He Could Not Die a Janitor

For 18 years at a hospital, Jesus Velasquez found the good in his work, smiling humbly while pushing a dust mop or stripping wax off endless corridors of gray linoleum.

He felt he was part of a system. With his diligent cleaning and sterilizing, he helped patients heal.

But alone down in the morgue at midnight, when the dim fluorescent light clouded faintly in his eyes, an emptiness gnawed at him. He felt expendable, just one of the faceless legions forever marching north from Latin America, always the next to be laid off.

Scouring dried blood off the floor of White Memorial Medical Center in Boyle Heights, Velasquez would hear the steel gurneys rattling ominously through the silence. The cadavers forced his wandering mind to confront his own mortality--the inescapable limbo he felt at age 37. It was a drowning feeling that haunted even his dreams: visions of unmopped hallways stretching for blocks and the notion that his monotonous routine would continue even after he died.

Occasional slights nagged at him, like the day he asked a doctor in an expensive suit not to cross a slippery hallway he had just mopped.

“Are you going to stop me?” the doctor shot back.

“No, I’m just telling you . . . “

“Are you going to stop me?” the doctor demanded again, then stormed across the floor and fell, messing up his suit. Velasquez laughed, but soon the lingering pangs returned.

He could not die a janitor.

This is not me, he thought, his hands worn raw and wrinkled by the stripping solution. This was not why his mother had so vigilantly made him study back in Mexico. It was not what he envisioned while dreaming on those warm evenings under the swallows, playing chess in front of his father’s barbershop.

Back then, Jesus was champion of Gomez Palacio, his small farming town in the arid flats of Durango. He had started playing chess with his father after work, chewing pumpkin seeds as they straddled a worn pine bench in the dusty twilight.

At first his dad had sat in silent fury when his son was beating him, slamming down the pieces and taking irrational risks. But eventually he accepted the boy’s talent. Jesus loved chess like most kids loved soccer, the pride of one brain battling another. The strength of his mind would make him important some day.

He began playing with the town’s wealthy dons, whose boots he shined while they waited for a haircut. Over the chessboard his focus never wavered, even when the diesel buses rumbled down the narrow streets. He entered a tournament in town and soon won the regional competition, held in the sweaty back room of an upholstery shop in Torreon. He was still a teenager.

As the winner, he was expected to attend the national championships in Mexico City, but his father could not afford the trip--he could barely keep his family afloat. Kidney stones and heart problems often kept him home, and when he did work his insistence on talking politics sent many customers looking for a less confrontational haircut. At home, meat increasingly became a rarity at the afternoon comida. The kids wore frayed secondhand clothes doled out at the local Jesuit college. Instead of the soda they once drank, their mother reverted to making agua de sandia, watermelon juice mixed with water.

With destitution looming, Jesus’ sister, Josefina, moved to Los Angeles, where she took a job as a hospital custodian to earn money for the family. Jesus continued his schooling with the dream of becoming a doctor. His mother deeply wanted him to rise above simple labor, to be more than she and his father.

There was no way. Student loans didn’t exist for the indigent in Mexico--not for college, let alone medical school. Health problems soon forced his dad to quit work.

So Jesus took a low-paying job after high school, packing Tucan tortilla chips, hoping to save some money for college. His older brother Pablo ran the barbershop, promising to give a portion of the profits to the family.

But one day Pablo’s checks stopped coming, and their mother, the strong spine of the family, sobbed desperately. Velasquez felt helpless in Gomez Palacio.

He would have to strike north.

Driven to Learn English

His new goal was to learn English and return to Mexico as a tour guide in the gringo resorts. In California, Josefina managed to get him a student visa, so at 18 he headed to the town bus terminal with a small copper-cornered trunk he got from the Jesuits. At the border, he showed the immigration agents the 1,200 pesos he had saved and walked into El Paso.

After a long hot journey through the American West, Jesus arrived at the cramped bedroom his sister was renting on a trash-strewn alley in Boyle Heights. Josefina worked nearby on Brooklyn Avenue at White Memorial. The two siblings had never been close, for she was 12 years older. But now they were lonely allies in a foreign world.

He immediately began taking night classes at Roosevelt High School. He had to learn English. He hated the demeaning, sometimes angry, look in people’s eyes when he spoke Spanish. The “Americans” seemed to assume his mind was as simple as the thoughts he conveyed in this second language. He struggled with words whose pronunciations varied for no ostensible reason. He made flash cards to memorize vocabulary, and practiced with whomever he found. Eventually, he took the anglicized nickname Jesse.

His English improved, and he was offered a job with his sister at the hospital. Even though it included cleaning toilets, mopping and sweeping, he knew it was temporary--a means to save some money and return to Mexico.

He liked the people he worked with, even some of the doctors and nurses. The shy young man couldn’t walk down a hallway without hearing an eager greeting, “Hi, Jesse!”

As he and his sister made more money, their extended family in Mexico, debts growing, asked them to send more home. The relatives were coming to rely on the remittances; the work of their two faraway family members no longer appeared temporary.

Jesse was promoted to part-time janitorial supervisor, but continued his cleaning duties. He thought he was on track to become the department’s director and that this would lead to a lucrative future.

Years passed. The promotion never came. He was married and divorced within months while in his early 20s. His father died, then his mother. Jesse managed to get his associate’s degree at East Los Angeles College on the side. He stayed with his sister all along and continued sending $100 a month back to brothers and sisters in Durango. For a while, supporting his family gave him a sense of importance that his job alone could not provide.

But Jesse was fascinated by what he saw at the hospital, particularly in the operating room. All those monitors and adrenaline and cold, sterile steel. The surgeons hunched resolutely over wide-open bodies while the nurses rushed around for instruments.

He envied the nurses, assisting with the procedures, comforting the patients and preparing them for surgery. That must be fulfilling, he thought. It looked like something he could do.

The medicine intrigued him too. When doctors were preparing for surgery, he would often ask what type of procedure they were going to perform. He usually questioned Dr. Sherif Azer, a big, amiable Egyptian man who knew him by name and took the time to chat with the custodians.

“What are you doing today, Dr. Azer?” he asked one day.

“This is a cholecystectomy, Jesse,” the anesthesiologist replied. “We have to remove the gallbladder, because it’s not releasing bile right. Gallstones are clogging the ducts, and the bile is backing up and irritating the patient.”

Jesse glowed. He knew all about the gallbladder: It released bile to aid with the digestion of fats. He learned about it in his anatomy and physiology classes at East L.A. College. Now he yearned even more to put his knowledge to work.

He was growing restless with his job. The hospital no longer managed “housekeeping services” but contracted with another company to supervise the janitors. The new managers didn’t understand the rigors of the job, and required more work than could be finished on a shift. They knew that if an employee complained, there was an endless supply of immigrants who would gladly step up to the task.

Jesse felt powerless, that his job was no longer secure, that his family would never stop demanding his money. He needed something better.

He could not die a janitor.

He would be a nurse.

A Surge of Enthusiasm

Jesse looked into the two-year nursing program at East L.A. College and realized he already had the prerequisites. But because his employment seemed precarious, he needed to save some money. He took a weekend job at a gym in Garcia Park and told his relatives in Mexico, to whom he had sent money for nearly two decades, they could survive on their own.

At 38, Jesse felt a surge of enthusiasm for his new track in life. He was determined to succeed, even while working two jobs and going to school.

He stopped going to the mall with his girlfriend and buckled down, firm in the notion that he must be obsessed to reach his goal.

His first clinical assignment for school was at a nursing home in Alhambra. For Jesse, this was tough. The facility was overcrowded, the patients poorly tended, and a stale fecal smell permeated the stuffy air. It was the assignment meant to weed out those who just didn’t have the stomach or the heart.

His first patient was an unresponsive stroke victim, a 180-pound Latino man whom he had to roll over, sponge, and give suppositories to move his bowels.

Jesse grew depressed, wondering if this was truly what he wanted to do. The smell brought him close to vomiting, and he knew that this patient would never improve. The convalescent home purged any wisp of unfounded romance he felt for this career.

Then one day, as he looked at the man’s stroke-stiffened leg and his vacant gaze, it hit him: This was a lonely place to die. Lost in his introspection and rising ambition, he had forgotten what mattered: He could actually help people here. If he were ever to die in a place like this, he would want a nurse to make him comfortable.

This would be his new mantra. When his stomach began to churn from the smell, he suppressed it. He imagined the men’s fragrance counters he and his girlfriend passed at the Glendale Galleria. He made sure to breathe deeply and even dabbed a little cologne under his nose to mask the stench. His dream endured the first bout of reality.

Three days a week Jesse went to class from morning until 1 p.m. Then he rushed to the hospital and was scrubbing and mopping by 2. He wrote medical terms on 3-by-5 cards and pored over them on his breaks. He got home at 11 and studied his anatomy textbooks into the early morning. On weekends at the gym, while basketballs resonated on the office wall, he memorized how medications reacted with each other. He often read chapters before they were assigned, always bracing for a crisis.

His sister, who had recently gotten a job preparing food at the hospital, did what she could to see her younger brother triumph. She did his errands and the cooking, took the car to the mechanic and cleaned house. Jesse’s path was starting to emerge.

But his boss, another immigrant who had risen through the custodial ranks, didn’t like his new aspirations, Jesse thought. He didn’t seem to want his own employee to make more money than he. He kept assigning more and more work at the hospital, until Jesse was leaving work well after his shift ended. This threatened to throw off the delicate balance with which he organized his life. He wasn’t getting enough sleep as it was.

He couldn’t quit his job, because he hadn’t saved enough money yet. He found himself nervous before work. If he was given one extra task, he might not have time to study, or would be too groggy to take a test. He had already failed a math exam. If he failed another, he would be kicked out of the program.

By the end of the first year he was getting desperate. But he was reinvigorated every time he did well on a test. Each exam was the little triumph he needed.

Then three months away from graduation, management brought down the ax: His boss told Jesse he would have to start working the morning shift because someone had quit.

“You know that then I’d have to miss school,” he said, a rage seething behind his eyes. He saw his dream about to vanish on this man’s whim. His muscles were rigid, ready to strike.

“Your schooling, that’s not a priority,” his boss said.

Jesse took a breath to relax, to regain that cold, quick logic he had developed years ago ruminating over a chessboard with the moths in the street light. The emotion cleared out of his mind, and the potential paths before him fanned out like the squares before a rook. He just had to analyze each move.

I’ll do the new work on my evening shift, he told the supervisor. You’ll save 200 bucks, because you won’t have to pay an extra man--and you can pocket it.

After three months of hell, and two years of struggle, Jesse Velasquez got his degree. In his 20th year at White Memorial, he was ready to be a nurse.

Exactly What He Hoped For

“Dr. Azer, you know I’m going to nursing school,” Jesse had said one day earlier.

“What kind of nursing school, Jesse? You’re going to be a nurse’s aide?” he asked, always intrigued by this janitor so interested in medicine.

“No, no, a registered nurse.”

“Really?” Azer said.

“Yes, I’m finishing the program at East L.A. College.”

“Wow. Would you like to work here in the operating room?” Azer asked.

It was exactly what he was vying for. He wanted to work in a unit with excitement and teamwork, where patients improved. Azer introduced Jesse to the nursing supervisor. She hired him as a surgical technician while he waited for the results of his board exams.

Jesse was nervous his first day at the new job. The supervisor took him to the operating rooms to reintroduce him to a staff that knew him as a janitor.

“Do you know Jesse?”

“Oh yeah, what’s he doing here?”

“Well, actually, we’re doing cross training now, so he’ll be helping with surgery,” she said. Jesse laughed and started to work. He fumbled a bit, learning where and what everything was. There was a world of information he didn’t learn in nursing school.

If a doctor was doing stomach surgery and asked for the scissors, Jesse had to know whether he wanted suture scissors, Mayo scissors or Metzenbaum scissors. He had to know the difference between a Kelly clamp and a mosquito clamp and anticipate the doctor’s moves.

When Jesse passed his boards, he started working as a nurse.

One nurse told him he’d never make it. Another asked if he really got his license in the United States. But he worked late and pressed on. He learned how to use some instruments that only a few nurses understood, like the cell saver, which filters blood during surgery. He started working in the mornings three or four days a week at USC Medical School just to learn certain techniques not practiced at White Memorial. He would not die a janitor.

Always Moving Forward

Today, in his 29th year at White Memorial, Jesse Velasquez is shift supervisor of the five-member crew of evening nurses and technicians--including, on occasion, the one who said he’d never make it. He is 48. His beloved sister died six months ago of breast cancer, but her legacy lives on in his success.

He knows he must always move forward to stay ahead.

He recently received his license to be a first-assistant registered nurse, a new category--in which White Memorial has yet to hire anyone--that allows a nurse to replace the assisting surgeon during an operation, doing procedures such as stapling flesh and tying sutures. His supervisor is convinced he’ll be the first to be hired at White. It would be his next step toward his next goal: becoming a physician’s assistant.

He’s so fulfilled by his job that he says the salary is secondary. He regrets the years wasted going down a dead-end road. When he sees janitors competing and back-stabbing in order to rise in the custodial ranks, he tells them to learn English, to go to school, to find the better road.

His staff says he acts more like a father than a boss.

Carmen Orta was a custodian when she started chatting with Jesse a few years back. She had been a surgeon in Mexico and came to California to get treatment for her son, who had cerebral palsy. She spoke no English, and her license was worthless here. Jesse urged her to go to college. She listened and eventually got her anesthesiology technician’s license. Now she is on his staff.

When she doesn’t understand something the doctors tell her to do, Jesse explains, always in Spanish so the others don’t see. She is now trying to get her surgical technician license. She has to spend a lot of time feeding and taking care of her 15-year-old boy. But she says she can do it.

“I’m going to follow Jesse,” she said.