Narrative Magazine's Friday Feature: A Story by Adam Atlas

07/01/2011 07:27 am ET | Updated Aug 31, 2011

Narrative Magazine: [link “Narrative Magazine” to] What would you do as a lonely expat in Italy if you accidentally cut off the top of your thumb while cooking? Whom could you call, where would you go for help? The narrator of Adam Atlas’s short story lands in a Naples hospital where he finds himself with a host of punks injured by fireworks. In a world of the displaced and damaged, Atlas gives us a frank view of sudden miseries and mercies. His confident narration secured his story Second Place in Narrative’s 2009 Winter Story Contest, as well as several other prominent awards.

New Year’s Weekend on the Hand Surgery Ward, Old Pilgrims’ Hospital, Naples, Italy


by Adam Atlas

OUTSIDE, THE NEIGHBORS were firing a pistol and setting off firecrackers in honor of the coming New Year. I decided to make a lasagna so I began chopping onions and I cut off the end of my thumb.

In Italy the emergency number is different for police and ambulances. I couldn’t remember which emergency number was which so I called a pediatrician to whom I had been giving English lessons and she called the ambulance.

The dispatcher started calling me, she kept asking me which building was mine and I kept telling her which one it was. I eventually realized the ambulance guys didn’t want to walk up all the stairs to my apartment, so I called my neighbor, Norma, to ask her to go down and meet them, but I accidentally called my ex-girlfriend on the speed dial. I don’t know if I hung up before it started to ring. The fourth time the dispatcher called, she said the ambulance guys were waiting at the bottom of the stairs. We began to argue. I told her I understood that they wanted me to go down but I was in one room and my thumb was in the kitchen. I kept saying, my thumb is on the cutting board! My thumb is on the cutting board with the onions in the kitchen!

Shut up, the dispatcher told me, just shut up.

When the ambulance guys finally came, they were put out and winded. They asked me if I had a plastic bag for the piece of thumb and they watched with their arms folded while I stumbled around and found them a plastic bag.
In the emergency room, a doctor began cleaning the wound using a silver cauterizing pen to stop the bleeding. Two delinquents with tanning-salon tans and blood on their shirts wandered in and started to watch. The skin around their eyes was white from the goggles they use in the tanning booths and they kept staring at me and the place where the end of my thumb used to be.

While she was talking to a colleague about changing her clothes, the doctor pressed down into the wound with the pen. It felt like lightning going into my hand. Another doctor from the university where I teach English arrived, a pediatric allergist. He came in and put his hands behind his back and watched silently. The doctor cleaning the wound suddenly got serious and told the delinquents to go away. After she finished, the doctor said to come back the next day when there would be a hand surgeon on duty who could examine me. Then she said that the piece of thumb was useless. She pointed to a yellow trash can and told me to throw it away so I went over and threw it away.

The hand surgeon on duty said they would need to operate, and that even though my surgery couldn’t be scheduled until New Year’s Eve, three days off, I should admit myself the following morning, since there would be an open bed: “A bed opens up and you stay in it until it’s your turn to be operated on, that’s the way it works around here.” On New Year’s Eve, he told me, the Hand Surgery Ward would fill up with the Neapolitan delinquents who buy boxes of contraband fireworks to celebrate.

“Dozens of them will blow off their hands at midnight,” he said.

WHEN I CHECKED into the hospital, there was a family in the room. Their boy, Giovanni, was there because of a large firecracker he’d found on the ground. He just picked it up and it exploded in his hand. His father was a little shorter than me, barrel-chested with thick hands, a strong, straight nose, balding with straight hair on the sides of his head. He was wearing a green plaid shirt and jeans, very neat and clean. Giovanni’s hand was wrapped in a gigantic bandage and there were no fingers poking out of it. He said his fore- and middle fingers were just bones underneath the bandages, they didn’t have any skin on them anymore. His thumb had been blown out of its socket, all the muscles shredded. His pinky and ring fingers were okay though. On Saturday, just me and Giovanni and his father were in the room (there were four blue linoleum beds in that room, and four blue linoleum chairs, and there was a blue linoleum table). Giovanni and I had to have the same pre-op exams, the blood work, EKG, anesthesiology exams, and so on, so we went to those together. When we saw the anesthesiologist, Giovanni went in first. I waited outside while the orderlies looked at his X-rays and shook their heads and said, “Mamma mia” and, “What a shame.”

After dinner, Norma came to visit and we all talked. Giovanni and his father were from Vico Equense, a small town on the Amalfi Coast, near Sorrento. Norma mentioned her dog, Pasquale, and the boy’s eyes lit up, he said they had seven dogs, five for the boar hunt and two for hunting birds. Norma said she didn’t know that they hunted wild boar on the Amalfi Coast, and then Giovanni explained how clever and conniving the boars were and how they had killed a number of their dogs by tricking them into falling off a certain cliff. Giovanni was fourteen. He was a country kid like so many I had known back home, tall and skinny, with bright eyes always watching everyone and everything in the room. The father was a bricklayer and they had some land. Giovanni was his only son.

We smelled cigarette smoke in the room but didn’t know where it was coming from. Norma started to talk about how she didn’t like to eat meat and we made fun of her. She left and really there wasn’t much to say, but Giovanni offered me a little cake. I told him I didn’t need it, that he and his father might need a snack, but Giovanni threw it onto my bed with his good hand and told me to have it for breakfast. He said that breakfast in the hospital wasn’t very good. Every time the orderlies came around with our meals, they also had one for Giovanni’s father. He had to help everyone else in the room cut their meat before he could allow himself to eat.

An orderly came by at eight that evening and warned us to hide our wallets, our watches, our phones. On Saturday nights, delinquents hid inside the hospital and roamed the halls, sneaking into the rooms and stealing whatever they could find. “Saturday nights are sad in the hospital,” the orderly said, “real sad.” After the orderly left, Giovanni’s father lay down on one of the empty beds. Fireworks were going off outside. In the dark, waiting for the delinquents, we saw the flashes. We heard a boom. A flare went up and I saw Giovanni in silhouette. He was looking out the window.
“Firecrackers,” he said.

THE NEXT MORNING, at about six-thirty, they brought in a guy who was moaning. He had gotten his hand stuck in a machine that cut off three of his fingers. He was from a place called Cassino, which is about halfway between Rome and Naples. He didn’t say much that morning because he had been in surgery for seven hours while they sewed his fingers back on. He was awake the whole time during the surgery. His thumb was still black with oil from the machine. The man slept and cigarette smoke seeped into the room. Giovanni’s father cleaned his son’s head with a Wet-Nap. He made his way down to his good arm and then he started to weep. Giovanni looked at the ceiling and tried not to cry.
A couple of hours after the man from Cassino came, the orderlies wheeled in a delinquent from Secondigliano, the notorious slum outside Naples, the epicenter of the clan wars around here. He had been playing with some fireworks and one went off in his hand. As soon as they brought him in he wanted to know when lunch was going to be served. He was taller than me with a large head and chin. Maybe he was a bit retarded or maybe he was the typical idiot-delinquent—he had just lost the upper digits of his middle and ring fingers but he didn’t even seem to care. His bandages were bloody and he was with the two friends who had driven him to the hospital. Then his mother arrived. Secondigliano started yelling at her, “What are you doing here, what are you doing here?” His mother slapped him on the head and said, “What the fuck have you done? What the fuck have you gotten yourself into?”

“Ma,” he said, “when do they serve lunch around here? Get me some smokes, get me some water, get me some decent food.” His mobile phone kept ringing and ringing.

THE SURGEON WALKED in, the surgeon who would be operating on me and Giovanni and Secondigliano. The surgeon first went to Giovanni and looked at the X-rays. Giovanni’s mother and sister were there too. The surgeon was very curt with the family. When the father asked if they could save the boy’s fingers, the surgeon said, “Save? Save? Excuse me, is there something you didn’t understand? Did I not explain myself well enough?” and the father, who spoke only dialect and not real Italian, didn’t say anything else. The surgeon had combed-back white hair, wore spectacles, and was extremely tan, probably from skiing. Because I was American, the surgeon was more respectful to me, giving me the formal Lei, and treating me with something that could be called tolerance, like tolerating a toothache. When Secondigliano’s case was explained to him, the surgeon told Secondigliano that at least the boy had the excuse of being young, but at Secondigliano’s age there was no excuse for playing around with fireworks. “Doc,” Secondigliano said, “is it possible to have a smoke in here every once in a while?” The surgeon said no, no smoking was permitted inside the hospital. Finally, he looked at the hand of the man from Cassino. The surgeon who had been on duty had operated on him. One of the fingers didn’t look so good. It might have to come off. Again.

The surgeon told Giovanni to follow him to another room so he could see what was underneath the bandages. Secondigliano chimed in, asking what time they would serve dinner and the surgeon didn’t answer. He just turned around and walked out. Later, I was outside the room, sitting in the hallway. I heard the white-haired surgeon saying to Giovanni’s family, “What happened to your son is an utter disaster. Despite our best efforts, we may not—” and then I stopped listening.

NORMA VISITED ME again that evening. We sat out in the hall and she asked if I had called my psychologist. I told her no, she was out of town and anyway it wasn’t such a big deal. I said the only hard part had been watching Giovanni’s father begin to cry, and while I was speaking I suddenly choked up and couldn’t talk anymore so we just sat there not saying anything. Eventually, a man came out from behind a door. The man was visiting his mother. By this time, Giovanni and his father had come out into the hall too, probably just to get out of that hot, blue room for a second. The man looked at my thumb and asked, “Firecrackers?” I said that I had cut myself while chopping onions. “Ah, a moment of distraction,” he said. “You should have been more careful.” He was one of these bald, macho types almost feminine in the machismo, the fastidiousness of the pressed jeans, the dramatic gestures with the hands on the hips, and then the hands in the air, gesturing. Giovanni and his father were standing there near us, not really part of the circle of conversation, but not apart from it either. The man started speaking, pontificating, “Idiots, whoever hurts themselves playing with firecrackers. They deserve what they get. There isn’t a person more stupid than the person who plays with firecrackers.” He went on and on. “I tell my son here never to touch firecrackers. Would you ever pick up any firecrackers, son?” “No, Dad, never.” “That’s right, son. I brought my only boy, my only son here with me tonight not just to visit his grandmother but so he could see what happens to idiots who play with firecrackers.” The man’s son must have been nine or ten. He was short, plump, and really hairy. He had glasses and a clubfoot and a little mustache. Giovanni and his father were standing there looking desperate. The man turned to Giovanni and said, “And you? What about you? Firecrackers?”

“Firecrackers,” Giovanni said.

“Firecrackers,” the man said, and looked at the ceiling dramatically.

I couldn’t listen to the man anymore. But five minutes later I saw him touch Giovanni’s chin and tilt it up. “Took a little bit of it in the face, did you?” He looked at the cuts and scrapes on that smooth, porcelain cheek.

Earlier that day, the man’s “companion,” a black-haired girl with gray teeth, wandered into our room. She saw me, asked me what had happened. I told her I had cut off the end of my thumb. She said, “You cut off your thumb?” My thumb was wrapped in gauze but it was pretty obvious I hadn’t cut the whole thing off. I told her no, just this part here, just the end, and I showed her on my good thumb about how much I had cut off. She looked at me with her empty eyes. “You cut the whole thing off?” she said.

SECONDIGLIANO WALKED AROUND the Hand Surgery Ward as if he were on holiday, going out and smoking, horsing around. After visiting hours were over, some friends of his arrived, two more delinquents. One of them was dressed preppy in blue jeans, a blue button-down shirt, and a navy blue sweater. The other one had an extremely oval-shaped head, which was shaved, a tanning-booth tan, and a big overbite. He was wearing a backward baseball hat and athletic gear. They brought a girl into the room too, a bleached blonde, and Giovanni stared at her and I stared at her, and even if she was big, even if she was tawdry, even if everyone around here knows female delinquents are the worst delinquents of all, she still embarrassed us, she devastated us, us in our pajamas and bandages and everything we didn’t have underneath those bandages. All of them went out to the stairwell and smoked, and the man from Cassino with three fingers cut off woke up and began to talk. He had a big store in Cassino. He had land with thirteen thousand olive trees on it. In the afternoon, his family and his brothers and sisters had called him, they told him it was time to stop working, time for him to retire. He was fifty-seven but had been working since he was fifteen and his brothers and sisters had told him it was time to stop. “We’re all getting older,” his brother had told him on the phone. “At our age we can only get ourselves into trouble.” The man from Cassino said he didn’t care anything about the finger that might have to come off. “When all this is over,” he said, “I just want to be able to eat again with two hands.”

Secondigliano and the two delinquents came back without the girl. The two delinquents pulled up their chairs next to his bed and began talking, sometimes screaming, mobile phones ringing constantly. While Secondigliano was out of the room, Giovanni offered me another kind of cake. I told him I didn’t want it and he rolled his eyes and said, “Madonna però,” and threw it on my bed. “We’ve got to eat,” he said, “we’ve got to eat a lot. After midnight we can’t eat anymore.” I ate the cake. Giovanni’s father said his back hurt. He had fallen thirty feet in September and broken nine ribs. One of the ribs had punctured a lung. He rested his head at the foot of Giovanni’s bed and tried to sleep a little bit. The man from Cassino said he should take a night off from watching over Giovanni. There was a long pause. “A night off?” Giovanni’s father said, looking at his boy, his voice cracking.

The two delinquents stayed in the room. Secondigliano kept saying he still heard the firecracker ringing in his ears, he kept making a whistling sound like a bomb falling. The delinquent with the shaved head began telling Secondigliano how much the operation was going to hurt. The man from Cassino said, “What do you know?” and the delinquent held up his own hand. It was missing two fingers.

“Seven years ago I was playing around with some firecrackers, see . . .” he said and then he began to laugh.

THE DELINQUENTS STAYED until past midnight. At a certain point, Secondigliano’s mother called and Secondigliano said, “I’m sleeping, call me tomorrow,” and the delinquents laughed. We wanted to sleep, but the way the delinquents positioned themselves around Secondigliano’s bed was the classic way of the organized criminals, even the ones who aren’t organized criminals—a delinquent is wounded and the others sit next to him, they protect him and show off their loyalty. We knew better than to say anything. We didn’t want to make things worse. The night before, a guard had passed by every so often, but that night no guard passed by. The delinquent with the shaved head began talking to Giovanni’s father. They went through the various prognoses. If they can save this finger, if there’s enough of that bone left. The delinquents went away. We all went to sleep. At three a.m., Secondigliano’s phone rang. He spoke loudly. We all woke up and we didn’t say anything. Two hours later it rang again.

The next morning, Giovanni was the first one to be operated on. Then they called Secondigliano, and fifteen minutes later they called me. I was in the waiting area outside the operating room when I heard Secondigliano scream. He screamed three or four times and then nothing. I saw a man in a white coat and a beard run out of the room. It was scary, really scary. Then it was my turn and they wheeled me into the operating room. As they wheeled me through the doors I saw Secondigliano on a gurney, asleep. It was the anesthetic that had made him scream. They hadn’t even touched him yet.

There were two surgeons. One was the white-haired surgeon from the day before. The other I’d never seen. They asked me where I worked. I said I gave English lessons at the medical school. They asked me why I didn’t go there for the surgery and I said that I lived five minutes away from their hospital and thirty minutes away from the medical school and, anyway, most of the doctors I knew were pediatricians. They said those were good reasons. They wondered aloud if I was there as a kind of “favored” case. I told them I hadn’t asked anyone for any favors. Then they began to discuss if I were a “signaled” patient, which is to say someone who is less than “favored” but better than “normal.” Finally one said to the other, “Anyway, he told us he worked at the university, so he signaled himself.” I told them that they had asked me where I worked and I had answered honestly. The chief surgeon, the one with the white hair, asked me who I worked for at the university. I told him. He asked me who the director of my department was. I told him. He asked me what my role was and I pretended not to hear him. I heard the clicking of whatever they were using to shave a layer of skin from my thumb. I felt them transferring the skin onto my wound. He said he wanted me to say hello to the director of my department on his behalf. He repeated his request. “Do you know who I am?” he asked, “Do you know my name?” He was sewing the layer of skin into place. I said I had to admit that I didn’t know his name (and he had never bothered introducing himself, but I didn’t remind him of that). He told me his name, but I couldn’t understand what he was saying. He had his mask on and I had a sheet over my head to block the view of my hand. I’m the director of this ward, he finally said.

The pediatric allergist, the one who’d watched over me in the emergency room, had told me he knew the wife of the director of the ward. They’d worked together years before. The pediatric allergist even tried to call her, but her phone was off. “Must be on vacation,” he’d said. I asked the surgeon if he knew the pediatric allergist. “I know everyone,” the surgeon said, “and everyone knows me.”

THE WHITE-HAIRED SURGEON explained what he had done using Italian anatomical terms. He asked if I had understood what he had said. Then he explained it to me using a simpler terminology. He walked out of the room for a second and I asked the other surgeon how it had gone. The other surgeon told me that the goal of their work is to save as much as they can. He said that if the thumb is “three” and it’s been cut down to “two,” there’s no way it can ever be three again. While they were wheeling me out, I saw they were getting ready to move Secondigliano into the operating room. He began to scream again.

BACK IN THE room, Giovanni was asleep, but he opened his eyes when I came in. While I was in the operating room, the orderlies had placed a pandoro next to each of our beds. Later, the surgeon entered our room and told Giovanni’s family what he had done. Giovanni’s arm was in a gigantic Ace bandage–type sling. His hand had been sewn into his gut in hopes that some skin would form around his fingers. The surgeon talked about prosthetics. The sister, speaking for the family since she spoke proper Italian, asked the doctor something about the kinds of movements her brother would be able to make. The surgeon said, “Did I not explain myself well enough? Was I unclear? Your brother will never make those movements! What he has lost will never be recovered.” The surgeon turned his back on her and looked me in the eye. “You, sir, have been lucky enough to be the beneficiary of a perfect reconstruction of the left thumb.”

When he got to Secondigliano, he said they had sewed the wounds shut and performed various skin grafts. As the surgeon was leaving, Secondigliano asked him if they had reconstructed his fingers and the surgeon looked at him and said, “A bomb exploded in your hands, young man. There was nothing to reconstruct,” and walked out. It was the first question Secondigliano had ever asked about his wounds. The nurse who had been in the operating room told Secondigliano that he had lost the upper segments of his middle and ring fingers. The nurse told me I could leave later that day. Giovanni stayed in his bed, he had never complained once, not about anything. He turned his head to me and said, “Does it hurt?” I said it hurt a little, but it was tolerable. I asked him how he was doing. He said it hurt, but it was tolerable. Meanwhile, Secondigliano kept trying to convince everyone that he had it worse than Giovanni. But Giovanni was so dignified that it wasn’t embarrassing, just sad. Secondigliano wanted to eat as soon as he came back in the room, but they told him not to. He acted like an ass until his anesthetic started to wear off, then he writhed and moaned and cried until they gave him an injection and he fell asleep. After he fell asleep, they brought us dinner, the traditional New Year’s dinner with a seafood salad and a “strengthening” salad, a total of four heat-sealed boxes of food for each patient. Giovanni’s father took a metal knife he’d brought from home and began doing for us what some of us would have to learn from scratch how to do for ourselves—he took that knife and slit open our boxes of hospital food and cut it up into little pieces.

WHEN I WAS released from the hospital, they called me to the nurse’s room to sign all the papers. I told the head nurse what had gone on the night before, the delinquents, the phone calls. The on-duty surgeon was there, the one who had operated on the man from Cassino. He was out on the balcony, smoking, finishing one cigarette, and then lighting another, waiting for all those people to come in without their hands. Even if it was only early evening, it was New Year’s Eve, the firecrackers were already going off one after the other, the windows were shaking and flashes of light and flares were diffused in the soft, curling cigarette smoke. The head nurse and the on-duty surgeon listened to me, nodding. They said they would alert the guards, but I don’t think they did anything. New Year’s Eve was the busiest night of the year on the Hand Surgery Ward at the Old Pilgrims’ Hospital in Naples. I read in the newspaper that ten came that night, to that hospital, to that ward.

NORMA HELPED ME with my bags and we called a cab and went outside to wait for the cab, and it was New Year’s Eve and there was chaos in the streets, people were shooting off fireworks and firecrackers everywhere, from their balconies, from their windows, even from right down on the street in the middle of everyone. The cab pulled up and we went home, the cabbie cursing Naples, saying that Vesuvius needed to take care of things, Norma saying she agreed but hoped some of us would be spared, and the cabbie finally declaring that what was needed was a Vesuvius intelligent enough to distinguish the good from the bad or the bad from the good, and the cabbie left us there on the corner instead of at our building’s door like Norma had asked. It would have been too hard for him to turn around, he said, so we ended up having to walk a couple blocks up the hill to the top where our building sits. We met some other neighbors along the way and we walked up with them, and some kids shouted,“Auguri!” from a window, and a few seconds later a gigantic boom came upon us from behind, a firecracker they had dropped nearly on top of us, and the kids began to laugh.

The parents of these kids are the ones with the pistol. Around the neighborhood they say this family used to be dirt-poor. Now they own a restaurant and have four cars that they drive and a pistol that they fire into the air. I’m waiting for those bullets to come in through my windows, to come up through my floor, to come down through my ceiling, to hit me in the head. It’s time for me to get out of here. I don’t claim that any of this is so traumatic but Norma is after me to call the psychologist. I already talked to the psychologist. The psychologist said that me cutting off the end of my thumb wasn’t an accident. She said it was a conclusion, that there was a “before the thumb” and now there is an “after the thumb.”

I sit here wondering if something drove me to do this to myself, if something inside me acted on its own so that I would finally end this self-imposed exile, so that I would finally just go home.

Like Giovanni, I too am someone’s only son. My father is eighty. Ten years ago, when I was in college, he divorced my mother and he wanted me to become responsible for my mother in his place. She is often a patient in mental hospitals from which she always seems to escape. That is why I fled to Italy. Now my father has cancer, and my mother has disappeared again, and he calls me to ask me once more to come home. I tell him about my thumb, and when I tell him I had to throw part of it away, he cries.

Stop crying, I tell him. It was an accident.

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