Watch and Wait

by J. Lynn

Clara noticed immediately when the woman in Bed 4 began to thrash, her movements jagged and desperate. Seeing her patient frantically clawing at her own arms, Clara didn’t hesitate; she sprinted across the linoleum, reaching the bedside just as the woman’s cries began to rise.

“Es kriecht,” the woman rasped, dragging her nails from wrist to elbow, leaving furrows that welled dark in the low light. “Die Käfer. Sie sind unter der Haut. Überall!”

Clara couldn’t understand the German; she didn’t need to. She caught the woman’s thin wrists, slick with cold sweat, and held them. The older woman flailed against the traction frame, muscles rigid, her shattered leg suspended in its cradle of pins and pulleys. Her eyes were wide, dilated, fixed on horrors only she could see. Clara was terrified that one violent lurch would tear the traction pins straight out of the bone.

It was 12:40 a.m. Clara Novak had been a registered nurse for fourteen months. “You’re safe,” she said, uselessly, in English. “I’m Clara, your nurse.”

The woman gagged, dry-heaved, gagged again. Nothing came up. There was nothing left in her to come up. Clara held the emesis basin and wiped her sweating brow.

***

The Red Deer Hospital in the autumn of 1984 was a mix of harsh light and quiet corners. By 3:00 a.m., the night shift was an exercise in staying awake and alert against the hum of fluorescents that threatened to lull you to sleep. Outside, Alberta frost settled over the dark prairie, stretching all the way to the Rocky Mountains.

Clara was twenty-three; her starched cap weighed heavy with responsibility. She was still on probation—expected to take vitals, chart neatly, and keep her opinions to herself. Her final review was eleven days away. She desperately needed this job; her rusty bicycle chained beside the delivery entrance was a fair summary of her finances.

The woman in Bed 4 had arrived two days before the screaming started. Her name was Hannelore Weber, a heavy name for the small, frail figure beneath the white sheets. The police report clipped to her chart was only four sentences long: a seventy-four-year-old tourist from Munich. Hit black ice on Highway 2. The rental car had rolled twice. Transported to Red Deer Hospital with her belongings.

Hannelore had come out of it with a shattered femur, now suspended in traction, and a concussion severe enough that the admitting physician had written: disoriented; unable to communicate in English, and moved on.

If Hannelore had ever known any English, the trauma had erased it. She was stranded—not just in a Canadian hospital, but inside her own head, surrounded on every side by a language that meant nothing.

Hannelore had spent two nights calmly gazing at the ceiling tiles as though counting them. Clara had believed she was resting. Later, Clara felt ashamed of how easily she had mistaken her stillness for peace.

On the third night, just after midnight, the stillness broke like an ice dam on the Red Deer River. As Clara rushed to help, Hannelore’s hands were shaking so hard the sheets rustled like dry leaves. Her skin was damp and cold but not fever-damp, something clammy and wrong. Her pulse hammered, fast and thready. Her wide eyes were fixed on something Clara couldn’t see.

Then came the clawing, and the German, and the beetles under the skin.

Clara knew the word: formication—the phantom sensation of insects crawling beneath the skin. She had filed it away in school with a hundred other terms she never expected to need. Up close, it was heartbreaking: an older woman fighting her own body in the dark, in a language no one understood, while the traction weights swayed like bells in a belfry.

Clara quickly phoned the resident, who advised, “Post-trauma delirium. Haldol 5mg IM. Watch and wait.” Following his instructions, she administered the medication and stayed until the worst of the episode passed, which took almost an hour. Then she charted the entire encounter exactly, in her small careful handwriting, noting both the medication given and the resident’s orders.

She decided she didn’t much like the words ‘Watch and Wait’ before she hung the chart back on the rail.

By the fourth night, the ward seemed to listen intently whenever Bed 4 went quiet. The day staff handed her over with lowered voices and apologetic shrugs. The doctors had settled on “post-traumatic delirium,” or the lazier “sundowning,” and left standing orders for mild sedatives that managed the problem, Clara thought, about as well as trying to ride her bicycle to the moon.

Clara spent most of that shift on a low plastic stool beside the bed. She held the emesis basin while Hannelore retched on an empty stomach; she wiped the woman’s face and forearms with a cold washcloth, hoping the shock of cool water might distract a nervous system that was misfiring like a short circuit. Between the bad stretches, Clara completed her hourly rounds at a half-jog and came right back.

In the breakroom, she spent her fifteen minutes with a borrowed German–English dictionary. “Ich bin hier,” she whispered that night, mangling the vowels. “Ich bin hier.”

Hannelore’s eyes found her. For a moment—just a moment—something in them focused.

Without a shared language, they built a small one of their own. A firm grip on the hand meant I’m still here. A palm laid flat on the forehead meant you can rest now. When Hannelore reached out wildly into the dark, Clara caught her hand and squeezed twice, and eventually Hannelore began to squeeze back with a faint, exhausted pressure.

In those long hours of holding that frail hand, Clara did what her probation did not particularly encourage: she thought.

The tremors, the soaked sheets, the heart rate that refused to stabilize. The hallucinations were tactile—bugs crawling under the skin—a textbook presentation matched by total insomnia for three nights running. This wasn’t concussion delirium. It was something Clara recognized from training: she had cared for a rancher’s widow who had used mail-order sleeping pills for nineteen years, and was found convulsing on day four of a hospital stay because no one had thought to ask what the nice old lady took at bedtime.

In the 1980s, nerve pills were everywhere, prescribed for anxiety, grief, and the general difficulty of just being alive. Women took them for years because stopping was when the trouble began.

Clara asked the charge nurse for access to Hannelore’s inventoried belongings, hoping to find some next-of-kin information that the police report had missed. Inside Hannelore’s battered leather purse, she sorted through the remnants of a life upended: a rain bonnet, a worn wallet, and a small, gilt-edged address book with a photograph of a young man in a university cap inside. In a zippered pocket tucked discreetly into the lining, she found an amber pharmacy bottle. The labeling was German, but the text was unmistakable: Diazepam 10 mg. It was nearly empty, with a refill date stamped just two weeks prior.

Hannelore’s body was not only enduring a traumatic accident but also a sudden cutoff from a medication she had probably used each night for years. Stranded half a world away from anyone who could speak for her, she was trapped in a life-threatening withdrawal while her chart said watch and wait.

Clara signed both the address book and the pill bottle out and took them upstairs. She suspected she would need evidence.

Morning rounds began at seven with Dr. Miller at the head of them.

Miller was a senior surgeon of the old school variety with a good pair of hands; everyone said so. He also regarded questions from nurses much like he regarded houseflies. When he reached Bed 4, with an intern and resident trailing after him, he barely broke stride.

Hannelore’s back suddenly arched. Her arms jerked hard enough to rattle the bed rails, and one hand flew toward the traction ropes. Clara caught it before she could pull.

“If she’s still restless,” Miller said to the intern, “double the Haldol.”

Haldol. It might quiet her, but it could also lower her seizure threshold while the withdrawal kept gathering force.

Clara pictured her probation review, the rent folded beneath the sugar bowl at home, and her old bicycle silvered with frost outside. Then she heard herself speak.

“Dr. Miller.” She stepped to the end of the bed, into his path, the empty pill bottle in her fist. “It’s not delirium.”

The rounds party stopped short. The intern looked at his shoes. Dr. Miller frowned.

“It’s severe benzodiazepine withdrawal. Her heart rate’s been over 130 for two days. She’s diaphoretic, hallucinating, and hasn’t slept." Clara held out the bottle. “Diazepam, ten milligrams, filled in Munich two weeks ago. Almost empty. We stopped it on admission because nobody knew she took it. If we don’t begin a proper taper, she may seize. Haldol could make that even more likely.”

Miller took the bottle, glanced at it, and looked at Clara the way a man looks at a chair that has spoken.

“Nurse... Novak,” he said, looking at her name badge that still had the blue ‘on probation’ stripe, “stick to changing linens and leave the diagnosing to the people who went to medical school. She’s an elderly grandmother from Munich, not a drug addict. Do not exaggerate.”

“She’s both a grandmother and dependent on a benzodiazepine,” Clara said. Her heart hammered, but she kept her voice clinical, in the tone he respected. “Those aren’t opposites. Her pressure is spiking. Her tremor worsens every shift. It’s all in the chart, every four hours, in my handwriting.” She paused. “If this were your mother, and a nurse showed you this bottle—would you call it exaggerating?”

The room was very quiet. Somewhere down the ward, a ventilator sighed on schedule.

Miller stared at her for a long moment. Then he looked past her—at Hannelore, shivering under the thin blanket, her steel-pinned leg hanging in its ropes, her lips moving around words nobody present could understand. He looked at the bottle in his hand. He looked at the chart, longer than Clara expected, flipping back through four days of her small, careful entries.

He grunted. It was not an apology, but from Dr. Miller, it was as close as it came.

“Start a slow diazepam taper,” he said to the resident, taking the pen from his breast pocket and writing the order himself. “Cancel the Haldol. And get neurology to see her today, not Thursday.” He hung the chart back on the rail, and as he moved off down the ward he said, without turning around, “Good catch, Novak.”

The intern looked up from his shoes and gave Clara a small, astonished smile.

Clara discovered she needed, quite badly, to sit down.

***

The taper worked slowly, one careful dose at a time. By the second night, Hannelore’s heart rate had come down out of the stratosphere. By the third, the beetles had gone wherever phantom beetles go, and she slept—four real hours—while Clara watched the steady green line of her monitor like it was the best show on television.

But there was another problem no medication could touch. Hannelore had been in a Canadian hospital for a week, and her family did not know anything about it.

The accident report listed her name but no Canadian contact. Her passport gave a Munich address; the home number in her travel papers was never answered. Police inquiries and the family’s missing-person report had travelled through different offices without meeting. The German consulate in Edmonton had opened a file; it was presumably waiting in a tray. Meanwhile Hannelore gazed at the photograph Clara had propped against her water pitcher.

“Lukas, mein sohn,” she said.

During her break, Clara retreated to the nursing station with the address book, sitting before the intimidating rotary phone. Connecting to an international operator was a struggle against language barriers and the persistent, static-filled crackle of the transatlantic line. She knew the resulting long-distance charges would trigger an administrative inquiry, but she had already decided to pay the charges herself if necessary. She turned to the Munich entry and found Lukas’s number—crossed out and updated, the clear sign of someone who mattered. The exchange swallowed her first two attempts, but she persisted, listening to the mechanical sweep of the rotary dial return after each digit. With every slow, clicking rotation, she felt the distance of the eight time zones diminishing between them.

The line rang three times. It was early afternoon in Munich; her own window showed a starry black prairie sky.

“Hallo?” a man’s voice answered, sounding tired.

“Is this Lukas Weber?” Clara pressed the receiver hard against her ear. “My name is Clara Novak. I’m a nurse—I’m calling from the Red Deer Hospital in Alberta, Canada.” She spoke slowly, spacing the words. “I have your mother here. Hannelore. She was in a car accident. She is hurt, but she is going to be all right.”

The silence lasted so long she thought the line had dropped. Then came a shaky exhale and the unmistakable sound of a grown man coming apart, with more than a week of dread breaking into a stranger’s ear.

“We called everyone,” he finally managed, in careful broken English. “The airline, the police, the embassy. Nobody—no one could tell us anything. We thought…” He stopped. “We thought…”

“It’s okay,” Clara said. “She’s here. She’s safe. Bring your coat. It’s cold.”

He laughed, wetly, and asked Clara to say it all again, slower, so he could write it down.

***

That night, before Clara left shift, she brought the dictionary to Bed 4 and built a sentence out of it, word by clumsy word, while Hannelore watched her with growing attention.

“Ihr sohn,” Clara said. “Your son.” She pointed at the photograph of the young man in the cap. “Lukas. Er kommt. He is coming.”

Hannelore looked at the photograph, and then at Clara, and her chin began to tremble—not the withdrawal tremor, Clara had learned every register of that by now, but the older, ordinary tremble that needs no diagnosis. She reached out and gripped Clara’s hand and squeezed.

“Ich bin hier.”

Clara squeezed back.

***

Two days later, the autumn morning came up bright over the prairies, the frost evaporating on the windowsills; long beams of sunlight stretched across the ward floor, casting a bright glow over the room. Bed 4 was quiet now, but it was a normal quiet. The quiet of a woman free from drugs, sitting contentedly against her pillows, with her hair combed. She was pale and thin, but present. Her hands were steady as she held a plastic cup of water. That steadiness, Clara thought, had required more bravery and hard work than anyone walking past would ever guess. Hannelore was officially clean and sober, free from the drugs that had ravaged her body.

At ten past seven, the elevator chimed. A man in a dark wool coat stepped out, a small suitcase still in his hand as if he had not stopped moving since Munich. He scanned the ward—and froze.

Then he dropped the suitcase where he stood and ran.

“Mutter!”

Clara stayed back by the nursing station. What passed at Bed 4 was in German and much too fast to follow, and anyway, it wasn’t hers to follow. She watched Lukas gently sit on the edge of the bed and take his mother’s face in both hands, and she watched Hannelore—who had been alone in every sense a person can be alone—pat his cheek and say something that made him laugh and cry in the same breath.

After a while, Lukas came down to the nursing station. His eyes were red, and he had the particular unsteadiness of a man who has been awake across an ocean. He took Clara’s hand in both of his.

“The doctor on duty told me what you did,” he said slowly, choosing each word. “He said you found out what was wrong. The medication. He said…” Lukas searched for the words. “He said you would not let it go.”

“Anyone would have done the same,” Clara said, which was not, strictly speaking, what the last ten days had demonstrated.

“No,” Lukas said, simply, and let it stand. “Danke, for saving her. Danke, for finding me.”

From the bed, Hannelore was watching them. She caught Clara’s eye and gave a small, tired nod, and said one word, softly, that needed no dictionary.

“Engel.”

Clara, who had emptied this woman’s basins and held her wrists while she fought imaginary beetles at one in the morning, felt that angel was too much. Still she smiled and nodded back anyway.

Her shift ended an hour later. She hung her cap in her locker, signed her charts, and stepped into the crisp, bright cold, her feet aching in the particular way night-shift feet ache. At the delivery bay, her rusty bicycle leaned against the brick, furred with frost. She thought of the international telephone bill working its way through accounting and wondered whether, after paying it, she would be able to afford the new brake pads it needed.

She freed the frozen lock, but did not leave yet. Beside the parking lot, she stopped with one hand on the handlebars. The sun was fully up, the frost steaming off windshields, and far to the west the Rocky Mountains had come out of the night—a low white jagged line on the edge of everything, exactly where they should be.

Nursing was hard work. It would stay hard: the aching feet, the doctors who looked at you like furniture, the long hours holding a stranger’s hand in the dark and hoping it was enough. But in that hallway at 3:00 a.m., with a borrowed dictionary, a hunch, and the stubbornness to not watch and wait, Clara knew she had been exactly where she was supposed to be.