And he probably had his ruptured groin for five years before he even came in to see you, he was thinking. If all of us didn't have to five with you around here I'd like to straighten you out or see somebody do it.
"As a matter of fact," Jaffrey was saying, "my investigation reveals that the confusion that apparently existed here last night, and I can well believe it, had little or nothing to do with my being delayed. It turns out that my room would have been available at 9 o'clock, but I was displaced by Dr. Berkman, whom I don't even know, incidentally, on the pretext that he was doing a child."
Berkman would be the one to straighten you out, he was thinking. Berkman put himself through college working summers in a steel mill and was the intercollegiate middleweight wrestling champion and he'd straighten you out. Unfortunately he might do it with a forward chancery and bar, and that would be something to behold.
"Berkman is doing a child right now," Maury Rand was saying.
"Regardless," Jaffrey said, turning on Maury Rand. "I'm as fond of children as anyone on this staff and I've successfully done my share of them, too. This business of not wanting to keep them fasting in the morning is carried to a ridiculous extreme. Anyone knows you can keep them hydrated with an intravenous which is what you're going to do on the table, anyway."
Great, he was thinking. Just great. The kid wakes up hungry and sees the other kids eating and doesn't know what it's all about and starts to cry, and you want to start an intravenous.
"Do you gentlemen know what I'm going to do now?" Jaffrey was saying. "Miss Sarah Wheeler informed me that it was her belief that she could give me a room at 12:30. Can you imagine that? Having postponed me for three hours, she finds me here on time. . ."
You're always on time, he was thinking. Promptness is your greatest virtue.
". . . and then she has the insufferable gall to tell me I'm to be delayed for another hour and a half. Who does she think I am?"
She thinks you're the Great Jaffrey, he was thinking. That's what she calls you.
"So I told her a thing or two. I told her that if she can't run an O.R., this institution had better find somebody who can. I told her to take my case off for today, and I'm on for 8 o'clock tomorrow morning. I'll do it then."
And if it's a simple inguinal hernia, he was thinking, it would take a good man a half-hour but it will take you an hour and a half. As refined as you may appear, you've never learned to refine your work, and you'll reminisce about all the big cases in your glorious past to impress the nurses. The patient won't suffer but the nurses will, and, it has got so that lately the house staff has been drawing lots to see who has to scrub with you.
"And if I weren't being decent and concerned with the public image of this institution," Jaffrey was saying, "do you know what I'd do? I'd go right up and apprise my patient of what this is all about."
That's enough of this, he was thinking. I'd get out of here, except for Stan. This must really brace up Stan.
"Excuse me, Arnold," he said. "I don't mean to interrupt."
"That's quite all right," Jaffrey said. "You see my point."
"I do, but I've got a little business to transact with Stan."
"Oh, that reminds me," Jaffrey said, looking at Frank Stanczyk. "I note that you're one of the fortunate ones around here."
"Fortunate?" Frank Stanczyk said, looking at him.
"You're blessed with a towel. The last two occasions when I've had some need of a clean towel there hasn't been one. It seems to me that if we had an extra orderly around here we might stand a chance of having our minimal and modest needs answered. Excuse me, gentlemen."
He turned and they watched him stalk out, his cane over one arm. Maury Rand was standing in the doorway to the shower room, holding the door open.
"After that," he said, "I have some minimal and modest needs of my own that I'm going to answer right here and now."
"Enjoy yourself."
"After that cathartic it'll be easy," Maury Rand said. "Excuse me, too."
"Did you ever hear anything like that?" Frank Stanczyk said.
"Yes. I've heard him before."
"He wants another orderly. Every time he operates he has one of them in here shining his shoes."
"Forget him," he said. "There's nothing we can do about his kind, but attrition takes care of them. You're young and you know you're good, and I'm concerned right now about you."
"Honestly, Matt," Frank Stanczyk said, "right now I feel like chucking everything."
"Don't be ridiculous."
"I'm not being ridiculous. It's the way I feel."
"All right, but I don't have to go over the lesson you learned today. You've already learned that."
"I'll say."
"You did what you believed was right at the time. Also, you've heard it said, and you know it's true, that the coward who underoperates does the same disservice as the man who gets too brave."
"I should have saved this one, Matt."
"All right, but I want you to remember something else. I recall very well why you got into medicine and then surgery in the first place. You said it, and I heard you say it twice, that you believed that if you could extend one human life one day you'd be doing more than you could do in any other endeavor."
"I was a kid, just talking, Matt. Besides, I didn't extend that one today."
"You weren't just a kid talking, and what I want you to remember now is not just the tough one you lost today, but the many tough ones you've already won. We're all inclined to forget those. I can't tell you how many there are already in your career, or in mine, either, but you wouldn't want to support all yours for the rest of their lives, would you?"
"Hardly."
"That's what I mean."
"Matt?" Bob Robinson said, standing in the doorway.
"All right, Rob."
"Hello, Stan," Bob Robinson said. "I'm sorry to hear about that."
"Thanks, Rob," Frank Stanczyk said.
"They'll be ready in about five minutes, Matt. Have you got time to go up and see Mrs. Scheller?"
"Why? Anything wrong with her?"
"No. She's just nervous about her husband. She's got her son with her, and they'd like to talk with the great surgeon himself."
"Where are they?"
"They're waiting for you in the lounge on the sixth floor."
"Okay."
"I'll see you inside," Bob Robinson said. "Take it easy, Stan."
"I will."
"I'll tell you what," he said to Frank Stanczyk. "Why don't you come up to the place for dinner some night next week?"
"I'd like that."
"I'll check with Marion, and let you know."
"Thanks a lot, Matt, and thanks a lot for everything. I appreciate it."
"Then snap out of it. Start bouncing back."
"I'll try."
He'll bounce back, he was thinking, walking to the elevator. We all bounce back, but the trouble is that we never bounce back all the way. We lose a little of our resiliency with each one, and it is like that poet said, something about no man being an island and every man being a piece of the continent and every man's death diminishing us. It goes something like that.
XV
"You have to learn to handle your deaths with grace," he said once. "You have to leam not to take them out on your associates, your wife, and certainly not on your next patient."
He had learned to handle his deaths with grace. He had learned to carry them around the hospital and around the office but he had never learned how to leave them there or how to carry them, with that same grace, into the presence of his wife.
"What happened?" she asked once.
"Who told you?" he said.
"You always do," she said, "by the way you walk through that door."
It is strange, he had thought often, how we can be with death hundreds of times and yet we can never quite accept death. We understand, as the layman doesn't, that whole series of immutable changes by which the progression of living becomes
the process of dying. We accept this inevitable metamorphosis as a basic law and it controls our medications and the mechanics of our surgery, but we never quite accept death.
He must have been four or five years old when he became vaguely aware for the first time of the ending of life. His mother had planted flowering bushes against the back of the house and one morning he noticed the butterflies settling in the warmth of the early sun on the small yellow blossoms. The butterflies were brown with round spots on their wings and must have been buckeyes, and when they settled they brought their wings up and together and he discovered that, if he stood almost still and moved his hand slowly, he could pick them up by their wings as by a handle.
He found a cardboard shoe box and began picking them off the blossoms and putting them into the covered box. Their brown coloring powder came off on his fingers and stained them brown and his fingers felt more smooth than they had ever felt to his own touch. This tactile sensation pleased him and his greed grew until he became almost fanatical, and there must have been dozens of the brown butterflies in the box when he tired of the game and left the covered box under the bushes.
He did not think of the box again until sometime the next day. When he opened it the brown butterflies with their purplish eye spots, some with folded wings, some with open wings, some with broken wings, were inert. They had died, of suffocation and dehydration, but he did not know this or conceive of this as death. It was merely something that happened to brown butterflies when you put them in a box. Many years later, because he could still see a small, rompered boy picking brown butterflies off yellow blossoms and putting them in a cardboard shoe box and then finding them dead, because these scenes still played across his mind with all the clarity of a technicolor motion picture, he realized that he had actually then, for the first time, been aware of, and affected by, death.
As he became older his father let him watch when he killed the chickens for Sunday dinner and when the Mexican ranch hands slaughtered a steer. His father would take the small gray-and-white, protesting Plymouth Rock fryers and pull their wings down to their legs and, holding the wings and legs in his left hand and his hatchet in his right, the chickens convulsing as he held them, he would behead them on the upturned cottonwood log. The Mexicans would truss the steer by its legs, the steer lying on its side on the bam floor, its eyes bulging with fright. With the 8-to-1 pulleys attached to one of the crossbeams of the bam they would pull it up by its hind legs until its head hung at the level of their knees and then they would cut the carotid arteries in the neck and catch the blood in the buckets. All this he observed with a feeling of pity and sadness but with a curiosity he couldn't explain but that made him watch.
When he was seven years old he was allowed to walk into town twice a week with his brother, who was then twelve. They would pull their wooden hand wagon to the general store and load it with the groceries and pull it back home again. They would each buy a penny length of licorice rope and the trick, on the way back, was to make the licorice last until they reached home.
"When you go to town this morning," his mother said to them on this day, "I don't want you to go near the Jenkins' house."
"Why?" his brother said.
"There's smallpox in that house," his mother said.
"What's smallpox?" he said.
"It's a terrible sickness," his mother said, "and there's already death in that house. Mr. Jenkins is dead and Mrs. Jenkins is sick and dying, so you stay away from it."
"How far away from it?" his brother said.
"I don't want you to go into the yard for any reason," his mother said. "You just stay on the road. You don't have to run past it and make a scene, but I don't want you standing there and staring at the house, either. Do you understand?"
As they walked down the road, the dirt- and gravel-grating sound of the iron rims of the wooden wheels of the wagon following them, they could see the house ahead, standing white in the morning sun and about fifty feet off to the right of the road. It did not look any different to him from the way it had looked before, but as they neared it and then passed it, walking faster and looking at it out of the corners of their eyes, it seemed more alone and still and silent than any house he had ever seen. It seemed to be standing, its shades drawn and its white paint peeling and powdering but still glaring in the sun, in the middle of a thin, invisible something that separated it from the road and the fields and everything else around it; and that something, he thought, must be death and what it looks like, even though you can't really see it.
When he was nine years old he began to pull the wagon into town alone one afternoon a week to collect beer bottles. He would work the alleys behind the houses, searching through the trash barrels. The people in the town buried the leavings of their food in their back yards or in the fields beyond the town, but the barrels held tin cans and broken glass, old shoes and old corsets, sometimes eyeless dolls' heads and dented, wom-out coffee pots, and after a while he learned in which barrels to look for the beer bottles.
He had an old burlap sack in the bottom of the wagon, and when he had a dozen bottles in it he would take it to the saloon and carry the sack of bottles down into the cellar. When he came upstairs the bartender would go down and count the bottles and give him ten cents for the dozen. While the bartender was downstairs he would take a cold roast beef sandwich from the free lunch at the end of the bar and put it inside his shirt, and pulling the wagon on the way home he would eat the sandwich and feel of the pennies or nickels or of the dime in his pocket and think of the flashlight or the Daisy air rifle he would someday buy in the general store.
"Whenever you're in town and you hear gun shots," his father had told him and his brother, "you're to run right home. I don't care what you're doing or where you are, you run home. Out here gun shots mean hunting, but in town they mean killing, so you run home."
On this afternoon he had just started to work the alleys, and his wagon was still empty, when he heard the shots, three of them, clear and sharp like claps. He ran, the wagon bouncing behind him, until he could run no more, and then he walked the rest of the way home. About two hours later his cousin came out from town and found him.
"You ever see a dead man?" his cousin said.
"Nope," he said.
"You wanna see one?" his cousin said.
"Who's dead?" he said.
"The sheriff," his cousin said. "Somebody shot him."
The sheriff was his first real hero. For a while his first hero had been the Mexican who moved from ranch to ranch, breaking the new horses, but after a time he had come to realize that the Mexican was not really a hero. He was just big and heavy and he held the hom of the saddle and didn't really ride and he just broke the horses with his weight, and wasn't really a hero like the sheriff.
Why the sheriff was a hero he never knew. He never heard of anything brave that the sheriff had done, but somehow he had derived from things he had heard his father and the other men say that they all looked up to the sheriff. The sheriff was big, but not heavy, and his skin was sun-tanned and he had light blue eyes and one day, when he was in town with his wagon, the sheriff had nodded to him and said hello.
"But don't you want to see him?" his cousin was saying. "He's lyin' right there in my dad's."
His cousin's dad, his own Uncle Frank, was the town furniture dealer and undertaker. He was a short, stout, red-faced man who chewed tobacco, and the comers of his mouth were always brown.
"I don't know," he said to his cousin.
"You scared?"
"Nope."
"Then why don't you wanna see him?" his cousin said.
He walked with his cousin back into town. They went in through the front of his Uncle Frank's store, past the overstuffed furniture in the window and the dining-room furniture and then the kitchen tables and chairs stacked near the back.
"There he is," his cousin said.
The sheriff was lying, but it did not look like the sheriff at first, on his back on the und
ertaker's slab. He was naked, and he seemed so white, because only his hands and wrists, his neck and face were tanned, and there was a small hole, singed black, in his left chest.
"A gunman shot him," his cousin said, "but he killed the gunman, too. You wanna see the gunman?"
"Nope," he said, and he was afraid that he was going to be sick.
"Why not?"
"'Cause I have to go home."
"Don't you wanna stay and play?"
"Nope," he said. "I have to go home."
On the way home he felt that he would be sick and then he felt that he would cry. He could see the sheriff alive, sun-tanned and tall and walking, and then he could see him dead, pale, and not so tall, and lying there not like a real person at all. For several days he kept seeing the sheriff first the one way and then the other way until it became difficult for him to remember the sheriff alive and he saw him only lying there; and he decided that death was when you didn't look like a real person any more.
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