The Final Day in Rome

John H. Culver

The waiting room in the ER at Rome’s Policlinico was a vast rectangle with four banks of chairs set facing each other in a much smaller rectangle. One group of chairs was missing a front stabilizer, which meant that any time someone sat down or stood up, the rest of the chairs moved in unison. Those not seated milled about in quiet conversation or stood near the faded tan walls that were covered with a variety of posters providing health tips and warnings. Two big-screen television sets hung from opposing walls. Reruns of Starsky & Hutch and Quincy dubbed in Italian aired across the gulf of the wide room. The ceiling was a good fifty feet above us. You could play field hockey in this place if you removed the chairs. The tile floor was grooved from foot traffic.
    Ten hours earlier we had been on a tour bus seeing the sights. We had listened to the recorded dialogue in Spanish, French, English, and German announcing the various historic buildings we passed. The bus slowed at these but didn’t stop. Rome was easing into its hot summer period, and I imagined how stifling the city would be if the temperatures were fifteen degrees warmer, and there was no breeze to stir the air. Now I was standing in the emergency room wondering if she would live or die.
    I alternated between scribbling notes on my small pad of paper and pacing the enormous room. I felt the need to record things since my mind was not holding on to facts or the sequence of events that had brought me to a hospital in Rome at the end of what had been a glorious day. Occasionally, I would glance at the TV screen to see a suspicious Jack Klugman in the autopsy room about to cut into a corpse. Before his scalpel touched flesh, he would say something that seemed to be of major importance, even dubbed in Italian. I never saw this show back home, but the Italian language made the scenes appear interesting. Starsky & Hutch was a chase-and-crash cop show, an insult in any language.
    Across from me, a petite woman with the complexion and bone structure of someone from the Balkans sat quietly with her Italian partner. There was no indication of what they were doing in the medical facility. Neither of them had visible wounds or bandages, nor was there any blood on their clothes. They never approached the desk where several attendants recorded business. The woman, who was so small and delicate it seemed I could hold her in my hand, would periodically get up and go to both the men’s and women’s bathrooms and emerge with thick skeins of toilet paper wrapped around her hands. She would then patiently unwrap and rewrap the paper. The man never said a word, but every thirty minutes or so, he would walk outside for a smoke. Everyone seemed to light up, nurses, patients, family, which left the outside patio carpeted with cigarette butts.
    The ER was in Rome’s largest hospital, which was also a teaching hospital. Ambulances, dented and scraped from numerous encounters with other vehicles, wailed into the bays at regular intervals, their service increasing as afternoon wore into evening in response to rush-hour incidents. The hospital was built in the post-war years, and different wings had been appended at various times over the decades. White-clad staff came and went, the waiting room a central passage point to the other medical areas. The tiny woman unraveled her toilet paper. An ancient man with a cleaning cart mopped around the chairs and the surrounding areas by the walls with regularity, tingeing the air with a whiff of disinfectant. After he did the bathrooms, the woman retrieved the replenished supply of toilet paper. We veterans of the ER were amused by newcomers who entered the respective bathrooms and emerged with quizzical looks on their faces; it had taken me two hours to realize that only the bathroom reserved for the handicapped contained toilet paper, something they would deduce for themselves if they remained in the ER long enough. Every now and then the loudspeaker would broadcast a message or request in rapid-fire Italian that would have been incomprehensible in any language; every hospital in the world has the same garbled public address system.
    There was an orderly chaos to everything. No one was frantic. Doctors and nurses hurried by; some stopped briefly at the time clock to punch in or out; others opened doors and quickly disappeared behind them. Periodically the main ER portal opened, and someone would call out the name of a waiting family and ask them to come inside or beckon someone waiting for treatment.
    We had stopped at a small market after the tour ended to pick up a few things for the long flight home the next day. After a few minutes I realized she hadn’t moved. She stood by a fruit bin. One hand was placed on the left backside of her head. “Pain,” she said. I asked if it was like one of her migraines. “No, that’s over here,” and she tapped the back right side of her head. “This is different.” After a few moments the pain lessened, and we slowly walked the several blocks back to the hotel. She felt better after resting and then went to the bathroom to pack her toiletries. She came out, grabbed the left side of her head again and muttered, “Oh God.” The pupils in both eyes vanished behind her eyelids, and she slowly folded into my arms. In the ambulance I showed one of the attendants her insurance card, but she just looked at me sternly and said, “No, free, free.”
    I finally heard the call of “Robertson,” not my name but hers. A man in a white coat saw me respond and quickly came to guide me to a small office behind the desk as if I couldn’t navigate by myself. Three youngish women were there, two in white physician garb and the other in a nurse’s uniform. One had tears in her eyes. Between the three struggling to find the right words in English, I heard “brain aneurysm,” “wasn’t expected to make it through the night,” and “do you want to say good-bye?”
    Contemporary American pop tunes were playing in the ER. The staff went about their business, giving injections, inserting tubes, and cleaning the graybrown seepage from the brain of the man in the bed next to hers. Many sets of eyes were on me as I looked at her. She was comatose, her chest rising and falling with shallow breaths, a ventilator in her throat. I said good-bye for her daughters, two grandchildren, and myself. A beautiful woman, inside and out. I left through the ambulance doors, nodding to those taking a smoke break, and walked back to the hotel in utter disbelief at what had taken place over the four hours since she had collapsed in our hotel room.
    I returned at six the following morning. There was an odd but different collection of souls in the waiting room from the previous evening. Now the televisions were showing Italian news. I alternated between pacing and sitting for three hours before “Robertson” was called out again. She had died moments earlier. I repeated the good-byes and collected myself as best I could, sitting at a small desk that had the computer with the charts of the several people in the ER visible on the screen. Nurses and physicians patted my shoulders. Their touches and anguished looks were heartfelt. My final act in the hospital was to sign the form for organ and cornea transplants. Another gathering of medical staff stood outside smoking when I left. We traded single arm waves in the air.
    The US Embassy was several miles from the hospital, a walk that went quickly. Italian soldiers were stationed in front of the embassy, sinister automatic weapons slung over their shoulders as if a terrorist movie scene were about to be filmed. I stated my business to one, went through the security check, and walked up the stairs to the second story where a few of us gathered to report lost passports and other problems. I filled out the Report of Death in a Foreign Country form. The Italian man who assisted me anticipated my questions, probably from handling such reports too many times. I surrendered her passport and printed the contact information for her daughters. He asked if I wanted to use the embassy phone to call anyone back home, or if I needed additional funds to fly home. I didn’t. He gave me a sheet with the names of several funeral homes in Rome that had experience—and staff fluent in English—in handling the deaths of Americans.
    I arranged for her to be cremated and the ashes returned to me by air at an international airport since the urn had to clear customs. I gave her clothes to a maid at the hotel who knew no more English than I did Italian, but her sorrowful look said she was aware of her morte.
    My seatmate on the plane and I chatted a bit. She was several years older than I and was returning to the West Coast, where her third husband would meet her. She had outlived two previous husbands, and this one wouldn’t travel with her, she reported with a laugh. She recommended the Nixon-Frost movie. We both put on our earpieces, and the movie began. We were flying west with the sun. I dreaded the return to earth.

John H. Culver taught political science at Cal Poly State University, San Luis Obispo, California, for twenty-eight years. He retired after California voters elected Arnold Schwarzenegger as governor in 2002 on the assumption the state would be better off without one of them. He is enjoying a delightful post-academic life in Durango, Colorado.

“The Final Day in Rome” appears in our Summer 2013 issue.