Beat the Reaper: A Novel (3 page)

But that might be decades from now, and there might or might not still be evidence, or interest, by then. And it assumed that these guys actually managed to get “made,” and didn’t get rejected, or choose to just go back to their jobs at Best Buy or whatever.

The whole thing was weak. It was thin. Maybe it had been a serial killer after all. Or some junkies.

But the hounds don’t shun the fox for being mangy. The mob theory was all I had to go on, so I chased it.

And nothing else was coming. I’d pushed Mary-Beth too hard one day, and she had cried on my chest and said she worried that I didn’t really love her.

When you grow up in northern New Jersey you hear a lot of bullshit about the mafia and whose fathers are in it. But you also hear about a military academy day school in Suffern, where every time you meet someone who goes there he’s some smug dipshit with an Iroc-Z and a gold necklace that looks like it’s going to break his cocaine mirror. And where, when you look up luminaries of the Five Families in
Who’s Who in New Jersey,
a fuck of a lot of them turn out to have gone to school.

I won’t name it. Suffice to say it has the same name as one of the more famous military academies in England, despite having been founded 150 years after the Revolutionary War.

I’d been expecting a Catholic school, but it didn’t make much difference. I was already doing the push-ups.

I transferred over the summer. The school was expensive, but I still had money from the wills and the insurance settlement. And, like I say, I didn’t have too many other needs.

As a military school it was a hoax. Reveille at “07:30” and “14:30,” forty minutes a day of parade class, parade show once a month. There was a core of dipshits who took it all seriously, and went out for the sports teams and so on, but everyone else smoked pot in the bathrooms and snuck out to the Pizza Hut on the highway to hook up with the girls from the girls’ school, which was on the other side of the tennis courts and the woods. The bathrooms at the Pizza Hut were coed.

You had to wait in line.

I chose Adam Locano to make friends with because he was so popular, not because of his mafia connections. I wasn’t even sure those existed until later, when I asked him how he got his nickname, which was “Skinflick.”

I’d heard it was because he’d made a porn movie with his babysitter when he was twelve.

“I wish,” he told me. “It was a hooker in Atlantic City. Dude, I don’t even remember it, I was so drunk. Then some asshole from my dad’s social club stole the tape and made copies for everyone. It sucked.”

Bells went off, and I knew I’d stepped knee-deep into mafia. But before then I couldn’t be sure, because Locano was different from the other mob kids.

Like me, he was fifteen. Unlike me, he was pudgy, with puffy, diagonally creased nipples and a Droopy Dawg face with jowls and eye bags. His lower lip was too fleshy. Also unlike me, he was
cool
. He made looking like he did a point of pride, managing to appear—even in the dumbass uniforms we had to wear on parade—like he’d been out all night drinking. In Las Vegas. In 1960.

Another part of his charm (and another part I could only wonder at) was that he seemed to speak his mind with absolute freedom. He’d talk casually about whacking off or taking a crap, or about how he was in love with his first cousin, Denise. The second he got angry or frustrated he said so—including, inevitably, when he was annoyed at how much better I was at sports or fighting than he was.

I did my best to avoid those kinds of situations, but, being kids, and particularly kids at a so-called military academy, they came up. And I was permanently impressed by how gracefully Skinflick dealt with them. He would bellow in rage, then laugh, and you knew he’d been honest in both responses. On top of which, despite the way he acted, and his claim that he had read only one book cover to cover in his life, he was the smartest kid I’d ever met.

He was also self-assured enough to be friendly with all kinds of people—geeks, cafeteria workers, everybody—and this made it possible to get close to him.

Not that I didn’t have to work for it. I cut down on the Old Europe mannerisms and started dressing shaggy-preppy, with Vuarnets and a coral necklace. I slowed my speech down and lowered it, and spoke as seldom as possible. Every loner high school kid should be given a deadly serious incentive to fit in. It cools you up fast.

I also started dealing drugs. I had a connection through a nerd I’d known at my old high school, before my grandparents were killed and all my friends had stopped speaking to me because they didn’t know what to say. The nerd’s older brother was making a business of it, and got me eight-ounce bags of weed and full-on ounces of cocaine for a good rate. I think the two of them thought I was self-medicating.

I ended up having to sell for below cost anyway—it turns out buying friends is not the world’s most unique idea—but it worked. It was through pot that Skinflick and I met.

He passed me a note in class one day that said, “Brother, can you spare a dime?”

I am surely God’s original asshole—a monkey in the Mayan ruins, shitting on what I can’t understand, worse than a Neanderthal. But of all the shameful things I’ve done, the easiest for me to understand is falling in love with Adam Locano and his family when I was fifteen years old.

Years later, the Feds tried to break me down with it: with how only a complete dipshit could go from finding his grandparents killed by mob scumbags to living with mob scumbags, and working for them, and sucking up to them, and needing them. But the reasons were obvious.

There are cops who go bad for 70,000 dollars and half a kilo of cocaine. The Locanos took me into their
family
. Their literal family, not some mafia movie bullshit. They took me
skiing,
for fuck’s sake. They took me to
Paris,
and afterwards Skinflick and I went to Amsterdam on the train. They were not fundamentally kind people, but they did have empathy toward others, and they were remarkably kind to me. Besides Skinflick and his parents, there were two younger brothers. And no one in that family had haunted looks, or a constant awareness of mass murder. They all seemed to face forward, into a world of life, instead of backwards into a deathtrap they couldn’t explain. And they seemed like they wanted to take me with them.

I wasn’t even close to strong enough to pass it up.

David Locano, Skinflick’s father, was a lawyer at a four-partner law firm near Wall Street. I later learned he was the only partner who did mob work, though he was also the one who kept the firm afloat. He wore sloppy expensive suits and had black hair that winged down off the back of his head. He never managed to fully hide how sharp and competent he was, but around his family he seemed mainly befuddled, and in awe. Any time he needed to know something—about a computer, or whether he should take up squash or go on the Zone diet or whatever—he would ask
us
.

Skinflick’s mother, Barbara, was thin and humorous. She made appetizers frequently and either actually cared about professional sports or did a reasonable job of pretending to.
“Oh please,”
she liked to say. Like
“Oh please, Pietro—now
you’re
calling him Skinflick?”

(Pietro was my actual name, by the way. Pietro Brnwa, pronounced “Browna.”)

And then there was Skinflick. Hanging out with him was not exactly like being brainwashed, in that brainwashing usually tries to get you to accept as desirable a reality that is, in fact, shitty, whereas hanging out with Skinflick was
fun
. But it had the same effect.

Tell me this, for example:

What is the value of one night at a bonfire party on the beach? How about if you get to be sixteen years old at the time? And you can feel the fire on one side of your face and the wind on the other, and the cold sand on your ankles and through the butt of your jeans, but the mouth of the girl you’re kissing and can barely see is hot and wet and tastes like tequila, and you feel like you’re communicating with her telepathically, and furthermore you have no regrets or disappointments in life, because for all you know the future’s going to rock, and you’ve had losses, sure, but it seems only right to expect to gain just as much as time goes on?

What are you supposed to give up for that? And how do you weigh it against your obligation to the dead?

It isn’t complicated: you take one look and walk away. You shake your head and go back to being a giant, lonely geek whose grandparents are dead. You be happy you’ve kept your soul.

I didn’t do that. I stayed with the Locanos long after I’d gotten what I’d set out to get from them, until my life became a mockery of my original mission. I could say being raised by my grandparents had given me lousy defenses against people for whom lying and manipulation were ways of life and forms of entertainment. But I could also say that being with the Locanos made me sick with happiness, and I didn’t want it to end.

And the truth is, I’ve done plenty of worse things since.

3

The man in the bed in the Anadale Wing is a guy I used to know as Eddy Squillante, aka Eddy Consol.

“What the
fuck?
” I snarl, grabbing up a fistful of the front of his gown. I double-check his chart. “It says your name’s LoBrutto!”

He looks confused. “It is LoBrutto.”

“I thought it was Squillante.”

“Squillante’s just a nickname.”

“
Squillante?
What kind of nickname is
Squillante?
”

“It’s from Jimmy Squillante.”

“That shitbag from the garbage industry?”

“The man who
reinvigorated
the garbage industry. And watch your mouth. He was a pal to me.”

“Wait a minute,” I say. “You’re called Squillante because Jimmy Squillante was a
pal
to you?”

“Yeah. Though his real name was Vincent.”

“
What the fuck are you talking about?
I knew a girl named Barbara once—I don’t ask people to call me Babs.”

“Probably wise.”

“What about ‘Eddy Consol’?”

“That’s another nickname of mine. From ‘Consolidated.’” He chuckles. “You think somebody’s real name is ‘Consolidated’?”

I let go of him. “No, I got that part, thanks.”

He rubs his chest. “Jesus, Bearclaw—”

“Don’t call me that.”

“Okay...” He trails off. “Wait a minute. If you didn’t know I was Squillante, how’d you find me?”

“I didn’t find you.”

“What do you mean?”

“You’re a patient in a hospital. I’m a doctor.”

“You’re dressed as a doctor.”

“No. I
am
a doctor.”

We stare at each other.

Then he says, “Get the fuck outta here!”

I find myself waving it off. “It’s not that big a deal.”

“Bullshit! Mazel Tov, kiddo!” He shakes his head. “You fuckin Jews. What, they don’t let wiseguys become lawyers?”

“I was never a wiseguy.”

“I’m sorry about that.”

“I’m not asking you to apologize.”

“It was an oversight. No insult intended.”

I’ve forgotten that mob guys talk like that—like there was some unified and democratic meeting they all attended. “Don’t worry about it,” I say. “Half the guys I shot for David Locano were wiseguys.”

He swallows, which isn’t that easy when you’re getting all your fluids through your arm. “You gonna kill
me,
Bearclaw?”

“I don’t know yet,” I tell him.

His eyes shoot to his IV bag.

“If I do, I’m not going to put air in your IV tube,” I say.

If getting a small amount of air in your IV tube really killed you, half the patients at Manhattan Catholic would already be dead. In real life the LD50 of air—the dose that will be lethal in 50 percent of people—is two cubic centimeters for every kilogram of weight. For LoBrutto, or whatever his name is, that would be about ten syringes.
*

Maybe I should stick a cork down his throat. Light woods are invisible on X-ray, and no pathologist at Manhattan Catholic is going to go to the trouble of dissecting Squillante’s voice box. But where am I going to find a cork?

“Stop thinking about it!” he says.

“Relax,” I say. “Right now I’m not even sure I’m going to kill you.”

A moment later I realize this is true, because I’ve figured out how to do it if I have to.

I’ll just jack him with potassium. If I do it slowly enough, it will stop his heart without spiking his EKG,
*
and after he’s dead so many of his cells will burst that his whole body will be flooded with potassium.

“Jesus,” he says. “For all I know I have cancer anyway.”

“You do have cancer,” I say.

“What do you mean?”

“I just read your biopsy results.”

“Jesus! Is it bad?”

“No, it’s fantastic. That’s why everybody wants it.”

Squillante, with tears in his eyes, shakes his head. “Such a fuckin smartass. From the time you were a kid.” He grabs my ID badge. “What are they calling you these days, anyway?”

When he reads it he boggles. “‘Peter Brown’? Like in the Beatles song?”

“Yeah,” I say, impressed.
†

“They changed your name from Pietro Brnwa to
Peter Brown?
How stupid do they think we are?”

“Pretty fuckin stupid, apparently.”

An announcement comes out of the PA in the ceiling:
“Code Blue. All available medical staff to 815 South.”
It repeats a couple of times.

Squillante realizes what’s up. “I won’t say shit, Bearclaw,” he says. “I promise.”

“If you do, I’ll come back and kill you now. Are you capeeshing that, you dickhead?”

He nods.

I grab the phone cord and rip it out of the wall on my way out.

I reach the code. The hallway outside of it, anyway.

All the world loves a code, because you get to act like you’re on television. Even if you don’t get to yell “Clear!” with the defibrillator paddles, you might get to squeeze the respirator bag, or inject drugs handed to you by nurses from out of the crash cart. Also, people come from all over the hospital—not just from Medicine, for whom it’s mandatory—so it’s a great opportunity to socialize. And if the person who called the code did it because the patient is actually crashing, you might even save someone’s life, and justify your awful career choice.

This is not one of those times, however, I remember as soon as I get there. This is one of those times when the patient’s been dead for hours, and some nurse is trying to cover his Latvian ass.

“Who’s got time?” I say.

A nurse named Lainie turns around with a stopwatch and a checklist of who’s required to be there. “Yo hi, Dr. Brown,” she says. She winks. “I already put you down.”

“Thanks,” I say. Lainie’s foxy, but she’s married. Granted, to a man who looks twelve and wears a basketball jersey long enough to be a cocktail dress, but homey don’t play that.

What homey
do
play is getting back to Squillante’s room. And either killing him or figuring out what to do about him instead.

There doesn’t seem to be an obvious choice. If I let him live, and he tells David Locano where I am, I’m either dead or on the run. On the other hand, supposedly I work at a hospital to
make up
for killing people.

Or something along those lines.

“Sir?” It’s a small voice behind me. I turn.

My medical students. Two cups of human misery in short white coats. One is male and the other one female, and they both have names. That’s all I can ever remember about them.

“Good morning, sir.”

“Don’t call me sir. I work for a living,” I say. “Go check labs.”

This mostly confuses them, but one of them says, “We already did.”

“Then just stay here.”

“But—”

“Sorry, kids. I’ll teach you something later.
*
And I’ll see you at Attending Rounds at seven thirty.”

Of course, ten feet farther on I get beeped by Akfal, who’s in the Intensive Care Unit. “You got a minute?” he says when I phone him back.

Instead of “No,” I say, “Is it serious?” Which is a stupid question, since Akfal wouldn’t page me if it wasn’t. He doesn’t have that kind of time.

“I need your help on a thoracostomy.”

Fuck. “I’ll be right there,” I tell him.

I turn back to my med students. “Change of plans, kids,” I tell them. “Uncle Akfal’s got a procedure for us.”

As we head toward the fire stairs, one of the med students nods nervously back toward the code. “Isn’t that our patient, sir?”

“She’s God’s patient now.”

Thoracostomy is just sticking a sharpened tube through someone’s chest wall. You do it when the amount of blood—or pus, or air, or whatever—in their thorax is starting to compress one or both lungs, making it difficult for the person to breathe. You have to avoid the key organs—lungs, spleen, liver—and the undersides of the ribs, since the undersides are where the vein, artery, and nerve run. (You can see this on a rack of ribs, even after it’s been cooked. Then you can go yack.) But otherwise placing a chest tube is simple, as long as the patient’s holding still.

Which is never. That’s where I come in. Though it gives me no joy to admit it, the medical task I perform nearest to perfection is holding people down. My med students are about to get a rare glimpse of genius.

So I’m surprised when we get to the Intensive Care Unit to find the patient canted over on his side, with his eyes open and his tongue hanging out. In fact I’m worried he died while Akfal was phoning me, but then I feel the patient’s carotid and it’s pulsing fine, though there’s no indication he can feel me checking. “Was he like this before?” I ask.

Akfal’s setting up a procedure table, using all Martin Whiting Aldomed materials. “Apparently he’s always like this. Massive CVA
*
six years ago.”

“So what do you need us for?”

“Chart says he’s capable of sudden violent movements.”

I tap the guy’s eyeball. No response. “Somebody’s bullshitting you. The guy’s a lawsuit Barbie.”

“Probably.” He opens a pack of Dermagels onto the blue paper tablecloth he’s set up, then pulls them on one at a time, touching only the insides with his skin. “Ready,” he says.

I crank the bed up, and each med student takes a leg. I untie the guy’s gown and let it drop to his waist. The guy is saggy with coma fat.

Akfal iodine-sponges a patch on the lower left ribcage, then picks up the tube. I throw an arm across the top of the guy’s chest and arms.

Akfal jabs. The patient screams and boots both med students off his legs so hard they hit the walls. One of them also knocks over some kind of monitor.

But the tube is in. In
what
is up for debate, since the fluid that sprays out—and across Akfal’s chest and face before he can grab up a bedpan to deflect it—looks like dark, ropy blood. After a couple of moments it begins to pulse out normally.

The patient sighs and relaxes again in my arms. “Kids, you all right?” I say.

“Yes, sir,” they both say, shaky.

“Akfal?”

“Lovely. Watch out: there’s blood on the floor.”

Later, when the students and I emerge from the ICU, we get stopped by a guy who looks just like a younger, less zombified version of the patient.

“How’s my dad?” he says.

“He’s doing great,” I tell him.

In the fire stairs, headed back up, I say:

“What’s the lesson, kids?”

“DNR,” they say in unison.

“Damn straight.”

The Do Not Resuscitate order. The
for-Christ’s-sake-let-me-die
request.

Which, if doctors explained it to their patients and patients signed it, might rescue a U.S. healthcare system that now spends 60 percent of its funds on people who will never see the outside of a hospital.

Think that’s doing the Reaper’s work? Newsflash: by that point, the Reaper’s work is done. “Brain death” doesn’t mean the brain is dead, although it is. It means the brain’s so gone that the
body
is effectively dead. The patient’s beating heart might as well be in a vat.

Speaking of not doing the Reaper’s work, I decide to head back to Squillante’s room, certain now that I will do everything possible to scare him into silence before I even think about killing him.

Pretty certain, anyway. I send the kids ahead to Attending Rounds—an event so loathsome that even under the circumstances I feel guilty for not getting them out of it—just in case.

Sure enough, though, when I get there, Squillante’s talking on a cell phone.

“I’ll be off in a minute,” he says to me, covering the mouthpiece. “What am I, a fuckin dinosaur, I don’t know how to use a cell phone?”

Then he holds up a finger and talks into the phone again. “Jimmy,” he says. “I gotta call you back. The Bearclaw’s here right now.”