God's Country

The day Miranda met Rick, he was her fourth patient of the day. First she had driven out to the Lawrence Welk retirement village, just north of Escondido, to see Mrs. Brown. Mrs. Brown was another unpopular patient who had ended up on Miranda’s roster. Ninety-four years old and savage with it, she had outlived all her family and had probably never had friends. She spent her daily eighteen or so waking hours deliberately tormenting her Yugoslavian caretaker, Mara. Young Mara was stoic, worth her indenture to stay in America and learn English. Mrs. Brown could not live much longer. Could she? Miranda hoped every visit would be her last. It isn’t that her compassion was faulty. Rather, with her wide experience with the range of human pain and suffering, she understood that Mrs. Brown was angry with God for keeping her alive, for abandoning her on this plane. God was not around to be yelled at, so she belittled Mara. And Miranda, and, in fact, any human being foolish enough to get within range of her mercifully dimming senses.

Mrs. Brown was bedridden, and sores tended to form on her heels, even with the best-quality foam cushions and regular care by Mara. She also needed her oxygen tank replaced. Miranda rang the front doorbell, huffing a little under the weight of the tank. Mara opened the door and the two women greeted each other cheerfully.

"You’re late!" screeched Mrs. Brown from the living room. Mara had put her in her chair so she could wheel about the tiny mobile home and watch a bit of TV. Mrs. Brown still watched on black and white, being too cheap to spring for color. She had been wealthy once, and as far as I knew, still was. She was paying Mara herself, and could have afforded to pay her significantly more. The only reason she was on the county’s list is because all the private nursing agencies had stopped taking her as a patient. Miranda Ruth, last stop for the recalcitrant, for those too stubborn to give up their stubbornness, even when their lives were on the line.

"I’m right on time, Mrs. Brown, I called Mara before I left the house. And, you’re my first patient today so I haven’t had time to fall behind yet," said Miranda evenly, entering the living room and setting down the tank. She deftly changed out the old one and lugged its carcass back to her car. She went back in the trailer and the plastic and metal door banged to behind her.

"Shut up, I’m watching my show!" bellowed Mrs. Brown. Mara, making oatmeal in the miniature galley kitchen, caught Miranda’s eye and shrugged. Such is life, said the shrug. She’ll be dead soon enough.

Miranda knelt on the brown shag carpet at Mrs. Brown’s feet. She cleaned the sores and changed the dressings, to the music of Mrs. Brown’s complaints about her clumsiness and tiny screams as she pretended to be hurt. Miranda knew she had almost no nerve endings left in her feet, so she ignored her, focusing instead on keeping her work clean and professional. If Mrs. Brown did die, she wanted it to be clear to all that she’d had no hand in hurrying her along. She finished in less than fifteen minutes and bid the truly suffering Mara farewell. She saw Mara light a cigarette through the kitchen window as she pulled back out of the driveway. Hardly ideal for a patient on oxygen. On the other hand, she could hardly blame her. If she had to live with Mrs. Brown, she would probably be smoking something stronger than tobacco.

Her next two patients took longer. They were both down in Rancho Bernardo, the land of white stucco and city-mandated red-tiled roofs. Darling community of the retired set, who seemed to enjoy the stamped sameness of their tiny piece of the American Dream. Dennis Farrell and Claire Munton lived in the same independent senior living complex, essentially private condos with communal dining facilities and extra services for mostly mobile seniors. They had never met. Dennis had recently had knee-replacement surgery. He had been an active man all his life, still tall and tanned at eighty-three. He chafed to get back on the tennis court. The wound, however, was inflamed from his attempts to hurry it along and Miranda had to give him a stern lecture. He pouted like a four-year-old but grudgingly agreed to rest more when she warned him that it would collapse right out from under him on the tennis court if he didn’t take care of it.

Tiny Mrs. Munton lived alone with her calico cat, Sinbad. She was suffering from a bad bladder infection and was temporarily on a catheter. She was so modest, a flower from a different age. It embarrassed her terribly to have even a nurse like Miranda look at and touch those areas. Miranda put on music and spoke to her, distracting her attention from the unpleasant task. But the catheter was leaking. Claire would have to go to the hospital, and the doctors would have to re-insert it. Miranda called the ambulance for her and waited until it came, gazing with pity at the tiny figure being bundled into the back. She hated it so much, those rough men with their hard voices and thick, violating fingers. It just wasn’t right, she’d breathed to Miranda, right before she had opened the door to the paramedics.

Damn, it was almost noon. And Rick, her next patient, was halfway across the county. Now she really was going to be late. Oh well, at least he was her last patient of the day, and he wasn’t that far from her own house, relatively speaking. She preferred to finish early so she could go home and tackle the paperwork. If she didn’t do it every day, it quickly grew into an unscalable mountain. She thought about Rick on the long drive out, everything she’d heard from the other nurses.

"He’s so rude," said Brenda, her big blonde hairdo bobbing. "I mean, we’re there to help him and he never says thank you." He couldn’t be more rude than Mrs. Brown, thought Miranda, who had once told her she didn’t want some ugly brown immigrant laying hands on her.

"It’s so dirty out there, it’s disgusting," said Faith, violently scrubbing a brush under her fingernails. "He’ll die of some stupid infection, mark my words."

"I’m afraid to go out there. All those…boys. They sit around and smoke pot and…watch me," said pretty little Karina, blue eyes wide. They won’t be watching me, thought Miranda. She was unremarkable in every way. A typical, brown-skinned, wide-faced, mixed-blood Californian. Just the nurse. At 30 years of age, she knew well that she wasn’t the woman to turn men’s heads when she walked into a room. She was sturdy rather than svelte. Practical rather than flirtatious. She’d had a few brief, uninspired relationships, but nothing worth more than a couple of sentences in her journal. If you asked her, Miranda would say that she hoped for love, but didn’t expect it. Peace was enough. Peace, and the good feelings she got from doing her job well, from caring for others.

She got off the 15 North at the Pala exit and headed inland, twisting through the hills. A few unmarked turns led her off onto the road toward Paco Ano, less than 10 miles from her house, where she had never been. The road became dustier as the land on either side grew poorer, the rich succulence of San Diego North County fading into an otherworld of cowboy gloom. The road straightened and the land flattened into a sparse valley. A terrible smell invaded her nostrils, a smell like bodies, nearly decayed into dirt. "Janet’s Mushroom Farm," she read on a hand-painted wooden sign. There were houses, sun-blasted squares and rectangles with peeling paint and no windows. Dirt driveways, skinny dogs hunching together in small packs or lying flat in patches of shade, too weak from lack of food to worry about a passing stranger. Cars, big old heaps, parked in front of these houses in random sprawl. No garages, no real yards. A few gardens lifted green heads from behind stick and wire fences. Clearly, these were used for food, not for flowers or decoration. It reminded her of pictures she’d seen of West Africa.

There were a few oddities. A huge, three-story brick mansion, built just off the road where it could be seen by all. A rickety museum, dedicated to the art of the Paquitos. A busy clinic, with the first actual people she’d seen. But that was it. This scraggly valley, with no grocery stores, no gas stations. No curtains. Almost no people, except for the clinic. It was as though it was too depressing for people to step outside their homes. No one wanted to look at it. It was easier to stay inside, to watch TV and imagine they lived the lives other Americans lived. The richest country in the world, with the highest standard of living.

Miranda wanted to be appalled. She wanted to be outraged. She wanted to think that if she had been born here, raised here, a mere 10 miles to the north and east, she would have somehow pulled herself out. That she would somehow have gotten good grades, gone to college, gone to nursing school. Not gotten pregnant at 14. Not developed alcohol or drug problems. Not been abused, tormented, demoralized until she was accustomed to, used to, expecting to live like this, like these people lived. She feared, however, that it wouldn’t be so. That she would be sucked down into the miasma of despair she saw so clearly before her under the late August sun. She had never been rich, far from it, but she had never truly understood the meaning of "grinding" poverty. But now she knew – that was exactly what it did. It took people, tiny virtuous just-born souls, and ground them up, ground them down. It wasn’t only bodies lacking nourishment out here. These people were starved, in every way that mattered. She understood now why the other nurses didn’t want to come out here, and it had little to do with Rick, and everything to do with the res.

She turned off the main road onto an unmarked dirt side street. Three houses down, the big yellow one, Brenda had said. Don’t worry about the dogs, they might bark but they won’t come near you. Good to know, Miranda thought, as five of them slavered up to my windows. She sat a moment, waiting them out. They backed off, still barking. She took a deep breath and opened the car door. They ran to the back of the house. She got out and pulled some supplies from the trunk and went up to the front door. She knocked on the battered wooden door, any paint that had once been on it long worn away. No answer. She knocked harder. No answer. Some of the dogs came sniffing back around, so she tried the front door. It opened. She stepped in, shouting clearly.

"Hello? Is anyone home? It’s the nurse!"

"Back here," she heard faintly. She stepped gingerly into the living room. The windows were open to the sun and breeze, but it still seemed dark inside. A ratty plaid sofa and a scarred coffee table were the only furniture. By the smell, Miranda could tell that the overflowing ashtrays held the remains of joints as well as cigarettes. A few lighters and half-empty beer bottles were scattered on the table. An enormous TV sat on a wooden crate. A large kitchen was off to the left. To the right, a long dark hallway, painted blue. Something moved and Miranda jumped. She realized someone was on the sofa, passed out. A young man, heavy in the face, with a mane of thick, true-black hair. She walked past him quietly and made her way down the hallway, where the voice had come from. She peered into open doors. A bathroom on the right, reeking and filthy, a medical person’s nightmare. A bedroom, also on the right, another sleeping body passed out on a dirty mattress. A closed door to the left. Two more doors beyond that, open. Miranda passed the closed door and kept on toward the open ones. In the last room on the left, she found him.

Rick was in a hospital bed, placed under an open window, sun streaming in and catching in her eyes so she could barely see him. The whole room was painted the same flat blue as the hallway. Flies buzzed in and out freely. It smelled of old food and beer. There was a small sofa and several mismatched chairs, a tall lamp, and a weathered bedside table crowded with items she could barely take in. It was the most furnished room in the house. Someone else was asleep, crunched nearly in half on the small sofa.

"John," said Rick. "Get the fuck out of here, the nurse is here." The someone else stumbled to his feet and across the hall. Miranda heard the sound of pissing. He hadn’t bothered to close the bathroom door. She set her things down on one of the chairs.

"Hi Rick, I’m Miranda."

"Where’s Brenda?" he asked brusquely. She moved further into the room, changing the angle of the light and he suddenly came into focus. She caught her breath. Rick Fuentes was beautiful. The same fall of true-black hair she had seen on the sleeper in the living room. Real, honest-to-God carven cheekbones. Black brows drawn together in a sullen expression over a prominent, but fitting nose. Thick-lashed black eyes. He looked like a goddamn Indian prince. The Indian prince fumbled at his bedside table and extricated a bong. As she watched, he lit up, inhaling deeply.

"Brenda won’t see you anymore," Miranda said abruptly but quietly. "I’m the last one left who will see you. Piss me off and die in your own shit." She took the bong out of his hands and set it down across the room. "Do this on your own time."