Acceptable Losses

by Irwin Shaw

  As he left the room, Sheila was coming in. She had gone down to the cafeteria for a cup of coffee. Damon had kept count. It was the sixth cup of coffee of the afternoon for her. Ordinarily she had one cup of coffee at breakfast and that was it for the day. It was the one sign of strain that she permitted herself. Her face was calm and composed and her hair was carefully brushed. She smiled at Dr. Rogarth, who made the slightest of corpulent bows.

  “I just dropped in,” the doctor said, “to assure myself of the state of your husband’s morale, Madam. I’m happy to say I find it excellent.”

  “He jests at scars who never felt a wound,” Damon said lightly. Empty bravado, he thought, for the gallery. Grandstanding, as Manfred Weinstein would have said in his baseball days. “This is a first time for me.”

  “You’re a lucky man, Sir,” Dr. Rogarth said. “Myself, I’ve had three major operations in the last fifteen years.”

  “Then you’re a walking advertisement for them,” Damon said, a small blandishment for the knife wielder.

  Dr. Rogarth smiled bleakly. “I’m too fat,” he said. “I don’t drink and I hardly eat and I’m too fat.” He left the room, majestically.

  “That’s the first thing he’s said up to now,” Damon said, “that sounded human. About being fat.”

  “You all right?” Sheila stood over him, staring hard at him.

  “Fine. I just feel foolish lying here in a bed in the middle of the afternoon.”

  “This hospital’s been here for over fifty years,” Sheila said. “You’re not going to change their routine in just five days. I called Manfred. He’s chipper as a blue jay. He’s hopping all over the hospital and he’s already discovered a marijuana ring. He’s also discovered a twenty-two-year-old nurse he’s seriously thinking of marrying. He said he’d like to make a bet with you that he’d get out of the hospital before you did. He said he’d give you eight-to-five odds.”

  Damon grinned. “Maybe we’ll have a coming out party together.”

  “I told him that no matter who gets out first he has to come and stay with us at least until he can throw away his crutches.”

  “You’re going to have two cranky old men on your hands. Why don’t you arrange to hire a practical nurse to help out?”

  “You two can be as cranky as you want,” Sheila said decisively. “I don’t need any help. You know me. I can match crank for crank with anybody.”

  “That’s no lie.” Damon reached out and took her hand. “When I hold your hand like this,” he said softly, “I feel that no harm can come to me.”

  He felt a sudden spasm of pain in his stomach and involuntarily he gripped Sheila’s hand.

  “What is it?” she asked, alarmed.

  “Nothing.” He tried to smile. “The last flicker of Doris’s potato salad.” He wished the hours would pass quickly and that the sedation he had been promised had already taken effect. For the first time in his life he longed for unconsciousness.

  It was past noon and Sheila and Oliver were still sitting in the private hospital room. They had both been there when Damon had been wheeled out, with a last little sedated wave of the hand at seven that morning. By now they had exhausted all conversation and they tensed again and again when they heard footsteps approaching along the corridor. Sheila, who had given up smoking when she married Damon, had gone through a whole package of Marlboros and the room, even with the door open, was thick with smoke. Both Rogarth and Zinfandel had promised Sheila they would come down and talk to her as soon as the operation was over.

  It was over five hours now and neither of them had appeared.

  Then Dr. Rogarth came into the room, still in his green operating smock and cap, with the gauze mask pushed up on his forehead. He looked tired and grave.

  “Where is he?” Sheila demanded. “How is he? What took so long?” Her voice was harsh, no trace of her usual melodic civility in it. “You said he’d be here by now.”

  “I’m sorry, Mrs. Damon,” the doctor said. “He’s in the Intensive Care Unit. Your husband is a very sick man, very, very sick.”

  “What does that mean?”

  “The operation was much more extensive than we had hoped it would be,” Rogarth said wearily. “Please try to be calm, Madam. There were complications. The ulcer turned out to be perforated. There was an extensive infection of the tissues around the perforation that had to be excised. By all rights your husband should have been screaming in pain for days …”

  “It’s not his habit to scream.”

  “By medical criteria,” Dr. Rogarth said, “stoicism is by no means an advantage. These were complications that an earlier operation could have avoided. There was so much bleeding … so much.” His gaze wandered, his voice flattened. “It was impossible to see exactly. We’re doing everything we can. He’s on all life support systems, respirator, transfusions … I have to go back now. I have to consult with Dr. Zinfandel, the other doctors who were in attendance. It appears that some bleeding has started again. We have to hope that it will stop by itself.”

  “And if it doesn’t?” Sheila said, biting out the words.

  “That is why we have to consult. We’re not certain he could endure another session in the operating room. We have to discuss our options, hope the transfusions will be sufficient … They’re continuing.”

  “How many transfusions has he had so far?” Oliver asked.

  “Twelve.”

  “Good God,” Oliver said. “And you’re giving him more?”

  “It’s necessary. The blood pressure is down so drastically … You must understand—heroic measures.”

  “I don’t know much about medicine,” Oliver said, his voice as hostile as Sheila’s, “but my brother’s a surgeon at Cedars-Sinai in Los Angeles and he once told me that multiple transfusions are terribly risky.”

  Rogarth smiled wanly, all papal certainty gone. “I agree with your brother,” he said. “But if he were here today, I’m sure he would be forced into the same measures we’re taking. I have to go now. They’re waiting for me …” He started out the door.

  “I want to see him.” Sheila put out her hand and gripped the doctor’s arm.

  “It’s impossible just now, Mrs. Damon,” Rogarth said gently. “He’s being worked on. Perhaps some time in the afternoon, if you come up to the Intensive Care Unit. I can’t promise anything. I’m terribly sorry … It happens so many times …” He sounded vague. “So many times. You go in looking for one thing … you find another. So much bleeding … Dr. Zinfandel will try to come down and keep you abreast of developments.”

  “Is he conscious?”

  Rogarth shrugged. “It’s hard to be sure,” he said, and went out.

  Oliver put his arms around Sheila. “He’ll pull through. I just know it. He’s strong …”

  “Your husband’s a very sick man, very, very sick,” Sheila said in a monotone, like Rogarth’s. “Doctor’s gobbledegook. Translation—prepare yourself for the minute that he’s going to die. And soon.”

  “Sssh, sssh.” Oliver pulled her closer, kissed her forehead. “I’ll call my brother. If anybody can tell us what has to be done, he can.”

  “Three thousand miles away,” Sheila said, “I feel as though everything’s three thousand miles away.”

  He awoke, or thought he awoke. He felt no pain. It’s finished, he thought. I’ve pulled through. But he was not in bed. He was in what seemed like a small theatre. There was a white screen at the back of a raised stage. He was alone. At least, his was the only presence he felt in the room. He couldn’t tell whether he was sitting or standing or lying down. The screen was lit by a white light, then an image appeared on it. A photograph of Dr. Rogarth, in pearl gray, smiling. Under it the caption—“Dr. Alexander Rogarth Presents—The Death of Roger Damon.”

  Damon was furious. “That’s a lousy idea of a joke,” he said or thought or might have said.

  Then he was conscious that he was lying, slightly diagonally, on the floor of the apron of the small
stage, as the light went off on the screen. Next to him Maurice Fitzgerald was lying, at the same angle. They were not their normal sizes, but elongated; they were both young men and they both were dressed in evening clothes.

  “They’re serious,” Damon whispered in the curious manner of talking and not talking at the same time that he seemed to have acquired. “There’re no drinks.”

  Then he was conscious that the legs of a corpse jutted out from the wings of the stage on his left. The toes of the corpse were black and swollen, as though they had been bound tightly with wire at their base for a long time to cut off all circulation of the blood. One of the feet was pierced by a gaping dark hole at the instep. Damon knew it was Christ who was lying there, with the wound of the spike that had nailed his foot to the cross. He was Christ and Christ was him and being prepared for burial. He was swept by unutterable sorrow, but could not move.

  Dr. Rogarth, still in his pearl-gray suit, came out from the wings and touched the blackened foot, the congested toes. “As I thought,” Rogarth said. “The toes were frozen by pre-Flood water, which never freezes itself but turns everything it touches into ice.”

  “I think he recognized me,” Sheila said to Oliver. They were in the little waiting room in the Intensive Care Unit. A small gray-haired woman in a pretty flannel suit was crying softly across from them. Sheila had been allowed in to see Damon for a few minutes toward eight o’clock in the evening. “His eyes were open and I think he tried to wink at me. With all those tubes, especially the two going down his throat, he couldn’t talk if he wanted to. They’re still giving him blood. It’s accumulating in his chest and abdominal cavity, and he’s swelled there to twice its normal size and growing bigger by the minute. It’s compressing the lungs, and he’s having trouble breathing and they have him on oxygen.” She spoke flatly, as though giving a dry annual report to a PTA meeting. “The circulation’s stopped to his feet and they’re as cold as marble. I got the nurse to wrap his feet in a warm blanket. You’d think they’d have thought of that themselves. There’s no word of encouragement from anybody. Zinfandel just keeps repeating, ‘Your husband’s a very sick man.’ He admitted that they now believe an artery has been cut. Until he told me that, all they kept saying was that there was excessive bleeding. Preeminent in their field,” she said bitterly.

  Now he was on a boat. He could feel the throbbing of great engines. Somehow he knew that they were on the boat, somewhere in warm Pacific waters, probably off the coast of Indonesia and they were there making a movie, under the direction of Mr. Gray. Only Mr. Gray was not there. He had disappeared. Mysterious Indonesia. Damon had to continue without him.

  He descended below decks. A man in a white coat was bent over a radio transmitter. The man had a straggly brownish beard and was young, with a kind face. “In the absence of Mr. Gray,” Damon said to the man, “I will take over the movie. I appoint you to run the ship.” The man with the beard looked angry. “I have other things to do,” he said.

  A very pretty Eurasian girl with flat features passed through the room. She was wearing blue jeans and a man’s shirt hanging outside them, flapping on her. Damon knew she was to be the star of the film. She was supposed to sing in the film, but when she talked her voice was a harsh, unmelodious croak. Damon winced as he heard her. “You have to do something with that girl’s voice,” he said to the man with the beard.

  “Leave me alone,” the man said impatiently. “Can’t you see that I’m busy?”

  “I called my brother,” Oliver said. It was the next morning. Sheila had slept in the private room, Oliver on the couch in the waiting room. Whenever any of the doctors passed them, they seemed annoyed. “He asked if they’d put in an arteriogram, to see where the bleeding is coming from. Have they?”

  Sheila shook her head numbly.

  “Anyway, he said you should suggest it to them. Do you know what it is?” Oliver asked.

  “No.”

  “Neither do I.”

  Sheila nodded. “I’ll try. I don’t know if anything’ll do any good. The doctors seem to have given him up. They’re just going through the motions. Thank God for the nurses. They don’t leave him alone for a minute. The night nurse said he’s not making any red blood corpuscles, the level is sinking to the critical point. And he’s having trouble breathing. They think he has pneumonia now. They keep pumping out his lungs through a tube. His eyes are still open but he doesn’t seem to recognize me.”

  A little later Zinfandel came in, his eyes red with lack of sleep, his nose twitching nervously. “I believe, Mrs. Damon,” he said, “that you ought to try to get some rest or we’ll be having to work on you too. You’re not doing your husband any good by wearing yourself out like this.”

  “Is he still bleeding?” Sheila asked, ignoring what he had said.

  “I’m afraid he is.”

  “Are you going to try an arteriogram?”

  Zinfandel looked at her suspiciously. “What do you know about arteriograms, Mrs. Damon?”

  “Nothing.”

  “You’ve been talking to other doctors.” The tone was accusing.

  “Of course I have. I’ll talk to a thousand other doctors if I thought one of them would save my husband’s life.”

  “As a matter of fact,” Zinfandel said, without grace, “we’ve decided to try an arteriogram this morning.” Then he resumed his more cordial pedantic manner, like a kindergarten teacher. “It’s a process in which a needle is put into an artery in the groin and a catheter is inserted through it to the suspected lesion. Then contrasting material, a dye if you will, is introduced. After it has flowed through to the source of the trouble X-rays are taken and with luck we find where the trouble lies. Then small gelatin pellets are blown under pressure through the catheter into the artery, two, three, four, depending on the case. With luck, the pellets block the rupture. There is no guarantee of success. If the hemorrhage is stopped, we must wait for several days to see if it is permanent. Is that all clear, Mrs. Damon?”

  “Thank you, yes.”

  “I am not one of those doctors,” Zinfandel said with pride, “who likes to mystify either the patient or his loved ones. I believe in presenting things as they are at all times, no matter how drastic it may seem at the time.”

  “I appreciate it,” Sheila murmured.

  “I will tell you how it comes out as soon as I know. In the meantime, please take my advice and get some rest.”

  “Thank you again,” Sheila said.

  Zinfandel bustled out of the room. He moved through the hospital at a lope, as though that were the only gait that would keep pace with enveloping death in the impossibly great area he had been appointed to oversee.

  “He’s a horse’s ass, if you ask me,” Oliver said, “but he seems like one hell of a doctor.”

  “Yes,” Sheila agreed. “If only he had operated instead of the other one.”

  He was in a vaulted stone room on the top of a building. Now he realized he was in some special place in a hospital. Across from where he was lying there was a large brightly lit room where nurses and their friends seemed to be having a party, eating and drinking and chatting gaily to each other. There was the continual drone of funereal music from several cassette machines. A young doctor said, “This is a real find. I got it today. The music played at the funeral of Prince Albert of Belgium. It cost two hundred dollars, but it was worth it.”

  He said, or thought he said to Sheila, who seemed to float in and out of his consciousness, leaning close over him, “Tell them to stop that damn music.”

  In the same room with him there was an old man. A muscular young black in a skivvy shirt who looked like an ex-boxer was beating ferociously on the old man’s chest and abdomen. Damon knew the old man was going to die and he did. Damon knew that he was going to be next, but his hands were tied down one on each side of the bed and there was nothing he could do about it. The corpse of the old man was carted away, and the black turned to him and began to pound him ferociously with the n
aked muscled arms jutting out of the skivvy shirt. From time to time the black would stop hitting him and shave him with an old-fashioned straight razor. With each stroke he would put a thin piece of adhesive tape on Damon’s cheek and write the date and the hour on it with a ball-point pen. Then he would resume hitting him again. Damon refused to cry out and resigned himself calmly to being killed by the black man.

  But there was a gale of laughter in the brightly lit room across from where he was lying and somebody said, “We’re late for the party. Put him away somewhere until tomorrow.”

  He was moved, he couldn’t tell where, and everybody left, talking gaily, and he was alone with bright lights shining painfully in his eyes.

  Sheila drifted over him again. “You’ve got to get me out of this place,” he said, although he knew somehow that no sound came out of his mouth.

  “Darling,” Sheila seemed to say, “people pay a great deal of extra money to die in this room.”

  “At least,” he said soundlessly, “keep the black man away from me. He’s going to kill me. They’re all going to kill me. You’ve got to go to the police. Have Oliver call up the Times. He knows everybody on the paper. And you have to get away, too. They’ll kill you, too.”

  Sheila drifted away and he tried to sleep, but the bright light in his eyes kept him awake. There was a big clock on the wall, but it was going backward and moving swiftly, so that the hands on the dial were constantly moving. They want to fool me about time, Damon thought, they don’t want me to know day from night. It was an exquisite refinement of torture.

  “He can’t talk,” Sheila said to Oliver, “but somehow he let me know he wanted a pen and a piece of paper. At least the arteriogram worked—so far—and he seems a little stronger now. He can hold a pen in his hand, and communicate something. It’s almost impossible to read what he writes, but I could understand that he thinks the black male nurse is trying to kill him. The man is just doing what he’s been ordered to do—pounding the chest to dislodge the stuff that’s collecting in the lungs so that it can be siphoned up and Roger can breathe. But go explain that to a man who’s out of his mind most of the time. Damon’s the least racist man I know, but I suppose somewhere inside all of us, irrationally …” She shrugged hopelessly. “Anyway, I told the doctor in charge of the ICU to keep the man away from Roger. He’s got enough things to worry about, as it is. Now it turns out that the first day they gave him twenty-six transfusions. Nobody knows what’s keeping him alive. His kidneys have shut down. They’ve ordered a shunt to put him on a dialysis machine, but the doctors who do it won’t be able to start till tomorrow morning. And they have to take the tube out of his throat soon and do a tracheotomy so his vocal cords won’t be ruined. That’s the first hopeful sign—” Her tone was bitterly ironic. “They think there’s a chance that he can live and they want him to be able to talk if it turns out that way. But the specialist who does it won’t be in till Monday, that’s four days from now, and it may be too late. You’d think that in an enormous place like this they could find someone else to do it immediately. There are all those stories in the newspapers about people doing it with a pen-knife on the floor of a restaurant when somebody is choking on a piece of steak. And they can’t even agree on the name of the operation. One doctor calls it a tracheotomy, another says tracheostomy.” Sheila shook her head wonderingly. “Naming things is important. The addition or subtraction of a single s may change the entire meaning of a word. How do I know? Now I wish I’d gone in for medicine when I was young instead of child psychology. Then maybe I could fight this terrible, hulking hospital machine.”