The house of God

by Samuel Shem

  After a pause that sent a shiver through me, he said, "Money is not shit. It is nothing to be ashamed of. This great country has a long and glorious history of graft and corruption and exploitation. Just think of what we've done to whole continents and entire little countries chock full of underdeveloped little people we've treated like rodents, let alone what we do to individuals. Why should I-or we-hold back? Did that anti-Semite Henry Ford hold back? Did Spiro Agnew? Did Joe McCarthy or Joe DiMaggio?you know the Yankee Clipper is hocking instant coffee on TV these days?or Marilyn Monroe hold back from letting any subway grate in the world blow up her flimsy dress and whistle around her frigid genitalia? Did Norman Mailer ever, on anything? Did the CIA or the FB?fucking?I? The hell they did, Basch, the hell they did. You just gotta do it, flush it, and pick up the money you get for it."

  "For fraud?"

  "For dreaming the American Dream. In this case, the American Medical Dream."

  The Runt and Chuck sat down with us, and the Runt, like a TV serial that you couldn't turn off, rolled out the latest thrilling episode of Thuunnnn?der Thighs: "She was her usual voracious self. We were watching TV, she rubbed the inside of my thigh, the news finished, she took off all her clothes, she walked into the bedroom. She didn't want to mess around with a lot of foreplay, and the first time, she said something?it got me so turned on I was short?circuiting left and right."

  "Well, man, what'd she say?"

  "I'm not sure, but I know it had the word 'cunt' in it. She's a gold mine. I'd been poring over her body quite a bit, and it was getting to the point where she was going to have to do some poring over mine. I'd been nibbling at her, labia-they're fine and thin, like puppy dog's ears-and since I've had this fantasy that she was knocked up in high school and had a kid, I was trying to get in there to have a good look for an episiotomy scar, but I got too close, and my eyeballs got all steamed up. Ha! We were really building —up to something big-we were in this crazy contortion sort of the Reverse Dog with her sort of sitting on my face like my old roommate Norman's women used to do to him and she was bending over fiddling with my cock and then I did it. I sort of gave her one big slump and gently nudged her head down between my legs and I'm telling you she . . . went . .

  We all stopped chewing.

  ". . . bananas!"

  "Bananas?" asked Fats, jaw slack.

  "Very bananas," said the Runt. "HA! It was animal. We were all over the bed. She was moving around on my face and I could feel her teeth on the base of my dork. Wow! Those girls my mom liked, they'd scream whenever my pants would get lumpy at the sock top. And do you know what she said this time, when I was inside her?"

  We did not know what Angela said with the Runt's penis inside her.

  "She said, 'Oh, Dr. Runtsky, you're soooo big!" and the Runt did look kind of big, sitting there before our eyes. "This morning she handed me a toothbrush, and when I went to the bathroom, mine was the third toothbrush in the rack."

  The Fat Man had stopped eating at about the time that Thunder Thighs had put her lips on the Runt's penis, and staring at him as if he were loony, Fats said, "What the hell's been going on with you guys up there anyway?"

  So we told him. We told him about Chuck and Hazel and about me and Molly and about how the Runt with the help of Towl and Thunder was getting bigger. We told him about the Golden Age, where we were legendary in our ability to care for "the toughies" and legendary in our liaisons, which, because of Hazel, had produced clean sheets and bug-free bedding and, because of Molly, had produced snappy instant nursing care. We told him how we were as high as the golden leaves riding the crests of the October maples, falling through the gestating skeleton of the Wing of Zock.

  "There's only one thing missing," I said, "placement. We still can't get the gomers placed. Anna and Ina are still there."

  "No problem," said Fats, "placement is as easy as pie. Who's responsible for placing the gomers?"

  "The Social Service."

  "Yup. The Sociable Cervix. The third toothbrush means that Angel doesn't mind sharing, so why should you? You guys gotta scrog the Sociable Cervix. Oh, and remember: if you want to scrog the librarian, you gotta talk about Shakespeare. So long, and good luck."

  Well, of course it was brilliance. Each ward had a Sociable Cervix, whose responsibility it was to get the gomers placed. It was an impossible job. No one wanted the poor gomers. The nursing homes would say the gomer was too well and didn't need them, and the families would say that the gomer was too sick and needed a nursing home, and the House Privates would say the gomer was way too sick and needed the House of God Blue Cross care, and the terns would say we couldn't stand having Broccoli Ladies who blasted us for keeping them alive, and would the Cervix kindly get them the hell out. The gomers offered no opinion.

  The Cervix was the pimp. It was made up of two types of women: the first was young and energetic and idealistic, working out the guilt of separating from her parents and abandoning her grandparents, all the time jockeying for Mr. Right, who had to have a stethoscope in his pocket; the second was menopausal, divorced , abandoned by kids like the first, not energetic but empathic and tearful, cynical and masochistic, working out the upcoming old age and all the time searching for a second or third Mr. Right, who had to have something nonstethoscopic in his pants. The younger Cervix for us was Rosalie Cohen, a young woman who had that pizza?faced look of severe adolescent acne, the kind that sever responded to anything. She had the habit of opening her blouse down past Thursday, as a decoy from her pitted face. The older, or Head Cervix, was Selma, whose nose was big and bent. Billing and cooing with Selma would be more bill than coo, perhaps earning the tern a punctured eyeball, and yet from the neck down Selma was good. Struggling against the life force as it swept by her, Selma was sexy and suffused with the form fruste of the more?liberated?than?my?children syndrome that was ravaging America in the seventies, producing the pot?smoking mama, and the daughter wailing, "Pass me the joint, Mother, please." Selma fell right into my lap: "I attended that grand rounds where you made those points about keeping the patients in the House too long, Dr. Basch, and I want to tell you, the way you handled the flak was terrific."

  Chuck looked at me and then at the Runt, who looked at him and then?at me, and I looked at Chuck and then back at Selma, who went on: "For thirty years I've been trying to learn to express my anger like that, and you've already got it. I wish you could show me how. And let me tell you, a lot of psychotherapists?the best in town?have tried and failed"

  Smiling seductively, heart sinking, I knew that I was the one.

  The next morning, Chuck was first to arrive at Jo's rounds, a half?hour late. An hour later I straggled m, and sometime later, in rolled the Runt. When we had a shaken off the foaming Jo, I told Chuck and the Runt how I'd gone over to Selma's that night, hove we'd started listening to hard rock, how Selma had started to talk about her loneliness and her burdenous nosh and how, after a drink and a joint, Selma had told me she wanted me to stay. Cringing at the way she reminded me of my mom, I'd thought of my obligation to my buddies and prepared for the worst, and, when Sehna rheostatted down the lights and took off her bra, I was shocked.

  "Bad, huh? Man, we'll never get these gomers placed."

  "Nope, not bad. Good. Great! Her breasts are beautiful. Vintage Ava Gardner, made in 1916 and still dynamite."

  "Well, man, how does she do it?"

  "I asked her. Premarin."

  "Premarin? Premarin!"

  "Premarin. Estrogen supplements. Total?body female hormone. It's like making love to purified molecular woman. Stupendous!"

  During all this, the Runt had been silent, but as I finished, he burst out with his story, which was that he'd spent the night with Rosalie Cohen, which prompted Chuck to grimace and say, "You did it with that ugly?bugly? Yecch!"

  "It was grr?ate," said the Runt, beaming his maniac smile.

  "The Man Who Scrogged 'Rosalie Cohen," I said. "Chuck, we have created a monster."

  "Man, what was i
t like to wake up to ole Rosalie?"

  "Well," said the Runt, "I did try hard not to look on her face."

  The gomers began to get placed. The true Golden Age had arrived. From the Leggo to the Bruiser, no one in the hierarchy could understand how the nursing-home beds seemed to open at a touch for ward 6?South, and only for ward 6?South. Gomers as close to legal death as possible were described by our Cervix as being "of excellent rehabilitation potential" and were admitted to the homes the day the beds fell free. Incontinent gomers who were shitting all over the ward were described as "continent of feces and urine" and, shitting on the ambulance stretcher and shitting on the down elevator and shitting in the hallway leading to the ambulance and shitting through the wailing ambulance ride; came to rest to shit their way to immortality in the nursing home of their family's choice, in homes like the New Masada, their bodes stacked floor by floor in order of morbidity, those imagined closest to death put on the topmost floors, imagined closest to heaven. Anna and Ina had been around for four months, and so it was sad to see them go, but if they sensed our waving good?bye, they answered only with ROODLE and GO AVAY. Heaving and smelly, the Broccoli Lady left too, and the exodus went on and on.

  As the gomers left, the ward filled up with more toughies, and every once in a while one of these dying young would be saved. One day, in Saul the leukemic tailor's latest bone?marrow biopsy, like a rash of crocuses in the charred fields of Hiroshima, normal white cells sprouted.

  "What?" I said, peering through the microscope at these millions of flowers that meant that Saul might live. "A remission! Look!"

  "Damn! Somethin' else!" said Chuck, looking.

  "Rr hhmmmmm rhmmmm, now, ain't that some fine shit!"

  "It's wonderful!" I said, realizing how I'd kept myself from hoping anything for Saul, given the odds: against these buddings, these buds, and I ran up to his room, and panting, yelled at him, "Said, you've got a remission"

  "Sounds bad," he said, "first leukemia, now remission. Oiy."

  "No?remission means cure. A miracle! You're not going to die."

  "I'm not? What do you mean I'm not going to die?"

  "Not now you're not, no."

  The bruised little man stopped, still. He let go of his banter, he looked me in the eye, he slumped down on his bed. "Oh . . . I'm not going to die now, I mean right now?"

  "No, Saul, you're not. You're going to live."

  "Oh . . . Oh, thank God, thank . . ." and he grabbed me and put his head on my shoulder and with all those centuries and years of never daring to hope, he sobbed, and his thin body trembled against me like a child's. "So? So some more of this wife of mine, eh? Oh, it's good, it's real good. Thank God-mind You, Dr. Basch, till now, for me, He hasn't done so much, but this . . . this is life . . . this is a new baby, born . . ."

  We were so happy. The whole world was curable and sexual and fun, and we were high, we were redhots at the bosoms and nipples and bangles and thighs of the House of God. It was as comforting as had been the trucks rumbling down the cobblestone hill in the Bronx lulling me to sleep as a child when we stayed at my Aunt Lil's, and it was all so easy and it was all so damn much fun.

  It wasn't easy and it was not fun. Our crooked Veep resigned and honest Jerry Ford started right in bashing those helicopter doors with his head. On the Sunday after Nixon's Saturday Night Massacre, when he tried to stop people trying to get rid of him by getting rid of them, I awoke to a blaring late?fall day leaved with all the leafy colors, glad to be alive, until I entered the living death of the House of God for the next thirty?six hours. Sundays in the House always made me feel like a punished kid, locked inside and looking out. Jo, the outsider, spent her life looking in, and, reluctant to entrust her ward to sex fiends and maniacs like us, she'd always come in on her day off, Sunday, to help.

  Jo had invited me to dinner the previous week. Her apartment was motel?cool. The stereo was still not unpacked. There were no plants. The dining?room table had had to be cleared of journals and texts. Struggling stiffly through dinner, we sat and talked. I became immersed in her loneliness. When she talked about how hard it was to be a woman in medicine, to meet men outside the field, what could I say? She wanted to try hard to understand us, even be friends with us. She didn't like the tension on the ward. Choosing me because I was the oldest, seemingly the leader, she asked me what I thought was getting in the way.

  "You've got to trust us more," I said. "Loosen up. It's no crime not to do everything for every patient always, is it?"

  Nervously she said, "No, it's not. I know that, but it's hard for me to accept it."

  "Try."

  "What can I do?"

  "Well, I guess one thing would be not to come in when I'm on call next Sunday. That would be a good start."

  "Right. I'll try. Thanks, Roy, thanks a lot."

  On that Sunday, Jo was in the House of God earlier than me.

  Trying to restrain myself, I said, "You had to come in?"

  "I tried not to, Roy, believe me I tried. But I'm studying for Boards, and I can only study so much. Besides, you might need some help:"

  I realized I was trapped. Enraged, I couldn't tell her, for fear it would send her hurtling down off a bridge. Even with her terns tormenting her with their sexual carnival, each hint of which hurt her, making her feel more and more left out, her only happiness was inside the medical hierarchy inside the House, where she could kill herself by doing super-dedicated medical stunts.

  The admission brought me to my knees. The admission? Henry was a twenty?three?year?old with no workable kidneys, who'd been sent from one of the Mt. St. Elsewheres after they'd parlayed his renal disease into an infected dry dribbling uremic mass of flesh just this side of the grave. Henry was also retarded. To save Henry, I had to be able to understand the chart sent in from the Mt. St. E. It was lightly photocopied, unnumbered, and written by a Foreign Medical Graduate and I could not read it. The Bruiser came in and tried to help by reading some of the chart out loud. I told him that this was not a BMS case and to scram, and, leaving, he asked, "What's he got?" "Microdeckia," I said.

  "What's that?"

  "Look it up."

  He left, and once again I tried to read the chart and I could not. I looked out the window at the autumn.

  A young couple was having a leaf fight, the leaves sticking to their white Irish sweaters. I got tears in my eyes. I was all choked up with what I was missing, the second cup of coffee in bed with the woman and the Sunday Times, the ache in the lungs from the icy morning air. Jo came in and asked me to "present the case." I blew. I forgot everything and screamed at her that if she stayed one more minute, I was leaving. I shouted at her, all kinds of dark green things about her, her emotional problems, her hunger to be on the inside. I stood up, towering over her, and I yelled until I was bright blue and tears were on my cheeks, and I didn't stop until I'd chased the little twirp of a victim of success out the door, down the elevator, and out of the House of God.

  I went back to the notes on Fast Henry. I sat there and cried. It was a balancing act, and I slammed my fist down on the desk over and over, bashing away at the world. I could not go on. I thought what I'd thought as a kid, playing Superman: if I did my best, I couldn't be wrong. I went on. I went to see Fast Henry, a gray young fellow with a retarded look, a voice that leaped from bass to falsetto every other word, and his hair parted down the middle like Wrong Way Corrigan. I asked him how he was doing and he said, "Doc, if I died tomorrow I'd be the happiest man alive," and somehow that helped me and I went to work on him. The other help that miserable day was the Bruiser, who single?handedly destroyed Jo's ward. He'd started to work up the second admission, a young woman with black lace undies, suffering from ulcerative colitis. Although the Bruiser was excited at the blood and mucus he found on his finger on rectal exam and was all hot to sigmoidoscope her that day and go to the library to "read like crazy about stool," he was embarrassed by the erotic part of the exam. Unfortunately, the patient took a liking to the Bruise
r and, naked head to toe, got the message to him that she was turned on, enjoying his exam. When the Bruiser got that message, he freaked, ran away, and came to me quivering.

  "I've never seen a woman naked before, and never a young female patient. They didn't teach us about this. Oh, I'm so ashamed"

  "Ashamed? What the hell did you do to her?"

  "Nothing. I'm ashamed of the unprofessional thoughts in my heart."

  He was so upset that he refused to continue to work her up until he'd talked it over with his analyst, and so I let him continue to work on Mrs. Biles, the woman with the fake heart disease, whom he'd bruised earlier in her House stay. At one A.M. the Bruiser stood before me and said, "Well, I've just finished hypnotizing Mrs. Biles."

  "You did what to whom?" I asked nonchalantly.

  "Mrs. Bites. I hypnotized her to take away her cardiac pain:"

  "No fooling. Does Dr. Kreinberg know?"

  "Nope. Didn't tell him yet."

  "Hey, I'm sure he'd like to know. Why don't you give him a buzz?"

  "Now?" asked Bruiser. "It's one in the morning."

  "So? He likes hearing new developments on his patients"

  The Bruiser called Little Otto Kreinberg.

  "Hello, 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, wanted to tell you I've just finished hypnotizing Mrs. Biles for her angi? . . . hypnotizing . . . h?y?p?n . . . right, like a magician, and she . . . for her anxie and I . . . yes? . . . sure . . . oh . . . ohhhhh . . . it's an accepted . . . OK, sorry, yes, I'll awaken from her trance right away, sir, good?bye."

  Looking sheepish, Bruiser started to slink out, I asked him if he'd do me a favor.

  "Yeah?" he asked, thinking he might redeem himself.

  "I'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."