House of God (10 page)

She slept. I lay awake, afraid of my tomorrow, my upcoming first night on call.

5

When I went to. wake up Chuck the next morning, he looked wrecked: his afro smushed down over one side of his head, his face scarred from the wrinkles of the sheets, the white of one eye red, and the other eye swollen shut.

‘What happen to your eye?'

‘Bugbite. Bugfuckinbite, right in my eye. There's some kind of bug in this on-call room.'

‘Your other eye looks terrible too.'

‘Man, you should see it from this side. I called Housekeeping for some clean sheets, but you know how it is. I never answered calls neither, before those postcards started arrivin'. There's only one way to handle Housekeeping, man, and I'm gonna do it.'

‘What's that?'

‘Love. The boss of bedmaking is named Hazel. She's a big Cuban woman. I know I could love her.'

In the cardflip, Potts asked Chuck how it had gone.

‘Great. Six admissions, the youngest seventy-four.'

‘What time did you get to sleep?'

‘Midnight.'

Amazed, Potts asked, ‘How? How'd you ever get the write-ups done?'

‘Easy, man, shitty write-ups, man, shitty write-ups.'

‘Key concept,' said the Fat Man, ‘to think that you're doing a shitty job. If you resign yourself to doing a shitty job, you go ahead and get the job done, and since we're all in the ninety-ninth percentile of interns, at one of the best ternships in the world, what you do turns out to be a terrific job, a superlative job. Don't forget that four out of every ten interns in America can't speak English.'

‘So it wasn't so bad, Chuck?' I asked hopefully.

‘Bad? Oh, it was bad. Man, last night I was used.'

My worst warning was the Runt. As I'd walked into the House that morning, deflated by the transition from the bright and healthy July to the diseased neon and a-seasonal stink of the corridor, I'd passed the room of the Yellow-Man. Outside it were the bags marked ‘Danger—Contaminated,' now full of blood-stained sheets, towels, scrub suits, and equipment. The room was covered with blood. A special-duty nurse, wrapped like a spacewoman in sterile clothes, was sitting as far from the body as possible, reading
Better Homes and Gardens
. The Yellow Man lay still, absolutely still. The Runt was nowhere to be seen.

It wasn't until lunch that I was to see him. He was cigar-ash gray. Eat My Dust Eddie and Hyper Hooper led him to the lunch table like a dog on a leash. As he put his tray down, we noticed there was nothing on it but silverware. No one pointed that out.

‘I'm going to die,' said the Runt, taking out his pillbox.

‘You are not going to die,' said Hooper. ‘You are never going to die.'

The Runt told us about the exchange transfusion, about taking the old blood out of one vein and putting the new blood into another: ‘Things were going pretty well, and then, I'd taken a needle out of the groin and was about to put it into the last bag of blood, and that porpoise, Celia the nurse, well, she held up this other needle from the Yellow Man's belly and . . . stuck it in my hand.'

There was a dead silence. The Runt was going to die.

‘All of a sudden I felt faint. I saw my life ebb past me. Celia said Gee I'm sorry and I said Aw shucks it's all right it just means I'm going to die and Mellow Yellow's twenty-one and I'm twenty-seven and I've already lived six more years than him and I've spent my last night doing something I knew was completely worthless and we'll die together, him and me, but it's OK, Celia.' The Runt paused, and then screamed, ‘HEAR ME, CELIA? IT'S OK! I went to bed at four
A.M.
and I was sure I'd never wake up.'

‘But the incubation period is four to six months.'

‘So? So in four months one of you will exchange-transfuse me.'

‘It's all my fault,' said Potts. ‘I shoulda hit him with steroids.'

After the others had left, the Runt turned to me and said he had a confession to make: ‘It's about my third admission last night. In the middle of all this crap with the Yellow Man, this guy comes into the Emergency Room and I . . . I couldn't handle it. I offered him five dollars if he'd go home. He took it and left.'

Prodded by my fear of its arrival, my time to be left alone on call arrived. Potts signed out his patients to me and went home to Otis. Scared, I sat at the nursing station, watching the sad sun die. I thought of Berry, and wished I was with her, doing things that young ones like us were supposed to be doing, while we still had our health. My fear mushroomed. Chuck came up, signed out his patients and asked me, ‘Hey, man, notice anything different?'

I did not.

‘My beeper, man, it's off. They can't get me now.'

I watched him walk down the long corridor. I wanted to call out to him, ‘Don't go, don't leave me alone here,' but I did not. I felt so lonesome I wanted to cry. The Fat Man, earlier in the afternoon, as I'd gotten more and more nervous, had tried to reassure me, telling me that I was lucky, that he'd be on call with me all night.

‘Besides,' he'd said, ‘tonight's a great night, it's
The Wizard of Oz
and blintzes.'

‘The
Wizard of Oz and Blintzes
?' I asked. ‘What's that?'

‘You know, the tornado, the yellow brick road, and that terrific Tin Man trying to get into Dorothy's pants. Great flick. And at the ten-o'clock meal, blintzes. We'll have a ball.'

That hadn't helped me much. As I tended to the chaos of the ward, handling the now-hydrated and violent Ina Goober and tending to the feverish Sophie, who by now was so out of it from the LP that she'd attacked Putzel, I almost trembled with fear of what was to come. And then, when my time came, I choked. I was on the toilet and from six flights down, in her communications bunker, the page operator scored a direct hit:

DR. BASCH CALL EMERGENCY WARD FOR AN ADMISSION, DR. BASCH . . . Someone was dying in the E.W and they wanted me? Didn't they know not to come into a teaching hospital in the first week of July? They wouldn't see a doctor, they would see me. What did I know? I panicked. Olaf's Potato started to zing through my mind again, and, heart pounding, I sought out the Fat Man, who was in the TV room immersed in
The Wizard of Oz
. Nibbling at a salami, he was singing along with the flick: ‘Because because because because because of the wonderful things he does. We're off to see the Wizard, the wonderful Wizard of Ozzz . . .'

It was difficult to interrupt him. I thought it peculiar that he'd take an interest in something as playful as
Oz
, but I soon found out that his interest was, like many of his interests, perverted:

‘Do it,' Fats muttered, ‘do it to Dorothy with the oil can. Spin her around on your hat, Ray, spin her around on your hat.'

‘I've got something to tell you,' I said.

‘Shoot.'

‘There's a patient, an admission, in the Emergency Ward.'

‘Good. Go see her. You're a doctor now, remember? Doctors see patients. Do it. Ray Bolger, do it to her STAT!'

‘Yeah, I know,' I squeaked, ‘but I . . . you see, someone's going to be dying down there, and I . . .'

Taking his eyes off the tube, Fats looked at me and said in a kind voice, ‘Oh, I see. Scared, huh?'

I nodded and told him that all I could think of was Olaf's big potato.

‘Right. OK, so you're scared. Who isn't, his first night on call? Even I was scared too. Let's go. We gotta hurry. We've only got half an hour till the ten-o'clock meal. What nursing home is she from?'

‘I don't know,' I said as we walked to the elevator.

‘You don't know? Damn. They've probably already sold her bed, so we won't be able to TURF her back there. One of the true medical emergencies, when the nursing home sells the gomere's bed.'

‘How do you know it will be a gomere?'

‘The odds, just playing the odds.'

The elevator opened, and there was the 6-North tern, Eat My Dust Eddie, standing with a stretcher on which was piled his very own first E.W. admission: three hundred pounds of flesh, naked but for dirty underpants, huge herniations of his abdominal wall, a great medicine ball of a head with little slots for eyes, nose, and mouth, and a bald skull covered with purplish criss-crossing neurosurgical scars so it looked like a box of Purina dog chow. And all of it was convulsing.

‘Roy,' said Eat My Dust, ‘meet Max.'

‘Hi, Max,' I said.

‘HI JON HI JON HI JON,' said Max.

‘Max perseverates,' said E.M.D. ‘They unhooked his frontal lobe.'

‘Parkinson's disease for sixty-three years,' said Fats, ‘a House record. Max comes in when his bowels get blocked. See that intestine pushing its way out through the scars in his belly? Those lumps?'

We did.

‘If you X-ray it, you'll find it's feces. Last time Max was here, it took nine weeks to clean him out, and the only thing that finally worked was a small-handed female Japanese cellist who was also a BMS student, equipped with special long-armed gynecological gloves, and promised the internship of her choice if she would disimpact Max manually. Wanna hear “Fix the lump”?'

We did.

‘Max,' said Fats, ‘what do you want us to do?'

‘FIX THE LUMP FIX THE LUMP FIX THE LUMP,' said Max.

Eat My Dust Eddie and his BMS put their shoulders to the wheels of the stretcher, and Max, gathering momentum, rolled off into the neon sunset. Yoked together, the three looked like they were trudging around a ring of the mountain of Purgatory. Coming back to my senses as we rode the elevator down, I asked the Fat Man how come he seemed to know all the patients, like Max, Ina, and Mr. Rokitansky.

‘There is a finite number of House gomers,' said Fats, ‘and since GOMERS DON'T DIE, they rotate through the House several times a year. It's almost as if they get their yearly schedules in July, just like us. You get to know them by their particular shrieks. But what diseases does your gomere have?'

‘I don't know. I haven't seen her yet.'

‘Doesn't matter. Pick an organ, any organ.'

I fell silent, so scared that I was having trouble thinking of an organ.

‘What is this? Where did they get you from? On quota? Is there affirmative action for Jews? What lies inside the chest cavity and beats?'

‘The heart.'

‘Good. So the gomere has congestive heart failure. What else?'

‘The lungs.'

‘Terrific. You're really cooking now. Pneumonia. Your gomere has CHF and pneumonia, she's septic from her indwelling catheter, refuses to eat, wants to die, is demented, and has an unobtainable BP. What's the first thing—the crucial thing—to do?'

I thought of the diagnosis of septic shock, and suggested an LP.

‘Nope. That's BMS textbook. Forget textbook. I am your textbook. Nothing you learned at the BMS will help you tonight. Listen—key concept—LAW NUMBER FIVE: PLACEMENT COMES FIRST.'

‘I think that's going a little too far. I mean, you're making all kinds of assumptions about this person. You're treating a human being like a piece of baggage.'

‘Oh? I'm crass, cruel, and cynical again, am I? I don't feel anything for the ill. Well, I do. I cry at movies, I've spent twenty-seven Passovers being pampered by the sweetest grandma any Brooklyn boy ever had. But a gomere in the House of God is something else. You'll find out for yourself tonight.'

We stood at the nursing station of the E.W. Several others were sitting there: Howard Grinspoon, who was the new tern on call in the E.W.; and two policemen. Howard I'd known from the BMS. He was blessed with two traits which were to prove to be so useful to him in medicine: unawareness of self, and unawareness of others. Not smart, Howard had slurped his way through BMS and into the House by doing something with urine, either putting urine through computers or running computers on urine. This had endeared him to that other man of little urine, the Leggo. A plodder and a planner, Howard was also into using IBM computer cards to aid in medical decision-making. By the start of the ternship, he already had developed a terrific bedside manner, to hide his rampant indecisiveness. Although Howard wanted to ‘present the case' to Fats and me, Fats ignored him, focusing on the policemen. One policeman was huge, barrel-shaped, with red hair growing out of and into most of the slitty features on his fat red face. The other policeman was a matchstick, decked out, facially, in white of skin and black of hair, with vigilant eyes and a large and worrisome mouth filled with many disparate teeth.

‘I'm Sergeant Gilheeny,' said the red, barrel-shaped one, ‘Finton Gilheeny, and this is Officer Quick. Dr. Roy G. Basch, we wish you hello and Shalom.'

‘You don't look Jewish,' I said.

‘You don't have to be Jewish to love a hot pumpernickel bagel, and besides, the Jews and the Irish are similar in one respect.'

‘What respect is that?'

‘In their respect for the family unit, and the concomitant fucked-up nature of their lives.'

Howard, irritated at being ignored, tried to tell us again about my admission. The Fat Man silenced him at once.

‘But you don't know anything about her,' said Howard.

‘Tell me her shriek, and I'll know it all.'

‘Her what?'

‘Her shriek. Whatever sounds she makes.'

‘Well,' said Howard, ‘she does shriek. She makes a ROODLE.'

‘Anna O.,' said Fats. ‘Hebrew House for the Incurables. This admission will be approximately number eighty-six. You start with a hundred sixty milligrams of the diuretic Lasix and you go up from there.'