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Fistula Patient on Four

When I joined the surgical team, she was already a fixture, having languished there on the fourth floor for over two months. Attractive, in her early thirties, she wore little but skimpy lingerie–garb that seemed at odds with her belly, criss-crossed as it was with surgical scars and small holes that weeped gastric juices and intestinal fluids. On the team’s daily rounds, the surgeons would don gloves, avoid eye contact with her, hem and haw their way through a cursory exam, then quickly move on.

Only a medical student, and feeling awkward in her presence, I would trail behind, tapping out a note before hurrying off to catch up with the team.

It wasn’t clear to me at what point she had begun refusing to wear the sack-shaped hospital gowns, with their ties and shoulder snaps, their backs open to the air, their hue the color of vomit. And although the hospital gowns were no less revealing than her chosen attire, made as they were for unfettered access to the body, she was ridiculed for her choice of clothing. By staff. By doctors. Behind her back. While she walked the halls in her feather-edged wrap. In whispers. But not always out of earshot.
She was telling us something with her see-through teddies, her frilly undergarments. It was a plea: Look at me! This isn’t  my fault!

Nothing we did worked. Her duplicitous fistulas, the holes that shouldn’t have been there, continued to leak. Still, we had difficulty looking her in the eye. We were unable to ask her how her day had been, whether her family had visited, how were they coping, how she was coping, because in our minds we were failing her. We knew we would blame us, were we in her place. But she did not blame us–at least for that.

Hamish Rickett
Missoula, Montana


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