House of God (52 page)

Overwhelmed. Speechless. Excited, even happy. Yet it seemed too easy. ‘I want to believe you, but it all seems so painful. The whole year seems like a nightmare now.'

‘Not all of it. There was pleasure in it, too: the pleasure of the mastery of medicine, the pleasure of your group of guys, of latency.'

‘Latency? What's latency?'

‘Latency is the lull before adolescence. Latency is the time of clubs, groups, teams, when baseball is the most important thing in your life and the days are too short for all that you want to do. Latency is caring. This year's been a latency trip: during your internship, with all of you scared and brutalized, the caring in your bunch of guys sustained you.'

Cradled in her arms, I think back to then, to the tree house in the overgrown shallow ravine, to the early-summer nights running out of the house leaping up and up in the warm dusk, to the baseball games when the pepperpot shortstop pegged a two-hop bouncer over to first base to just nip the runner in time, and as I begin to curl down into the river must of sleep, like a song hummed by a tyrant and picked up by the birds and spread all along and away, a blanket of soothing ideas spreads itself over me, and I think of days so still that a match flame won't bend and I think of blind fish in the black world of a mammoth-painted cave who somehow, even in their icy smooth-walled limestone pool know about the flat hot slabs of summer slapped against the lime-white walls to warm a dozing cat in the middle of a street of a French hillvillage overlooking a rivervalley laced with châteaux of the real sort and of the mirrored marbled butchershop sort caressing chilled meat laced with ribbons of lard and a box of
patisserie
tied with a green ribbon with a loop looped for a child's finger and a market ebbing quiet as the words flow louder from the mouths of the cafés where men caricaturing French peasants sit with their cigarettes stuck to their lips and a cemetery which chimes ‘
Priez pour elle
, Priez pour elle' in deathly silence and then I think that outside the House of God even in a cemetery there is no result just process and that here at last, with my love holding me, each day might be filled with all things and all colors and the eternal repetition of all colorful things renewed, and I feel that it just might be that in the flow of time the layers of bitterness might begin to peel away, until bitterness itself had become but a faint etching on a glass wall, layers of etched glass walls leading down a life toward a latency, a summergame, a summer of fun, and as I struggle to rest the layers of bitterness are beginning to peel off, are peeling off, leaving me homing upriver toward innocence and nakedness and rest, as in the time before the House of God with Berry thank God for Berry and except for Berry where would I be for without her I could never learn to love as once I did love and will love and love.

Humbly, I ask her to marry me.

Glossary

Admission: a patient entering the House of God; two types: emergency, through the emergency room; elective, scheduled.

Agonal: just before death, as in ‘agonal' respirations.

Amyloidosis: chronic degenerative disease with increasing deposits of a starchy substance, amyloid, in many organs; rare; incurable.

Anal: pertaining to the anus, as in fissure (tear), sadism (a Freudian concept whereby a sadistic urge is related to early anal activity), and Mirror (cf. Dr. Jung's).

Aneurysm: a ballooning out of a vessel, especially an artery, before it bursts.

Angina pectoris: a pattern of cardiac pain, often felt in the chest, signaling severe disease of the coronary arteries, often a prelude to a heart attack.

Ascites: fluid in the abdominal cavity, always abnormal, often associated with liver disease or infection, resulting in distended belly.

Attendings: private doctors affiliated with the House of God.

A-V node: Atrio-Ventricular node, a collection of pacemaking cells in the heart, between the atria and ventricles, which can, if the normal sinus node fails, take over the initiation of the heartbeat.

Black Crow: the House Award given to the intern who collects the most postmortem permissions in the course of the year; prize is a tiepin and a free trip for two to Atlantic City, for AMA meetings.

Blue Blazers: House Administration; often tanned, blond, gold-buttoned; comprising the staff of HELP; origin and function unknown.

BMS: Best Medical School (in the world).

BMS: a BMS student.

BUFF: polish to make look good, as BUFF a car, BUFF a chart, BUFF a gomer; part of BUFF and TURF.

BUN: Blood Urea Nitrogen; indirect measure of heart failure.

BOUNCE: to return to: ‘I BUFFED her and then TURFED her to Urology, but she BOUNCED back to me.'

Bowel Run: part of the Gastrointestinal Workup, a series of tests, including upper GI series with small bowel follow-through, barium enema, sigmoidoscopy, liver scan, gall-bladder series etc.; a specialty of the House; prior to the bowel run the ‘cleanout' is necessary, a series of enemas and cathartics to render the bowel, in the words of a surgeon, ‘so clean I can drink the stuff coming out'; The Emperor of the Bowel Run: Dr. Putzel; The Bowel Run of the Stars: the Fat Man's dream.

Cardiac catheterization: threading catheters through veins and arteries into the heart so that radio-opaque dye can be injected and the structure of the vessels and the chambers can be seen.

CHF: congestive heart failure, progressive incurable decay of the heart, in which it can't pump blood efficiently; leads to renal failure, pulmonary edema, stasis ulcers, death.

Cirrhosis: chronic degeneration of the liver; usually fatal.

Clavicular: of the clavicle, bone at the top of the chest running between the shoulders.

CVP: central venous pressure, the pressure in the vein feeding directly into the heart; CVP line, a catheter placed in that vein to measure pressure.

Cytology: study of cells, especially cells suspected of being malignant.

Defibrillator: machine used to attempt to shock the heart back into normal rhythm or to start it again after it stops; electrodes are placed on chest wall; also called cardioverter.

DERM: Dermatology, the study of skin; an NPC Specialty.

Disimpaction: using a finger to dig impacted feces out of the rectum.

Dr. Jung's Anal Mirror: allegedly the Fat Man's Great American Medical Invention, allowing the user to view his or her own anus ‘in the comfort and privacy of the home.'

Dyspareunia: pain during intercourse: especially in the female.

Ectopic nodal pacemaker: abnormal initiation of the heartbeat from the A-V node instead of from the sinus node.

Ectopic pregnancy: abnormal location of the fertilized ovum, often in the fallopian tubes; upon rupture, often fatal.

Egodystonic: a thought, feeling, or action which causes discomfort to oneself; opposite of egosyntonic.

Episiotomy: incision in vagina during labor and delivery to allow baby to be born without damaging the mother unnecessarily.

Feeding tube: polyethylene tube put into stomach through nostril, through which pureed food is injected.

Flatulence: farting.

Foley catheter: tube put into bladder through urethra to assure flow of urine.

France: a country.

Fulminant necrotic hepatitis: inflammation of the liver, acute; various causes; virtually always fatal.

GAS: Anaesthesiology; an NPC Specialty.

Gastrocnemius: muscle of the calf; soleus is another calf muscle.

GI: Gastro-Intestinal, pertaining to the gut.

Glomerulonephritis: inflammation of part of the kidney; often fatal. Room, ‘a human being who has lost—often through age—what goes into being a human being'—(the Fat Man).

Gluteal: muscle forming the ass.

GOMER: Get Out of My Emergency.

GOMERE: feminine of GOMER.

HELP: organization in the House of God, comprised of Blue Blazers, summoned by dialing H-E-L-P; origin and function unknown.

Hospice: French word; home, asylum, poorhouse.

Hotel-Dieu: French word; literally ‘House of God;' hospital.

House of God: hospital affiliated with the BMS; founded in 1913 by the American People of Israel when their medically qualified Sons and Daughters could not get good internships because of discrimination; competitor of MBH (See MBH).

House Staff: interns and residents of the House of God.

HTE Service: Hold The Elevator Service; allegedly promulgated by Grenade Room Dubler as an intern, to transport the allegedly murdered gomers down to the morgue.

Intercostal: between the ribs.

Intertrochanteric; between the protrusions of bone at the head of the upper legbone, the femur; often synonymous with fracture of the hip.

Intubated: with a rubber tube inserted through the mouth down into the trachea, by which to artificially respirate a patient.

IV: intravenous, inside a vein.

Lasix: a drug; diuretic often used to treat congestive heart failure.

LAWS OF THE HOUSE OF GOD: a series of rules, almost commandments, many formulated by the Fat Man.

Lay analyst: a psychoanalyst who is not an M.D.

Limbic: primitive part of the brain, thought to be a center of aggressive and sexual impulses; allegedly linked to cortex.

LOL in NAD: Little Old Lady in No Apparent Distress; not a GOMERE.

LP: Lumbar Puncture, the introduction of a needle into the spinal column to procure a sample of spinal fluid; also Low Profile, the intern technique of not being seen.

M and M: Morbidity and Mortality; a regularly scheduled conference of the medical hierarchy at which mistakes are aired; an opportunity for the higher-up Slurpers (See SLURPERS) to roast the lower-down.

MBH: Man's Best Hospital; a BMS-affiliated hospital founded by WASPs; competitor of the House of God.

MI: Myocardial infarction, heart attack.

MICU: Medical Intensive Care Unit.

Monilia: a species of yeast. causing infection, often with swelling of lymph nodes; common cause of vagitch.

MOR: Marriage On Rocks; frequent event during internship; cf. ROR.

Mt. St. E.: Mount Saint Elsewhere, generic term for any hospital not affiliated with the BMS; often used to denote small community hospital.

Multiple myeloma: one type of bone cancer; fatal.

* * * MVI * * *. Most Valuable Intern; allegedly the House Award given to the intern who is most valuable; alleged prize is a tiepin and a free trip for two to Atlantic City.

Narcolepsy: disease in which the main symptom is sleepiness; endemic to radiologists.

NIH: National Institute of Health; a step up the Slurper cone.

Nitro: nitroglycerin, tablet placed under the tongue to relieve the pain of angina pectoris.

NPC Specialty: No Patient Care Specialty in medicine, numbering, according to the Fat Man, six: RAYS, GAS, PATH, DERM, OPHTHALMOLOGY, PSYCHIATRY.

NSR: Normal sinus rhythm, the normal working of the heart, in which the heartbeat is initiated in the pacemaking cells in the sinus node.

Onanism: masturbation.

OPHTHALMOLOGY: surgical specialty dealing with eye; an NPC specialty.

ORTHO: Orthopedics, the surgical specialty dealing with bone.

Parotid: gland in jaw that produces saliva.

PATH: Pathology, an NPC Specialty.

Perineum: Genital region, especially that between the anus and scrotum or vulva.

Pishke: Yiddish word; tin box into which to place coins for charity.

Placement: process of finding a home for a gomer or gomere, especially, finding a nursing home; a possible TURF.

Primum non nocere
: first of all, do no harm.

PRIVATES: Private doctors of the House of God; ‘Double O' Private is one ‘licensed to kill.'

Psoriatic: pertaining to psoriasis, a disease producing scaly skin.

PSYCHIATRY: an NPC specialty.

Psychoanalysis: the Freudian technique of psychotherapy.

Pulmonary edema: flooding of the lungs with fluid, often from a backed-up flow of blood during congestive heart failure; along with the bowel run, a specialty of the House.

Pulmonary embolus: a bloodclot lodging in the lung; often a sudden event in bedridden patients which produces death.

Putzeled: to be treated as Dr. Putzel, House Double O Private, would treat; colloq.: ‘screwed.'

Q.E.D.: Quod Erat Demonstrandum, ‘which was to be demonstrated,' ‘thus.'

Quadriceps: four large muscles of the thigh.

RAYS: Radiology, an NPC Specialty.

Redhot: hotshot, whizkid, ace, young mensch, ‘my man.'