Josh Bazell: Beat the Reaper: A Novel

I laugh.

Like I always do when he tells me that joke.

In the bed by the door of Mosby’s room—the bed Mosby had until the ward clerk decided he’d be less likely to escape if he was five feet farther from the door—there’s a fat white guy I don’t know with a short blond beard and a mullet. Forty-five years old. Lying on his side with the light on, awake. When I checked the computer earlier, his “Chief Complaint”—the line that quotes the patient directly, thereby making him look like an idiot—just said “Ass pain.”

“You got ass pain?” I say to him.

“Yeah.” He’s gritting his teeth. “And now I got shoulder pain too.”

“Let’s start with the ass. When did that start?”

“I’ve already been through this. It’s in the chart.”

It probably is. In the paper chart, anyway. But since the paper chart is the one the patient can request, and that a judge can subpoena, there’s not much incentive to make it legible. Assman’s looks like a child’s drawing of some waves.

As for his computer chart—which is off the record, and would contain any information anyone actually felt like giving me—the only thing written besides “CC: Ass pain ” is “Nuts? Sciatica?” I don’t even know if “nuts” means “testicles” or “crazy.”

“I know,” I say. “But sometimes it helps if you tell it again.”

He doesn’t buy it, but what’s he going to do?

“My ass started to hurt,” he starts up, all resentful. “More and more for about two weeks. Finally I came to the emergency room.”

“You came to the emergency room because your ass hurt? It must really hurt.”

“It is fucking killing me.”

“Even now?” I look at the guy’s painkiller drip. That much Dilaudid, he should be able to skin his own hand with a carrot peeler.

“Even now. And no, I’m not some kind of drug addict. And now it’s in my fucking shoulder, too.”

“Where?”

He points to a spot about midway along his right collarbone. Not what I’d call the shoulder, but whatever.

Nothing’s visible. “Does this hurt?” I say, poking the spot lightly. The man screams.

“Who’s there!?” Duke Mosby demands from the other bed.

I pull the curtain aside so Mosby can see me. “Just me, sir.”

“Don’t call me sir—” he says. I let the curtain fall back.

I look down at Assman’s vitals sheet. Temp 98.6, Blood Pressure 120/80, Respiratory Rate 18, Pulse 60. All totally normal. And all the same as on Mosby’s chart, and on the vitals sheets of every other patient I’ve seen on the ward this morning. I feel Assman’s forehead like I’m his mother. It’s blazing.

Fuck.

“I’m ordering you some CT scans,” I tell him. “Seen any nurses around here lately?”

“Not since last night,” he says.

“Fuck,” I say out loud.

Sure enough, a woman five doors down is flat-out dead, with a look of screaming horror on her face and a vitals sheet that reads “Temp 98.6, Blood Pressure 120/80, Respiratory Rate 18, Pulse 60.” Even though her blood’s so settled at the bottom of her body that it looks like she’s been lying in a two-inch pool of blue ink.

To calm myself down I go start a fight with the two charge nurses. One’s an obese Jamaican woman busy writing some checks. The other’s an Irish crone cruising the Internet. I know and like both of them—the Jamaican one because she sometimes brings in food, and the Irish one because she has a full-on beard she keeps shaved into a goatee. If there’s a better Fuck You to the world than that, I don’t know what it is.

“Not our problem,” the Irish one says, after I’ve run out of things to complain about. “And nothing to do about it. We had that pack of Latvian cuntheads on the overnight. Probably out selling the lady’s cell phone by now.”

“So fire them,” I say.

It makes both nurses laugh. “There’s a bit of a nursing shortage on,” the Jamaican one says. “Case you haven’t been noticing.”

I have been noticing. Apparently we’ve used up every nurse in the Caribbean, the Philippines, and Southeast Asia, and now we’re most of the way through Eastern Europe. When the white supremacist cult Nietzsche’s sister’s founded in Paraguay re-emerges from the jungle, at least its members will be able to find work.

“Well I’m not filling out the certificate,” I say.

“Sterling. And fuck the Pakistani, eh?” the Irish one says. Her face is remarkably close to the computer screen.

“Akfal’s Egyptian,” I say. “And no, I’m not leaving it for him. I’m leaving it for your Latvian shitheels. Stat.”

The Jamaican one shakes her head sadly. “Won’t bring the lady back,” she says. “You ask them to do the certificate, they’re just going to call a code.” [5] “Stat” is short, though not very, for Latin “ statim ” , “ immediately" . “Calling a code” is what you do when you want to pretend you don’t know someone’s already dead.

“I don’t give a fuck.”

“Párnela?” the Jamaican one says.

“I neither,” the Irish one says. “Dim bitch,” she adds, sort of under her breath.

You can tell by the way the Jamaican one reacts to this that she knows the Irish one is talking about me, not her.

“Just tell them to do it,” I say, leaving.

I feel better already.

But even after that I have to take a slight break. The Moxfane I chewed up half an hour ago, along with some Dexedrine I found in an envelope in my lab coat and ate in case the Moxfane took too long to kick in, is making it hard for me to concentrate. I’m peaking a little too sharply.

I love Dexedrine. It’s shield-shaped, with a vertical line down the middle so it looks like some vulvae. [6] In fact, the medical word for pubic hair, “escutcheon,” “shield,” although in free-range humans only women’s pubic hair is shield-shaped. Men’s is naturally diamond-shaped, pointing up toward the navel as well as down toward the groin. Which is why women who shave their pubic hair into a diamond shape subconsciously skeeze you out. But even on its own, Dexedrine can sometimes make things too slippy to focus on, or even look at. On top of a Moxfane it can make things start to blur.

So I go to the medicine residents’ call room to chill out, and maybe take some benzodiazapines I’ve got hidden in the bed frame.

The second I open the door, though, I know there’s someone in there in the darkness. The room stinks like bad breath and body odor.

“Akfal?” I say, though I know it can’t be Akfal. Akfal’s aroma I will take to my grave. This is worse. It’s worse than Duke Mosby’s feet.

“No, man,” comes a weak voice from the corner with the bunk bed.

“Then who the fuck are you?” I snarl.

“Surgery ghost,” [7] This is an actual job, though it’s not interesting enough to go into. the voice says.

“Why are you in the Medicine call room?”

“I...I needed a place to sleep, man.”

He means, “Where no one would look for me.”

Great. Not only is the guy stenching up the call room, he’s using the only available bunk, since the upper one is covered by a complete run of Oui magazine from 1978 to 1986, which I know from experience is too much of a pain in the ass to move.

I consider just letting him stay. The room smells unusable for the foreseeable future anyway. But I’ve got that Moxfane Edge,™ and there’s always deterrence to think about.

“I’ll give you five minutes to get the fuck out,” I tell him. “After that I’m dumping a bottle of urine on your head.”

I turn the lights on as I go.