Сэмуэль Шэм - Mount Misery

By eleven I hadn't sat down, eaten, or gone to the bathroom, and that was just the start. A baby came in with a laceration on his forehead, needing two sutures. He was almost blue from screaming. The nurse asked the worried mother to leave, which wrenched me, as it had rarely wrenched me during my internship when I'd viewed mother or father or whoever else was there beside the patient as a mere bother, adding to my time awake, to be gotten rid of. Now, as I strapped the baby down on a papoose board, I saw in his desperate face that of an old man, bald, tormented at being strapped down into a nursing home bed, both faces at once. With a tiny hooked needle clasped in my forceps, I hovered above the baby's face, sweating now, trying to place just two little sutures in that wound. The baby's eyes suddenly became immense, as if the forehead were all eyes, eyes plump as ripe grapes, and his head moved back and forth with remarkable strength despite the nurse's hands, and I thought, What if this needle hits his eye? The point snagged skin. I was amazed again at how tough skin is, even a baby's. I curled it through, snagging the other edge, pulled, tied, cut. Drenched in sweat, I threw in a second suture. Done. I sighed with satisfaction. Undid the damp baby. Handed him back to his mom.

Much of what I saw was psychiatric: belly pain, anxiety, phobias, depression, suicide attempts, hallucinating crazies. Before, these had been "turkeys," unfathomable and untreat-able, mocked by us real docs and turfed to the shrink or back out onto the street. Now they were familiar, and easy. In a few

minutes I got the feel of where this person stood in the world. I had learned something in my year of psychiatry, something about how to listen to intense feeling without flinching, how to make sense of it

At about midnight there was a lull. I went to see a woman complaining of shortness of breath. She had been to many specialists. No one could find anything wrong except eosino-philia, a high number of allergic cells in her blood. She'd even been to MBH-Man's Best Hospital-with no luck. She was a fine-featured, pleasant woman of fifty, sitting in her emergency room nightie, oxygen mask over her face, gasping for breath. I listened to her story. She was neither crazy nor hypochondriacal. I began asking her not about her breathing, but about her Me. One thing led to another. It turned out that she rented out rooms of her house, and that one of her boarders was a magician who kept pigeons hi her basement. Curious, I asked about this magician, these pigeons. It turned out that the pigeons were kept in cages near the washer-dryer. Whenever she did the wash, the pigeon shit got blasted up into clouds, which she inhaled.

"That's it," I said, "your lung disease."

'The pigeons?"

'The pigeons' shit. You've got 'pigeon breeder's lung disease.'"

"But what's the treatment?"

"Move the pigeons!"

"I will!"

You listen with curiosity, you hear it all.

I went to bed at two, but was awakened from deep sleep by a nurse, staL I felt I had slept for ten hours, but it turned out to have been ten minutes. I had that horrible feeling of stumbling up out of a sweet dark dream into a fluorescence and having to face a terrible emergency, trying to remember where I was let alone what to do as a doctor. A two-car collision. Bodies mangled and cut and messed up in unmentionable ways. I was running to and fro and calling surgeons, who came cheerily in, happy to be doing nice civic things like sewing fingers back on hands and hands on wrists and lining up bones straight as five irons. Finally everybody was into operations or casts or cars home. I finished and stood there shivering hi the spring cold, for I was wearing only a thin green operating room shirt, about

to go back to bed again, but then the nurse said she had a case of child abuse where a father had broken a baby's arm and then another car crash with two great drunken Americans going through the windshield so it was Laceration City and a woman giving birth, which brought back my days at the National Maternity Hospital in Dublin where at eleven-thirty at night we'd get kicked out of The Silent Woman-which so many of the docs and med students hung out at that we nicknamed it "the Office"-and staggered up to Delivery and half-banjaxed on Guinness would pull out a baby or two before staggering back down to bed. And then a kid with a temp of 105 and seizures from it and an old man with a blood pressure of 60 and a temperature of 106-in whose scared tight face I saw that of the baby I'd sewn up earlier-and then, before five, I got a call to do a favor for a local doctor who had been called at home to do it but didn't want to come in, to go up onto the ward of the hospital to pronounce someone dead.

Sleepily, I took the silent elevator up to the top floor and walked the waxy corridor toward the light near the end, stethoscope tapping one side of my belly and then the other like an elephant's trunk. I stopped at the nursing station, got the name, went down to the room.

There lay a man, his body emaciated. His eyes were open and dead and his mouth was open and dead and his color was more blue than white, which meant he was recently dead, the oxygen in his blood vanishing, but not vanished. His age was hard to guess, given his disease. Probably about sixty. A whole life, a whole family, a whole life of learning to creep and crawl and cruise and walk and talk and love and hate and beat out a single down the first base line and make money and woo and wed and have children and sicken and now die. My not knowing anything about him gave his death depth, for it was anyone's death. My death, and Malik's-for here was metastatic cancer.

1 laid my stethoscope on his heart and heard nothing.

I went to the nursing station and signed him out as dead and walked down the still smooth corridor to the elevator alone and secure in my mortality. Secure, yes, for I felt comforted that sooner or later someone else would be viewing me this way, as anybody, once alive, now dead. I felt a sense of awe at that, at the brief human day, a blink in the eye of whatever

lasts, a part of whatever is whole, the awe at all the faces and bodies I'd seen and treated that night.

Secure in my mortality, I went to bed.

I slept as if dead until seven, then dressed and walked out into the fluorescents. Caroline the night nurse thanked me and I her, for the good job we'd done. I followed the smell of freshly baked muffins to the cafeteria, where I sat watching the manly, insecure construction workers drink coffee and talk sports and "pussy" and eat muffins and get ready to do death-defying ironwork in the name of making more hospital. Then I got into my car, but instead of heading back toward Misery, for some reason I drove down the main street of colonial mansions crowned with widow's walks and through the slums of the seaport with its bars and yuppie shops and then along the sea to the neck of land leading out to the five-mile-long island, half of which was a bird sanctuary, half public beach.

Berry and I had walked here once, a couple of years before, during my internship. She had suggested walking the whole beach in silence. I remembered how, that day, despite the bright sun and deserted beach and optimistic gulls and the hand of the woman I loved clasped in mine, my mind had been busily elsewhere, over and over running a tape of how, compared to others, I was a failure at… at… I couldn't even recall at what now.

But it had spoiled our day. My obsession with comparing myself to others, and my feeling like a failure, had gotten ia the way of my being with her. What insanity.

Now I looked around at the expanse of nipping, sharp sea, the gulls and sandpipers and husks of crabs and sand dollars, and then looked back to the twisted slats of dune fencing and willowy grasses taunting the wind, to the bird sanctuary.