Beat the Reaper: A Novel (8 page)

What was I going to do, shout “
YOU WERE AN EVIL FUCK FIFTY YEARS AGO
”? Or “
YOU PROBABLY STILL ARE, THOUGH IT LOOKS LIKE YOU DON’T HAVE THE ENERGY TO DO ANYTHING ABOUT IT
”?

Well, I was about to find out. I felt the spark in my fingers before my eyes even processed the image: Budek’s address was listed, six blocks away.

It was the top floor of a townhouse in a row of townhouses that backed onto a long narrow park with a private gate. I considered entering through the park and going in through the back, but before I knew it I was up the steps and had rung the twist-type bell.

Sweat appeared all over me, like all the water in my body was trying to form a shadow version of me and run off. I told myself to calm down, then gave up on that. Why bother?

The door opened. A wizened face. Female. Or at least the housecoat was pink.

“Yes?” she said, in Polish.

“I’m looking for Władysław Budek.”

“He isn’t here.”

“Slowly, please,” I said. “My Polish is bad. When do you expect him?”

She studied me. “Who are you?” she said.

“I’m an American. My grandparents knew him.”

“Your grandparents know Władys?”

“Yes. They did. They’re dead now.”

“Who were they?”

“Stefan Brnwa and Anna Maisel.”

“Maisel? That sounds Jewish.”

“It is.”

“You don’t look Jewish.”

I had the feeling I was supposed to say “Thank you.” I said, “Are you Mrs. Budek?”

“No. I am Władys’s sister, Blancha Przedmieście.”

Things became suddenly surreal. I had heard about this woman from my grandparents. Legend had it she had spent the war simultaneously fucking a Nazi and a man whose wife had connections to the Jewish underground, and had thereby made her brother’s scheme possible.

She said something I didn’t understand. “Excuse me?” I said.

“I am very well known to the police,” she repeated, more slowly.

“Why would you need the police?”

“I don’t know. You are American.”

Good answer. “Can I come in?” I said.

“Why?”

“Just to ask you some questions about your brother,” I said. “If you don’t like them, you can call whoever you want.”

She considered. Jew-hating may be a primordial cracker urge, but loneliness goes back to the amoeba. “Fine,” she finally said. “But I won’t feed you. And don’t touch anything.”

Inside, the apartment was musty but uncluttered, with boxy sixties furniture and a television with a bulging screen. A couple of side tables held framed photographs.

One was of two young people in front of an ivy-covered stone wall: a woman who might have been this one and a bleak-looking black-haired man. “Is this him?” I asked.

“No. That is my husband. He died when the Germans invaded.” Using a series of words and hand gestures she indicated that this was because her husband had been in the horse-drawn artillery, and the Germans had used airplanes. “Władys is here,” she said, pointing.

This one was a flip-looking blond man on skis on a mountaintop, laughing bucktoothed in the sunshine. “He was a beautiful man.” She seemed to be daring me to contradict her.

“You say ‘He was.’ Is he dead?”

“He died in 1944.”

“In
1944?
”

“Yes.”

“What happened?”

She smiled bitterly. “Some Jews killed him. They came in through the window. They had guns.”

It took me a while to understand what she said next. Apparently the Jews she was referring to had tied her up in the kitchen and shot her brother in the living room, near where I was standing at the end of the couch. They had used a pillow so no one would hear.

“But the police were already on their way,” she said, “and they caught them going out.”

“Wow,” I said.

So someone had gotten here first. By a fairly healthy margin.

“It was a boy and a girl,” she said. “Teenagers.”

“Excuse me?” I said.

She repeated it.

“Are you joking?”

“What do you mean?” she said.

I felt nauseated. I sat down on the couch in case it showed and she tried to throw me out.

I needed more information. “What did they look like?” I said.

She shrugged. “Like Jews.”

I tried another tack. “Why were the police on their way?”

“What do you mean?” She sat down on the armchair, but on the edge of its cushion, with good posture, like she was prepared to lunge for the phone at any moment.

“How did the police know there was going to be trouble?”

“I don’t know, Władys had already called them.”

“Before the boy and girl came in?” I said.

“Yes.”

“But how did he know they were going to come in?”

“I have no idea. Perhaps he heard them. It was a long time ago.”

“You don’t remember?”

“No. I don’t.”

“Two Jews came in through the window and tied you up, and you don’t remember how your brother knew they were coming?”

“No.”

“Was it because you and he had taken money from them by claiming you could save their relatives?”

She grew very still. “Why are you asking me these questions?”

“Because I want to know what happened.”

“Why should I discuss this with you?”

I thought about it. “Because you and I are the only two people on earth who care, and you don’t look like you’re going to be around much longer.”

She said something along the lines of “Bite your tongue.”

“Just tell me what happened. Please.”

She was going from pale to red. “We sold the Jews hope. God knows they could afford it.”

“Did you save any of them?”

“It was impossible to save Jews during the War. Even if you wanted to.”

“And if they looked at you too closely, you had them killed.”

She turned away at this. “Leave now,” she said.

“Why did you hate them so much?” I asked.

“They controlled the whole country,” she said. “Just like they control America. Get out of my house.”

“I will,” I said. “If you tell me the names of the Jews.”

“I have no idea!” she said. “Get out!”

I stood. I knew I was as sure as I ever would be.

I went to the door. Freezing wind came in when I opened it.

“Wait,” she said. “Tell me the names of your grandparents again.”

I turned back. “I don’t think I will,” I said. “I’m just wondering why they let you live.”

She stared at me. “I’ve always wondered that,” she said.

I left and pulled the door shut after me.

For the record, what I decided was this:

No female targets (which was obvious), but also no targets whose misdeeds were solely in the past. Only ongoing threats. I had no way of knowing why my grandparents had let Blancha Przedmieście live, but she was a woman, and killing her brother had been enough to shut down their operation. So there you had it.

Meanwhile, if David Locano wanted to sic me on killers whose deaths would improve the world, I would verify his information and then feel free—obligated, even—to hunt them down and kill them.

Not once did I think that maybe, if my grandparents would have approved of this course of action, they would have preached to me less about peace and tolerance and told me more about their mission to assassinate Budek. I felt no need to consider such things. Fate itself had told me what to do.

Ah, youth. It’s like heroin you’ve smoked instead of snorted. Gone so fast you can’t believe you still have to pay for it.

9

I’m on my way to catheterize a couple of people when my med students find me. “Survival five years status post gastrectomy is ten percent,”
*
one of them says. “But only fifty percent survive the operation.”

“Huh,” I say.

The upside of this information is that if Squillante
does
live through his surgery, his odds of surviving another five years are actually more like twenty percent than ten, because the ten percent figure presumably includes people who die during the operation. The downside is that Squillante has fifty-fifty odds of dying
today,
on the table. And calling David Locano down on me if he does.

The elevator doors open in front of us: Assman, getting returned to the floor in his stretcher-bed. Mostly to make it look like I’m doing something, I fall in beside him.

“How are you feeling?” I say.

He’s still lying on his side. “I’m fuckin dying, you fuckin asshole,” he says. Or something like that. His teeth are chattering too hard to be sure.

It gets my attention. He certainly looks like he’s dying. “Allergic to any medications?” I ask him.

“No.”

“Good. Hang in there.”

“Fuck you.”

I follow him back to his unit and quickly write orders for a whole collage of antibiotics and antivirals, putting “STAT” on every one of them. Thinking:
Should I go threaten Squillante some more? With what, and to what end?
Then I go pull Assman’s CT scan up on a computer screen.

It’s calming, in a way. If you know what you’re doing, trackballing through a CT is beautiful. Probably even if you don’t. You rise or fall through the hundreds of horizontal cross sections, and the various ovals—chest, lungs, heart chambers, aorta— expand and contract like roiling weather patterns, passing through each other and tapering at different levels. But even then you always know where you are, because the inside of a human being has practically no two cubic inches that are identical. This is true even on a left-right basis. Your heart and spleen are on the left while your liver and gallbladder are on the right. Your left lung has two lobes while your right has three. Your left and right colon are different widths and follow differently shaped paths. The vein of your right gonad drains directly toward your heart, while the vein of the left joins the vein of your left kidney. If you’re male, your left gonad even hangs lower than your right, to accommodate the scissor motion of your legs.

So the two golf ball–sized abscesses on Assman’s CT are immediately noticeable, one behind his right collarbone and the other in his right buttock. On closer inspection they might have some sort of fuzz around the edges—a fungus or something. They look like what alcoholics get when they pass out and inhale their own vomit, then grow colonies from it in their lungs. I’m pretty sure I’ve never seen anything like it in muscle before.

I send my med students off to page Pathology. It tends to be difficult to pry those people out of their nasty little lairs, which are lined with bottles of human organs like the homes of the serial killers they chase on TV, but Assman is going to need a biopsy. I tell them to page Infectious Disease while they’re at it, since odds are neither service will answer us.

And once they’re out of sight I close out the CT screen on the computer and Google Squillante’s surgeon, John Friendly, MD, just to take one more depth reading on the shit I’m in.

But surprise: the word is positive. My man Friendly has either banded or reduced the stomach of every obese celebrity I’ve ever heard of. In fact,
New York
magazine—which should know, since its primary function is to transfer pathogens between the hands of people in waiting rooms—names him as one of the five best GI surgeons in the city. Friendly even has a book that’s doing not too sucky on Amazon:
Eye of the Needle: Cooking for the Surgically Altered Digestive Tract.

I keep searching until I find a picture that confirms these people are really talking about the guy I met earlier, since it’s been that kind of morning. Along the way I find more happy articles. Apparently Friendly just did the colostomy on the guy who played the dad on
Virtual Dad
.

Like that guy must have said: what a fucking relief.

I try to figure out just how much of a relief. Does this mean Squillante actually has a seventy-five percent chance of surviving the operation? If so, what are the odds he keeps his word and doesn’t rat me out if he lives? I get a page from a room where I don’t currently have any patients.

I stare at the number on my pager screen and wonder if it’s the new patient Akfal said something about to me three hours earlier. Then I realize it’s the room with Osteosarcoma Girl in it, and run to take the fire stairs.

The first thing I realize when I see her again is that, although she’s beautiful, her eyes really don’t look like those of my lost Magdalena at all. Then I feel embarrassed to be so disappointed.

“What’s up?” I say.

“What do you mean?”

“I got paged.”

She stops biting her thumbnail to point toward the side of the room where the door is. “I think it was the new girl,” she says.

Oh right. That curtain’s now drawn, and there are voices coming through. I pat Osteosarcoma Girl on her nondiseased leg, then knock on the wall and pull the curtain aside.

Three nurses are still setting up a new patient in the bed that was empty before.

It’s another young woman, though it’s hard to tell her age precisely because her head is shaved and bandaged, and the front left quarter of it is missing. Where it should be, there’s just an indentation in gauze.

Below it she looks at me with wild blue eyes.

“Who’s this?” I ask.

“New patient, Dr. Brown,” the senior nurse says. “She’s in from Neurosurgery.”

“Hi,” I say to the patient. “I’m Dr. Brown.”

“Ay a ly ly ly,” she says.

Naturally. In all right-handed people, and most left-handed ones, the front left lobe is where the personality is. Or was. The bandage over the missing part of her head starts pulsating from the effort of speaking.

“Just relax. I’ll go read your chart,” I tell her, and leave before she can answer.

Or respond to stimulus, or whatever you want to call it.

Head Girl’s chart is brief: it says she’s “
s/p craniectomy for septic meningeal abscess s/p lingual abscess s/p elective cosmetic procedure
+
s/p laparotomy for calvarium placement.
”

In other words, she got her tongue pierced and the infection ran to her brain. Then they cut her head open to get to it, and afterwards took the chunk of skull they’d removed and implanted it under the skin of her abdomen to keep it alive while they waited to see if the infection came back.

Calling a tongue piercing “cosmetic” is a bit of a stretch, since you don’t get one because it makes you look better. You get one because you’re so desperate for affection that you’re willing to gruesomely harm yourself to advertise how well you suck dick.

Christ,
I think:
I am in one bad mood.

Just to complete my research into the house of mirth that is Room 808W, I call up Osteosarcoma Girl’s chart.

Not much to learn there: a lot of “atypical” this and “high likelihood of” that. Her right femur sometimes bleeds, just above the knee. Other times it doesn’t. And she’s due to get the whole thing removed at the hip in a few hours.

The weirdest, worst shit happens to people.

I do Head Girl’s admission paperwork without looking at it, but before I’m done I get another page, this one to the room shared by Duke Mosby and Assman.

The deal, by the way, is this: Akfal and I are required to admit thirty new patients to the ward each week. How long we keep these people in the hospital is up to us. Obviously we have an incentive to get them out fast, so we don’t have to take care of them. But on the other hand, if they come back to the emergency room less than forty-eight hours after we’ve discharged them, we have to take them back onto our service. Whereas if they come back, say, forty-
nine
hours after discharge, they get assigned randomly, as if it were their first visit, and odds are five to one they’ll be someone else’s problem.

The art is in spotting the exact moment when a patient is sufficiently well to survive a full forty-nine hours outside, then flushing them. It sounds harsh—actually, it is harsh—but the second Akfal and I stop doing it, our job will become impossible.

It’s almost impossible already. Some insurance executive long ago found the precise line past which it won’t pay to push us—our own forty-nine-hour mark, if you will—and is doing an expert job of keeping us there. Between admitting new patients and discharging old ones, both of which are paperwork nightmares, we barely have time to manage the patients who are staying around.

This means that checking on any one of the patients we’ve already seen for the day—like Assman and Duke Mosby—is a pure waste of time. Unless the patient is in immediate, fixable trouble.

Which is always an outside possibility, and in this case sends me back to the fire stairs, then running down the hall to their room.

There’s a crowd just inside: the Attending Physician from rounds (of all people), Zhing Zhing, our four med students, and the Chief Resident. There are also two male residents I don’t recognize. One, who’s darkly handsome but also crazed-looking, has a giant syringe in his hand. The other one is birdlike and looks annoyed.

“No way,” the Chief Resident is saying to the one with the syringe. “Unh uh, Doctor.” She’s standing between him and the bed.

I say, “Hi,” and hold a fist out for Assman to knock with his knuckles, but he just glares at me. “Who are you guys?” I say to the residents.

“ID,” says the one with the hypodermic. Infectious Disease.

“Pathology,” says the other one. “Did you page me?”

“Maybe an hour ago,” I say. “Did you page
me?
”

“I did, sir,” one of the medical students says.

“This guy wants to biopsy the lesions,” the Chief Resident says to me, meaning the ID guy.
*

“Okay,” I say.

“Okay?”
the Chief Resident says. “This patient has an unknown pathogen that’s
spreading,
and you want to risk disseminating it farther?”

“I want to find out what it is,” I say.

“Did you think about informing the CDC?”

“No,” I say.

Which is true.

“It’s already gone from his glute to his upper thorax,” the ID guy says. “How much farther can it disseminate?”

“How about through my whole fucking hospital ward?” the Chief Resident says.

The birdlike Pathology guy breaks in. “Why did you page
me?
” he says.

The Chief Resident ignores him and turns to the Attending. “What do you think?”

The Attending looks at his watch and shrugs.

“I’m going in,” the ID guy says.

The Chief Resident says, “Wait—”

But the ID guy gets an elbow around her and moves in with the needle. Taps twice on Assman’s upper chest, raising a scream with the second tap. ID keeps his finger there and sinks the needle in right next to it, then quickly tugs at the plunger. Assman’s howl rises in pitch, and the chamber of the hypodermic fills with blood swirled with yellow fluid.

“God damn you!” the Chief Resident shouts.

The ID guy yanks the needle out and turns to her, smug, but overestimates the distance between them. Actually there is no distance between them. As the Chief Resident gets knocked backwards, she and ID guy flail into a tangle and start to fall together.

Right toward me.

I shift sideways, but there’s a med student under me, yapping beneath one of my clogs. I jam into the wall, and all I can do to protect my face is raise a forearm. Which the hypodermic hits, sinking up to the plastic.

There’s a pause.

Then people start to get up, backing away from me. I stand too. Look down at my arm. The hypodermic’s sticking out of it, empty, plunger all the way down. Starting to give me that pain any large shot will give you, because it separates the planes of tissue. I twist the syringe out of my arm.

I snap the needle off and drop it into the drawer of a sharps box on the wall behind me. Then I take hold of the front of the ID guy’s scrub shirt and drop the hypo chamber into his pocket. “Scrape what you can out of this and analyze it,” I tell him. “Take the Path guy with you.”

“I don’t even know what I’m doing here,” the Path guy whines.

“Don’t make me hurt you,” I tell him.

“Dr. Brown,” the Attending says.

“Yes, sir?” I say, still looking at the ID guy.

“Give me a five-minute head start?”

“You left ten minutes ago,” I tell him.

“You’re a mensch, kid. Cheers,” he says as he leaves.

Everyone else stands frozen.

“Stat, you fucking assholes!” I tell them.

I’m almost out of the room when I realize something’s wrong. Something else, I mean.

Duke Mosby’s bed is empty. “Where’s Mosby?” I say.

“Maybe he went for a walk,” one of the med students says, behind me.

“Mosby’s got bilateral pedal gangrene,” I say. “The guy can’t even hobble.”

But apparently he can run.