Samuel Shem: The house of God

When Leo had returned to life, Fats walked us back to the nursing station, put his feet back up, opened the paper again, and said, "All right all right so you panicked and you feel like shit. I know. It's awful and it's not the last time neither. Just don't forget what you saw. LAW NUMBER THREE: AT A CARDIAC ARREST, THE FIRST PROCEDURE IS TO TAKE YOUR OWN PULSE."

"I guess I wasn't worried about him because he was an elective admission and not an emergency," said Potts.

"Elective doesn't mean shit around here," said Fats. "Leo would have died. He's young enough to die, you know."

"Young?" I asked. "He looks seventy?five."

"Fifty?two. Congestive heart failure's worse than most cancers. It's ones his age that die. There's no way he'll become a gomer, not with a disease like that. And that's the challenge of medicine: gomers gomers gomers where you can't do anything for them, and then, suddenly?WHAM!?in comes Leo, a lovely guy who can die, and you gotta move fast to save him. It's like what Joe Garagiola said last night about Luis Tiant: 'He gives you all his herky?jerky stuff and then, when he comes in with his heater, it looks a whole yard faster.' "

"His heater?" asked Potts.

"Oh, Jesus," said Fats. "His fast ball?HIS FAST BALL!?where did they get you guys, anyway?"

By that time I was wondering the same thing, and so was Potts. Both of us felt incompetent. For some reason, Chuck was different. He didn't need help. He knew what to do. Later that afternoon I asked him about how he seemed so competent already.

"Easy, man. See, I never read nuthin'. I just did it all"

"You never read anything?"

"Just about them red ants. But I know how to put in a big line, tap a chest?you name it, I done it. Ain't you?"

"Nope. None of that," I said, thinking about my piddling around with Sophie's aspirin.

"Well, man, what all did you do at the BMS?"

"Books. I know all there is to know about medicine in books."

"Well, it looks like that was your failing, man, that right there. Like my not joinin' the army. Maybe I still . . ."

Standing in the streaming July light was a nurse, the afternoon and evening nurse. She stood with her hands on her hips, reading the med cards, legs apart, rocking first one foot on its lateral edge, and then the other. The sharp sunlight made her costume almost transparent, and her legs flowed in smooth lines from her thin ankles and calves all the way up to where all seams meet. She wore no slip, and through her starched white dress I could see the bright patterns on her panties. She knew they would show through. Through her dress showed her bra strap, with its pleading unhookable hook. Her back was to us. Who could know about the front? I half?wished she would never turn around, never spoil the imagined breasts, the imagined face.

"Hey, man, that's somethin' else."

"I love nurses," I said.

"Well, man, what is it about nurses?"

"It must be all that white."

She turned around. I gasped. I blushed. From her ruffled front unbuttoned down past her clavicular notch showing her cleavage, to her full tightly held breasts, from the red of her nail polish and lipstick to the blue of her lids and the black of her lashes and even the twinkly gold of the little cross from her Catholic nursing school, she was a rainbow in a waterfall. After a day in the hot smelly House, after a day of being whacked by the Privates and the Slurpers and the gomers, she was a succulent chilled wedge of an orange squirting in my mouth. She came over to us.

"I'm Molly."

"Gurl, the name's Chuck"

Thinking to myself is it true what they say about interns and nurses, I said, "I'm Roy."

"This your first day, guys?"

"Yeah. I was just thinkin' of joinin' the army instead."

"I'm new too," Molly said. "Started just last month. Scary, eh?"

"No foolin'," said Chuck.

"Hang in there, guys, we'll make it. See ya round the campus, eh?"

Chuck looked at me and I looked at him, and he said, "Sure does make you glad to be spendin' time in here makin' it with the gomers, don't it?"

We watched Molly disappear down the corridor. She stopped to say hello to Potts, who was talking to a young Czech patient, a man yellow from liver disease. The Yellow Man flirted with Molly, and then ogled her as she, giggling, wiggled down the corridor. Potts came over to us and picked up the lab results from the morning.

"Lazlow's liver functions are getting worse," he said.

"He looks mighty yellow," said Chuck. "Lemmee see. Too high. If I was you, Potts, I'd give him some roids."

"Roids?"

"Steroids, man, steroids. Whose patient is he, anyhow?"

"He's mine. He's too poor to afford a Private doctor"

"Well, I'd give him the roids. Never know if he don't have fulminant necrotic hepatitis. If'n he does, unless you hit him with the roids now, he's gonna die."

"Yeah," said Potts, "but the tests aren't that high, and steroids have a lot of side effects. I'd just as soon wait a day."

"Suit yourself. Looks awful yellow, though, don't he?"

Thinking about what the Fat Man said about the young dying, I got up to do some work. When. I returned to the nursing station I saw two LOLs in NAD peering through their thick cataract?defying glasses at the blackboard on which were written the names of the new interns on the ward. They mentioned my name, and I asked them if they were looking for me. Tiny, a foot below me, huddled together, they peered up at me. "Oh, yes," said one.

"Oh, aren't you the tall young doctor."

"Handsome and tall," said the other. "Yes, we want to hear the news about our brother Itzak."

"Itzak Rokitansky. The professor. Brilliant, he was."

"How is he, Dr. Basch?"

I felt trapped, not knowing what to say. Fighting the impulse to say PURRTY GUD, I said, "Well . . . I've only been here a day. It's too early to tell. We'll wait and see."

"It's his brain," said one. "His marvelous brain. We're glad you'll be taking care of him, and we'll look for you tomorrow. We visit every day."

"We spend much of our time now visiting the ones who are ill. Good?bye, Dr. Basch. Thank you so much."

I left them, and noticed them pointing at me to each other, pleased that I would be their brother's doctor. I was moved. I was a doctor. For the first time that day, I felt excited, proud. They believed in me, in my art. I would take care of their brother, and them. Take care of the whole world, why not? I marched down the hallway with pride. I fingered the chrome of my stethoscope with a certain expertise. Like I knew what I was doing. Far?out.

It didn't last. I got more and more tired, more and more caught up in the multitudinous bowel runs and lab tests. The jackhammers of the Wing of Zock had been wiggling my ossicles for twelve hours. I hadn't had time for breakfast, lunch, or dinner and there was still more work to do. I hadn't even had time for the toilet, for each time I'd gone in, the grim beeper had routed me out. I felt discouraged, worn. Before he left for the day, the Fat Man came by and asked if there was anything else I wanted to talk about.

"I don't get it," I said. "This isn't medicine, this isn't what I signed up for. Not writing orders for cleanouts for the bowel run."

"Bowel runs are important," said Fats.

"But aren't there any normal medical patients?"

"These are normal medical patients."

"They can't be. Hardly any of them are young:"

"Sophie's young; she's sixty?eight."

"Between the old people and the bowel runs, it's crazy. It's not at all what I expected when I walked in here this morning."

"I know. It's not what I expected either. We all expect the American Medical Dream?the whites, the cures, the works. Modern medicine's different: it's Potts being socked by Ina. Ina, who should have been allowed to die eight years ago, when she asked, in writing, in her New Masada chart. Medicine is 'bedrest until complications,' Blue Cross payments for holding hands, and all the rest you've seen today, with the odd Leo thrown in to die."