The Cider House Rules (58 page)

'Before a fella can fathom the torpedo,' Ray liked to say, 'he has to understand the gyroscope.' Homer was interested, Olive was polite—and what's more, thoroughly dependent on Ray; if he didn't fix all the machinery at Ocean View, Olive was convinced that the apples would stop growing.

Candy was cross much of the time—everyone's war {463} effort seen.ed to depress her, although she had volunteered to pitch in herself and had worked some very long hours at Cape Kenneth Hospital as a nurse's aide. She agreed it would be 'indulgent' to go to college, and she'd had no trouble convincing Homer that he should pitch in, too—with his background, he could be a more useful nurse's aide than most.

'Right,' Homer said.

But if Homer had returned to a semi-hospital life against his will, he soon found he felt comfortable there; however, it was at times difficult to withhold his expert opinion on certain subjects and to play the beginner in a role he was disquietingly born to. Even the nurses were condescending to the nurse's aides, and Homer was irritated to see that the doctors were condescending to everyone —most of all, to their patients.

Candy and Homer were not allowed to give shots or medication, but they had more to do than make beds, empty bedpans, give back rubs and baths, and run those errands of friendliness that gave the modern hospital such a constant scuff of feet. They were given deliveryroom duties, for example; Homer was unimpressed with the obstetrical procedure he witnessed. It could not hold a candle to Dr. Larch's work, and in some cases it could not hold a candle to his own. If Dr. Larch had often criticized Homer for his heavy touch with ether, Homer could not imagine how the old man would react to the heavy-handedness that was applied to that inhalation at Cape Kenneth Hospital. In St. Cloud's, Homer had seen many patients who were so lightly etherized that they could converse throughout their own operations; in Cape Kenneth's recovery rooms, the patients struggling to emerge from their ether doses looked bludgeoned—they snored gap-mouthed, with their hands hanging deadweight and the muscles in their cheeks so slack that at times their eyes were pulled half open.

It especially angered Homer to see how they dosed the children—as if the doctors or the anesthetists were so {464} uninformed that they didn't pause to consider the patient's body weight.

One day he sat with Candy on either side of a fiveyear-old boy who was recovering from a tonsillectomy. That was nurses'-aide work: you sat with the patient coming out of ether, especially the children, especially the tonsillectomies—they were often frightened and in pain and nauseous when they woke. Homer claimed they wouldn't be nearly so nauseous if they'd been given a little less ether.

One of the nurses was in the recovery room with them; it was the one they liked—a young, homely girl about their age. Her name was Caroline, and she was nice to the patients and tough to the doctors.

'You know a lot about ether, Homer,' Nurse Caroline said.

'It seems overused to me, in certain cases,' Homer mumbled.

'Hospitals aren't perfect, they're just expected to be,' Nurse Caroline said. 'And doctors aren't perfect, either; they just think they are.'

'Right,' said Homer Wells.

The five-year-old's throat was very sore when he finally woke up, and he went on retching for quite some time before any ice cream would slide down his throat, and stay down. One of the things the nurses' aides did was to be sure that the children, in such condition, didn't choke on their own vomit. Homer explained to Candy that it was very important that the child, in a semietherized state, not
aspirate,
or inhale, any fluid such as vomit into the lungs.

'Aspirate,' Nurse Caroline said. 'Was your father a doctor, Homer?'

'Not exactly,' said Homer Wells.

It was Nurse Caroline who introduced Homer to young Dr. Harlow, who was in the throes of growing out his bangs; a cowlick persisted in making his forehead look meager; a floppy shelf of straw-colored hair gave Dr. {465} Harlow's eyes the constant anxiousness of someone peering from under the brim of a hat.

'Oh, yes, Wells—our ether expert,' Dr. Efarlow said snidely.

'I grew up in an orphanage,' said Homer Wells. 'I did a lot of helping out around the hospital.'

'But surely you never administered any ether?' said Dr. Harlow.

'Surely not,' lied Homer Wells. As Dr. Larch had discovered with the board of trustees, it was especially gratifying to lie to unlikeable people.

'Don't show off,' Candy told Homer when they were driving back to Heart's Haven together. 'It doesn't become you, and it could get your Doctor Larch in trouble.'

'When did I show off?' Homer asked.

'You really haven't, yet, 'Candy said. 'Just don't, okay?'

Homer sulked.

'And don't sulk,' Candy told him. That doesn't become you, either.'

I'm just waiting and seeing,' said Homer Wells. 'You know how that is.' He let her out at the lobster pound; he usually came in with her and chatted with Ray. But Homer was mistaken to confuse Candy's irritability either with coldness toward him or with anything but the profoundest confusion of her own.

She slammed the door and walked around to his side of the van before he could drive away. She indicated he should roll down his window. Then she leaned inside and kissed him on the mouth, she yanked his hair, hard—-with both hands, tilting his head back—and then she bit him, quite sharply, in the throat. She banged her head on the window frame when she pulled herself back from him; her eyes were watery; but no tears spilled to her face.

'Do you think I'm having a good time?' she asked him. 'Do you think I'm teasing you? Do you think I
know
whether I want you or Wally?' {466}

He drove back to Cape Kenneth Hospital; he needed work more substantial than mousing. It was the Goddamn mousing season again—how he hated handling the poison!

He arrived simultaneously with a sailor slashed up in a knife fight; it had happened where Ray worked—in Kittery Navy Yard—and the sailor's buddies had driven him around in a makeshift tourniquet, running out of gas coupons and getting lost on the way to several hospitals much nearer to the scene of the fight than the one in Cape Kenneth. The gash, into the fleshy web between the sailor's thumb and forefinger, extended nearly to the sailor's wrist. Homer helped Nurse Caroline wash the wound with ordinary white soap and sterile water. Homer could not help himself—he was accustomed to speaking to Nurse Angela and to Nurse Edna in the voice of an authority.

'Take his blood pressure, opposite arm,' he said to Nurse Caroline, 'and put the blood-pressure cuff on over a bandage—to protect the skin,' he added, because Nurse Caroline was staring at him curiously. 'The cuff might have to be on there for a half hour or more,' said Homer Wells.

'I think
I
can give instructions to Nurse Caroline, if you don't mind,' Dr. Harlow said to Homer; both the doctor and his nurse stared at Homer Wells as if they had witnessed an ordinary animal touched with divine powers —as if they half expected Homer to pass his hand over the profusely bleeding sailor and stop the flow of blood as quickly as the tourniquet stopped it.

'Very neat job, Wells,' Dr. Harlow said. Homer observed the injection of the 0.5 percent Procaine into the wound and the subsequent probing of Dr. Harlow. The knife had entered on the palmar side of the hand, observed Homer Wells. He remembered his
Gray's,
and he remembered the movie he had seen with Debra Pettigrew: the cavalry officer with the arrow in his hand, the arrow that fortunately missed the branch of the median {467} nerve that goes to the muscles of the thumb. He watched the sailor move his thumb.

Dr. Harlow was looking. There's a rather important branch of the median nerve,' Dr. Harlow said slowly, to the cut-up sailor. 'You're lucky if that's not cut.'

'The knife missed it,' said Homer Wells.

'Yes, it did,' said Dr. Harlow, looking up from the wound. 'How do
you
know?' he asked Homer Wells, who held up the thumb of his right hand and wiggled it.

'Not only an ether expert, I see,' said Dr. Harlow, still snidely. 'Knows all about muscles, too!'

'Just about that one,' said Homer Wells. 'I used to read
Gray's Anatomy
—for fun,' he added.

'For
fun?'
said Dr. Harlow. 'I suppose you know all about blood vessels, then. Why not tell me where all this blood is coming from.'

Homer Wells felt Nurse Caroline brush his hand with her hip; it was surely sympathetic contact—Nurse Caroline didn't care for Dr. Harlow, either. Despite Candy's certain disapproval, Homer couldn't help himself. The blood vessel is a branch of the palmar arch,' he said.

'Very good,' said Dr. Harlow, disappointed. 'And what would you recommend I do about it?'

'Tie it,' said Homer Wells. Three-o chromic.'

'Precisely,' said Dr. Harlow. 'You didn't get that from
Gray's.'
He pointed out to Homer Wells that the knife had also cut the tendons of the
flexor digitorum profundus
and
the flexor digitorum sublimis.
'And where might they go?' he asked Homer Wells.

'To the index finger,' Homer said.

'Is it necessary to repair both tendons?' asked Dr. Harlow.

'I don't know,' said Homer Wells. 'I don't know a lot about tendons,' he added.

'How surprising!' said Dr. Harlow. 'It is only necessary to repair the
profundus,'
he explained. 'I'm going to use {468} two-o silk. I'll need something finer to bring the edges of the tendon together.'

'Four-o silk,' recommended Homer Wells.

'Very good,' said Dr. Harlow. 'And something to close the palmar
fascia?'

'Three-o chromic,' said Homer Wells.

'This boy knows his stitches!' Dr. Harlow said to Nurse Caroline, who was staring intently at Homer Wells.

'Close the skin with four-o silk,' Homer said. 'And then I'd recommend a pressure dressing on the palm—you'll want to curve the fingers a little bit around the dressing.'

'That's called “the position of function,”' Dr. Harlow said.

'I don't know what it's called,' Homer said.

'Were you ever in medical school, Wells?' Dr. Harlow asked him.

'Not exactly,' said Homer Wells.

'Do you plan to go?' Dr. Harlow asked.

'It's not likely,' Homer said. He tried to leave the operating room then, but Dr. Harlow called after him.

'Why aren't you in the service?' he called.

'I've got a heart problem,' Homer said.

'I don't suppose you know what it's called,' said Dr. Harlow.

'Right,' said Homer Wells.

He might have found out about his pulmonary valve stenosis on the spot, if he had only asked; he might have had an X-ray, and an expert reading—he could have learned the truth. But who seeks the truth from unlikable sources?

He went and read some stories to the tonsillectomy patients. They were all dumb stories—children's books didn't impress Homer Wells. But the tonsillectomy patients were not likely to be around long enough to hear
David Copperfield
or
Great Expectations.

Nurse Caroline asked him if he would give a bath and a back rub to the large man recovering from the prostate operation. {469}

'Don't ever underestimate the pleasure of pissing,' the big man told Homer Wells.

'No, sir,' Homer said, rubbing the mountain of flesh until the big man shone a healthy pink.

Olive was not home when Homer returned to Ocean View; it was her time for plane spotting. They used what was called the yacht-watching tower at the Haven Club, but Homer didn't think any planes had been spotted. All the men spotters—most of them Senior's former drinking companions—had the silhouettes of the enemy planes tacked on their lockers; the women brought: the silhouettes home and stuck them on places like the refrigerator door. Olive was a plane spotter for two hours every day.

Homer studied the silhouettes that Olive had on the refrigerator.

I could learn all those, he was thinking. And I can learn everything there is to know about apple farming. But what he already knew, he knew, was near-perfect obstetrical procedure and the far easier procedure—the one that was against the rules.

He thought about rules. That sailor with the slashed hand had not been in a knife fight that was according to anyone's rules. In a fight with Mr. Rose, there would be Mr. Rose's own rules, whatever they were. A knife fight with Mr. Rose would be like being pecked to death by a small bird, thought Homer Wells. Mr. Rose was an artist —he would take just the tip of a nose, just a button or a nipple. The
real
cider house rules were Mr. Rose's.

And what were the rules at St. Cloud's? What were Larch's rules? Which rules did Dr. Larch observe, which ones did he break, or replace—and with what confidence? Clearly Candy was observing some rules, but whose? And did Wally know what the rules were? And Melony—did Melony obey
any
rules? wondered Homer Wells.

'Look,' said Lorna. 'There's a war, have
you
noticed?' {470}

'So what?' said Melony.

'Because he's probably in it, that's so what!' Lorna said. 'Because he either enlisted or he's gonna get drafted.'

Melony shook her head. 'I can't see him in a war, not him. He just doesn't belong there.'

'For Christ's sake,' Lorna said. 'You think everyone in a war
belongs
there?'

'If he goes, then he'll come back,' Melony said. The ice on the Kennebec in December was not secure; it was a tidal river, it was brackish, and there was open water, gray and choppy, in the middle. But not even Melony could throw a beer bottle as far as the middle of that river in Bath. Her bottle, bouncing off the creaky ice, made a hollow sound and rolled toward the open water it couldn't reach. It disturbed a gull, who got up and walked a short way along the ice, like an old woman holding up a number of cumbersome petticoats above a puddle.