I don’t have many enemies, but I look upon the ones I have with venomous wrath. If I were allowed to select their eternal torments, my first choice would be drowning in a lake of boiling excrement while insane hornets hatch from their ear canals. If that’s unavailable, my second choice would be sitting in a hospital room, staring at a sick person in the bed, feeling stupid and helpless.

People don’t go to hospital rooms for amusement. They are neither fun nor funny. I don’t know of any jokes that begin, “A nurse, a man with no kidneys, and a bag of plasma walk into a bar…” Patients don’t go to these rooms voluntarily—they’re carted in on vans like veal delivered to an Italian restaurant. Their family and friends are dragged along by affection, obligation, sympathy, and terror.

When you’re sitting in a hospital room, you know almost nothing about what’s happening around you. The nurse could be injecting a pain killer, or she could be sucking the blood out of your mother’s heart for a satanic ritual. You’d never know the difference. Your ignorance is matched only by your inability to accomplish anything more useful than shifting pillows and moving flowers closer to the window. It’s not exactly busy work, but you know it has nothing to do with whether the patient will be breathing when she leaves the room.

When a person lies in a hospital bed, the room tightens with the pressure of uncertainty. I imagine it feels like the inside of a shaken soda can. That pressure erodes you, and you start begging nurses and doctors for slivers of information that might say what direction things are headed, and how long this whole experience has to last. You unobtrusively consider death, even if the patient is only suffering from a hernia. Death has been in this room, and it marked its territory like a bear. It can snatch anyone it wants in here.

You focus on the patient, which is the one thing you think you understand. If she doesn’t want to talk about her pain, you talk about what a bitch Aunt Lilly is when she calls for a half-hour chat. If she does want to talk about her pain, you nod and tell her that things will be better soon. If she doesn’t want to talk, you hold her hand. Fussy patients are the best, since they give you a lot to do. You bring blankets, adjust the bed, help them cheat on their hospital diet, and comb their hair. It relieves you more than it relieves them. If the patient wants socks and ice chips, then maybe she wants life, too.

After a ponderous length of time, you find out how this will end. If the patient is going home, you first want to know when, because you’ve got to get out of here before you’re reduced to paste. You tell the patient how great she looks, and you talk about having dinner next week, and you pack up vases of flowers that she’ll throw away tomorrow. And everyone talks, with sterling reverence, about how glad they will be to get out of this hospital room. The tension bleeds off a bit, but not much, because pain still hangs in the air, and if it attacks again you couldn’t do anything about it. At last you exit this room with its fake air and crappy TV and wall paint that’s trying a little too hard to be cheerful.

If the patient will never ride a wheelchair out of this room alive, the pressure intensifies—sort of as if the hospital room was now on the ocean floor beside the Titanic’s engine room. You knew earlier that you couldn’t do anything useful, but at least you hoped that someone else could. Now you know they can’t. You realize that there are not many good things to say to someone about to die. Maybe there aren’t any. So you let the patient say what she wants to say, and you hope your answers aren’t stupid and don’t upset her—as if anything you could say would upset her more. As the patient slides away, the air gets as tight as harp strings. Each time she closes her eyes, you feel a nick of panic that you’ve forgotten something important and now time’s run out. When she’s finally unconscious, nothing else can be said. Maybe you try anyway and tell her things you think you’d like to hear. Maybe you stare at her, trapped like a bird in the ugly hospital sheets that have carried dozens into death before her. Maybe you lean back in a plastic chair and pretend you won’t be relieved when it’s all over and you can get out of here. Maybe you sing to her, and she cries in her sleep. That has nothing to do with your singing, but no one around is a big enough jerk to tell you that.

When the patient leaves the room, it collapses on itself. Occupied, it had character. All of its character was lousy, but it had some. Now it droops like an empty balloon, as purposeless and generic as you could imagine. The patient carried every splinter of life away with her when she left. Then you leave too, perhaps with a happy rush, or perhaps wandering out like the victim of a train crash. But in any case, you leave with relief.

That relief is what helps you go through this and not smash clocks and chew on tires. And that relief is what I wish to deny my enemies. Or at least I thought I did. After a little reflection, maybe I’ll just poke my enemies in the eye and put a rat in their beer.