by Samuel Shem
With that Chuck and I knew we had created a monster and felt real good about it, but Chuck pointed out that it was sort of like watching your mother-in-law drive your new Cadillac off a cliff, because we knew that Jo would not go fuck herself but would go talk to the Fish, who would go talk to the Leggo, who would get us back but good, since the essence of any hierarchy is retaliation. Jo led the rest of rounds in silence, until we got to the admission named Jimmy, who’d been TURFED to the SICU. Jo insisted we go see him, and as our caravan turned up the hall, Jo got excited about the case, and unable to contain herself any longer, blurted out, ‘Hey, Roy, that sounds like a really great admission.’
Without thinking, remembering how Jimmy’s decompensation had strung me out, as if from somewhere else than me, although I knew it did come from some bilious region within me, I heard myself create a new LAW—NUMBER NINE: THE ONLY GOOD ADMISSION IS A DEAD ADMISSION, which stopped Jo in her tracks, the same way that, a few minutes later, when Chuck and the Runt and I were poodling around the SICU while Jo macerated Jimmy, we were stopped in our tracks when we saw, rigged up in an orthopedic apparatus, the remains of a human. Bandaged head to toe, it was clear that the patient had collided with something and that the point of impact had been his testicles. They were cantaloupe, even honeydew. Here we had an aberrant Hell’s Angel who, on his Harley Hawg, had smashed head-on into a tree. A sign on the end of his bed read: IT TAKES BALLS TO RIDE A HARLEY.
None of us could have imagined what an ace auto mechanic Angel was until we heard from the Runt how, even the first time, she had fixed his compact car: ‘Well, I was so upset at what was happening last night, I couldn’t even talk straight by the time I got to her apartment. I don’t know what you said to her on the phone, Roy, but when she hung up, things were a lot easier. She poured me a drink, but all I could think of was Lazarus and Risenshein and the graffiti above the urinal at the Chinese restaurant: STAND CLOSER, IT’S SHORTER THAN YOU THINK. Well, anyway, she asked if I’d like to watch TV and I said sure. We were sitting on the couch, and I didn’t know if she liked me, and then all of a sudden she’s sort of leaning her boob against me and her red hair is unpinned and down to her scapula and I start to feel better. And she says It’s kind of uncomfortable in here, why don’t we watch inside, and unplugs the TV and carries it into the bedroom. I couldn’t believe it. I start to nuzzle her neck and she says Clothes are such a hassle, and she takes off her sweater and her skirt. Well. She starts to make husky noises and since she’s taken off her sweater, I take off her bra. Ha! Perfect! Big soft tits! Ha! I pull off her panties,’ said the Runt, pulling off Angel’s panties right before our eyes in the middle of the nursing station, ‘and she pulls off my pants. Incredible!’
‘What about her pubic hair?’ I asked.
‘Bright red!’ said the Runt with a wild look in his eyes. ‘Perfect! Ha! Well, then I kind of hesitated when I go to put it in, and I think of Lazarus dying and all and it . . . well, it dies too.’
‘Damn!’ said Chuck.
‘But, she’s right there with her hand, and it raises right back up, and when I get it in, she’s wet and ready, not like June or all the others my mother always liked. The first time I was a little off, and I came too soon but before I knew it she had her hand between my legs and we’re at it again. Ha! Hahaaa! Twenty-three minutes. I timed it. And then when she was reaching orgasm she said something like This is terrii—fick! and her words were like a whip spurring me on. Bells rang and the earth shook. Yippeee! And then the next time—’
Chuck and I looked at each other.
‘—she was sort of lying there with her back to me, and I thought she was asleep, but no, she kind of reached around and started pulling on my penis and the next thing I knew she had kind of maneuvered it in and we were at it again, and I think that was the time that did it. Yee-ow!’
‘Did what?’
‘Did what you guys said it would—made me a doc. We went on and on, her moaning and calling out things, and me sweating and grunting, and just before we came she started saying, at first in a whisper and then louder and then screaming it out so I was worried that someone might hear, DOCTOR RUNTSKY DOCTOR RUNTSKY DOCTOR RUNT—SKEEE! and when it was over, lying there, she snuggled up to me and sighed this wonderful satisfied sigh and said, Runt, you are a great doc, g’night, and the last thing I saw this morning was the sunlight on those fiery red pubic hairs. Ha! I owe it all to you. There’s nothing I won’t try now, nothing!’
‘Damn,’ said Chuck, ‘Runt, you’ve become completely unnervous.’
‘Right, I can’t wait to tell that dry bitch June it’s all over. Poetry? Ha! That ain’t poetry, this is. You know what’s coming next?’
Neither Chuck nor I knew what was coming next.
‘I’m gonna taste her pubic hair, ‘cause I know in my heart that it’s strawberry red. Roy, I just want to say thanks. Thanks for taking over my service last night, for helping me out, and for kicking me out of the House and into bed with Angel.’
Such was the first installment of the Runt’s relating to us, blow by blow, his love affair with Angel. While Chuck and I at first felt a little uncomfortable listening to the intimate details the morning after each thrilling episode, we didn’t feel so bad that we couldn’t listen, and we realized that the Runt was going through a healthy stage of development that we’d both passed about ten years before. Besides that, it was unctuous steamy stuff. In gratitude, we taught the Runt medicine, and each of us, with a growing sense of camaraderie, helped each other do the work of the House of God.
Shortly after the Runt’s first auto repair, Chuck’s true greatness came out. First it was Lazarus. Chuck and I, in an effort to lighten the Runt’s load, had flipped a coin for Lazarus, and he’d become Chuck’s patient. One day on rounds we stopped outside the room Lazarus had occupied since July. Screams came from it. A fresh gomer was in the Lazarus memorial bed.
‘What happened to Mr. Lazarus?’ asked Jo.
‘Oh, he’s daid,’ said Chuck.
‘Dead? What happened?’
‘Dunno, gurl, dunno. Guess he died.’
‘Potts and I and the Runt and I kept him alive for the past three months, and then the first night he was on your service he died? What’s going on?’
‘Wish I knew.’
‘Did you get the postmortem?’
‘Nope.’
‘Why not?’
‘Who knows, gurl, who knows?’
That same day, at Chuck’s insistence, we stopped outside the room containing the woman who was to make Chuck famous throughout the House. ‘Now, this is the most amazin’ thing,’ said Chuck, ‘I was called down to the E.W. to see this whale. She’d been seen already by Howard, by Mad Dog, and by Putzel. She was lyin’ there, not breathin’ worth shit, and nobody could figure out why not. Well, I went in there and did my exam. I say to myself, Not breathin, eh? Hmmm. Better have a look in her mouth. I opened it up and looked in. Damn! I say, what’s that big ole green thing in there? So I put on about four pairs of gloves and I reach on back down in there, and this is what I foun’.’
He took out a specimen jar in which was a large sprout of broccoli.
‘Broccoli!’ said the Bruiser, with one of his rare correct answers.
‘Nuthin’ but,’ said Chuck. ‘Howard, Mad Dog, Putzel—none of them dudes bothered to look in the ole lady’s mouth.’
‘The Broccoli Lady,’ I said. ‘A save!’
‘No foolin’. Y’all come in an’ see her.’
The Broccoli Lady was huge, gomertose, and smelly. Except for an occasional spasmodic shiver of her chest, she still wasn’t breathing and she didn’t look like she was doing too great.
‘Doin’ great, ain’t she?’ asked Chuck.
‘A real save,’ said the Runt.
‘What are you doing for her?’ asked Jo.
‘What am I doing for her? Why, I got her on a low-broccoli diet, gurl, what else?’
From that time on, the House looked at Chuck not
as a dumb black admitted on quota, but as a smart tern. As he and I and even the Runt became competent, we began to realize that since no one else would want to do what we terns were forced to do, we were becoming indispensable. The House needed us. The House thought it needed us to do something for the gomers and for the dying young.
What the House really needed us for was to do nothing for the gomers and to bear the helplessness of caring for the dying young. As autumn flared, as it looked more and more like both Agnew and Nixon would get thrown into the slammer at the same time, we struggled to hide our doing nothing from our ferret, Jo. Rounds became a bravura performance in duplicity, with us trying to recall what imaginary test we’d written down, what imaginary complications had ensued, what imaginary treatment for the imaginary complications had been initiated, and what the imaginary response to all this had been, and all the time working like hell on trying to get the gomer placed. It was such a great strain on us that occasionally things would break down. One day, faltering under Jo’s demanding why I hadn’t ordered a four-A.M. temperature to work up Anna O’s imaginary fever, I blurted out another new LAW—NUMBER TEN: IF YOU DON’T TAKE A TEMPERATURE, YOU CAN’T FIND A FEVER, and I’d begun to catalogue the others that you might not do, to not produce something you might not treat, such as, instead of TEMPERATURE and FEVER, substituting EKG and CARDIAC ARRYTHMIA, and I’d gotten as far as CHEST X RAY and PNEUMONIA before Chuck and the Runt collared me and ushered me out of Jo’s grasp.
To ease the strain, Chuck and I spent more and more time with our feet up drinking ginger ale in the nursing station, doing nothing. Although the Runt was somewhat calmer, he was still too tense to sit with us. Towl, his BMS, was not, and filling a ginger-ale container, Towl groaned and put his feet up.
‘Towl, I want to ask you about Enid,’ said the Runt. ‘She’s still not cleaned out for her bowel run.’
‘Rrhhmmmmm rhmmmm, Ah know. So wut?’
‘So what should I do? I gotta get her cleaned out, and no matter what I do, without eating anything she keeps gaining weight and hasn’t had a bowel movement for the past three weeks. Her daughter says she hasn’t unloaded spontaneously for eight years. It’s amazing—she turns water into shit.’
‘Rrhhmmmmm rhmmmm, Ah know. Why you wanna do the bowel run?’
‘Because that’s why she’s here.’
‘Yeah, but I mean, is she really havin’ the bowel run, or are we jus’ pretendin’ she’s havin’ the bowel run? Ever since I toined her over to you, I caint keep her straight.’
Sheepishly the Runt admitted that Enid’s Private, Putzel, wanted the bowel run done, and the Runt was really trying to do it.
‘Rrhhmmmmm rhmmmm, well, then, give her milk and ‘lasses, down her mouth and up her direcschum hole, the both at once.’
‘Milk and ‘lasses?’
‘Right. Milk and mo-lasses. Both ends. She gonna explode.’
Inevitably, during our ginger-ale rounds, like a floor-walker, the Fish would appear. He walked up and, avoiding our eyes, asked, ‘Hey, guys, how’s it going?’ and then, without waiting to hear how it was going, said, ‘You know, don’t you, that that looks unprofessional.’
‘Fine, fine,’ said Chuck, lifting his feet down off the counter.
To irritate the Fish, I lit a cigarette.
‘I hear from Jo that you’ve been coming in late.’
‘Oh, yeah,’ said Chuck. ‘Well, the thing is my car. Keeps breakin’ down and I gotta keep takin’ it to the garage.’
‘Oh, well, that’s different. Got a good mechanic? You could use mine if you like. Get the damn thing fixed right once and for all, so you don’t have to worry about it. Yes, and another thing: your spelling is atrocious. We’ll go over a few of your write-ups together, OK?’
‘Fine, fine.’
‘But there’s one thing I don’t understand,’ I said, ‘I can’t figure out if I drink ‘cause I pee or I pee ‘cause I drink.’
‘Stop drinking and see what happens.’
‘I tried that. I get thirsty.’
‘Perhaps you have Addison’s disease,’ said the Fish, and his attention shifted to my cigarette until he couldn’t stand it any longer and said, ‘I don’t understand how, knowing what you know about lung cancer, you continue to smoke. Maybe you don’t inhale?’
I did not inhale, and so I said, ‘I inhale.’
‘Why do you do it?’
‘It feels good.’
‘If everyone did what feels good, where would we all be?’
‘Feeling good.’
‘You’re too loose,’ said the Fish, ‘I don’t know how you do such good work, being that loose. Enjoy that cigarette, Dr. Basch, for it’s three minutes off your life.’
Just then Little Otto marched in, went to the blackboard to leave a note for me, saw the space taken up with a fresh ripe
* * *
* * * MVI * * *
* * *
let out a sharp bark which turned all our heads toward him, and finding no eraser handy, spat on the board and wiped the thing off with his sleeve, snarling.
‘Now, that’s just the kind of thing I resent,’ I said to the Fish, ‘having that damn * * * MVI * * * smeared all over the House under my name. Your kinky bouncers haven’t done anything. Can’t you stop it?’
‘I tried,’ said the Fish, ‘but it didn’t do any good. The damn thing may all be a practical joke anyway.’
‘That’s not what I heard. I heard that the prize for the * * * MVI * * * is a free trip for two to Atlantic City for the AMA meetings in June, with you and the Leggo.’
‘I didn’t hear that,’ said the Fish, beginning to leave.
‘Damn!’ said Chuck. ‘Man, would you look at that!’
The Fish and I and Towl and Little Otto looked at that, which was, somehow, under my name on the blackboard, in all the colors of the rainbow, that neat yet ornate insignia:
* * *
* * * ROY G. BASCH * * *
* * *
* * * MVI * * *
* * *
Later that week the Leggo and the Fish called a B-M Deli luncheon to announce another award, which we were to nickname the Black Crow. Since this was the first time all the terns had been gathered together since July the first, we greeted each other warmly and with relief. Everything had happened. Most of us had learned enough medicine to worry less about saving patients and more about saving ourselves. Although some of our ways of saving ourselves were beginning to seem bizarre, they weren’t so far-out, yet, as to be dangerous or intolerable. Looking around the room, hearing the simmering jokes and laughter and chatter that from time to time popped its lid and boiled over into a happy roar, I realized how much we’d grown to care about each other. We were developing a code of caring, helping each other leave early, not fucking each other over, tolerating each other’s nuttiness, and listening to each other’s groans. Each life was being twisted, branded. We were sharing something big and murderous and grand. Sensing that, I felt close to tears. We were becoming doctors.
Eat My Dust Eddie, being run ragged in the deathouse, the MICU, looked awful, and was talking about his previous night on call: ‘I was admitting my sixth cardiac arrest and I got this call from the E.W.—Hooper, it was you—saying that there was a guy down there who’d arrested and you were thinking of sending him to me if he survived. I hung up the phone, got down on my knees, and prayed: Please, God, kill that guy! I was on my knees, I mean ON MY KNEES!’
‘He died,’ said Hooper. ‘Jo was the resident, and she wanted to keep pumping his chest, but I said, “As far as I’m concerned, this guy was dead ten minutes ago,” and I left.’
‘Hooper, you’re a great man,’ said EMD. ‘I feel like kissing you.’
‘Kiss me you can, kiss me if you like, but all I know is that if a human disaster like that had shown up in Sausalito, he’d have had to sign his own postmortem permission slip to be admitted at all.’
‘I think that’s a bit crass,’ said Howie, grinning.
Potts came in, late, made a thin sandwich, and sat down, and I was reminded that the Yellow Man had yet to die. Potts was haunted by him, linked with him, and whenever we saw Potts, we saw the Yellow Man. Potts was becoming more withdrawn. He hadn’t come out for our touch-football game. He was a tree with a limb ripped off, the pulp a harsh raw white. No one ever mentioned the Yellow Man to him. Or to the Runt. But if the Runt was infected, at least he’d have done some snazzy dirty things with Angel before he died. I asked Potts how he was.
‘I don’t know. OK, I guess. Otis loves the fall, the leaves. I keep thinking I’m not doing a good job here, you know.’
‘You’re all doing a good job,’ said the Leggo, standing before us, ‘but you as a group have not been getting enough postmortem permissions. It’s hard to describe the importance of the autopsy. Why, the autopsy is the heart—no, the flower, the red rose—of medicine. Yes, the great Virchow, the Father of Pathology, performed twenty-five thousand autopsies with his own two hands. It’s crucial to our understanding of disease. For instance, that Czech, nicknamed—what was he called, Dr. Fishberg?’
‘Not was called, sir, is called. The Yellow Man, sir.’
‘Yes, take the Yellow Man . . .’
The Leggo went on to take the Yellow Man, stressing how important it would be for us to get the post when he died, and as he spoke, each word seemed to rip into poor quiet Potts.
‘When I was an intern,’ said the Leggo cheerily, ‘we got seventy-five percent post permissions. Of course, in those days we did the autopsies ourselves, but you know something, we didn’t mind. Because we were helping to advance the science of medicine.’
The Leggo said that the terns were not getting enough postmortem permissions, and since he knew ‘how hard it is to approach the family for permission in their hour of need,’ he thought of ‘a way to raise the incentive: an award. The award will go to the intern with the most postmortem permissions for the year. The prize will be a free trip for two to Atlantic City for the AMA in June, with Dr. Fishberg and myself.’