Dr. Galen's Little Black Bag

by R. A. Comunale M. D.

  Also by R.A. Comunale

  Requiem for the Bone Man

  The Legend of Safehaven

  Clover: A Dr. Galen Novel

  Berto’s World

  Shoes: Tails from the Post

  Dr. Galen’s Little Black Bag

  Copyright © 2011 R.A. Comunale

  All Rights Reserved

  ISBNs:

  978-0-9846512-8-3 (EPUB)

  978-1-4956004-3-2 (Mobi)

  978-1-4956004-4-9 (PDF)

  Published in the United States of America

  By Safehaven Books

  A division of Mountain Lake Press

  Ebook formatting by

  eBookIt

  Cover design by Michael Hentges

  This is a work of fiction. Any resemblance of the characters to real persons living or dead is unintentional and purely coincidental.

  No part of this book may be reproduced, stored in a data base or other retrieval system, or transmitted in any form, by any means, including mechanical, electronic, photo-copying, recording or otherwise, without the prior written permission of the author.

  To my long-suffering secretaries, Virginia and Barbara. Friends and consiglieres of unlimited wisdom, they’ve saved my ass more times than I can count.

  PROLOGUE

  Hey, Mistah, wanna buy a duck?

  He don’ need no duck, kid. He’s a quack.

  Hey, Rube!

  I know that I’m old … over four score … but I’m not senile.

  Just because I fall asleep in my chair, mouth open and snoring to beat the band, I still have all my faculties … I think.

  So why the hell am I hearing voices?

  I’m up here, Gazoonie!

  It sits on my shelf, companion to the stuffed toy dog my beloved Leni brought me that last day of her life.

  A black-leather doctor’s bag.

  It sits there, mute testimony to over sixty years of interacting with the lives of countless patients.

  Did I say mute?

  Yeah, Galen, it’s me. You haven’t held me in a coon’s age, have you?

  Like me it’s well-worn, the gold lettering on its side now faded and illegible; its surface scuffed and cracked.

  Well, ain’t you curious, old man?

  I rise from my chair. I reach up, take hold of the handles, sit back down and set it on my lap.

  I open it. Its hinges creak stiffly, just like mine.

  Inside I see my old friends: bottles, glass ampoules and rubber-stoppered vials with faded labels; worn metal gadgets that would make today’s doctors laugh at the primitive state of medicine once practiced. I do not remind them that such shamanism kept their parents, grandparents, and great-grandparents alive to carry on their genetic whirlpool.

  Now ya got it, old man. Remember?

  Yes, I do. There’s the old scalpel I used in cadaver lab. Don’t know why I kept it. Never used it on anyone living … I think.

  Hey, Galen, you really did a hatchet job on me, didn’t you? You got damned big fingers to go poking around my insides.

  Harry? You here, too?

  Patients who endured the fumbling of a medical student and survived; patients who became my friends and extended family; young patients who stroked my ego by following in my footsteps—all peering up at me from that bag.

  Doc, look what ya made us do! Ya sure ya ain’t the devil?

  Listen, guys, can I help it if you were foolish enough to become doctors? Crescenzi, Criswell, Shepland, all of you—admit it. You wanted it, too, didn’t you?

  Yeah, and you were just some innocent recruiter, weren’t you? Come on, Doc, you conned us into it. We never got our seventy two virgins, either!

  Heh, heh, so I lied, guys. Sue me!

  I see other things as well: my passions, my loves, my failures and … my few successes? I see the rich, the poor, the famous and the unknown. In the end all shared the same human traits: the boy who shot himself in order to live; the child with Down’s syndrome, who understood more than most; the politicians whose idiosyncrasies would startle and disgust their followers, and the quiet lives of heroes and cowards.

  I return it to my shelf, not-so-mute testimony to sixty years of my life.

  My little black bag: the one life companion the Bone Man could not take from me.

  —Robert Anthony Galen, M.D. (retired)

  When Harry Met Sal

  Hey, Berto, let me outta this damned thing!

  Sal, is that you?

  Sho’nuff, Dottore.

  What the hell am I doing here, Sal?

  Don’t you know, kid?

  “Wake up, City Boy! No bad dreams today.”

  My roommate, Dave, stood over me wearing only his birthday suit.

  “Wha … what’s going on?”

  I lay in a cold sweat, almost as naked as Dave, sprawled half in, half out of my dorm bed.

  “You were yellin’ at somebody named Sal.”

  I shook my head. I couldn’t get the image out of my mind: my dead friend Salvatore zipped up in a rubber body bag.

  “Come on, roomie, let’s hit the showers. Can’t keep the dean waitin’!”

  “Welcome, sons and daughters of Aesclepius!”

  My mind’s eye sees them all: the extroverted, the silent, the hand shakers and the wallflowers. I remember the ones who made it through four years of medical boot camp and the ones who did not.

  It was the first day—young men and women vibrating with an awareness of something indescribable—that magical first day of medical school, that first day of the rest of our lives.

  Today’s young doctors tell me their initiation as acolytes of the son of Apollo began with a white-coat ceremony: Friends and family watch, while dignitaries bestow the traditional garb on each new student. Each dons it as a vestment of the priesthood he or she is about to enter, while the Oath of Hippocrates is recited by candlelight.

  Youngsters! We had no such elegance. Neither did we share in a very wonderful and new tradition of honoring the memory of those who had bequeathed their bodies, so we could learn from the mortality of others.

  No, we had the black bag.

  We listened with half-baked attention, while the dean and other school officials welcomed us, but our eyes kept darting toward a row of tables at the side of the conference room.

  There sat more than a hundred small, black-leather bags—real doctors’ bags—enticing and bewitching us with their silent siren call. Not fancy and not big. Those would come later; these were easily recognizable as student bags.

  And yet—and yet—they held the tools of our future trade: a simple stethoscope, a little metal hammer with a triangular rubber head that made us giddy, as we laughed and tapped one another’s knees to watch the involuntary-reflex twitching, and more.

  We had to buy the sphygmomanometers—aka blood-pressure cuffs—and the fancy flashlights called oto-ophthalmoscopes. We bruised our arms trying them out. We also nearly blinded ourselves by shining the white-and-green lights in our eyes, and we induced bleeding in our auditory canals, when we jammed the dark-green, plastic speculums into fellow students’ ears.

  Do not laugh.

  We clutched those bags tightly, as we walked back to our dormitories, ignoring the knowing smiles and outright derision of the upper classmen. We didn’t care.

  “Ow! Damn it, Dave, go easy with the cuff!”

  Dave assumed that maximum inflation was necessary in his first attempts to take my blood pressure. My arm was frequently numb and swollen.

  “You’re burnin’ a hole in my retina, you moron!”

  Ah, yes, the moron was me. My initial ineptitude at trying to visualize the back of the eye—the retina and the optic disc—gave him ma
ny a migraine.

  Dave, whom I called Country Boy, and I served as guinea pigs for one another. We’d hold open our Textbook of Physical Diagnosis and listen and thump and blind each other in desperate attempts to imitate the “correct way” of examining patients. It didn’t matter that we still knew squat about the human body. It also didn’t matter that we were embarrassed to hell and back at the more intimate examinations, which were more painful than a baseball to the groin. We were playing doctor, and this time it was for real.

  “Oh, God, today’s gross anatomy lab.”

  My classmate Carol’s tiny voice quivered, as we trotted across the campus to that first lab session. Back then the gross anatomy lab was in a different building—a dirty red brick Civil War relic without air conditioning—and we arrived at the door out of breath.

  “Hey, City Boy, what the hell are those things on the walls?”

  I had to laugh. Dave was a weed-thin Lynchburg farm boy. If he had grown up in my tenement neighborhood back in Newark, and had gone to my ancient elementary school run by nuns, he would easily have recognized gaslight fixtures that predated the electric light.

  A bald-headed gnome and a parrot-faced woman waited impatiently, until we settled down.

  The gnome harrumphed.

  “Ladies and gentlemen, I’m John Hedley. This is Mrs. Gertrude Gable, my assistant. There are some rules of behavior that we expect—no, demand—of you.”

  Gable’s gravelly voice cut in.

  “You will be assigned four to a table. You will wear your lab smocks and gloves at all times. I hope you are wearing shoes and clothes that you won’t miss at the end of the year. You won’t want to keep them.”

  Dave and I looked quizzically at one another.

  “What the hell is she talkin’ about?” he mouthed.

  But Gravel Gertie was right; I still have my shoes. Sixty years later I can still smell the formaldehyde. It never did come out. The clothes and green smock are long gone, more the product of diet than a lack of sentimentality. I’m still good looking but not as svelte as I used to be.

  “At no time will you be disrespectful of the bodies you will be working on. Treat them as you would want your own body to be treated.”

  Hear that, kid? Did those police docs treat mine with respect?

  Sal, you’re dead. You don’t belong here!

  Can’t think of a better place for a dead guy to be, Berto.

  I noticed Hedley staring at my name tag.

  “Mr. Galen, did you have something to say?”

  “Uh … no, sir. Sorry, sir.”

  Hedley cast a baleful glance at me then held up a pudgy hand and pointed at us.

  “If I catch any one being an ass, violating these bodies in any way, I will have you expelled right then and there. Do you understand?”

  Was he looking right at me?

  We nodded. Why would anyone even think of doing something as grotesque as violating a cadaver?

  You are one dumb shit, Berto.

  Get outta my head, Sal.

  Unh- uh, kiddo. Just wait. You’ll be glad I’m here.

  I was no stranger to death. My old neighborhood hosted a charter chapter of the unexpected-death club. I met my first member when I was eight years old—my beautiful Marigold Lady of the river, a casualty of a back-alley abortion. Still, I admit, nearly six decades later, I felt a cold chill, as Hedley took a key from his vest pocket and unlocked the lab door.

  The odor. That’s what hits you first. The vapors of the preservative liquids assault your nose and forever imprint themselves on your olfactory lobes in that most primitive part of your brain. You never forget it.

  So, there we stood, dressed in green lab smocks and staring at row upon row of stainless-steel tables. On each lay a dark-brown, rubber bag, its contents elevating the fabric in the unmistakable shape of a human body. It was a classroom of the dead.

  “Pair off in fours.”

  Two on each side, we all stared down at those zippered containers then jumped as Gable rasped, “Open your bags!”

  The four of us eyed one another, each waiting for someone else to make the first move. We were two guys and two girls: Dave and me, Carol, and Tara. The females glanced at us males with nervous smiles, and we tried to feign nonchalance.

  But no one touched that zipper.

  “Come on, come on!” Hedley’s voice was almost Mel Blanc in quality.

  You heard Porky Pig, Dottore Berto, go for it!

  As the great Yogi Berra once said, it was déjà vu all over again.

  For a moment I was back home, standing in the police morgue beside my mentor, Dr. Corrado Agnelli. Salvatore Gatto, my best and only surviving early boyhood friend Sal, had been brought there. My clothes were still covered with blood and bone spatters from the shotgun blasts that had taken his life an hour before.

  Now Sal’s mutilated body lay on the same stainless steel table that had cradled my dead lady, my Marigold Lady, thirteen years earlier.

  “Corrado, I can’t go through with this. I can’t!”

  The dead lady had decided my life’s work; Sal’s death had made me question my resolve.

  “You must, Berto, for Sal’s sake … and your own.”

  I watched the police surgeons dissect what had once been a friend, the person who had been my surrogate brother.

  You heard Agnelli, Berto. Show me ya got the balls ta do it.

  Shut up, Sal

  Chicken!

  Cut it out, for cryin’ out loud!

  Chicken shit, chicken shit!

  I took a breath. My hand moved forward and grasped the zipper. I felt my classmates’ hands rest on my own. Together we pulled it down.

  Bravo, Dottore, bravo!

  Grazie, Sal.

  “City Boy, you okay?”

  Dave was shaking me.

  I opened my eyes.

  “Huh? Oh …uh … yeah, Dave. Sorry guys.”

  The girls smiled at me. It made me feel good.

  Now, wasn’t that worth it, paisan?

  Suddenly we heard retching and a male voice crying out, “Oh, sweet Jesus!” and then the sound of a collapsing body.

  Hedley and Gable raced to that table and helped our classmate stand back up.

  “He worked for my father! He used to play with me when I was a kid!”

  Chet’s tearful voice kept repeating those words. Hedley and Gable re-zipped the bag and wheeled the cart out of the lab. Within minutes the morgue attendant arrived with another body.

  We began examining our cadaver.

  In life he had been a big man, powerfully built, like a boxer. African-American, he didn’t appear to be older than his mid-to-late forties. What could have killed a man like this? We would soon find out.

  Hey, Sal, bet this is what you’d have looked like in twenty five years!

  No answer.

  “Listen up, peepuwl.”

  Jeez, now he’s Elmer Fudd!

  Hedley continued: “What happened to your colleague this morning is a reminder; death overtakes us all. At some point, each and every one of you will see someone close to you—someone you know—die.”

  Carol nodded.

  I remembered Angie, Tomas, and especially Salvatore; all my early childhood friends now gone, snatched from life before my very eyes.

  “We’re going to remove the brain first. It’s the most fragile and difficult organ to preserve and some may … uh … not be in …uh… good shape.”

  Gable and Hedley exchanged glances.

  At that remark a group of graduate anatomy students arrived, each carrying an electric circular saw and a large morgue scalpel. One walked to our table, and, as we watched, he made a semicircular cut two-thirds around the cadaver’s scalp. He reached out and in one, sock-removing motion, pulled the scalp up and forward. Then he placed the saw against the now-bare skull, and the rotating blade easily cut through the bone.

  Dead bone smells like burning dog hair when it’s cut.

  “Voila! Ladies
and gentlemen, I give you the human brain.”

  Our graduate student bowed as we applauded.

  Once more the sounds of retching, but this time it was a response to the terrible, rotting-flesh odor filling the air.

  “Sorry, folks,” Hedley said, “but as I told you, sometimes the preservative doesn’t reach the brain.”

  Damned good thing my brain was fresh, right Berto?

  Sal, you didn’t have one.

  That wasn’t an insult. One of the shotgun blasts had taken half of Sal’s head off.

  Two rows down a foul-smelling pablum oozed from the brain case of the cadaver lying there.

  The graduate student at the table cleaned up the mess. Meanwhile Hedley and Gable circulated, eventually reaching us.

  “Ah, splendid!” Hedley gushed, as he noted our cadaver’s intact brain.

  Well, not truly intact. A large, preserved blood clot had indented a good portion of the left side.

  “This is wonderful, students. It’s obvious what killed this man.”

  Gable seemed in ecstasy.

  Whatever turns ya on, lady.

  Shut up, Sal.

  Our cadaver, whom we soon nicknamed “Harry,” had died of a massive stroke. A major artery had ruptured in his brain, probably killing him instantly. In life, like many African-Americans, he had suffered from uncontrolled high blood pressure. Unfortunately, like most men of any skin color back then, he probably ignored the symptoms or had no inkling that he had a problem.

  I think of the myriad drugs we have today to treat elevated blood pressure and the ethnic-specific drugs that can be even more effective. Back then we had fluid pills—diuretics—and a drug called alpha methyl dopa, which caused people to pass out when they stood up too quickly. Our biggest gun was a hideously powerful and unstable medication called nitroprusside. It often killed more than it helped.

  Once more Hedley’s voice changed, this time a close match to Daffy Duck.

  Wonder if he can do Bugs Bunny.

  Each of you has your disthecting kit, yeth?

  His pronunciation of “dissecting” would have made Daffy or even Sylvester the Cat proud.

  We all nodded. The wallet-sized, plastic kit held a large bladed scalpel, semi-dull scissors, pointed probe and tweezers.