House of God (11 page)

‘How'd you know all that?' asked Howard.

Ignoring him, Fats turned to the policemen and said, ‘It's obvious that Howard has failed to do the most important things in the case. I trust that you two gentlemen have?'

‘Even in our role as policemen who patrol the city and environs of the House of God and often sit and chat and drink coffee with the brilliant young medicos,' said Gilheeny, ‘we do sometimes intervene in emergency patient care.'

‘We are men of the law,' said Quick, ‘and we followed the house LAW: PLACEMENT COMES FIRST, and called the Hebrew House. Alas, during the ambulance ride here, Anna O.'s bed was sold.'

‘Too bad,' said the Fat Man. ‘Well, at least Anna O. is a great one to learn on. She's taught countless House terns medicine. Roy, go see her. You've got twenty minutes till the ten o'clock meal. I'll wait here and jabber with our friends the cops.'

‘Magnificent!' said the redheaded policeman, beaming a grand sunny smile, ‘for twenty minutes of Fat Man chat is a gift horse we shall look everywhere but in the mouth.'

I asked Gilheeny why he and Quick were so well-informed about this medical emergency, and his reply puzzled me:

‘Would we be policemen if we were not?'

I left the Fat Man and the two policemen huddling together, intensifying their chatter. I went to the door of room 116, and once again I felt alone and afraid. Taking a deep breath, I went in. The walls were covered with green tile, and the bright neon light glittered off the stainless-steel equipment. It was as if I had stepped into a tomb, for there was no doubt that here, somehow, I was in touch with that poor thing, death. In the center of the room was a stretcher. In the center of the stretcher was Anna O. She lay motionless, her knees bent up toward the ceiling, her shoulders curved around toward her knees, so that her head, unsupported and rigid, almost touched her thighs. From the side she looked like the letter W. Was she dead? I called to her. No answer. I felt for a pulse. Heartbeat? None. Breath? No. She was dead. How fitting, that in her death her entire body should have hooked around in mimicry of her persecuted Jewish nose. I felt relieved that she was dead, that the pressure to care for her was off. I saw her little tuft of white hair, and I remembered my grandmother lying in her coffin, and I was filled with sadness for that loss. A lump formed in my midsection, tugged at the tip of my heart, and pulled itself up into my throat. I felt that strange sensation of gritty warmth that comes just before tears. My lower lip curled down. To control myself, I sat.

The Fat Man rushed in and said. ‘All right, Basch, blintzes and . . . hey, what's the matter with you?'

‘She's dead.'

‘Who's dead?'

‘This poor woman. Anna O.'

‘Baloney. Have you lost your mind?'

I said nothing to this. Perhaps I had lost my mind and the strange policemen and the gomere were all a hallucination. Sensing my sadness, the Fat Man sat down next to me.

‘Have I steered you wrong so far?'

‘You're too cynical, but whatever you say seems to be true. Even though it's crazy.'

‘Exactly. So listen to me, and I'll tell you when to cry, 'cause there are times during this ternship when you'll have to cry, and if you don't cry then, you'll jump off this building and they'll scrape you up from the parking lot and drip you into a plastic bag. You'll wind up a bagful of goo. Get it?'

I said I did.

‘But I'm telling you that now is not the time, ‘cause this Anna O. is a true gomere, and LAW NUMBER ONE: GOMERS DON'T DIE.'

‘But she's dead. Just look at her.'

‘Oh, she looks dead, sure. I'll give you that.'

‘She is dead. I called to her and felt for a pulse and listened for a heartbeat and looked for a breath. Nothing. Dead.'

‘With Anna, you need the reverse stethoscope technique. Watch.'

The Fat Man took off his stethoscope, plugged the earpiece into Anna O.'s ears, and then, using the bell like a megaphone, shouted into it: ‘Cochlea come in, cochlea come in, do you read me, cochlea come . . .'

Suddenly the room exploded. Anna O. was rocketing up and down on the stretcher, shrieking at great pitch and intensity: ROODLE ROODLE ROOOOOO . . . DLE!

The Fat Man plucked his stethoscope from her ears, snatched my hand, and pulled me out of the room. The shrieks echoed through the E.W., and Howard, at the nursing station, stared at us. Seeing him, Fats yelled: ‘Cardiac arrest! Room 116!' and as Howard jumped up and came running, the Fat Man, laughing, pulled me into the elevator and punched the cafeteria button. Beaming, he said, ‘Repeat after me: GOMERS DON'T DIE.'

‘GOMERS DON'T DIE.'

‘You betcha. Let's eat.'

Few things could have been more disgusting than watching the Fat Man shovel day-old blintzes into his mouth, talking all the time about things as different as the porno motif in Oz, the virtues of the foul food we were eating, and finally, when he and I were left alone, his prospects in what he still would refer to only as the Great American Medical Invention. I drifted off, and was soon with Berry on a June beach, filled with love's excitement, of possibility shared. Capability Brown. English landscapes. Eye within eye, sea salt on our caressing lips—

‘Basch, cut it out. You stay there much longer, and when you come back to this shithole, you'll snap.'

How had he known? What had they done to me, putting me with this madman?

‘I'm not crazy,' said Fats, ‘it's just that I spell out what every other doc feels, but most squash down and let eat away at their guts. Last year I lost weight. Me! So I said to myself, “Not your gastric mucosa, Fats baby, not for what they're paying you. No ulcer for you.” And here I am.' Sated, he mellowed, and went on, ‘Look, Roy, these gomers have a terrific talent: they teach us medicine. You and I are going down there and, with my help, Anna O. is going to teach you more useful medical procedures in one hour than you could learn from a fragile young patient in a week. LAW NUMBER SIX: THERE IS NO BODY CAVITY THAT CANNOT BE REACHED WITH A NUMBER-FOURTEEN NEEDLE AND A GOOD STRONG ARM. You learn on the gomers, so that when some young person comes in to the House of God dying . . .'

My heart skipped a beat.

‘. . . you know what to do, you do good, and you save them. That part of it's exciting. Wait'll you feel the thrill of sticking a needle blindly into a chest to make a diagnosis, to save someone young. I'm telling you, it's fantastic. Let's go.'

We did. With the Fat Man's guidance, I learned how to tap a chest, tap a knee, put in lines, do an LP properly, and many other invasive procedures. He was right. As I got better with the needle, I began to feel good, more confident, and the possibility that I might become a competent doc glowed inside me. Fear began to leave me, and when I realized what was happening, I felt, deep inside, a blush, a rush, a thrill.

‘All right,' said Fats, ‘so much for diagnosis. Now, treatment. What do we do for her heart failure? How much Lasix?'

Who knew? BMS had taught me nothing about the empirics of treatment.

‘LAW NUMBER SEVEN: AGE + BUN = LASIX DOSE.'

This was nonsense. Although the BUN—Blood Urea Nitrogen—was an indirect measure of heart failure, it was clear that Fats was playing another joke, and I said, ‘That equation is nonsense.'

‘Of course it is. And it works every time. Anna is ninety-five and her BUN is eighty. A hundred and seventy-five milligrams. Twenty-five to grow on, and it's an even two hundred. Do what you like, but she'll start to piss only when you get to two hundred. Oh, and remember, Basch, BUFF her chart. Litigation is nasty, so put a good shiny BUFF on Anna O.'s chart.'

‘OK,' I said, ‘but do I have to get her out of heart failure before I start her bowel run?'

‘Bowel run? Are you nuts? She's not a private patient, she's our patient. There's no bowel run on her.'

Feeling grateful, feeling glad that this medical wizard was with me, I said, ‘You know what you are, Fats?'

‘What?'

‘You're a great American.'

‘And with luck, soon a rich one. Bedtime for Fats. Remember, Roy,
primum non nocere
, and
hasta la vista
muthafucka.'

Of course he was right. As I wrote up my admissions from the day, BUFFING the charts, I tried lower doses of Lasix on Anna, and nothing happened. I sat at the nursing station listening to the cooings of the gomers punctuated by the BLEEP BLEEP of the cardiac monitors. It had a soothing lullaby quality:

BLEEP BLEEP, FIX THE LUMP: BLEEP BLEEP, ROODLE ROODLE:

GO AVAY, ROODLE ROODLE: FIX THE LUMP, BLEEP BLEEP:

BLEEP BLEEP . . .

Les Brown and his gomer band of renown serenading me as I awaited Anna O.'s pee. At 175 she trickled, and at 200 she gushed. It was crazy. Nevertheless, seeing the urine, like a new father, my chest puffed with pride. I announced the event to Molly.

‘Golly, Roy, that's terrific. You're going to get that nice old lady back on her feet. Great. Have a good night's sleep. I'll be here. We'll take care of things together. I've got a lot of confidence in you. Happy Fourth of July.'

I looked at my watch. It was two
A.M.
on the magnificent Fourth. Feeling good, feeling proud and competent, I walked down the empty corridor to the on-call room. Power trip. I was in charge of all this. I felt a chill go through me, like the intern in the book. Far-out.

The bed was unmade, and I couldn't find any surgical pajamas and Levy the Lost MBS was snoring in the top bunk, but I was so tired, who cared? As I headed toward my dreams, listening to the BLEEP BLEEP, I mused on cardiac arrests, and as my mind covered all I knew about cardiac arrests, I was soon left with all I didn't know. I started to worry. I couldn't sleep, because any minute I might be called to an arrest, and what would I do? I felt a nudge, and there was Molly. She put a finger to her lips to signal silence. She sat on the bottom bunk and took off her white nursing shoes and pulled down her white pantyhose and bikini panties. She lifted the covers and said something about not wanting to get her uniform wrinkled and sat cross-legged on top of me. She unbuttoned her front and bent over and kissed me full on the lips, and as I put my palm round her glassy ass her perfume—

There was a tap on my shoulder. Perfume. I turned my head toward the tap and found myself looking straight up into Molly's thighs as she squatted down to awaken me. Damn, it had been a dream, but this was not. It really was going to happen. She put her hand on my shoulder. Jesus, but wasn't she going to leap into the sack with me after all.

I was wrong. It was about a patient, one of Little Otto's cardiac cases who refused to lie quietly in her restraints. Trying to hide the stiff screaming crowd living it up in my white pants, I stumbled out into the corridor, blinking in the glare, and followed that pert bouncing ass to the patient's room. There was an explosion. We ran to find the woman, having GONE TO GROUND, standing naked in the middle of her room, screaming obscenities at her own reflection in the mirror. She picked up an IV bottle, screamed, ‘There! There! That old woman in the mirror!' and hurled the bottle at her reflection, smashing the mirror to bits. When she saw me she knelt in the broken glass, grabbed my knees, and said, ‘Please, mister, please don't send me home.' It was pathetic. She smelled stale. We tried to cool her off. We roped her back into restraints.

This was the first of a series of explosions, to mark the Fourth. When I called Little Otto to tell him that his patient was living it up, Otto exploded, accusing me of ‘worrying my patient with your inept attention. She's a nice woman and you must have upset her. Leave her alone.' Next, the elevator door opened, and exploding out of yet another ring of Hell, out rolled Eat My Dust and his BMS, wheeling yet another human carcass to the far end of the hall. This one was a bony mollusk of a man, with a red knobby protuberance popping out of his skull, sitting as rigid as a corpse, chanting:

RUGGALA RUGGALA RUGGALA RUGG,

RUGGALA RUGGALA RUGGALA GUGG . . .

‘This is my fourth admission,' said Eddie, ‘and it means that you're next up. You should see what they're cooking up in the E.W. now.'

Next up? Inconceivable. I went back to bed, and I fell asleep, until my finger, celebrating the Fourth on its own, exploded in pain. I screamed at the top of my voice, bringing Levy down from the top bunk and Molly in from the ward, pushing those fun thighs into my puss.

‘Something bit me!' I shrieked.

‘Honest, Dr. Basch,' said Levy, ‘I swear it wasn't me.'

My finger started to swell. The pain was excruciating.

‘I was going to call you anyway,' said Molly. ‘There's another admission for you in the E.W.'

‘Oh, no. I can't stand another gomer tonight.'

‘Not a gomer. Fifty, and sick. He's a doctor himself.'

Fighting panic, I went to the E.W. I read the chart: Dr. Sanders. Fifty-one. Black. On the House of God Staff. Previous history of parotid and pituitary tumors with horrible complications. Came in this time with chest pain, increasing weight loss, lethargy, difficulty breathing. Should I call the Fat Man? No, I'd see him myself first. I walked into the room.

Dr. Sanders lay flat on the stretcher, a black man looking twenty years older than he was. He tried to shake my hand, but he was too weak. I took his hand and told him my name.

‘Glad to have you as my doctor,' he said.

Moved by his helplessness, his weak hand still lying trustfully in mine, I felt sad for him. ‘Tell me what happened.'

He did. At first I was so nervous I could barely listen. Sensing this, he said, ‘Don't worry, you'll do all right. Just forget I'm a doctor. I'm putting myself in your hands. I was where you are once, right here, years ago. I was the first Nigro intern in the House. They called us “Nigroes” then.'