I Love the Smell of Red Tape

A pile of little, severed arms. That image was first conjured for me by director Francis Ford Coppola’s Vietnam War movie Apocalypse Now. No actual image of this is in the movie. Coppola delegates that to your imagination. It was only mentioned in a monologue I will tell you more about later.



I work in a hospital.  A grey man watching over his wife made the meaning of that image crystal clear to me one night. As I walked back to my desk that night after the encounter, I knew I had become aware. As if I had accepted an apple from Eve. Like a diamond bullet through my forehead, I had become aware.



I first watched the film Apocalypse Now when I was fifteen. A review I read at the time said the movie “seemed to float even as it cultivated chaos.” I remember relating to the protagonist, Martin Sheen’s Captain Benjamin Willard. But it was the character played by Marlin Brando that defined the movie.



Movies change us because they become part of the glass in the window we filter the world through. A tattoo on our personality. In Apocalypse Now Martin Brando’s character, Colonel Walter Kurtz, is on screen for a short time but his explanation of Machiavellian theory is a branding iron. Brando is Coppola’s mad warrior-poet, stoking the fire.  At the end of the movie Kurtz relates an epiphany revealing how he became an evil man. His explanation changed me as I watched and re-watched that movie over the years.



I'm a nurse. Well, a male nurse to be honest. I know you were thinking of something else so "male" has to accompany "nurse" or I am not really being forthcoming, right? But I stopped doing patient care recently and not I'm kind of a clipboard nurse. My interaction with patients is limited to delivering a (Code 44) letter the contents of which require explanation.



Calling this collection of words a letter is a ruse. It’s really a government form. The form outlines part of an obscure Medicare law. Understanding the explanation requires a knowledge of CMS billing most people don't need until they start having supper at 4:30 p.m. and can’t remember their dog’s name. Even then, most don't bother to learn the fine points.



I had read an article about Martin Sheen that evening and I was reliving my favorite scenes from Apocalypse Now as I sat ay my desk typing up a Code 44 letter. I finished it and clipped it to my clipboard and grabbed my phone and headed out of my office, warm sheet of Code 44 secured and two working pens in hand. I thought about Martin Sheen’s (Capt. Willard’s) opening monologue.



Willard: Every minute I stay in this room, I get weaker, and every minute Charlie squats in the bush, he gets stronger. Each time I looked around the walls moved in a little tighter.



I marched out. My task: explain the form; either a boilerplate attempt to get a sick, tired, usually elderly patient to sign something they don't understand or a tar baby of questions. How do you take on such a mission? Captain Willard would just call in an air strike. Napalm anyone? Like Willard, I was just doing my job. But it wasn’t morning, I didn’t need to surf, I don’t have any particular affinity for Wagner and I hadn’t been to lunch. So, I chose the weapon I had closest to me: my best smile. I held it up to my shoulder and looked down the iron sights. But Colonel Kurtz was behind the door to room 3389. When I opened the door, I had breached his perimeter. He was standing beside the bed. Looking up at the TV. And I was in his jungle

He was all of 70 but fit. High cheek bones and a sharp nose. Drill sergeant material except for clothes more fitting a college professor and hair just a little too long. Sandals with black socks. He turned as I opened the door.



“Hello, um, sorry to bother you. Are you Mrs. Smith’s husband?”



He was packing too. He aimed, fired and grazed me. “I am,” he smiled back. A flesh wound. Deep eyes.  Still smiling.



I continued, “Sorry to bother you. My name is Jeff and I’m one of the case managers. I just have a letter to give to you.”



He was bouncy and positive. Even his words smiled at me. “A letter? Wow. Well, the mail really can’t be stopped. Is it a bill already?” Another smile as he grabbed reading glasses from the night stand and perched them on his nose.



Me: “Yea, when your wife was originally admitted she was admitted as an inpatient in error and we need to change her to observation. It’s a different billing category so we need to change her.”



He looked up at the television. Baseball. “Do we?”



“Yea, it won’t make any difference in your bill provided you have Medicare part B. And, of course, the care you get won’t be any different. We just have lots of rules to follow in these matters. One of them requires us to place each patient in the correct category for Medicare billing purposes. Pretty boring stuff, huh?”



He ignored me and sat down and actually read the letter. I had never had this happen. No one reads the letter. When he was done he looked up at me.

“So, assume I didn’t have Medicare part B?”



I didn’t miss a beat. “Well, that certainly would be different. Do you have part B?”



“We do.” He paused and looked at his sleeping wife. Then continued. “But that isn’t the point. I mean, it seems to me that we should be informed of this when we were admitted.” He didn’t look up.



“Yea, we would definitely try to work with you on that if there were a problem….”

Willard: It's a way we had over here for living with ourselves. We cut 'em in half with a machine gun and give 'em a Band-Aid. It was a lie. And the more I saw them, the more I hated lies.



He smiled and looked up at me and unloaded a clip into my chest. “I used to work for the IRS a long, long time ago son. I’m just jerking your chain. I know you don’t make this crap up.”



Kurtz: I remember when I was with Special Forces... seems a thousand centuries ago.

I was relieved but didn’t show it. My sucking chest wound meant he was a better aim than I was and I was beginning to like him.



“How long have you been doing this job Son?”



Now curious, I said: “I guess about eight months. Are you from Topeka.?”



Willard: I'm a soldier.



He leaned back and turned the TV down. “Oh, hell no. Baltimore. And yea, that makes me an Orials fan so I will thank you not to bring baseball up tonight. ” He moved a thumb toward his wife, still asleep. “She is from Overbrook. And I needed to get away from work so… here we are. Been here about fifteen years.”



Kurtz: You’re an errand boy, sent by grocery clerks to collect a bill.



My standard question came next. It was usually a full metal jacket. Move on and get the job done. But tonight what came out of my mouth had as much chance of fulfilling its design as a bullet fired at Superman’s chest. “So you are retired?” Followed closely with, “ I just need you to sign that letter at the bottom…” I extended a pen and he took it. The faint and punch were going to work?



He picked up the paper again and paused and looked at his wife and said: “Do you know when I realized I was a bureaucrat?”  He looked at me over his glasses as he signed and handed my pen back but kept the clipboard. He folded his hands over it in a short motion. Still smiling.



Kurtz: It's impossible for words to describe what is necessary to those who do not know what horror means.



The pause was short lived. “I mean, you would think that one’s lot as a beuracrat would be self-evident, working for the I.R.S., right? But it isn’t.” He shifted quickly in his chair, like a salesman with a timeshare prospect on the other end of the phone. “One morning I got up, brushed my teeth, showered and got dressed. I drove to the office. It was a beautiful day. I sat down at my desk and took a voice mail message from a woman crying because we had initiated a foreclosure on her farm.” He feigned sad sniffles as if acting out a sad children’s play.



I smiled at him, going along, then looked at the floor as he shifted to the other hip and continued. “I transferred the call to a colleague because it wasn’t my job to follow up on such things. We got those calls all the time and I was busy with other, more important things than human tragedy. Of course, I had started the foreclosure. After all, they owed the money. And I didn’t feel a thing. You can’t, right? It would have interfered with my honorable job. I know you understand.”



Kurtz: We went into a camp to inoculate some children. We left the camp after we had inoculated the children for polio, and this old man came running after us and he was crying.



I leaned against the wall, arms folded and he continued. He was in full character now with a sage-like demeanor. But his voice had edge to it.  I supposed this story had been told a thousand times.



“I didn’t do my job with any pleasure or pain. No idea if these people had kids, dogs, savings, a butterfly collection, a pot to piss in, whatever. It was my job. As a matter of fact, I resented them for the extra work. I mean, didn’t these people understand the law?” He looked down briefly and his hands made gentle motions now. “I mean, I understood that people do not like loss and change. But the law was, after all, written down for anybody to read.”



He scratched his head and looked down for the first time then back up, still gleaming. His voice clear and positive and bright. “About a month later, I drove by the farm on my way to some other business and there was a bulldozer raising the house. A sign in the driveway noted that the farm had been incorporated into some giant poultry operation.” He said poultry operation as if chickens were the most important things in the world.



I tried to hold up my side of the conversation. “I suppose that could change a person.” And with that I had fallen into the tiger pit. Pungi stakes smeared with dirt skewered me.



He was more animated. “No, it didn’t change me and that’s the point.” A second looking into space and then he continued with a brief, self-directed scowl.  “It took dozens of interactions like that from maybe a hundred such foreclosures before I felt bad about anything I had ever done in that job. And by that time I was almost fifty. I didn’t realize I was a bureaucrat anymore than an alcoholic knows he’s a drunk.”



Kurtz: We went back there, and they had come and hacked off every inoculated arm. There they were in a pile. A pile of little arms.



He breathed in. “I was walking through mud for years. Even then I didn’t know what was wrong with me until I had ruled everything else out. I thought I wanted to get divorced. I thought I needed a new house, a new car.  I mean, that’s the forest for the trees truth of it all. I didn’t know what I was for most of my life. And when I figured it out,” he extended his arms, “I was an old man.”



He stopped and waited for me. He looked at his wife on the bed. I was to either reload or finish tying my white flag to my bayonet. This was now his place in the world and I was either going to listen or not.



He surveyed me and continued, only slower as if a spell were broken.  “I got tired of telling people what I did for a living. When I did realize who I was it was so clear. I was a bureaucrat. It couldn’t have been more clear.” He laughed. “Do you know what ‘bureaucrat’ mans?” He didn’t pause. “It means ‘an official of bureaucracy.’” And with that he chuckled. Glancing at me to see if I got the irony. Or, maybe to see if I got anything. He leaned back in his chair and looked over at his wife. His eyes were less deep for just a second.



Kurtz: And I remember... I... I... I cried, I wept like some grandmother. I wanted to tear my teeth out; I didn't know what I wanted to do! And then I realized... like I was shot... like I was shot with a diamond... a diamond bullet right through my forehead. And I thought, my God... the genius of that! The will to do that! Perfect, genuine, complete, crystalline, pure. And then I realized they were stronger than we, because they could stand that these were not monsters, these were men... trained cadres.



He handed me the clipboard. Grasping I asked: “So what do you do now?”

“Oh, I run a bar in Overbrook. It’s all mine.” The smile. “You should come in. You know I have an antique bar that Quantrill actually sat and had a drink at before he burned Lawrence? Or at least that’s what I tell people. That’s what the guy who sold it to me told me. So it’s true, right?”



“It has to be.” I said. 



Kurtz: Have you ever considered any real freedoms? Freedoms from the opinion of others... even the opinions of yourself?