

Pearl looked the dirty old man up and down. She was not in the mood to deal with a lecherous geezer. “My husband went to the cafeteria for me.”

“Mr. Elliott,” Blondie called him next.

“Take care, now.” The man smiled and nodded bye to Pearl before shuffling to the nurse.

“Oh for the love of Pete!” Pearl snapped to nobody in particular. She made eye contact with Red, whose perfect glossy lips mouthed, “Not much longer.”

“Mrs. Nunez,” Blondie called the rosary-toting woman.

“That’s it!” Pearl bellowed and stomped to the triage desk. “I’m sick and tired of sitting here watching degenerate bums go before me. I demand you take me back there right now!”

Blondie looked at Pearl, a pained expression on her face. “Mrs. Wallace, please be patient. I really need for you to work with me. The other people—”

“I don’t care about the other people! They can drop dead for all I care. Take me now.”

Red’s eyes twinkled and she stood up from her chair. “I’d be glad to show you the way.”

“That’s more like it!” Pearl turned to Blondie and gave her a nasty look. The nurse returned the look with tears in her eyes. “Good,” Pearl thought, satisfied she’d upset the little blonde fool. Maybe she learned her lesson.

Red put her arm around Pearl and guided her through the hallway. Screams of agony came from rooms, the putrid smell of death and decay stung Pearl’s sinuses. “This place is awful,” she said. “Is it State-run?”

“You insisted I bring you back,” Red said, her face inches from Pearl’s; her breath warm and sour. Pearl stepped back, wary.

“Come, here’s a room for you.” Red guided Pearl into a filthy room. The bloodstained bed and bedside toilet full of feces left Pearl speechless and horrified. She turned to leave and caught her reflection in the mirror above the sink. Her head, bloody and partially caved in on the left side, exposed moist, congealed white matter. Was she hallucinating?

“No,” Red said, reading her thoughts. “You and Ralph were in a car accident. Pronounced DOA. He was sloshed—hit the sauce pretty hard at the country club brunch buffet—so we got to take him immediately. Gotta love those drunk drivers. You killed the mother and her infant, too. Babies go right back with Blondie.”


“Some are slam dunks. I’ve always gotten the Nazis, but they’ve dwindled. We have most of them now. Reality show stars are our new staple.” Red shrugged her shoulders. “Everyone else is fair game. Blondie and I must wait and see how the rest choose to conduct themselves.”

Pearl shook her head. “That doesn’t make any sense. I’ve been in the waiting room waiting for a doctor.”

Red laughed, exposing a black, forked tongue. “You silly fool, that was Purgatory.”


“Purgatory. You had your chance to redeem yourself. God knows—literally—that my annoying goody-two shoes co-worker kept giving you opportunities, but you squandered them all away.”

Pearl thought of the hippy girl giving up her seat for the boy’s mother, the man offering to buy Pearl a snack, the lady praying with a rosary…the blonde nurse took them all.

Red grinned, teeth now pointed. “Yes, they redeemed themselves. But you, well you were a self-centered bitch, just like He likes ‘em.” She jabbed Pearl in the ass with a trident. “Come along now.”

Pearl’s screams echoed as Red dragged her down the corridor. 

Margi Desmond is the author of nineteen short stories and more than 100 articles. She's a member of Mystery Writers of America, Sisters in Crime, and the Short Mystery Fiction Society. In addition, she volunteers for the annual Colorado Book Awards and the Daphne du Maurier Award for Excellence.