âSo? He likes hearing new developments on his patients.'
The Bruiser called Little Otto Kreinberg:
âHello, Dr. Kreinberg, this is Dr. Levy . . . Bruce Levy . . . No, you're right, I'm not really a doctor, I'm a BMS but . . . right . . . well, I've gotten in the habit of calling myself Dr. Levy . . . Oh, yeah, I wanted to tell you I've just finished hypnotizing Mrs. Biles for her angiâ . . . hypnotizing . . . h-y-p-n-o . . . right, like a magician, and she . . . for her anxiety and I . . . yes? . . . sure . . . oh . . . ohhhhh . . . but it's an accepted . . . OK, sorry, yes, I'll awaken her from her trance right away, sir, good-bye.'
Looking sheepish, Bruiser started to slink out, and I asked him if he'd do me a favor.
âYeah?' he asked, thinking he might redeem himself.
âI've been busy all day and I haven't had a chance to go to the toilet. Could you go for me? A number two. I've done a number one.'
âYou can't treat me like this. Besides, I looked up “microdeckia,” and there's no such thing.'
âMicrodeckia? Sureâ “not playing with a full deck.” Night.'
I went to bed. Molly was night nurse, and all our efforts to get to bed had been frustrated, first by the Bruiser, then by the gomers. But now the Bruiser was in the library and I'd BUFFED the gomers for the night, and I sat on the on-call bed, naked, awaiting my nurse. Hazel had BUFFED the sheets, and next to the House of God pillow was a doll made from rubber tubing and gauze pads with a note pinned to it: âRoy the noisy boy, Molly the jolly girl; am coming in if you're my toy and not too busy for a whirl. Call me.' Finally!
In delicious anticipation I found myself looking out the window at the nursing-school dorm. In one of the rooms a nurse was undressing. She took off her uniform and then made that wonderful motion of hyperextending the elbows around her back to undo her bra. Just as Molly walked in, she let them fly. Fine, fine. I was a time bomb. Molly sat on the bed and I showed her what I was watching. I unbuttoned her dress and unhooked her bra and caught her little-girl breasts by their longing nipples. All over me, her dress was off her pantyhose were off her bikinis were off and she was going off. I thought of the Englishman's idea of perfection, when he, his alarm, and his mistress all go off at the same time, and just before we got that firm fun thing into her hollow funnelly thing, she stopped and in between her little gasps of pleasure said, âDid I ever show you what the nuns teach nurses to do when a patient gets an erection?'
âNope.'
âThe nuns said to slap it and it would go down.'
âDo you want it to go down?'
âNo, I want it to go up me and fuck me.'
And we started doing that more and more and more and more, and just as we were about to go off, there was an incredible CRASH that rocked the bed and my beeper lady fired again and she wanted me right away, but Molly wanted me more right away, saying, Jesus Christ Almighty oh finish it off ah ahhh ahhhhhh!
The CRASH had come when the Bruiser, in trying to make up for all he'd done wrong that day, had decided to help me out by using the TURF-tool, the electric gomer bed to TURF Mrs. Biles, the bruised and hypnotized Little Otto'd Mrs. Biles, elsewhere. He'd chosen the Orthopedic Height, and it looked from the right-angle bend in Mrs. Biles's left trochanter that she'd broken her hip.
âI did it for you, Dr. Basch,' said the Bruiser proudly, smiling. âI've already paged ORTHO.'
âBruiser, it's hard for me to tell you this: I appreciate what you did, but that gomer-bed thing was a joke.'
âA what?'
âA joke. The Fat Man was joking.'
âOh, God. Oh, my God. I think I've made a terrible mistake. I'd better go and phone Dr. Kreinberg right away.'
âBruiser?'
âYes?'
âCall your analyst first.'
Many of the dying young died. Jimmy, in the SICU with the BALLS TO RIDE A HARLEY guy, was treated with the standard ratbane used to wipe out cancerous bone marrow, and, bald and infected and bruised and bleeding, he died. Fast Henry, who in fact also had a cancer, got his wish to be the happiest man alive one tomorrow when he died, and many other young ones died. When I asked Chuck, âHey, how come the ones our age die?' he said, âDunno, but we sure are leading a great life, ain't we?' Everyone knew that eventually the Yellow Man would die, and all that time, Dr. Sanders had been dying.
Dr. Sanders had been dying a long time. Bald and infected, quiet and cachectic, he was getting his life in order. We were friends. He was dying with a calm strength, as if his dying were part of his life. I was beginning to love him. I began to avoid going into his room.
âI understand,' he said, âit's the hardest thing we ever do, to be a doctor for the dying.'
Talking about medicine, I told him with bitterness about my growing cynicism about what I could do, and he said, âNo, we don't cure. I never bought that either. I went through the same cynicismâall that training, and then this helplessness. And yet, in spite of all our doubt, we can give something. Not cure, no. What sustains us is when we find a way to be compassionate, to love. And the most loving thing we do is to be with a patient, like you are being with me.'
I tried to sit with him. I watched Molly take care to clip his fingernails and toenails so he wouldn't scratch himself and bleed or get infected. I watched everyone keep sterile around his bed. I watched Jo treat him like âa case,' and I watched his oncologist chatter to him with perfect objectivity about his impending death, and all the time I hoped against hope that when he died, he would die neat.
His death was a mess. I was called in the middle of the night, and found him, despite massive platelet transfusions that had been dissolved by the cytotoxic rat poison in his system, bleeding out. Barely conscious when I got to him, his blood pressure almost nothing, he had trickles of geranium-red blood dripping from both nostrils and from the corners of his bloated bruised mouth, and I knew that he was bleeding from every little ruptured capillary in his gut. He was only conscious enough to say, âHelp me, please help me.'
I realized that there was nothing I could do to help him except what he'd said was the only thing a doctor could do, be with him. I took his head in my lap and sponged away the blood and looked into his sightless eyes and said, âI'm here,' and I think he knew that I was.
âHelp me, help me.'
More blood trickled out, and I wiped it away and said, âI'm here,' and I just cried. In silence, so as not to scare him, I wept.
âHi, Roy boy, how's it going, anyway?'
Howard was in the doorway, filling it with his asinine grin and his pipe smoke, and I hissed at him, âGet out of here.'
Sitting down in the chair across the room, he puffed and said, âLooks bad for Dr. Sanders, doesn't it? Gosh, it's tough.'
âGet the hell out of here. Now!'
âYou don't mind if I watch, do you? Follow-up, you know. It's tough in the E.W., because you don't get any follow-up on the patients you admit. I always like followup. Sense of completion. Ending. Learn a lot.'
âGet outta here, Howard, please.'
âHelp me.'
The blood ran. My lap was wet with it. The eyes were glazing.
âI'm here,' and I hugged him.
âYou gonna get the post?' asked Howard.
I wanted to leap up and kill him, but I couldn'tâI wouldn't leave Dr. Sanders until he left me. I begged Howard to leave, and he smiled and said how hard it was to have someone dying whom you cared about, and he puffed his pipe and stayed.
âHelp.'
So I tried to obliterate Howard as I was wetted with Dr. Sanders' thin blood I found myself wanting only to be able to kill Dr. Sanders with something painless and neat instead of being with him in my helplessness.
âHelp me, God, this is awf . . .'
I tried to think of good things, of a woman in a punt on the willowed Cherwell at Oxford, trailing her finger in the leafy stream, but all I could think of was the day's headlines, the sixteen-year-old girl who'd run away to see the world and who was found off a Florida beach naked folded up in a weighted traveling case, and a beaten child wheeled into a courtroom curled up in a fetal position in a crib, who was a vegetable and who âwas not going to get any better' and the surgeon said that when he'd first gotten to the child he didn't even know what he was looking at because it was a mass of rotten flesh, days old, and on the abused child's back, burned into his flesh and scabbed over, were the letters: I-C-R-Y.
When I looked back down into my lap, Dr. Sanders was dead. Much of the eighty-percent blood-water that had been him was drained out onto me.
I held his head in my lap until his sick killer blood had oozed out of his heart and brain and into his gut and skin and all the places it should never have been, and, refusing to clot, had flowed out of all the open holes in his body, the last his laxing anus. I held his hairless head in my lap and in my arms until the flow stopped. I laid him back in his bed and covered him gently with his sheet and I wept. He was the first patient whom I'd loved who'd died. I went to the nursing station. The way I put my feet down, one in front of the other, made me think of a chronic schizophrenic I'd seen, a former Ziegfeld Girl who'd been at an asylum since the Follies, and who, each day, rain or shine, would trudge across the meadow with a determined and precise step in an unerring and clean straight line that would have brought joy to a surveyor's heart, CLOMP, CLOMP, CLOMP, going nowhere, empty inside.
âDr. Sanders is dead,' I said, sitting down.
âThat's too bad. Did you get the postmortem?' asked Jo.
âWhat?'
âI said, did you get the postmortem?'
I had a vision of lifting the little prodigy up by her thin shoulders, shaking her until her brain splattered against her shell of skull and she convulsed, kneeing her in the guts until I'd wrecked her ovaries from ever spitting out another egg, and then heaving her through the sixth-floor window so she'd splatter and have to be sucked up by noisy, powerful sucking-up machines and become a bag of goo, picked over and strained by Hyper Hooper's Israeli Pathology Resident in the morgue. But Jo was pitiful, and so I gritted my teeth and just said, âNo.'
âWhy not?'
âI didn't want to.'
âThat's not good enough,' said Jo.
âI didn't want to see his body ripped to shreds in the morgue.'
âI don't understand what you're saying.'
âI loved him too much to see his body ripped apart downstairs.'
âThat kind of talk has no place in modern medicine.'
âSo don't listen,' I said, beginning to lose control.
âThe postmortem is important,' said Jo. âIt's the flower of the science of medicine. I'll call the next of kin myself.'
âDon't you dare!' I screamed. âI'll kill you if you do!'
âHow do you think we're able to deliver such precise medical care to those entrusted to us?' asked Jo.
âThat's bullshit, that we deliver medical care at all,' I said.
âHave you gone mad? This wardâmy wardâis looked up to in the House for being the most efficient and having the most success with placement and handling the toughies with skill. My ward is a legend. Damnit,' said Jo, jutting her jaw, âI want that post.'
âJo. Go fuck yourself.'
âI'll have to report this to the Fish and the Leggo. I won't have sentimentality ruining my ward. My ward has become a legend in its own time.'
âDo you know why it's become a legend? You don't want to hear.'
âOf course I want to hear, even though I know why already.'
So I told her. I started by telling about how Chuck and I had, after our original empirical test on Anna O., become fanatics at doing nothing and had lied to Jo about it, making up all forms of imaginary tests and BUFFING the charts. I told her how in modified form we'd done the same with the dying young, who went ahead and died, but died without the hassle, pain, and prolongation of suffering that their care might otherwise have produced. The final thing I told her about was placement.
âPlacement picked up because the Social Service liked me and I did such a good job running my ward,' said Jo anxiously.
âJo, everybody hates you and the only reason that placement picked up is that the Runt and I are fucking Rosalie Cohen and Selma respectively. Not to mention the clean sheets.'
âWhat about the clean sheets?'
âChuck has been fucking Hazel from Housekeeping.'
âI don't believe you. No one would do this to me.'
âEveryone would if they could, but your terns are in a privileged position.'
âYou just think you're above it all, said Jo. âBetter than everyone else, like you don't have to stoop down to get postmortems. You're afraid of the dirty side of medicine, right?'
âNo, sir,' I said.
âYou mean you're not afraid of the dirty side of medicine?' asked the Leggo, his eyes running up and down my bloody whites.
âNo, sir, to my knowledge I am not.'
Clad in his butcher-length white coat and with stethoscope, as always, wending its way down to God knows where, he was standing looking out the window, holding my
curriculum vitae
in his hand. He looked lonesome. Like Nixon must have looked. I stood in front of his large desk. Diplomas buzzed me from all directions, and I was mesmerized by a model of the urinary tract, filled with colored water and driven by an electric motor, bubbling red urine through everything at a healthy clip. My mind was empty of everything but how Dr. Sanders had become a bag of bloodâsquishy, bloated, and dead.