Hot Lights, Cold Steel

by Michael J. Collins

  “Oh, God, how could you?”

  She looked like she was going to be sick. I started to put the goose on the table and go to her.

  “Don’t you dare!” she shouted. “Don’t you put that thing on my table. Get it out. Right now! I mean it, Michael. Get it out of here or I’ll throw up on you.”

  The left side of her body was trying to go back to the hallway while the right side was trying to push me out the back door. Under ordinary circumstances it would have been an amusing spectacle to watch. However, having been married for five years, and being a quick learner, I realized the combination of revulsion, disgust, hatred, and anger on her face meant Patti was not pleased. The revulsion and disgust would disappear if I took my goose and left the room. The hatred and anger I would have to deal with later.

  I backed out the door and trudged wearily back to the garage.

  Now what? Where was I going to put the goose? Patti wouldn’t let me keep it in the house. But if I left it in the garage, squirrels and raccoons would eat it. That left…the backseat of the car! Yeah, that’s it. Just for the night. I’d get it out first thing in the morning before Patti woke up.

  I set the carcass on the hood and then opened the back door of the car. One of the kid’s car seats was belted down. I couldn’t find the buckle in the dark so I went back to the hood, got the goose, and set it in the car seat. I made sure all the windows were closed, slammed the door, and went to bed.

  At six o’clock the next morning, Saturday, Eileen came into our bedroom and pressed her face into Patti’s.

  “Mom?”

  Patti opened her left eye ten percent. “Huh?”

  “Something happened to Mary Kate.”

  The eye opened another ten percent. “What happened to Mary Kate?”

  “She got shrunked.”

  Patti shifted a little under the covers and let out a sigh. “What do you mean, ‘she got shrunked’?”

  “She’s in her car seat and she got shrunked. And she doesn’t smell so good.”

  Oh, Jesus, I thought as I sprang out of bed. I’m screwed now. “Never mind, Eileen,” I said as I yanked on a pair of sweatpants. “Daddy will take care of it.”

  Patti slowly sat up and turned on me. I didn’t like the look in her eyes. It was the same look Godzilla gave Tokyo before he fire-breathed it.

  “You didn’t,” she said.

  I couldn’t look at her. “Relax, hon, it’s probably nothing. You know how kids are. Heh-heh. I’ll just run out and see what Eileen’s talking about.”

  I was out the door before I could hear everything she was saying, but the words “Michael” and “kill you” were repeated several times in gradually increasing volume. I tore out to the garage, whipped the goose out of Mary Kate’s car seat, stuck it in the wheelbarrow, and covered it with a bag of fertilizer. Unfortunately there was a spot of goose juice on the car seat and an unmistakable smell of the great outdoors.

  I turned and walked back to the house. Patti was waiting at the back door.

  “Well?” she said.

  There are times to lie, to shamelessly and obstinately lie, to deny everything, to look your wife right in the eye and swear black is white.

  This was not one of those times.

  All I could do was to throw myself on the mercy of the court. Court was in session, but the Honorable Attila the Hun was presiding. Patti was shocked, horrified, outraged. How could I have done such a thing? What could I possibly have been thinking? Poor Eileen would be scarred for life because of this.

  “I don’t know where that filthy thing is,” she said, presumably referring to the goose, not Eileen, “but I never want to see it again.”

  I was told if I cared anything, anything at all, about my wife and children I would get rid of that disgusting thing this minute. “And don’t come back until you do!” Then the back door slammed.

  I got the picture.

  I wrapped the goose in a plastic garbage bag and brought it to Jack Manning who was going up to St. Paul to see his sister. He promised to drop it off at my brother Pete’s apartment.

  Pete called a few days later to say he and his roommates stuffed and cooked the goose. “It was the best meal we’ve had all year,” he said. “It was really nice of you and Patti to send it to us.”

  “No problem.”

  “Be sure to thank Patti for us, too.”

  That is one message that has never been delivered.

  Chapter Thirty-Five

  November

  When we finished our last case I let Charlie Norrie go. He had been up all night and was dead on his feet. “Go home, Charlie,” I told him. “I’ll take care of rounds.” He was too tired to argue. He lifted a hand in thanks and was gone.

  I was the senior resident on Tom Hale’s service. Charlie was the junior resident. Tom was one of the young guns of the Mayo program. He was smart. He had great hands, and he let his residents do a lot of operating. Every resident at Mayo wanted to be on his service. Charlie and I were thrilled to get the chance to spend a quarter with him.

  We had twenty-one patients on our service, most of them recovering from major surgery: joint replacements, fractures, osteotomies, cuff repairs. We had patients in casts, braces, and traction; patients bleeding, draining, and vomiting; patients with high fevers, low blood counts, and weak pulses. It was challenging, daunting almost, but I approached each patient methodically, putting everything else out of my mind, trying to figure out exactly what was wrong and exactly what needed to be done.

  I had been insecure for so long, that even now, despite all I had learned, I still suspected I wasn’t as good as the other residents; consequently I forced myself to be so thorough that nothing would get by me.

  My insecurity had served me well. It incited me, it drove me, and it kept me persevering when fatigue or common sense would have made me stop. But it was also changing me in some not-so-pleasant ways. I was becoming almost obsessive about studying every night. I had to know everything about every problem in every patient.

  As usual it was Patti who helped me keep things in perspective. She knew when to encourage me to work, and she knew when to send one of the kids down to my office in the basement to “tell Daddy to put his books away. We’re going to the park now.”

  It took me three hours to make rounds without Charlie. When I finally finished, I dropped the last few charts on the desk at the nursing station. As I sat down, I noticed a framed picture on the wall behind the med cart. It was the photograph of a young woman, taken from behind. She was standing next to a tree, on the crest of a hill, with a vast landscape opening in front of her. Her hair was blowing in the breeze. It was a striking picture. I looked at it for a second or two before I realized the woman was on crutches. She had only one leg.

  “Do you like the picture, Doctor?” one of the nurses asked.

  “Yeah. It’s nice.” Nice, but disconcerting. A beautiful girl—but she was missing a leg.

  “That’s Sarah Berenson. She was one of our patients.”

  Sarah Berenson. Perhaps I gasped, I’m not sure.

  The nurse must have seen my distress. “Do you know her?”

  Sarah Berenson. Oh, God, how I despised myself at that moment. Did I know her? I helped Bill Kramer take off her leg. For months after her surgery I had been unable to get the vision of Sarah out of my mind. Sarah, her blond hair tousled on her pillow, her breasts nudging against the flowered hospital gown. Sarah, with that childlike light in her eyes, the light no amount of suffering had ever been able to dampen. Sarah was the girl I had sworn I would never forget.

  Another broken promise. I had forgotten.

  I realized that it had been close to a year since I had even thought of Sarah. How, I wondered, could I so completely forget someone who meant so much to me, whom I had sworn I would never forget?

  Sometimes I am not the most perceptive of men, and I had actually made a mental note to reread the section on memory in my old neurology text. But at that point something cl
icked in me, and I realized that there was no way I could have let Sarah slip through the cracks of my memory. I must have crammed her through the cracks myself. I must have pushed and squeezed and jammed her out of my memory. I must have realized that, in my profession, there were going to be a lot of Sarahs, and if I kept erecting shrines to them in my memory, if I kept lighting candles in front of those shrines, the conflagration eventually would burn me up.

  I must have wondered about Sarah. I certainly cared about how she was doing. And yet I never made an effort to follow up on her. I never asked Bill Kramer about her. I knew Annie Cheevers, the nurse who cared for her post-op, kept in touch with her, but I never asked Annie, either.

  Why? I wondered. It wasn’t that I didn’t care. I cared a lot about Sarah. Maybe that was it, maybe I cared too much. Maybe I was afraid of what I might find out if I asked too many questions. Maybe I suspected what the answer might be.

  Well, I wasn’t going to hide from it anymore. I would call Annie Cheevers that night and ask her how Sarah was.

  But it turned out I didn’t need to call Annie, for at that moment, the nurse standing next to me said, “Sarah died a few months ago. She was the sweetest girl. We all loved her.”

  I suppose I knew it all along. I suppose that was what I had been hiding from this past year. I looked at the picture, watching the way Sarah’s hair drifted in the breeze. I wondered what she had been thinking as she looked out on that vast panorama of life that opened before her. She knew, of course, for her it wasn’t opening at all.

  She died a few months ago.

  That meant Sarah lived for about a year after her surgery. So what the hell had we done for her? We took off her leg. We put her through a terrible amount of pain. And for what? She died anyway. Did our surgery do anything for her? Did it lengthen her life, or shorten it? I wondered if she would have been better off if she had never heard of the Mayo Clinic. We did the best we could, but for the hundredth time I realized that doing the best we could wasn’t enough. There was something in me that wanted results not just effort. Don’t tell me how hard you tried, tell me whether or not you succeeded.

  I couldn’t hold back. I began to bludgeon myself. Let me get this straight, I sneered at myself. A beautiful, young girl came to you. You cut off her leg, ripped out her pelvis, and spilled most of the blood in her body. Then you gave her poison that made her hair fall out, made her blood cells die, and made her vomit until her esophagus bled. Then you radiated her until you killed every egg in her ovaries. And you kept all that up until she was dead. But you insist it was the cancer that killed her. And despite all that happened, despite all you did, everything is supposed to be okay because “you meant well.” Huh. Do me a favor, Doctor, if I ever get sick stay the hell away from me with your good intentions.

  Thank God for the successes. Thank God for the people whose hips and knees we replaced, who showered us with gratitude. Thank God I didn’t have to go home every night wondering if anything I did mattered a goddamn. I couldn’t do it. I couldn’t handle a steady stream of failure and death.

  Maybe that’s why I “forgot” Sarah. Maybe it was just too much for me.

  Chapter Thirty-Six

  January

  We spent Christmas in Chicago, then drove back to Rochester on New Year’s Day in a blizzard. It was midnight before we finally arrived home. The car got stuck halfway up the driveway so I just left it there.

  I was up early the next morning, anxious to get going. It was a special day. I was going to begin my final assignment at the Mayo Clinic: chief resident in Orthopedic Surgery. I would have my own service with my own patients. I would do all my own cases, and would have a junior resident assigned to me.

  I should have been proud and thrilled. This was the culmination of everything I had worked for since I was a junior resident on Dr. Harding’s service three and a half years earlier. Unfortunately I took very little pleasure in being selected chief resident. I was no longer programmed for pleasure. I was programmed for achievement. Rather than spending a little time basking in the glory, I immediately moved on to planning my next achievement: becoming a good, no an excellent, chief resident. I began calculating what I should do and how I should do it.

  I told Patti I was worried. Being chief resident was a big responsibility and I didn’t want to screw up. She brushed away my concerns. “You’re awesome,” she said. “You’ll do great.” Of course, if I wanted to be Emperor of Japan Patti would tell me I was awesome and I’d do great.

  As I finished shaving I looked at Patti’s bathrobe, floppy slippers, and disheveled hair. “Lookin’ good,” I said.

  She pushed the hair back from her face. “Feelin’ good,” she replied with a smile.

  She bent over, picked up a rubber dinosaur, and stuffed it in the pocket of her bathrobe. As she wrapped the robe around her, I noticed it was getting a little tight—again. She was due with our fourth child in May.

  “You can kiss that Planned Parenthood Man of the Year award good-bye now,” Bill Chapin had said when he heard the news.

  “Unregulated animalistic breeding,” Patti’s liberated, older sister had said when she heard the news.

  “Who cawes?” our son Patrick had said when he heard the news.

  As I put on my L.L. Bean parka and Sorrel boots, I noticed the streets had been plowed, but a wall of snow now blocked my exit from the driveway. I wasn’t worried, though. I knew the old Battleship would get me through.

  I called good-bye to the kids who were down in the basement destroying things. They came thundering up the stairs. Eileen said Mary Kate took her crayons. Mary Kate said Patrick hit her with a hockey stick. Patrick said Mary Kate was “a alien,” and he was going to “vapowize her.” Patti grabbed the hockey stick and said she would vaporize them all if they didn’t knock it off.

  “Have a nice day, dear,” I said over the din as I zipped my coat and started out the door.

  She stuck out her tongue at me. “Close the door, you big omadhaun,” she said. “We’re all going to get pneumonia. It’s freezing out.”

  “Yeah,” Patrick said, “it’s fweezing out.”

  “You big omadhaun!” Eileen giggled as I shut the door.

  I crunched through the snow to the car, listening to everyone inside laughing. (“You called Dad an omadhaun!”) They were gathered in the living-room window, climbing all over each other, waving and pointing as I revved up the Battleship and sent it flying down the driveway, smashing through the wall of snow, and skidding into the snowbank on the opposite side of the street. I waved to the kids, gunned the engine, and fishtailed down the street.

  Alan Harkins, the senior resident assigned to me, was waiting when I got to the doctors’ lounge at St. Mary’s. Alan was a quiet, studious guy who didn’t play hockey, didn’t play golf, drank wine instead of beer, and preferred The Amsterdam Concertgebouw to the Clancy Brothers. On the surface we didn’t have a lot in common. We did, however, share one important trait: we were both very serious about our work.

  When we finished rounds I told Alan he could have Sunday off. I would make rounds by myself. He, of course, demurred, but I insisted.

  “I’ll see you at seven Monday morning,” I said. “And I’ll be around all weekend, so call me if you have any problems.”

  When Alan had gone I went to the residents’ lounge to check the bulletin board for practice opportunities. In six months my residency would be over. I needed to find a job. One good thing about being a resident at Mayo is that there is never a shortage of job offers: Seattle, Colorado, Chicago, Tampa, Dallas, Boston. I pretty much had my pick of places. It felt strange to be looking for a job. Even though I was now chief resident, I still felt as if I had just started, and now I was making plans to leave.

  Although I was eager to begin my work as chief resident, there was one thing that bothered me. It is traditional that the chief resident let his resident do a lot of surgery. Only jerks hog all their cases. I knew Alan expected me to turn over a lot of my cas
es to him, but this was going to be hard for me. Hell, I had just started getting comfortable doing cases myself, and now I had to let a less-experienced resident do them—in my name? If Alan screwed up, it was my reputation that was on the line. It was my patient who would be harmed. I didn’t know if I was ready for that.

  The issue of residents doing cases had come to a head in our department the year before when Bill Chapin was on Don Ashford’s service. Ashford was new on staff and was still insecure about letting residents do cases. His residents rarely got to do any surgery. Bill didn’t like it, and never one to back down from anything, he took his complaints to BJ Burke, insisting that something be done.

  “Either this is a training program, or it’s not,” Bill insisted. “And if it is, then residents have to operate.”

  Ashford took the moral high ground, insisting that “patient care” came first, and that “our mission to provide proper patient care takes precedence over our mission to train residents.”

  Ashford had pressed the right button and he knew it. Everyone at the Clinic paid lip service to the notion that patient care came first, even though everyone knew that wasn’t always true. It was one of those uncomfortable truths easier to ignore than to acknowledge.

  The patient did not always come first—especially in the surgical specialties. If the Mayo Clinic’s primary concern was patient care, then how could they ever let a resident do a case? The resident is virtually never a better surgeon than the attending surgeon. Now that I was chief resident I was pretty good at doing most orthopedic operations. But I never for a moment thought I was better than Antonio Romero or Tom Hale or Mark Coventry. So how could the Clinic justify letting me do cases when everyone knew I wasn’t as good as those guys? And how could I justify letting Alan do cases when I knew he wasn’t as good as I was?