Josh Bazell - Beat the Reaper - A Novel

SUPPORT IN SAN FRANCISCO Joseph Caston, Robert Daroff, Ellen Haller, Cassis Henry, Tamar Hurwitz, Marc Jacobs, Yunnie Lee, Peri Soyugenc, Kim Stopak, my co-residents at UCSF

SUPPORT ELSEWHERE Michael Bennett, Edward Goljan, the Gordon family, Mary Victoria Robbins, Lawrence Stern

CANINE SUPPORT Lottie

SUPPORT ALL OVER THE PLACE, SINCE BIRTH my sister Rebecca Bazell

JOSH BAZELL has a BA in English literature and writing from Brown University and an MD from Columbia University. He is currently a resident at the University of California, San Francisco, and is working on his second novel.

And you can compare this to your lower leg, where the same setup is vestigial. The two bones of the lower leg, the tibia and fibula, are locked in place. The outer one, the fibula, doesn’t even support weight. In fact you can take most of it out—to use as a graft or whatever—and as long as you don’t fuck up the ankle or the knee, it won’t affect the patient’s ability to walk.

Doctors always know how old you are. We use it to tell whether you’re lying to us. There are various formulas for it—compare the creases of the neck to the veins on the backs of the hands and so on—but they’re not really necessary. If you met thirty people a day and asked them how old they were, you’d get good at it too.

The tattoo on my left shoulder—winged staff, two snakes—turns out to actually be the symbol of Hermes, and therefore of commerce. The symbol of Asclepius, and therefore of medicine, is a nonwinged staff with one snake. Who knew?

Scrub suits are reversible, with pockets on both sides, in case you need to run anesthesia or whatever but are too tired to put your pants on correctly.

“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.

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.

This is an actual job, though it’s not interesting enough to go into.

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.

This was Konrad Preysing, aka “The One Good German.” Preysing made thirteen separate presentations of Holocaust evidence to Pope Pius XII, who in 1941 announced that Nazi policies did not conflict with Catholic teachings. When Pius gets sanctified, I hope they cite that as his miracle.

Auschwitz a death camp—Birkenau—but it also had Monowitz, which was a slave labor camp. That made odds of survival at Auschwitz 1 in 500, which is why you’ve even heard of Auschwitz. Odds of survival in the death camps were 1 in 75,000.

My parents had long since gotten divorced. My mother had become a real estate agent, and my father, who was Italian—but not, I should say, Sicilian—had moved to Riverside, Florida. Last I heard he ran an upscale franchise restaurant I won’t name. They both have different names now, and I am not in contact with either of them.

The actual amount that will stroke out any particular person is highly variable, because 30 percent of people have a hole in the wall between the right and left sides of their heart capable of sending a bubble that would otherwise go to their lungs (and from there into the atmosphere) directly into their brain. But most pieces of IV equipment are a lot harder to clear than a syringe, so nobody bothers to do it.

Electrocardiograms are abbreviated “EKG” because “ECG” sounds too much like “EEG,” which is an electroencephalogram. Or maybe Willem Einthoven, who invented them, called them “electrokardiograms.”

“Peter Brown called to say / You can make it O.K. / You can get married in Gibraltar near Spain.” Peter Brown was the longest-serving roadie for the Beatles.

This basic interaction—Good morning, sir/Sorry, kids. I’ll teach you something later—is the primary activity of the last two years of medical school. The primary activity of the first two years is a PowerPoint presentation by whatever bitter, unpaid PhD was too slow to avoid getting tapped by the dean that morning.

“CVA” stands for “cerebrovascular accident,” or stroke. A brain artery either getting jammed (usually by a clot, usually from your heart) or outright exploding. Meet the Reaper: it’s the number two cause of death in the United States.

Michael drops the gun after shooting the cop in because the kid drops the gun after shooting the cop in Where it at least makes sense, since during the Algerian Revolution the French had checkpoints every other block.

Oops, I said it.

Ishmael was my code name inside WITSEC, though no one except Prof. Marmoset ever actually called me that. WITSEC is the abbreviation the Feds use, helpfully, for the Federal Witness Protection Program.

Expand the mind, and the body will follow, you might say, but it never seemed to make me fat, and Skinflick was fat already.

Like a woman’s escutcheon, if you’ve been paying attention.

For those following along in their in medicine the solar plexus has been called the celiac plexus for the last few decades. About as long as it’s been since anyone read

Like you care what this means.

My favorite Lech Wałesa story is from shortly before I went to Poland. Realizing he was about to lose the presidency, Wałesa announced that his opponent was secretly Jewish. He then denied he was a bigot, saying, “Actually I wish I was Jewish myself. Because then I would have a lot more money.” Funny guy!

I. G. Farben, the chemical company that ran the labor camp at Auschwitz—it isn’t named after a person, it’s short for “International Dye Company” in German—stayed in business after the war by claiming it needed to pay reparations to its former slaves, of whom it had used 83,000 at any one time. It then went on to portray itself for decades as being unfairly hounded by greedy, vengeful Jews. In 2003 it found itself on the verge of being forced to actually pay out two hundred and fifty thousand dollars (total, not per person), and declared bankruptcy instead. But not until it had spun off Agfa, BASF, Bayer, and Hoechst (now half of pharmaceutical giant Aventis), all of which prosper to this day.

”status post ” abbreviated “s/p,” is a common medical term meaning “after” and implying “but not necessarily caused by.” It’s Latin for “Try suing me now, Fucker.”