At the beginning of my senior year in high school, I was sixteen years old, six foot one, and 155 pounds. I had just gotten my braces off, though no one had noticed yet. In the morning at the breakfast table I studied the box scores in the sports section of the San Diego Union. Then I checked the score of the Vietnam War, presented daily as a body count, ours versus theirs. In two years I would be eligible to go die for democracy in Southeast Asia, and though in 1972 everyone was saying the war would be over soon, they’d been saying that for as long as I could remember. I knew I didn’t have the luck to beat the draft or the nerve to run away to Canada. My future seemed to end abruptly in the jungles of Indochina, where I would step on a land mine or get strung up in some kind of razor-blade booby trap or spend the rest of my days suspended from a tree in a bamboo cage, being gnawed on by giant rats.

I rode three and a half miles to school every day uphill through a cold fog on my father’s old brown Royal three-speed bicycle, my long hair flying behind me, my pimples tingling in the wind. By the time I arrived I’d be having an asthma attack and would vow to quit smoking, but on the way home in the afternoon it would be sunny and downhill, and I would look for cigarette butts in the gutter. If I found one of sufficient length, I would pick it up and take it home. My father was teaching junior high, and my mother was at court-reporter school, so I’d have the house to myself until at least five. If I didn’t find a cigarette, I would roll one with tobacco from my father’s can of Prince Albert. Sometimes I would take off all my clothes and pour a finger of vodka and sit in the beanbag chair with a cigarette and feel all grown-up in those precious last days before I had to go off and be blown to bits.

One day I saw an announcement on my homeroom bulletin board for a class on how to become a “hospital assistant” — an orderly. It was being offered on campus by a state-funded outfit. The words career and tuition-free caught my eye, and I wondered if this might not be the path to a medical degree. (My great-grandfather had been a physician.) I also liked the idea of a job more consequential than frying hamburgers or mowing lawns. And I remembered my aunt, a registered nurse, waving her hand under her chin as she spoke about a particular orderly being the only healthy male in the hospital. Seeing myself surrounded by cute nurses, I immediately enrolled. My friends and neighbors made fun of me because orderlies were queers, they said, and I was going to empty bedpans and wipe asses, but my parents were thrilled. They bought me the white uniform and special white hospital shoes.

There were twenty guys in my class, none of whom I would ever have expected to see wiping asses or emptying bedpans. We were a cross section of types: whites, blacks, surfers, football players, stoners. We were all sixteen or seventeen years old, and none of us had ever had jobs.

Mr. Manfred, our teacher, was a tall, athletically built man with a gray flattop who looked and acted like a drill sergeant. We just about fell out of our chairs when he told us he was a nurse, even though we were basically going to be nurses too. Mr. Manfred called us all either “babe” or by our last names, which he had memorized within the first hour of the first day using what he called “mnemonic strategies.” For example, there was a stoner named Briggs who looked like he’d just gotten out of jail. (This drew broad laughter.) You could remember anything if you used these techniques, Mr. Manfred insisted. Then he drew on the board a picture of a parrot on top of a submarine so that we could remember the word “polymorphonuclear,” which I have not forgotten to this day.

My high school was experimental, perhaps because most of us would soon be sent to Vietnam to have our brains splattered up the side of a tree, so why not make our classes easy? Mr. Manfred’s hospital-assistant course, however, was hard. We needed to absorb college-level physiology and anatomy, and Mr. Manfred had no patience for slackness, tardiness, inattentiveness, squeamishness, flippancy, gum chewing, or complaining. He also had no tolerance for laughing at talk of fecal impactions or the word homozygote. There would be no grades. Whether you got a job or not — that was your grade.

Over the next few months we typed our own blood (I’m B positive); memorized the skeletal, circulatory, nervous, respiratory, digestive, lymphatic, and reproductive systems; and learned how to insert and remove catheters, replace colostomy bags, feed someone through a nasal gastric tube, dress decubitus ulcers, make a hospital bed with the patient still in it, stop bleeding, and identify and treat diabetic shock, heart attacks, and strokes. We learned the jargon of charting and how to walk, shower, sponge-bathe, and shave patients. (Some of us were not shaving ourselves yet.) And we learned, of course, about enemas, bedpans, and urinals.

At least once a week we donned our white uniforms and took a field trip to an acute-care or convalescent facility. We were instructed to behave like men, to fly right and not to giggle or embarrass the school, to help whenever we were asked. Often we went to the enormous new VA hospital in La Jolla, where there were acres of dying old soldiers and also some younger ones who had been mangled by land mines and razor-blade booby traps. Mr. Manfred made sure to take us to the vast wards of cancer and emphysema patients, where he would make his case about the boneheadedness of smoking. None of us paid him much mind, since we were probably not going to live that long anyway. The VA hospital, where cigarettes were only twenty-five cents a pack, was one of our favorite places to go.

I’d never taken a class where I’d learned so much, where I’d felt such admiration and respect for my teacher, or where I’d been asked to work so hard to prepare for a job I didn’t believe I would get. This was also the first group for which I’d felt not only loyalty but camaraderie. Outside the classroom my fellow hospital-assistant trainees would never have associated with me (except maybe for some of the stoners), but we had been made allies by the great scholarly task before us and the derision and suspicion of our peers for our ignoble choice of vocations: digging around in the backsides of elderly people.

Sometime in the middle of the year-long course, just after Christmas break, one of the football players, a brawny redhead, got a job in a convalescent hospital. Unable to conceal his pleasure, Mr. Manfred brought the boy to the front of the class to make the announcement. It was the first time we had ever seen our teacher smile. Two days later one of the surfers was hired on as an orderly at Lemon Grove Convalescent, and the next week one of the black guys, Simons, whom I had befriended because we were both quiet types, also found employment. Mr. Manfred beamed with intense pride as each of his charges left in their white uniforms and squeaky white shoes to enter society and earn $1.65 an hour.

I felt I was not yet ready to be an orderly, but I wanted to please Mr. Manfred and to show all my backwater neighbors and unemployed friends that I was not as useless and effete as I appeared. So I rounded up my gumption, borrowed my parents’ car, and drove the three miles to my local rest home, San Diego Convalescent Hospital. I had been to SDCH as a volunteer a month or so before and had seen their perennial “Nurse’s Aides Wanted” advertisement in the paper. The place had the usual pine-cleaner-death stench and fake plants and oppressive air of sorrow. The lobby was full of trembling old people shuffling around on walkers. A gorgeous nurse’s aide in a short skirt rustled past.

The application was a breeze to fill out since I had no work history, hardly any education, and no life experience to speak of — unless you counted sitting naked in a beanbag chair with a finger of vodka and a hand-rolled cigarette. I could not think of any reason they should have hired me, but they did. And since I wanted a car and a girlfriend before I died, and knew I could graduate without much effort from my hokeypokey experimental high school, I agreed to work at SDCH full time. I took the swing shift, 3:00 PM to 11:30 PM, five days a week. Most of my friends were shocked that I’d actually gone through with it. My parents were so ecstatic they lifted my weekend curfew, and my dad bought me a six-pack of beer. Mr. Manfred clutched my shoulder as if I were his only son and said, “Way to go, babe.”


The first thing you learn when you work in a convalescent hospital or a rest home is that they are neither hospitals nor homes. The second thing you learn is that there is not much rest for anyone, and even less convalescing. When the broken-down are turned over to low-wage earners in a rickety house that smells like a bad tooth, it is hard to escape the aura of apathy and despair.

I was properly trained, eager to prove my worth, and undistracted by a social life, so I should’ve made a competent orderly, but in my first few months at SDCH I was no good at all. I had too many patients. I could not lift most of them by myself. I ran out of time each night and usually left a few lying wet in their sheets, their call lights blinking. I had one who ate her own feces. I had another with some kind of organic psychosis who jumped out from behind curtains and doors to attack me. I had a stroke patient who could not stop vomiting. I had a kid my age who had been wiped out in a car accident and lay unresponsive, limbs contracting, and had to be turned and fed purées through a tube in his nose and hand-scooped every morning because he could not orchestrate his own bowel movements.

I had mastered Mr. Manfred’s Marvelous Methods for the Aspiring Orderly, but he had not equipped me to feed, change, walk, shower, shave, dress, undress, coerce, coax, console, entertain, chase down, put to bed, and chart twenty-three patients in an eight-hour period. He had not prepared me for lifting double amputees or cleaning corpses or dealing with the scorn of a head nurse, nor for jack-off artists or men who shouted all night like distraught children or patients my own age who only stared straight ahead into a future worse than death. It didn’t take me long to figure out why the job was so easy to get. I expect they would’ve hired anyone who’d walked through that door.

SDCH was right across the lot from an acute-care hospital with a cancer-treatment center, so there were considerably more cancer patients there than at the average rest home. There was not much hope for people with cancer in 1973. The cobalt and chemotherapy only seemed to aggravate their suffering. I don’t remember any of them ever recovering or going home. Time and time again I would stumble upon the same scene: the family gathered round the bed of a loved one in those last few hours, the nurse eyeing up another syringe of morphine sulfate, the room filled with a bluish light, the kind that filters through the trees in a cemetery at dusk.

Though I had studied cancer and glimpsed its victims, I was overwhelmed by the sheer grinding lethality of it. In my first six months of working at SDCH, twenty of my patients expired. They were good people, most of them, who fought to live, obeyed their doctors, never complained about my immaturity and disorganization, and believed until the end in a just and loving God. Already philosophically morbid and vulnerable to the fancies of my fertile imagination, I was quick to develop a full-blown case of Hideous Preternatural Geriatric Vision: I would see everyone, no matter how young and vital, as shriveled, sick, and old. I could see their death bed, the bluish light, the assembled family, the nurse with her needle in the cork of the morphine vial. If you’d asked me what the “truth” was at that time, I would’ve answered straight out of my pimpled boy’s face, “Death and nothing more.” The day of my high-school graduation meant little to me, though I threw my cap in the air like everyone else. As I look back over forty years it still seems to be hanging there.


A few weeks after I graduated, my mother and I were whipping across the deserts and plains of the Southwest in my uncle Roy’s Cadillac. Uncle Roy was at the wheel, a handgun in the glove compartment, the cruise control set at eighty-five. He was ten years older than my mother and the only family member on her side to have become a millionaire. (He owned a foundry in LA.) We were taking the southern route to Colorado, 8 to 10 to 40. My uncle did not want to stop for anything but food and gas, though somewhere around midnight he relented and pulled into a motel in New Mexico. Our room had a single bare bulb hanging from the ceiling, and I slept on the floor under a blanket. I was not going to have anyone find out that I’d slept in the same bed with my uncle or my mom.

The highways stretched alongside the rivers as they wound up into the mountains. We followed the Gunnison most of the way. I struggled not to get carsick along the sinuous roads. Hard peppermints helped. So did looking at the river, its water like green and silver snakes tumbling down a marble staircase. My mother and Roy had been born and raised in this part of Colorado. They’d once lived in Pinecliffe in a homesteader’s cabin with no electricity, an outdoor toilet, and a hand pump in the kitchen — a delightful experience, according to my mother, that had come to an end with the greatest snowstorm of the century. Later they’d lived in another cabin, then with relatives, and finally in a house their father, my grandpa Bing, had built all by himself. They did not talk much or reminisce on this trip, however. My mom was sad and distressed, and my uncle was urgent and grim. Grandpa Bing had lung cancer.

Grandpa had been born in 1898 in Pine, Texas, a town that no longer existed. In the fourth grade, after his father died, he ran away from home — and an abusive stepfather — and never went back. He rode the rails, hitchhiked, prospected, scouted, hired on at ranches, rafted, drifted, picked peaches and cotton, spent time in jail, and otherwise Huck Finned his way across America. At sixteen he joined the navy. (He lied about his age.) When he was twenty he caught the Spanish flu during the worldwide epidemic that killed more than 50 million people and almost got him. He never talked much about his travels (or “adventures,” as I preferred to think of them). My mother told me they were unsavory in his mind. She never learned why he went to jail. He had not always been a Christian, my mother said, but he had always been kind. And even though it was too late for me to have a cruel stepfather or to run away from home in the fourth grade or to join the navy at the age of sixteen, it seemed an enviable life, one that by its rigors and trials could possibly have toughened up even a wet noodle like me.

It was late afternoon when we arrived in Salida, Colorado, an Old West town of a few thousand sitting in a flat river valley with towering, white-capped mountains all around. Salida’s name (pronounced like “saliva” by the locals) is Spanish for “exit.” My grandparents had lived there on Palmer Street since my grandpa Bing had retired from the railroad in 1963. That part of high-mountain Colorado was sparsely populated, strewn with mining and railroad towns gone bust. Its train yards long dormant, Salida kept the ghosts at bay with a hospital, hot springs, nearby mining, and a trickle of tourism. There was a Pizza Hut, an A&W root-beer stand where the waitresses hung the tray from the lip of your rolled-down window, a hardware store with a wooden floor and a mouth-watering selection of fireworks, and a mortar-and-pestle pharmacy that smelled of mothballs and licorice whips. The Arkansas River, fattened by snowmelt and speeding green down the divide, flowed not far from my grandparents’ home. If you fell in, I’d been told, you’d likely make Cañon City by nightfall.

My grandmother Olive greeted us at the door of her snug three-bedroom home. We were the first relatives to arrive. Grandmother Olive had her hair up in curlers and mixed garden greens on the stove. My Hideous Preternatural Geriatric Vision didn’t work on her since she was already old. She had sparkling black eyes, smelled of lavender bath powder, never missed her TV game shows, and cooed as I kissed her downy cheek. Her trellises full of peas and beans flickered in the hazy sunshine outside the kitchen window. Everyone hugged, and there were tears. I noted Grandpa Bing’s Bible on the table, spotted the Roman-numeral clock that registered every second with a tick like one croquet ball striking another. In the guest room I found the package of Parliament cigarettes that I’d hidden on top of a painting the previous summer. There were photographs all over the walls of that room, including one of Grandpa Bing on his last elk-hunting trip and another of his youngest son, my uncle Charles, wearing a cowboy outfit in front of a colossal cottonwood tree that Grandpa Bing had once tried to take down by himself. (The attempt had left him bruised for months.) On the dresser was a picture of Bing leaning against his 1963 Toyota Land Cruiser, which reminded me of the time we were fishing for brookies and rainbows way up in the Sawatch Range and he dropped his thick-lensed cataract glasses into the stream and couldn’t find them. I was eleven, but I fished them out and felt heroic when he said, with complete sincerity (probably because he’d already been driving at my age), “You almost had to take us down the mountain there.”

Under the lamp was a photo-booth picture of Grandpa Bing in 1933 with his new bride, Olive. He looked daring, dashing, even dangerous. In the mirror before me was a skinny boy with a passive, artificial smile and nothing dangerous about him except the thoughts inside his head. One day soon he would be slaughtered in Asia. I shook a stale Parliament from the pack and took a stroll in Granny’s gnat-swimming, gossamer-vined garden. Through the window of the root cellar I could see the rows of jarred tomatoes, corn relish, and beets floating amid peppercorns and cloves. At the back of the yard was Grandpa Bing’s shed, where he sharpened blades, fixed watches and radios, and listened to his crazy religious radio programs.

That afternoon we went to visit Grandpa Bing at the hospital. I was encouraged that he was in an acute-care hospital instead of a terminal facility like the one I worked in. Intervention may yet have been possible, I thought: surgery or some miracle procedure. I was convinced that this sweet, generous, patient man with his luscious Texas drawl could not be as sick as everyone said.

When I was growing up, most of my relatives had forgotten what it was like to be a child, and so they took me to museums, shoe stores, and the musty parlors of doting aunts. Grandpa Bing had not forgotten what it was like to be a child. He took me to ghost towns and fishing holes. We went panning for gold and scouring for valuable old whiskey and liniment bottles. We hiked through the shady forests gathering piñon nuts. Best of all he took me to the dump. Once, among the heaps of discarded dining-room sets and TVs and washing machines, we found a pocket watch, grimy and inert. A week later he presented to me the same watch, gleaming and precise, with a little window in the back through which you could see all the dainty, scissoring mania inside.

Since Grandpa did not smoke tobacco or drink anything stronger than A&W root beer (out of a gallon jug in the fridge), I had always regarded him as the most robust, self-sufficient, and virtuous of my grandparents, the one who deserved to live the longest. I thought that, in a small-town railroad hospital, a misdiagnosis was possible. (“This dark mass on the X-ray, Bing,” says the doctor with a chuckle, “that’s where the radiologist had his thumb!”)

But as we walked into his private room with the Sangre de Cristo Mountains blushing in the distance, I perceived immediately that I had deluded myself. Grandpa Bing was so gaunt I barely recognized him. Cobalt treatment had made him bald. My mother moved quickly to hold his hand. Uncle Roy stood back, aghast. Grandpa Bing tried to pretend everything was fine, but he was in so much pain he couldn’t smile. Seasoned hospital employee that I was, I deflected my shock with medical pantomimes such as winding up his bed, reading his chart, and straightening his sheepskin underlay. We commented on the splendid view. To everyone’s relief, the nurse came in at last, drew morphine from a vial, slipped in the needle. My grandfather relaxed and fell asleep.

On the drive home we were dazed. My mother said it must have been exposure to asbestos while working on the railroad most of his life that had made him sick. Roy said Grandpa had probably kept his ailment a secret for as long as possible so he wouldn’t trouble anyone. That night I took a long walk through town and ended up on a stone levee, studying the gleaming Arkansas River. For an hour I sat and thought. Pretty soon I would need to become a man. But how did you do that? What was a man? Even at seventeen I knew it was not John Wayne, Mick Jagger, or Conan the Barbarian. You definitely didn’t become one by going off to burn villages in a foreign land. An image of Mr. Manfred appeared, followed by my father, but standing above them both was Grandpa Bing, laughing and kind, somehow unscathed by his long gauntlet of travel and sorrow. Someday I would take to the road like him and not be afraid and never look back.

When I returned to the house on Palmer Street, everyone had gone to bed. The couch was made up with blankets and sheets, and I sat on it for a while, listening to the knocking of the croquet clock. I opened the book I had brought, Flowers for Algernon, by Daniel Keyes, but I could not read it, seeing instead of words on the page the wasted, anguished face of my grandpa. I had watched so many strangers die like extras on Star Trek. Now it was time for me to watch someone I loved die, and I didn’t think I could do it.


Over the next few days the rest of the family arrived, including my dizzy cousin Fuzzy, two months older than I was, whose flirty, light-up-the-room personality and wild green eyes shot my somber self-absorption to pieces. Fuzzy had spent entire summers in Salida and knew Bing and Olive as well as she did her own parents. After we visited Grandpa Bing at the hospital, Fuzzy and I sat forlorn in the alley behind his shed and smoked her Old Golds. She told me that Grandpa Bing was an Indian: his mother was half Cherokee, which made him one-quarter Cherokee. (I already knew this.) She had heard him chanting and singing in the hills. The Indians were magical people with ancient cures, she said, so maybe Grandpa Bing would somehow be able to call upon the Great Spirit to save him. Fuzzy was so gorgeous and leggy and bubbly that I tried not to see her shriveled with age, her arm hanging off the bed, her mouth too dry to call for the night nurse.

“Let’s go shoot some pool,” she said, “and get a pitcher of beer.”

The guy pouring the pitcher at the bowling alley was so hypnotized by Fuzzy’s green-eyed, dimpled dance that he didn’t even look at me, much less ask for IDs. My cousin poured two glasses of foam, shook her golden hair, racked the balls, and ordered me to break. I tried not to send the cue ball across the room. After two glasses, I loosened up and hoped everyone in the alley thought Fuzzy was my girl. I was wearing tan corduroys, a new striped polo shirt, chartreuse socks, and desert boots — an ensemble I had been saving for just such an occasion. On the jukebox someone had selected John Denver’s painfully sentimental “Rocky Mountain High” six times in a row. By the time we strolled home, thanks to the influence of the beer and my vivacious cousin, my gloom had lifted. I decided that Salida, nestled in its crown of mountains jeweled with stars, might be the most beautiful city on earth.

Grandpa Bing was gone by the end of the week. I was checking his pulse when he simply stopped breathing. His chart read “DNR,” meaning do not reach for that life, wherever it may go. The doctor appeared, stethoscope poised, and there was a period of immense silence before he made his pronouncement. The pain was finally over, I told myself, though it had only just begun.

We stayed for the funeral, my first (and last, as far as I was concerned), a primitive open-casket affair with Grandpa Bing looking as rosy as a misplaced store mannequin in a suit he would’ve never worn and a lot of talk about paradise. “This was paradise,” I wanted to stand up and shout.