Josh Bazell - Beat the Reaper - A Novel

I’m feeling slightly more focused now, but still not focused enough to talk to patients, so I go and check labs on the computer. Akfal has already copied most of them into the charts. But there’s a pathology report on a patient of Dr. Nordenskirk’s who actually has insurance, so Akfal hasn’t touched it. Dr. Nordenskirk doesn’t let anyone who’s not white or Asian interact with patients with insurance.

So I scan the report on-screen. It’s a bunch of bad news for a man named Nicholas LoBrutto. The Italian name alarm in my head goes off, but I’m pretty sure I’ve never heard of this guy. And anyway mobsters—like most people with options—don’t come to Manhattan Catholic. It’s why I’m allowed to work here.

The key phrase in the pathology report is “positive for signet cells.” A signet cell is a cell that looks like a ring with a diamond (or a signet, if you’re still sealing your letters with wax) on it, because its nucleus, which is supposed to be in the center, has been pushed to the wall by all the proteins the cell can’t stop making because it’s cancer. Specifically, either stomach cancer or cancer that was stomach cancer and has now metastasized, like to your brain, or your lungs.

All stomach cancers suck, but signet cell is the worst. Where most stomach cancers just drill a hole through your stomach wall, so you can have half your stomach cut out and conceivably live, just not be able to shit solid, signet cell cancer infiltrates the stomach along the surface, producing a condition known as “leather bottle stomach.” The whole organ has to go. And even then, by the time you’re diagnosed it’s usually too late.

The CT scan of Nicholas LoBrutto’s abdomen is inconclusive about whether his cancer has spread or not. (Although, helpfully, he now has a 1 in 1200 chance of contracting some other form of cancer just from the radiation of the scan. He should live so long.) Only surgery will say for sure.

And in the meantime, at six thirty in the morning, I get to go tell him all of this.

Mr. LoBrutto? There’s a call for you on line one. He didn’t say, but it sounded like the Reaper.

Even for me, it’s early to be wanting a drink.

LoBrutto is bedded down in the Anadale Wing, the tiny deluxe ward of the hospital. The Anadale Wing tries to look like a hotel. Its reception area has wood-patterned linoleum and a schmuck in a tuxedo playing a piano.

If it really were a hotel, though, you’d get better healthcare. [8] Think more money can’t buy you worse healthcare? Forget the endless studies showing that the U.S. spends twice as much per capita as any other country, with results outside the top thirty-six. Take a look at Michael Jackson. The Anadale Wing actually does have hot 1960s nurses. I don’t mean they’re hot now. I mean they were hot in the 1960s, when they first started working at Manhattan Catholic. Now they’re mostly bitter and demented.

One of them shouts out to ask where the hell I’m going as I pass the charge desk, but I ignore her on my way to LoBrutto’s “suite.”

When I open the door I have to admit it’s pretty nice for a hospital room. It’s got an accordioning wall, now mostly retracted, that divides it into a “living room”—where your family can come eat dinner with you at an octagonal table covered with vinyl that looks easy to clean vomit off of—and a “bedroom” with the actual hospital bed. The whole thing has floor-to-ceiling windows, with a view, at the moment, of the Hudson River just starting to catch light from the east.

It’s dazzling. They’re the first windows I’ve looked out since I got to work. And they backlight LoBrutto in his bed, so he recognizes me before I recognize him.

“Holy shit!” he says, trying to crawl away from me up the bed, but held back by all his IV and monitor lines. “It’s the Bearclaw! They sent you to kill me!”

One summer when I was in college I went to El Salvador to help register indigenous tribes to vote. A kid in one of the villages I was visiting got his arm pulled off by an alligator while he was fishing with a hand line, and would have died in front of me if it hadn’t been for one of the other American volunteers, who was a doctor. Right then and there I decided to go to medical school.

This never actually happened, thank the Christ, and in fact I barely went to college, but it’s the kind of thing they tell you to say when you apply to med school. That or how you had some disease growing up that was so brilliantly cured you can now work 120 hours a week and be happy about it.

What they tell you not to say is that you want to be a doctor because your grandfather was a doctor and you always looked up to him. I’m not sure why this is so. I can think of worse reasons. Plus, my own grandfather was a doctor, and I did look up to him. As far as I could tell, he and my grandmother had one of the great romances of the twentieth century, and were also the last truly decent people on earth. They had a humorless dignity I’ve never managed to come close to, and an endless concern for the downtrodden that I can barely stand to think about. They also had good posture, and what appeared to be a sincere enjoyment of Scrabble, public television, and the reading of large and improving books. They even dressed formally. And although they were citizens of a vanished type, they showed forgiveness toward people who weren’t. For example, when my stoned-out mother gave birth to me, on an ashram in India in 1977, then wanted to go on to Rome with her boyfriend (my father), my grandparents flew over and took me back to New Jersey, where they raised me.

Still, it would be dishonest to place the origins of my becoming a doctor in my love and respect for my grandparents, since I don’t believe I even considered going to medical school until eight years after they were murdered.

They were killed on October 10, 1991. I was fourteen, four months away from being fifteen. I came home from a friend’s house around six thirty at night, which in West Orange in October is late enough that you need the lights on. The lights weren’t on.

At the time, my grandfather was doing mostly nonsurgical, though medical, volunteer work, and my grandmother was volunteering at the West Orange Public Library, so they both should have been home by then. Also, the glass pane next to the front door—the kind of glass they call “pebbled”—was broken, like someone had smashed it to reach in and open the lock.

If this ever happens to you, leave and call 911. There could be someone still in the house. I went in, because I was afraid someone would hurt my grandparents if I didn’t. You’ll probably go in too.

They were on the border between the living room and dining room. Specifically my grandmother, who had been shot through the chest, was on her back in the living room, and my grandfather, who had doubled forward after being shot in the abdomen and hence was face down, was in the dining room. My grandfather had his hand on my grandmother’s arm.

They’d been dead for a while. The blood in the carpet sucked at my shoes, and later, when I was lying down in it, at my face. I called 911 before I went and put my head down between theirs.

In my memory the whole thing is in vivid color, which is interesting, because I now know that we don’t actually see color in low-light situations. Our minds imagine it for us and paint it in.

I know I put my fingers in their gray hair and pulled us all together. When the EMTs finally got there, the only thing for them to do was pull me off so that the cops could photograph the crime scene and let City Services remove the bodies.

The particular irony of my grandparents’ story is that they had survived a much more elaborate attempt to murder them fifty years earlier. They had met, legendarily, in the Białowieża Forest in Poland in the winter of 1943, when they were fifteen, barely older than I was when I found them dead. They and a bunch of other newly feral teenagers were hiding out in the snow and trying to kill off enough of the local Jew-hunting parties so that the Poles would leave them alone. What this precisely involved they never told me, but it must have been pretty ferocious, because in 1943 Hermann Göring had a lodge at the southern end of Białowieża where he and his guests dressed as Roman senators, and he must have been aware of the situation. There’s also the question of a straggler platoon of Hitler’s Sixth Army that disappeared in Białowieża that winter en route to Stalingrad. Where, to be fair, it would have been wiped out anyway.