"How do you figure that?"
"The question does not deserve an answer."
As the week progressed, information on Laurier Castonguay accumulated while Amiko and her children were moved into their new home—Hawkeye's old house on the brink of Crabapple Cove. The radiologist reported that Laurier's left lung was hyperaerated, which means, simply, there was too much air in it, which suggested that air was trapped in it—that air could get in easier than it could get out. Hawkeye looked in with his bronchoscope and discovered that' the main bronchial tube that carries air to the left lung was narrowed down to a pinpoint. This explainer Laurier's shortness of breath.
Duke, like most veterans of Mobile Army Surgical Hospitals in Korea, had brought records of all his cases home with him. In his old records he discovered that he had taken care of L. Castonguay at the 4077th MASH. Given that information, it was easy to decide that the bullet which traversed Laurier's chest had caused injury resulting in nearly complete occlusion of the left main bronchus.
Duke and Hawkeye performed surgery that eliminated the bronchial stricture. Jocko Allcock, armed with facts supplied by the surgeons and his natural touch with Veterans Affairs, rapidly established that] for seven years, Laurier Castonguay should have been receiving 100 percent disability pay from the Veterans Administration. He presented Amiko with a check for $30,000 the day Laurier was discharged from the hospital.
While in the hospital various nonsurgical tests revealed a previously unsuspected fact. Laurier Castonguay was not stupid. He'd just never been exposed to anything. During his recovery period Laurier and Amiko were tutored in basic reading, writing and arithmetic by Mrs. Pierce, Mrs. Jones and Mrs. Forrest. Amiko Castonguay was the proudest and happiest person in the world, a few months later, when she was accepted for a six-month surgical technician's course at the new Spruce Harbor Medical Center. For Amiko to be working at the operating table with Dr. Duke, the Greatest Man in the World, was an impossible dream come true.
Laurier, breathing normally, learning to be a part of the world, quit the booze and became the man of the family. Dr. Pierce prevailed upon his uncle, Lew the Jew Pierce, to take on Laurier as an apprentice in the lobster-catching profession. Lew, recalcitrant at first, declared that he wouldn't have "no lily pad jumper hauling lobsters in Muscongus Bay." When Hawkeye offered to spring for one hundred new traps and suggested that Laurier do 80 percent of the work for 40 percent of the money, Lew meditated deeply.
"Come on, Jew," urged his nephew. "How can you lose? You'll have more income and less work. Your golf game has to improve. Whadda yuh say?"
"I give it a try," said Lew.
With Amiko and Laurier both making a living, everything improved. Amiko, once she got the hang of it, turned out to be a good student. By 1962 she had passed a high school equivalency test and been accepted at the nursing school down in Portland.
As I said in the beginning, I get a certain amount of heat about Duke Forrest being sort of a teacher's pet, hut that's the only beef I've had in the ten years that Amiko Castonguay, R.N., has been my Operating Room Supervisor.
PSYCHOANALYSIS
BEGINNING A week or so before Thanksgiving an continuing into early January, surgery at Spruce Harbor Medical Center slows down. Folks don't want to have elective procedures done during the holidays, and; the surgical staff likes to start skiing or just take it easy.
As administrator, I approach this season with apprehension because when my surgeons are not totally consumed by surgical responsibility they tend to get me in trouble. I got my first sniff of trouble about a week before Thanksgiving 1974 in the coffee shop when I overheard a conversation between Pierce, Forrest, Jones, Mclntyre and Solly (Wolfman) Davis, the bearded Afro-haired psychiatrist. Wolfman was saying, "Rex Eatapuss will be back from his course in advanced Freudian psychoanalysis, or whatever these phonies call it, on December 1. I think you guys should undergo analysis."
"Not me," said Trapper John. "I'm okay. I'm TM'ing it."
"What's that mean?" Duke asked.
"Transcendental masturbation. I sit in a corner, but I don't say my mantra. I just contemplate my equipment."
"It comes natural or you have to take lessons?" Hawkeye asked.
"I'm self-taught. Cheaper than paying a hundred bucks for that course in Meditation they're giving down at Androscoggin College."
"You capable of total contemplation?"
"Not quite. Spearchucker's the one who oughta go into analysis. I was reading about him in Sports Illustrated the other day. They said when he was with the Eagles he was a big, mean, aggressive, hostile nigger. You realize we got something like that right in our midst?"
"I could fix him," Wolfman volunteered. "Give him a little Central Maine Power. Turn him into a sissy."
Spearchucker just grinned his slow ear-to-ear, white-of-eye-popping grin.
"Don't grin too long, Chucker," Duke pleaded. "I can't stand the glare. You know I heard a rumor. I heard Hooker and Rex Eatapuss made some kind of deal—got some federal money for a psychoanalysis program in that damnfool Mental Health Center. I hear they don't get the money unless the medical staff undergoes analysis."
"I'll believe anything," said Hawkeye. "The wolf lobby is on Jerry Ford cuz he gave Brezhnev a wolfskin coat. Christly wolves got more power down there than the AMA."
"Shoulda given the bastard a live wolf coat," Duke suggested.
"I don't think the Hook thinks we'll hold still for Rex Eatapuss psychoanalyzing us," from Spearchucker.
"Oh, hell," said Trapper. "You know how those things work. The government's so crazy you gotta go along with a few things to get the money you need. Let's enjoy it."
This brilliant conversation was interrupted by thr page system ordering Doctors Pierce and Mclntyre to surgery. I was relieved that for the moment there wouldn't be open rebellion. The Mental Health Clini is an integral part of our overall health-care effort, and I did get a hundred grand just by agreeing to have my staff psychoanalyzed.
Late that same afternoon Dr. Pierce stopped in for a touch of Scotch from my office jug. He looked tired. "Jesus," he groaned after a sip of Chivas Regal, "I'm sure used up. Got up at four o'clock this morning for a GI bleeder, spent the whole morning in the O.R. and four solid hours in that office."
"That's more office time than usual for you, isn't it?'" I asked.
"Yeah. Ever since Mrs. Ford and Happy Rockefeller had their trouble, the broads have gone banana- feeling their breasts. Then they have their doctors feel their breasts. The doctors are all so eager not to miss anything they feel lumps that ain't there and refer; them to surgeons. Christ, half the time you take the broads in and do a biopsy just to make everybody happy. Know goddamn well nothing wrong."
"There've been a few cases turn up, haven't there, as a result of all the publicity?"
"Yeah, there have, so I don't complain too much. Just had one that's gonna be bad news. Broad named Rankin. Her husband's the Pope of the Supreme Spirit Church, or whatever. He's the head Supreme Spirit of the whole state. Mealymouthed, nasty pious- dumb bastard. Wife's a little broad, maybe forty, cou pie kids. I knew she was terrified the minute she came in. Christ, Doggy'd examined her just ten days ago, said she was okay, but she'd found something in her right breast, and she was right. I figure even money it's malignant, so I tell the Pope to come in, give 'em both the routine: if it's malignant, the breast goes. Mrs. Rankin was really shook. This jerk husband gave me the "we've committed our bodies and souls to Jesus Christ, His will be done" routine. I didn't know these gomers really talked that way. I despise him, and I only spent fifteen minutes with him. He was telling me he knows all about I'm a fine surgeon, I am the right hand of God gonna cut his wife's right breast. I hope the thing's benign. If it's malignant and a year from now she has a recurrence, I can see this Jesus freak praying over the poor woman. Christ, you could tell she's his chattel, not his wife. What she'll want and need is him to put his arm around her and say, 'Honey, I love you, we'll fight it all the way.' He is just
a cold-bjooded, Bible-spewing grunt."
When Hawkeye was on his second drink, my phone rang. The caller was the Reverend Mr. Rankin, Pope of the Church of the Supreme Spirit. He explained about his wife, told me about arrangements for her surgery by Dr. Pierce. He was, however, in a terrible dither because, as he left Dr. Pierce's office, he had seen a glassful of an obviously alcoholic beverage sitting atop the refrigerator in the little kitchenette one passes on the way out.
"No one, I repeat, no one," the Reverend repeated, "who uses alcohol will touch my beloved wife. I want your advice as to whom else I may employ to perform the delicate work required, someone whose lips have never touched the devil's brew."
"May I call you back?" I asked.
"Of course, Mr. Hooker. We place ourselves in your hands."
Addressing my Chief of Surgery, I asked, "You been belting the devil's brew in your office?"
"Huh?"
"That was the Reverend Mr. Rankin. He wants a different surgeon. He says you had a drink on top of your refrigerator."
"For chrissake, that's iced tea. Half of Spruce Harbor knows I drink iced tea in the office! You know it!"
"Yeah," I said, "I know it, but I thought maybe you'd like to get off the hook. If, as you think, this is a trouble case, you're bound to tangle with the Reverend sooner or later. Maybe it'll save trouble if we get Duke to take the case. He's not quite as opinionated, prejudiced and anti-Christ as you are."
"Duke, of course, doesn't drink. You think maybe that stuff he has shipped up from Georgia is pure spring water? Christ, his family's been cookin' shine since the dawn of time."
I pointed out, "If we try to find a surgeon who doesn't drink, we'll have to ship the lady to Africa and have her hunt up a missionary. It'll have to be Duke."
"That's okay," Hawk agreed. "In fact, as you suggest, it's a great relief, but I don't like the idea of that klutz spreading it around that I drink during office hours."
"Maybe you should start," I suggested. "You're always complaining you got too much work. Why not drive a few of them off?" As soon as I said it, I was sorry.
"Hell, half my patients would want to join me. Since I've been back here, I've operated on two hundred people I've been drinking with, here or there, one time or another."
"Yeah, I guess that's right. Will you call Duke and explain? Then I'll call the Reverend and complete the arrangements."
"Sure," agreed Dr. Pierce. "Finestkind."
Surgery was scheduled for three days later. In the interim I worried, hoped and prayed (well, almost) that all would be well with Mrs. Rankin. Also, I endured a barrage of comments from my staff about their forthcoming psychoanalysis.
Attitudes diverged. Boom-Boom Benner was openly enthusiastic, begged Rex Eatapuss to take him first. Rex Eatapuss, for whatever reason, did not, at least outwardly, respond with comparable enthusiasm. Duke, always the most sensitive, concerned, involved, told Rex over coffee, "Ah sure hope yuh all can cure Trapper from contemplatin'."
And on and on. Duke operated on Mrs. Rankin one Friday morning. Although Hawkeye and Duke had both thought the lump in her breast was malignant, it turned out to be a benign harmless cyst.
That evening Graveyard Alice, out of Bette Bang Bang's stable, attended services at the Spirit Church, accompanied by Jocko Allcock, whom she introduced to Reverend Rankin as her husband. The loving couple expressed a strong desire for salvation, explaining that, singly and together, they had indulged in more sin than your average everyday churchgoer. The Reverend Mr. Rankin, assessing Alice, correctly decided that her case merited special, intense, individual effort, and suggested an hour of prayer on Saturday afternoon. This worked out nicely because Mrs. Rankin was still in the hospital and Alice didn't work until 9 p.m.
To save Alice, the Reverend Mr. Rankin visited her in the semiplush apartment she sometimes shares with Jocko Allcock.
The Saturday afternoon group in the Bay View included most of my surgical staff and others prominent in the community. The weather was poor, skiing negligible, the deer season over, no golf, nothing to do, and all were there, waiting for news of Alice's salvation.
Finally at 3:28 Jocko arrived with the word. "He done saved her in fifteen minutes. Spent the next hour exercising her. Alice says he won't touch no booze, but come to exercise he ain't exactly what you'd call abstemious."
"Male and female, them Spirits always been strong horizontal," volunteered the historian, Lew the Jew. "But, Jesus, boy, I tell you, they can't cook worth a goddamn. Want to go to a good church supper, go to the Rollers. Course, afterwards, to the Rollers, even if a feller gets him a piece, tain't no good. Depends, I s'pose, on what a feller likes."
"Well," thought Trapper, "as long as we have both right here in our fair city, there's really no problem. We have the best of both worlds."
"I've decided to become a lush," Hawkeye Pierce announced, apropos of nothing and out of a clear sky. Possibly because he'd been considered a semilush for twenty years, this statement caused not even a riffle of conversational reaction.
"I said," he repeated petulantly, "I'm gonna become a lush."
"Another martini—make it a double—for the lush," Trapper ordered, then asked, "What is your mission?"
"I wish to decrease the size of my surgical practice. Also I think I will go foolish and get Rex Eatapuss to lay a cure on me, employing the technique of Sigmund Freud."
"Tight end, Kansas City Chiefs," chimed in Schweinhund Wincapaw, one of Crazy Horse Weinstein's champion peddlers of fine gents' apparel.
The group mulled this statement momentarily before its spokesman, Jocko Allcock, asked, "Whadda you talkin' about, Schweinhund?"
"Six four, two twenty, Alcorn A&M, Kansas City Chiefs," Schweinhund recited proudly.
"May I paraphrase Mr. Allcock's question, Schweinhund?" asked Trapper. "To what or whom do you refer?"
"Sigmund Freud."
Spearchucker was able to clear up the misunderstanding. "You're thinking of Julius Freud, Schwein- liund. He's the guy with the Chiefs. Sigmund Freud was a honkie headshrinker who promulgated the Freudian theory which is: Everything wrong with you is because you are pissed off at either your father or your mother."
"I love my parents," said Schweinhund.
"You're crazy, Schweinhund," said Hawkeye. "Anybody so uneducated he don't know enough to hate one of his parents gotta have help. What you need is Mental Health. I'll arrange an appointment for you with Rex Eatapuss, who has just finished an advanced course in modern Freudian psychoanalysis."
"He'll get me all messed up," Schweinhund protested.
"That's the whole point," Hawkeye explained. "Look, Schweinhund, I've known you all my life. You're completely normal. Small drink, little smoke, hardly any strange stuff except when your wife visits her mother, pay your bills, own your own home, two kids in college getting good marks, vote the straight Republican ticket. Schweinhund, for chrissake, you don't even take tranquilizers. And I've seen you shoot 92 and smile. By any modern standards, you are a mental health disaster. Your problem is you're too dumb to know you're a disaster. Rex Eatapuss will explain to you why you are a disaster, which will make you nervous. Then you can go to Wolfman who will help you by giving you Valium or Lithium or electricity and get you into the mainstream of society. You know, Schwein, I bet you're such a square you like H. R. Haldeman better than Ralph Ellsberg."
"You are one crazy sonovabitch, Pierce," said Schweinhund.
"You are right. Spread the word, will you, I've flipped. Get it all over town. I'm gonna have one more mart and then I gotta go buy a book for that stemmy Christer.”
"What book are you going to buy him?" asked Trapper.
"The Joy of Sex. What else? They got some great illustrations. Reverend Rankin will love it."
After buying The Joy of Sex and arranging for Halfaman Timberlake to substitute it for the Bible on the lectern at the Spirit Church, Dr. Pierce went home watched a football game on TV and went to bed early. At midnight, down in Tedium
Cove, two Simmons boys, which ones don't matter, had a shotgun shootout. Both were shot in the chest. Although not on call, Hawkeye was the only chest surgeon who could be found. By 8 a.m. he had removed half a lung from each Simmons.
When I went to the hospital about nine o'clock Sunday morning, just to look around, I found Pierce and an exhausted O.R. crew drinking coffee. Pierce was even smoking a cigarette, which he hardly ever does anymore. He looked asleep even as he sipped coffee.
"Good morning, hard working administrator type," he greeted me. "I trust you are rested, refreshed, that you are restored, replenished. Surely, this being the case, you will take me to the Bay View for some morning sustenance."
"Certainly, if you say so. You going to change your clothes first?"
At the Bay View Dr. Pierce ordered veal scallopini, scrambled eggs, spaghetti with clam sauce and a double bloody Mary. Halfway through this snack he said, "Look, Hook, I am physically and emotionally exhausted. There's just too much work. I'm almost fifty years old and instead of reaching some nice, easy plateau, I'm working harder than when I was an intern. And I don't seem to know how to get off the treadmill. We keep bringing in new people and I try to fence off the work, but look at last night. What the hell. Trapper and Boom-Boom won't take calls for anything but cardiovascular stuff. I don't blame them, but that leaves me with every chest emergency whether I'm on call or not. Try to get another chest guy in, he doesn't want to take care of gunshot wounds, he wants to do aortocoronary bypasses. That leaves me the grunt who takes care of the grunts who shoot each other or hit trees with their cars and break their ribs and puncture their lungs. And, baby, I'm about used up. I have reached the point where I don't want to talk to anyone, see anyone. I just want to be left alone."
MASH Mania Page 12