The surgeon

by Wilfred Charles Heinz

  "I'm afraid it is."

  "Are you sure? Are you absolutely sure?"

  "Yes, we're sure."

  "I don't know what to say, Doctor," Roger Kirk said, his eyes starting to fill now.

  "Of course you don't."

  "You'll have to excuse me, Doctor."

  "There's nothing to apologize for."

  "But how could it be?" Roger Kirk was saying, "How could it be? She's only been coughing for about a month. Otherwise she feels fine, so how could it be? I just don't understand."

  "I know, but we don't know the answer. Sometimes the disease is very fast-growing."

  "Did you take any of it out?"

  "Just a small biopsy to confirm the diagnosis. I made an incision only six inches long and removed part of the ninth rib in the back so we could look in there. She won't even know her rib is gone, but when we discovered that we couldn't remove all the disease, even on one side, we knew there was no point in submitting her to a larger operation on either side."

  "She and I haven't talked about it," Roger Kirk said, looking out the window now, "but I know she thinks that whatever it was you got it out. I know she thinks the worst is over."

  "It's better for her to think that right now."

  "I don't know what to say. I don't know what I should tell her."

  "It's not a decision you have to make right now."

  "But isn't there anything else that can be done?" Roger Kirk said, facing him again. "Won't radiation treatments help her?"

  "There's some hope there. X-rays work sometimes. I've had cases in which they've been successful, but you should know that, the way her disease has spread, the odds are against her."

  "But they do work sometimes? You have really had cases where X-rays worked?"

  "Yes," he said. "I've got a man, a fishing boat captain, who first came in nine years ago. He was thirty-five years old at the time and he's alive and well today at the age of forty-four."

  He was a big, willowy, smooth-muscled blond, and when he had opened him for a tumor the size of a lemon in the upper lobe of the right lung, he had seen that the cancer had spread, whitish-pink and looking like a healing skin burn, to the mediastinum, which is the area between the lungs. He had closed his chest and sent him for radiation therapy, 6000 roentgens total dosage in twenty-five treatments over five weeks.

  "Then it worked in his case?" Roger Kirk was saying.

  It had worked beautifully. The first X-ray plates were so totally obscure he could distinguish no detail. At the end of a year, though, he could actually see the contraction of the lung tumor and six months later it was even more obvious. At that point the shrinkage hit its level, and it had held it after two years and then five and now nine.

  "Yes," he said. "In that instance it worked, but his is an exceptional case. I tell you this because I respect your intelligence and your courage. I think you should know the whole truth."

  "I want to know it," Roger Kirk said, looking out the window again, "but I don't want my wife to know it."

  "If there's any way I can help I will."

  "You see," Roger Kirk said, "my wife and I have been married twelve years now, and we've never had any secrets. When we were married we said we'd never lie to each other, and we never have."

  "I understand."

  "Now I'll have to lie to her. For the first time, I'll have to tell her lies."

  "Let's say you'll have to put on an act. If you make up your mind to this let's say you'll have to be an actor, and you'll be a great one."

  "I don't know whether I can do it."

  "You'll do it."

  "Then we've got our two daughters. They're still just kids, and they won't know what's happening. You know you think of a lot of things at a time like this, Doctor. Now she'll never see her children grow up."

  "I met your children when Mrs. Kirk came to my office," he said. "They're great kids."

  The older girl seemed to be about ten years old and the younger must have been seven or eight, and she had turned the office appointment into a day in town for her children. While he had been examining her, Carrie had been amusing the kids or they had been amusing Carrie, and after he had completed the examination and looked at the X-rays and they had left, he had wished he had never seen the kids.

  "But if you give her X-ray treatments," Roger Kirk was saying, "she'll know. Won't she?"

  "Not necessarily. You see, we don't have to start her immediately. If the cell structure is going to be vulnerable to X-rays it will be vulnerable later on, too. So we don't have to face that at the moment."

  "When will we have to face it?"

  "Well, she'll feel fine for a while. She won't notice any change, or have any pain, for a couple of months."

  "At least we'll get through Christmas."

  "Yes."

  "When you have kids, you think of Christmas"

  "I know."

  "But then what?"

  "Sometime after the New Year she'll probably start feeling some discomfort. When she does, you have her call me and I'll tell her it's neuritis. If you still feel then as you do now about not telling her, I'll simply explain that we're going to give her treatments for neuritis."

  "And after the two months? I mean, supposing that the X-ray treatments aren't successful, will she have a month or two?"

  "No. It will be longer than that."

  "Can you tell me how long?"

  "No physician is God," he heard himself saying again. "We don't know. The X-rays may have a palliative effect. They may help for a while."

  "If they don't, will she have four or five months from now?"

  "She has six months at least, perhaps longer."

  "Six months," Roger Kirk said.

  "At least that."

  "That isn't very much, is it?" Roger Kirk said, his eyes filling again.

  "No."

  "You know I've just thought of something else, Doctor. I don't like to bother you with all these things, and take your time."

  "You're not bothering me, and I have all the time you need."

  "We're just about to sign the papers for a new home. We're buying a bigger place, and now that I think of it I wish we weren't. If she goes, the kids and I won't live in it alone."

  "I understand."

  "She's very happy about it and buying a lot of things for it. You know how women are."

  "Yes."

  "I mean, I don't see how I can call it off now."

  "Of course not."

  "If I do, she'll know something is wrong, and she'll realize what it is."

  "If the new home and all that goes with it are making her happy," he said, "and if you can afford it, I'm sure you'll want to go on with it."

  "That's true. That's not a problem, really, and I shouldn't even have mentioned it."

  "That's quite all right. Remember, I've painted a black picture here because I believe you want to know how I see it and what I think."

  "I do, and I thank you for it."

  "There's one thing that you shouldn't forget, though, and that's that we never know. There's always hope. They're searching and experimenting all the time on new treatments. Who knows? Tomorrow or next week or next month there may be a new drug. Some years ago a relative of mine died of pernicious anemia just five months before what we call the 'classic report' was published containing the cause and cure. This will happen some day with cancer, too. We just don't know when."

  "I see."

  "There's something else I want to tell you, too. I've found Mrs. Kirk to be an imaginative and impressionable woman. You know that, so you've made your decision not to tell her. It's going to be hard for you to lie, and you're going to want to free your conscience and tell her the truth. You must remember that you're doing by far the braver thing. You're carrying the burden alone, rather than to tell her and transfer to her shoulders all the tenor and fears that her imagination would multiply.

  "Remember, too," he said, "that you're not alone. There are many other husbands and wives who h
ave had to do this, too, and some are doing it right now. When it gets to the more difficult stage, when it starts to bother her, shell come to me and I'll give her drugs so she won't have any pain, and you and I will carry her along together."

  "You're really being most kind, Doctor. I appreciate this."

  "You and I understand each other, and we're going to share this together. We have the same problem in a way, because my conscience will bother me, too. Right now your wife thinks I'm a fine surgeon, but one day she'll say to me: 'I feel worse than before you operated on me.' Then I'll be tempted to tell her the truth. I'll want to say: 'But I'm not a bad surgeon, and no surgeon could have cured you.' Of course, I won't say that, and I tell you this only to show you that, in a way, I'm a small partner of yours."

  "Thank you, Doctor," Roger Kirk said, shaking hands and fighting back the emotion. "Thanks very much."

  "Mr. Kirk?" the voice behind them said.

  They turned, and it was a black-haired, brown-eyed young man wearing a dark blue flannel gown over pajamas.

  "Why, Rocco!" Roger Kirk said. "What are you doing here?"

  "I had my appendix out," Rocco said.

  "Oh, excuse me," Roger Kirk said. "This is Dr. Carter. This is Rocco DeVito. Rocco is one of our camera men."

  "How are you, Doctor?" Rocco said, shaking hands. "Pleased to know you."

  "I'm glad to know you."

  "You know a doctor named Stanczyk?" Rocco said.

  "Yes. I know him very well."

  "He's a real good doctor, ain't he?"

  "He certainly is."

  "You know somethin'?" Rocco said, turning to Roger Kirk. "You know, I always figured to be a real good doctor you should be an old doctor—not too old, but kinda old. This guy—excuse me, I mean this doctor, I got—is kind of a young guy but he's great. The day before yesterday he takes my appendix out, and already I feel good enough to go home. Ain't that pretty good, Doc?"

  "That's fine," he said. "Dr. Stanczyk is an excellent surgeon."

  But I wonder how Stan is doing on that sub-total gastrectomy, he thought. I wonder when I'll finally be able to get Mr. Scheller in there, but I've still got that bronchoscopy, that Louise Brower, if she's here yet.

  "So when are you coming back?" Roger Kirk was saying. "You know the show can't go on without you?"

  "Yeah?" Rocco said. "Don't kid me. I watched it last night and it was great. Believe me, I got all this sick leave and I never use it in my life and I'm gonna take it."

  "Good."

  "What are you doin' in here?" Rocco said.

  "Mrs. Kirk is here. Dr. Carter is caring for her."

  "She all right?" Rocco said. "I mean, everything all right?"

  "Fine," Roger Kirk said, smiling, "she's fine."

  "Good," Rocco said. "I'm glad to hear that, and I didn't mean to interrupt."

  "That's all right."

  "Glad to meet you, Doc."

  "Glad to meet you."

  "Take care of yourself now, Rocco," Roger Kirk said. "I'll see you."

  "Don't worry about this kid," Rocco said.

  "Rocco's a good boy," Roger Kirk said, turning back, 'but I don't want to take up any more of your time, Doctor."

  "I'll walk you back to the room."

  He's quite a man, he thought, walking away when he had left him. Roger Kirk is quite a man. It was something, the way he took that, and particularly when that Rocco walked up and he turned to him as if he didn't have a worry in the world. It was a great performance, and maybe he can do that because he's a performer. We're all performers and how I got started in this performance business I no longer know.

  VII

  His mother was the one who had started it all. She was thin and wiry, with high cheekbones and dark eyes and her black hair drawn straight back and parted in the middle, and when he and his brother teased her they called her "The Indian." Like their father she was deeply religious, and while she would be working around the house, standing at the stove and humming to herself or scrubbing the kitchen table until the wood was almost white, she would be casting her philosophy out.

  "Be a healer," she would say. "Jesus was a healer, but if you can't be a minister and heal the soul, be a doctor and heal the body."

  When a dust storm would start and they would see it moving slowly, ceaselessly toward them from the horizon like a great, gray-brown, whole-world-enveloping veil, she would call them into the house. They would stuff the cracks around the doors and windows with rags and newspapers and she would tie clean white cloths like bandit masks across the lower halves of their faces. They would stand by a window and watch for their father to come in, a dark, slow-moving, heroic shadow bent against the gray-brown universe.

  "'All service ranks the same with God,'" she might say. " 'With God, whose puppets, best and worst, are we; there is no last nor first.' A man named Robert Browning, a poet, wrote that."

  After a while, when they would look at one another, they would laugh. On the white bandit masks there would be two growing dark smudges over the nostrils behind them, and when the storm had passed and she would start at once to clean the house she would always begin at the tops of the frames of the doors and windows and work down.

  "God is everywhere," she would say often. "You don't see Him, but He sees you and everything you do, and He is with you always."

  It bothered him that God was with him, always following him but never showing Himself. He was about seven years old at the time, and he envisioned God as a kindly, white-haired Old Man, and he devised a method, a trick, by which he would surprise God and see Him.

  "Is little Matt all right?" the neighbor down the road asked his mother one day.

  She had come in to visit. As his mother used to tell it, they had been sitting in the kitchen and talking for some time before the good woman mentioned it.

  "Why yes," his mother said. "He seems well."

  "I've been wondering," the neighbor said.

  "Why? Has he been pestering you?"

  "No, but there's something kind of strange about him lately."

  "I haven't noticed anything. What's he doing?"

  "I don't really know," the neighbor said. "The last few days I've watched him walking down the road past our place to school. He walks along and then suddenly he stops and he turns quick. Then he walks along and stops again and turns quick the other way. He seems to have some kind of a nervous jerk."

  It was the trick he had devised. He had worked it out, lying in bed one night and thinking about God being with him always, but hiding always.

  When nobody else is around and I'm alone with God, he had said to himself, I'll fool Him and I'll see Him. I'll say out loud: "Now I'm going to see God. I'm going to turn quick now and look this way and see Him." Then when He hears me say that, and He thinks that's what I'll do, I'll turn quick the other way. That's how I'll see Him.

  When it was that he had stopped believing in God as a kindly white-haired Old Man, watching him always, he never knew. In college he read Spinoza, Diderot, Holbach, Huxley, and Darwin. At the fratemity-house bull sessions there was always some upperclassman who would stand up and defy God to strike him dead, giving Him thirty dramatic seconds in which to do it. In physics and chemistry, in biology and zoology, the devotion was all to scientism, the emphasis on provable certainty, and the rewards for accuracy of observation.

  There was the amoeba, that microscopic animalcule perpetually changing shape but dead now on the slide, and the assignment was to draw it, magnified. He had squinted through the microscope with one eye, the other closed, his facial muscles tiring because he had not yet mastered the ability to keep both eyes open and to admit into his consciousness only that which the 'scope eye sees. He had drawn the amoeba in three dimensions because his mother had taught him, while he was still small, to paint and to draw and to use the principle of perspective.

  The professor was Frog Ramsay. He was short and stocky, with long arms and large head and a shock of gray hair. He walked around the labo
ratory with his smock open, his hands clutched behind his back, stopping and looking and sometimes saying something and walking on.

  "Oh, yes," he said, when he had stopped and looked at the amoeba in three dimensions. "Now would you mind standing up and letting me see for myself this unusual creature?"

  He sat down on the stool and he bent his head and looked through the microscope. Then he stood up, his hands still behind his back.

  "Young man," he said, "draw only what you see. That's all you know."

  When he came home from college after his third year, the house shook with the reverberations of his revolt. He did not assail his mother but, torn and uncertain and trying to find the truth, he struck like a cornered, wounded animal at his father.

  "But I challenge you," he said. "I challenge you to prove any of it."

  "The proof is in the Bible," his father said.

  "The Bible?" he said. "The Bible isn't the only book in the world. It isn't the authority for everything."

  "If you believe this," his father said, "there is nothing I can do about it, but I don't have to hear it in my own house."