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nostril that he was actually bleeding, and then repacked it with so much stuff that by the time it was finished he felt like a small dog had crawled up and died in there.
    A half-inch square accordion-type gauze ribbon coated in Vaseline, four feet of it folded back-to-back compacted tight into itself and pushed in deep.  In front of that another tampon-like pledget, this one removable by means of a string.  In front of that something called a Foley catheter which inflated like a balloon.  Another four feet of folded ribbon.  Another pledget .
    He had no idea there was so much room inside his face.
    The man was hearty but not gentle.
    He was given drugs against the pain and possible infection and put into a wheelchair and wheeled into an elevator and settled into a hospital bed for forty-eight hours' observation.  Once again a nurse had to find and read his insurance and social security cards.  The drugs had kicked in by then and so had the loss of blood.  He didn't even know where his wallet was though he suspected it was in its usual place, his back pocket.
    The bed next to him was empty.  The ward, quiet.
    He slept.
    *****
    He awoke sneezing, coughing blood, a bright stunning spray across the sheets-- it could not get out his nose so instead it was sliding down his throat again, his very heartbeat betraying him, pulsing thin curtains, washes of blood over his pharynx, larynx, down into his trachea .  He gagged and reached for bowl at the table by the bed and vomited violently, blood and bile, something thick in the back of his throat remaining gagging him, something thick and solid like a heavy ball of mucus making him want to puke again so he reached into his mouth to clear it, reached in with thumb and forefinger and grasped it, slippery and sodden, and pulled.
    And at first he couldn't understand what it was but it was long, taut, and would not part company with his throat so he pulled again until it was out of his mouth and he could see the thing, and then he couldn't believe what he'd done, that it was even possible to do this thing but he had it between his fingers, he was staring at it covered with slime and blood, nearly a foot and a half of the accordion ribbon packed inside his nose.  He'd sneezed it out or coughed it out through his pharynx and now he was holding it like a tiny extra-long tongue and it continued to gag him so he reached for the call-button and pushed and fought the urge to vomit, waiting.
    "What in the world have you done?"
    It was the pretty nurse, a strong young blonde with a wedding ring, the one who'd admitted him and got him into bed.  She looked as though she didn't know whether to be shocked or angry or amused with him.
    "Damned if I know," he said around the ribbon.  Aaand ithh eye-o .
    He vomited again.  There was a lot of it this time.
    "Uh-oh," she said.  "I'm going to call your doctor.  He may have to cauterize whatever's bleeding up in there.  I'll get some scissors meantime, snip that back for you, okay?"
    He nodded and then sat there holding the thing.  He shook his head.  A goddamn bloody nose .
    *****
    It occurred to him much later that an operation followed by a hospital stay under heavy medication combined with heavy loss of blood was a lot like drifting through a thick fetal sea from which you occasionally surfaced to glimpse fuzzy snatches of sky.  In his younger days he'd dropped acid while floating in the warm Aegean and there were similarities.  He awoke to orderlies serving food and nurses taking his blood pressure and handing him paper cups of medication.  None of it grounded him for long.  Mostly he slept and dreamed.
    He remembered the dreams vividly, huge segments of them crowded spinning inside his head with unaccustomed clarity of detail and feeling--and then he'd seem to blink and they'd be gone, just like that, his mind occupied solely by the business of healing his ruptured body.  Adjusting the new packing to relieve the pressure,