Smoke Break At County

I.
Packed after midnight, the county ER hangs thick
with the sour aroma of blood, puke, sweat, shit.
I grab a smoke between calls and watch while the
regular patrons huddle under florescent bars
dressed in familiarity and futility-
sick crackheads and stoned cabbies,
screaming babies, shady ladies; they dig change
for the coke machine from pocket and purse,
pick at scabs, noses, lice-
all ignore the upscale magazines scattered about,
coffee-table literature donated by Docs who
wonder out loud to nurses who roll their eyes
why Yachting World and Modern Architecture
and GQ never seem to get dog-eared
like the worn out copies of Weekly World News.
A tweaker known as Blowfly to his compadres and
Gomer to the staff...get out of my emergency room...
picks up a copy of Yachting World and chatters with
profound clarity about the the America's Cup
to the empty chair across the aisle; when the triage nurse
calls his number, he falls silent, green eyes
gone as vacant as the south china sea.

II.
Two girls with bad complexions and pierced eyebrows
sit side by side on the tiled floor, heads bent over
a spread of fritos and a ham sandwich that had the crusts cut off-
Did a mother do this, or was it some nostalgic reflex
that rose up and bumped its unconscious head against the fog?
They picked at it with slender fingers that made me
think of concert pianists; their giggles
burst from teeth yellowed like old ivory keys.

III.
The sound has no volume control. New conversations
up their decibels in a struggle to be heard, old ones
rise to the challenge; The registrar pulls down his Plexiglas
window, a scratched and filmy shield against the din.
A woman and four kids like stair steps occupy a row
of dirty plastic chairs lining the back wall. she holds a baby
in her ample lap in the same way you would hold a bag
of groceries on the bus ride home, or a basket of towels
while you wait at the Laundromat for a machine to free up.
The baby cries in a continuous drone punctuated every little while
with weary hitches for breath, its eyes dry and drooped;
the resignation already learned clear in its monotonous song.
Two chairs down the same row, a hooker named Davita
gives a hand-job to a skinny black man in a Denny's uniform
and a blood-soaked rag around his wrist; he tries to hide
his pride behind Modern Architecture. The tallest stair step
watches in silence, his steady gaze empty of curiosity.

A group of boys argue by the door, their voices loud
and huge; their jackets decorated with turf colors.
A small boy screams over and over for his mother while
a girl with red hair and a tear tattooed beneath an eye tells
him to shut the fuck up in a tone that escalates in repetition.
A man in a business suit, his cheeks red and his forehead
glistening with rage yells at the registrar through the hole
in the Plexiglas shield; he doesn't give a happy rat's ass
about pacemakers, he needs to use his goddamed cell-
I can't help but smile when the wino in line behind him
leans forward and vomits quietly down the back of his coat.

IV.
In the middle of the room, a couple sit together,
each tight against the other. They stick out, the two of them,
washed out figures silent in a loud sea of life.
Their pale faces are immobile a patina of sweat.
The man is about fifty, his face lined by time and circumstance.
His shirt is buttoned wrong, one side of his collar turns up
and brushes his ear; his sockless feet cased in worn house slippers.
The woman is about the same age, but whatever brought her here
has added twenty years. She wears a housecoat that hangs loose
to show a flannel gown bedecked with tiny red flowers;
her left hand rolls a rosary between fingers whose nails
are bitten to the quick. He holds the other in a clinch tight
enough to drain his knuckles to a cold, bloodless white.
Fear and hope passed messages between them like familiar rivals.

I'd seen them before, and before and before-
Alone and in pairs, sometimes in groups; these people who come
to sit and stare in county, their faces different but wearing the same
anxious mask. The end of it is always the same, nothing is ever good
because that's just the way it is when the shields are pulled down
and the flags have gone up. And when some demi-god in a dirty lab coat
comes to hit them behind the knees, all that's left will be gathered
into purses and bags and buttoned-wrong shirts and spilled out like
rancid wine behind other doors, in other rooms.