by Samuel Shem
‘. . . maybe this year has been a little difficult, but all in all it was a pretty typical year, and we lost one in the middle, but sometimes that happens, and the rest of us will never forget him. Yet we can’t let our dedication to medicine suffer because . . .’
The Leggo was right: it had been your standard internship year. All across the country, at emergency lunches, terns were being allowed to be angry, to accuse and cathart and have no effect at all. Year after year, in eternam: cathart, then take your choice: withdraw into cynicism and find another specialty or profession; or keep on in internal medicine, becoming a Jo, then a Fish, then a Pinkus, then a Putzel, then a Leggo, each more repressed, shallow, and sadistic than the one below. Berry was wrong: repression wasn’t evil, it was terrific. To stay in internal medicine, it was a lifesaver. Could any of us have endured the year in the House of God and somehow, intact, have become that rarity: a human-being doctor? Potts? Fats had done it, yes. Potts?
‘. . . and so let’s have a moment of silence for Dr. Wayne Potts.’
After about twenty seconds the Runt blasted off again, shouting, ‘DAMNNIT, YOU KILLED HIM!’
‘What?’
‘YOU KILLED POTTS! You drove him nuts about the Yellow Man, and you didn’t help him when he was crying for help. If an intern sees a shrink, you stigmatize him, you think he’s nuts. Potts was scared that if he saw Dr. Frank it would damage his career. You bastards, you eat up good guys like Potts who happen to be too gentle to “tough it out.” It makes me want to puke! PUKE!’
‘You can’t say that about me,’ said the Leggo sincerely, looking crushed. ‘I would have done anything to save Potts, to save my boy.’
‘You can’t save us,’ I said, ‘you can’t stop the process. That’s why we’re going into psychiatry: we’re trying to save ourselves.’
‘From what?’
‘FROM BEING JERKS WHO’D LOOK UP TO SOMEONE LIKE YOU!’ screamed the Runt.
‘What?’ asked the Leggo shakily, ‘what are you saying?’
I felt that he was trying to understand, and I knew he couldn’t but that he was crying inside because we’d pushed the button that had him hearing the tapes of all his failings, as father and son, and I said as kindly as possible, ‘What we’re saying is that the real problem this year hasn’t been the gomers, it’s been that we didn’t have anyone to look up to.’
‘No one? No one in the whole House of God?’
‘For me,’ I said, ‘only the Fat Man.’
‘Him? He’s as kooky as Dubler! You can’t mean that, no.’
‘What we mean, man,’ said Chuck forcefully, ‘is this: how can we care for patients if’n nobody cares for us?’
At that, for the first time, the Leggo seemed to hear. He stopped, still. He scratched his head. He made a gesture with his hands, as if to say something, but nothing came out. He bent at the knee, and sat down. He looked hurt, a kid about to cry, and as we watched, his nose twitched and he dug into his baggy trousers for his handkerchief. Saddened, sobered, yet still mad, we filed out. We’d played for keeps. The door closed behind the last of us, leaving our Chief alone. Boozy, babbling, Nixon was coming apart in public places. People were filing out. What he was feeling, no one wanted to know.
Berry, Chuck and I were at the mansion of Nate Zock. We sat in the fake Elizabethan garden basking in the late-afternoon summer sun, looking back up toward the multimillion-dollar palace, a mixture of millennia of architectural vogue. Nate finished retelling the ‘Basch’s a tough guy, don’t cross him’ story. Berry and I excused ourselves to play tennis, leaving Chuck to booze it up with Nate and Trixie and the overweight bovines grazing on the hors d’oeuvres and low-calorie celery tonic. The tennis court was wind-sheltered by beech and poplar, and roses coated the fence enclosing it. The splash of color and waves of scent made it like playing tennis inside a rose. We sweated. We stopped, and Nate urged us to cool off in the indoor pool. We hadn’t brought swimsuits.
‘That’s OK,’ said Nate, ‘no one’s going to watch.’
‘And no one’s keeping track of the time,’ said Trixie, ‘we know all about the sex lives of our young Dr. Kildares.’
We wandered up the lawn to the house, and I realized that unlike the rich, I was unused to privacy, to being unwatched, to things—pools and tennis courts—coming in ones. We passed the garage, where the butler was waxing Berry’s Volvo, trying to match the shine on Nate’s white El Dorado. In the indoor pool, tile-echoing, secluded, we stripped, embraced, dived down into the perfectly right water. We played. Delight delight. Splash splash not the best splash splash but the most splash splash not the splash best but the splash fuckin’ most.
At dusk, after dinner, continuing with drinks, we chatted about the Letter of Zock. Nate had sent his letter about me to the Leggo, and had gotten a cordial reply. Not one to be satisfied with anything short of ‘the most,’ Nate had called up the Leggo and the Fish ‘to find out why those guys didn’t think you—both of you—were as great as I thought you were, ‘cause I’m a helluva judge of talent or I wouldn’t be where I am today.’ After some discussion with the Leggo and the Fish and a few other Slurpers, Nate had cleared it right up. Not only that, but to make sure that this clear area would remain clear, Nate had decided on something more permanent: there would be named, in my honor, in the Wing of Zock, a Room of Basch. Not only that, but in addition to the * * * MVI * * * and the Crow, there would be, annually, the Basch Award, a free trip for two to Palm Springs for the tern ‘who best exemplified the qualities of Roy G. Basch, M.D.,’ the principal one being ‘how to leave the patient alone.’ On hearing of the Room of Basch and the Basch Award, both the Leggo and the Fish had been filled with emotion, too choked up to speak. My Redeemer, Zock, liveth. My name would live on in the House of God.
Cigars were lit. The night was so still, the match flames stood upright. Chuck and Nate related their life stories. Chuck told the story of the postcards, the latest: WANT TO BE AN OFFICER IN THE NATIONAL INSTITUTE OF HEALTH? IF SO, FILL OUT AND RETURN THIS CARD. Nate loved it. Nate told the story of ‘out of the valley of the Depression rode the five hundred bucks to manufacture not the best but the most nuts and bolts,’ and ended with tears in his eyes. Chuck loved it. The long June evening ushered in a serenade of crickets, and the dusk lingered in the air like a dozing kitten’s purr. Berry leaned her head on my shoulder. Nate and Trixie loved her. They suggested she be a weight-control therapist for their fatties. Nate suggested, about me and Berry, that, as he’d been told by Trixie’s father years ago: ‘If you milk the cow, you gotta buy it,’ that we should get married. Chuck chimed in, warning me, ‘Like they say back home, man, if’n you plant it, you gotta watch it grow.’ Arm around me and Berry and Chuck, Nate kissed us good night, tears in his eyes, wishing we would accept his offer to start us in a private practice. At peace, at the level of love, I watched the silver liquid moonlight flow over the orange stucco roof of the House of Zock, reminding me of the stuccoed farm-houses of France.
26
In the House of God, whosoever had sighted the humps had been repulsed. These pneumatic, stupendous, astounding humps had stirred up even more speculation than a Zock. Given her rate of respiration—six breaths per minute—the oxygen theory was much favored, and many thought that the slightly green gomere had turned into a plant. And so, the last week of the ternship, LP Leon, his Fellowship secure, relented, and I lay on the top bunk going over her chart, the full story of Olive O., formulating how best to spring them on our Chief. I wanted to see if he’d show any human emotion upon sighting the horrible humps.
After the eye-opening lunch, the Leggo had in fact made some concessions and it looked like all but two or three terns would stay. The Runt and I were definitely leaving; Chuck hadn’t yet said. The others were staying. In years to come they would spread out across America into academic centers and Fellowships, real red-hots in internal medicine, for they had been trained at the Best Medical School’s best House, the House of God. Although a few
might kill themselves or get addicted or go crazy, by and large they’d repress and conform and perpetuate the Leggo and the House and all the best medical stuff. Eat My Dust had been promised by the Leggo that he could start off the second year as ward resident, with ‘a free rein’ on his new terns. And so, saying already that the ternship had been ‘not so bad,’ Eddie was preparing to indoctrinate his new charges: ‘I want them on their knees from day one.’ A year later it would be back to California for his Fellowship in Oncology. Hyper Hooper was staying as well. He’d sent us a postcard from Atlantic City, signed with a picture of a black crow. Upon returning to the House, he’d shown he hadn’t lost his touch: walking into a room containing a LOL in NAD who’d been getting better, Hooper had said, ‘Hi, dearie,’ she’d gasped, clutched her chest, and five minutes later was dead. The post showed a massive pulmonary embolus. Hooper had been promised by the Leggo that he could start off the second year in a Path elective, doing his own personal autopsies on his own personal patients. And so, saying that the ternship had been ‘not so bad,’ Hooper was also dreaming California Fellowship, in ‘Thanatology.’ The Runt was going west for a ‘classic Eastern’ psychiatric training program on the ‘mountain campus’ of the U. of Wyoming, run by a guru named Grogyam with a Ph.D. from the U. of Kansas. The Runt was so emphatic about his entry into psych being diametrically opposed to the psychoanalytic viewpoint of his parents’—‘classic Western’—that it seemed pretty clear that this ‘Eastern’ jag was a penultimate step that the Runt had to take in order to rebel against it and come on back to mom and pop and Freud to roost. Thunder Thighs had told the Runt that she would not miss him. The Runt imagined this was OK with him. Little did he know how lonely Wyoming could be.
My Clinic patients had been sad to hear I was leaving. They’d brought presents, brought family members, wished me good luck. One, who I’d recently told had incurable cancer and who continued to deny that it exists, had asked me, ‘Where will you hang up your shingle?’ When I’d told her I’d be taking a year off, she’d said, ‘That’s OK, I’ll be your patient when you get back.’ No. She’d be dead. It was hard, too hard. I went through my last Clinic taking deep breaths to keep back the tears. Mae, my black Witness, concerned about my puffing, asked, ‘Oh Doctuh Bass, you ain’t done caught my asthma from me, has you?’ When I’d told people I was thinking of going into psychiatry, many were surprised.
. . . NOT GOING ON IN YOUR MEDICAL RESIDENCY?! YOU PROMISED THEM! HOW WILL IT LOOK ON YOUR RECORD? RECONSIDER! I AM AMAZED! . . .
My father. For the first time, he’d been nudged out of his conjunctions. But then, calming himself again, he embraced his grammar, he embraced his son, and went on:
. . . I can’t understand your taking a year off and it is a waste of a potential year’s income. I’m amazed at your going into psychiatry and it seems a waste of your talent. I hope I am explaining the point well and probably not. I know that you will always give yourself over to your new field of medicine and I am sure you have all the attributes to make an outstanding practitioner of psychiatry. Your deep interest in people and what makes them tick will be a great basis for your work and I do hope you will be able to make a living at it. The new philosophy for people of all ages is to enjoy each day and do what you plan on doing within the limits of responsibility, work, and commitment, and mom and I will try to do this as we have always tried to, only more so now.
The weather has been wet, and remember, dear son number one: IT NEVER RAINS ON A GOLF COURSE . . .
I finally realized what all these conjunctions meant: hope. What was my hope now? To take a year off, to risk, grow, be with others, even to be with parents who’d loved me despite my shabby treatment of them, through so many arrogant years. Was the Fat Man my hope any longer? In what he’d taught me, yes, in showing me the one truly great American Medical Invention: the creation of a foolproof system that took sincere energetic guys and with little effort turned them into dull, grandiose docs who could live with the horror of disease and the deceit of ‘cure,’ who could ‘go with’ the public’s fantasy of the right to perfect health devoid of even the deterioration of age, a whole nation of Hyper Hoopers and other Californians who expected the day to be sunny, the body young, to be surfing along always on the waves of vitality, and who, when the clouds come, the marriage fails, the erection wilts, the brown blotches of age break out like geriatric acne on the backs of the hands, in terror, wipe out.
And so I’d succeeded in keeping Olive O. from being killed by the Privates and Slurpers and BMSs and Blazers and even Housekeepers of the House. In a few days a dew-fresh tern would get the gomere. We had survived. The Leggo arrived for rounds. As I began to present the case to him, I realized that ever since the emergency lunch he’d been out of sight, withdrawn, secretoid. In his rare appearances, he’d seemed down, sad yet bitter, vulnerable and suspicious. For some reason, it troubled me. And yet Olive, a real ‘fascinoma,’ seemed to perk him up. I made no mention of the humps, and the Chief’s questions were mainly to 789 about Olive’s diabetes. Why, the Leggo wanted to know, with Olive’s blood sugar three times normal on admission, had Sev infused more sugar, raising the level to nine times normal, a new House record? Sev gave a brilliant mathematical exigesis, drawing vector diagrams of enzyme action, which left us confused and subdued. In a rare burst of excitement the Chief said, ‘Great case! Come on, boys, let’s go see her!’
We fairly ran to the bedside. Chuck and I positioned ourselves at the head of the bed. Getting no oral response from Olive, the Leggo proceeded to physical exam. In hushed expectation we watched him gently peel back the bedsheet and then pause. It was not clear if he’d caught sight of the humps. As if communing with the dead, he rolled up the nightie, and there, suddenly, were the two homungus, smooth, fluctulant, translucent, greeny-veined, and mysterious, almost cabalistic humps. Did the Leggo so much as bat an eyelash, no. Many eyes focused on him, and none could detect any reaction at all. Even well-prepared strong-gutted terns had felt the queasy slosh of nausea on first sighting the humps, but our Chief never turned a follicle. And then what did he do? Silently, as cautiously as a cat around food, didn’t he take his right hand and put it on her right hump and then take his left hand and put it on her left hump, and it was all we could do to keep from screaming DON’T DO THAT! in amazement, revulsion, and disdain. And what did our Chief say was in them? Well, he didn’t say. He just stood there straight-legged palming her humps for two minutes or more, and no one could figure out what for, but the only things we’d ever seen him go after like that were Moe the Toe’s toe and God-given things filled with piss.
And then it was the last day. Relieved, happy, we bopped around the House saying good-bye, doing loopy nutty things, a carnival of interns. I searched out the Fat Man, and found him in an on-call room standing at a blackboard in front of three new terns, talking into the telephone:
‘Hi, Murray, what’s new? Hey, great! What? A name? Sure, yeah, no problem, hang on.’ Turning to the terns, Fats saw me, winked, and then asked, ‘OK you turkeys, what’s a catchy doctor’s name for an invention? I’ll be with you in a minute, Dr. Basch.’
So that was it: the reality of his inventions was only that they involved us with him, showing us that someone could stand outside the drudgery of the Hierarchies and create. He’d given us his inventions as a way of helping us through. How I would miss him! More than anyone else, he knew how to be with patients, how to be with us. Finally I understood why he stayed in medicine: only medicine could take him. Burdened by his precocity, all his life Fats had hurt people by being too much. From his puzzled parents through his grade-school teachers and chums to his college and med-school classmates who’d gather at dinner, where he’d scribble notes and equations with such prodigal brilliance that as he rose to leave there’d be a mad dash for the napkins, the Fat Man had found himself separated from others by his power and his genius. All his life, he’d had to hold himself back. Finally, after two years of testing it at the House, h
e knew that here at last was something even he couldn’t dent, that would not, in awe, in jealous anger, reject him and play with somebody else. He could dish out anything and not hurt anyone. He was safe. He would flourish. He would bloom.
Fats finished, escaped from the throng wanting to say good-bye to him, grabbed me and rushed me into the Men’s Room, locking the door. He was beaming: ‘Isn’t this great! I love it! It’s like being at Coney Island on the Fourth! And tomorrow, Basch, it’s the STARS!’
‘Fats, I figured out why you stay in medicine.’
‘Terrific!’ he said. ‘Hit me while I’m hot!’
‘It’s the only profession that’s big enough for you.’
‘Yeah, and you know what the damn thing is, Basch?’
‘What?’
‘It might not be, after all.’
We were interrupted by a banging on the door and the cries of the Fat Man fan club, and feeling rushed, I asked, ‘Really?’
‘Sure. But that’s the game, isn’t it?’
‘What is?’ I asked, feeling that this wily fatso had foxed me again.
‘To find out. To see if it matches our dreams.’
The noise at the door grew louder, more insistent, and, panicky, I felt in my gut that this—right now!—was our good-bye.
‘This is it,’ said Fats, ‘for now.’
‘Fats, thanks. I’ll never forget—’
Big fat arms hugged me, and the smiling fat face said, ‘Basch, come to L.A. Be “beautiful” like all the rest of us Californians. Even car crashes and rectums are “beautiful” out there. So? So listen, Roy Gee Basch, Emm Dee: do good, support your AMA, and once in a while, to remember where you come from, put money in the pishke to plant a tree in Yisroel.’
He unlocked the door, was embraced by his crowd, and was gone.
I went to the Telephone and Beeper Operators and handed in my beeper. Walking down the long fourthfloor corridor, I passed Jane Doe and ignored Harry the Horse’s HEY DOC WAIT. I found Chuck doing an invasive procedure on a gomere. He was wearing a bright orange shirt and a green tie with a heart of gold in the middle of which was the word LOVE. I asked how he felt and he said, ‘Man, it’s been pitiful, but like this tie says, I loved it. C’mon, Roy, there’s somethin’ I want to show you.’ We went into the on-call room, sat, and poured ourselves shots from the bottle in his bag.