Thomas McGuane - Driving on the Rim

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From one of America’s most acclaimed literary figures (“an important as well as brilliant novelist”—
) a major new novel that hilariously takes the pulse of our times.
The unforgettable voyager of this dark comic journey is I. B. “Berl” Pickett, M.D., the die of whose uncharmed life was probably cast as soon as his mother got the bright idea to name him after Irving Berlin. The boyhood insults to any chance of normalcy piled on apace thereafter: the traumatizing, spasmodic spectacle of Pentecostalist Sunday worship; the socially inhibitory accompaniment of his parents on their itinerant rug-shampooing business; the undue technical advancement and emotional retardation that ensued from his erotic initiation at the hands of his aunt. What would have become of this soul had he not gone to medical school, thanks to the surrogate parenting of a local physician and solitary bird hunter?
But there is meaning to life beyond professional accreditation, even in the noblest of callings. Berl’s been on a mission to find it these past few years, though with scant equipment or basis for hope. Hard to say (for the moment anyway) whether his mission has been aided or set back by his having fallen under suspicion of negligent homicide in the death of his former lover. All the same, being ostracized by virtually all his colleagues at the clinic gives him something to chew on: the reality of small-town living as total surveillance more than any semblance of fellowship, even among folks you’ve known your whole life.
Fortunately, for Berl, it doesn’t take a village. And he will find his deliverance in continuing to practice medicine one way or another, as well as in the few human connections he has made, wittingly or not, over the years. The landscape, too, will furnish a hint in what might yet prove, if not a certifiable epiphany, a semi-spiritual awakening in I. B. Pickett, M.D., the inglorious but sole hero of Thomas McGuane’s uproarious and profound exploration of the threads by which we all are hanging.

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I was standing in the corridor trying to puzzle out my day, gauging just how much caffeine it would take to get through it, when Alan Hirsch sidled up and accorded me a long gaze in which I thought I saw some affection. “I hope the detachment you exhibited at this morning’s meeting was simulated.”

“It comes and goes.”

“Because if it wasn’t, your problems are even bigger than I feared.”

I was having a hard time following this. We had, between how I was perceived by my colleagues and the ways in which I saw myself, true cognitive dissonance. That was enough to piss anybody off. Of course I understood what he meant, but I had to occupy some middle ground as a strategic matter. Groups that are of one mind, like the gathering this morning, are really only content with weeping confessions. It was time to throw Alan off the trail, and so I told him about a crow that had turned up on my flagpole several times this past month and addressed me in various combinations of caw-caw-caw in a way that made me understand it was an invitation for me to become a crow too. “Obviously I’d love to turn into a crow. Wouldn’t you, Alan?”

“No, Berl, I feel no need to become a crow. Cardiologist seems to work at the moment.” Alan had in fairness always been on my side, but I was unwilling to take on one more disturbing bit of self-knowledge.

Gladys was unable to come to the hospital. We’d been through this before — it was clear that she understood death was near, and her ranch was the place she intended to meet it. We’d had a couple of years of close calls, but each year’s calf crop reinvigorated her. Nevertheless, I’d had to make several diving catches to keep her on the planet a bit longer. Her neighbors, me included, branded for her, and as she looked out on the massed pairs in the drifting smoke, the horsemen moving slowly among them with the loops of rope pinned under their elbows, she always seemed to find enough life for another season. But today when I talked to Dale, I got the impression that this was it. “I doubt you’ll get here in time, Doc.” I started to put together a kit, but in the end just brought the electronic stethoscope. It was amplified and I could hear a pin drop anywhere in the body. I really trusted it to hunt down the faintest murmur, and auscultation was my personal juju: heart, lungs, intestines — just let me listen! Those turds at this morning’s meeting couldn’t hear a diesel backfire through their stethoscopes. I seemed to know that I was bringing it along for the moment when I heard nothing. You name it, Gladys had it. As to the clinical information, the on-site stuff I had just gotten from Dale: Gladys was a goner. In the long run, and without unwarranted credulity, you need an eyewitness. Dale had been studying Gladys for a quarter century and Dale thought she was about out of here.

Gary Haack caught me just as I left the building. I had farmed out all my afternoon patients and was ready to go. I was tired of his hyper little performance already, but it looked like I was in for more as he bounced around in his high-tops. “What’s this you’ve left me with? A twenty-five-year-old anorexic potter?” Sherry was not an easy case. I was glad he stopped me.

“Talk to her, Gary. I don’t know what to do with her. She needs counseling, really inpatient would be best. She thinks she has a tapeworm.”

“And you want me to talk to her about her tapeworm?”

“Yeah, talk her out of it. Get her some help. You’d be a new voice.”

“Here’s the only thing I know to do for tapeworms: You bring a candy apple every day for three days and shove it up the patient’s backside. On the fourth day you bring a hammer and no candy apple. When the tapeworm comes out of the patient’s behind and hollers, ‘Where’s my candy apple!’ you hit him over the head with the hammer. That’s the only cure I’m aware of.” I stared at him.

“Gary, the tapeworm is imaginary. If you start believing in the tapeworm, we can’t help this girl.”

I departed before Haack could object, leaving him, I hoped, with the impression that I thought he was as deluded as the patient. In any case, he’d have plenty on his hands: Sherry claimed to know all she needed to know about her body. When I told her she should get a little counseling about the tapeworm, to which I thereby lent inescapable credence, she snarled that she wasn’t about to walk into that trap. She placed one hand on her throat and the other on her buttocks to indicate the home of the parasite, and said, “He’s there. It has to be dealt with.” Since Sherry was an utterly beautiful young woman, I was sure plenty of people had bought into the worm.

Anyway, off to see dying Gladys at last, I took the road northeast over Tin Can Hill, off toward all those coarse and evocative features, “Dead Man,” “Hangman,” “Lone Indian,” “Sourdough,” gulches, draws, benches, coulees in a rangeland that on first look seemed tortured and on second, vigorous, confronting sky and grass and threadbare human occupation. Here, Gladys Bokma, child of settlers who cooked over buffalo dung, stood it all off in the little kingdom she called White Bird, which she herself had named in childhood, generating a persistent mystery to everyone, including her late husband, Wiley, who with a nicotine-stained hand always waved away the White Bird question and said it was something “she don’t share.” But inside the ranch gate, a hanging sign said “White Bird,” and I of all people who wished to be a crow had no intention of asking her about it.

The road to the house followed a dashing creek, and the sun shone down through the streamside brush, igniting parts of the running water and small pools where clouds of gnats danced in the shadows. Just shy of the ranch yard, the stream had hollowed a sandstone face into a tall, deep shell, its roof layered with the nests of cliff swallows.

Dale waited for me in the stand of windblown hollyhocks that surrounded the doorway. A straw hat shaded his gaunt face and concealed his ever shifty eyes. I could note that he still wore Wiley’s shirts, as they were a good deal too big for him. A sprinkler made its weak attempt to keep twenty square feet of lawn green, but it was in a bad fight with the west wind. Dale had started here so long ago, an incongruous figure in a ducktail haircut, Lucky Strikes rolled in the sleeve of his T-shirt and a hot-rod Ford coupe. He wasn’t worth a shit then and he’d gone downhill ever since, but Gladys liked him. He had grown children in town with various mothers from the hot-rod Ford days. Right up there with White Bird as a mystery was the fact that Gladys and Wiley had never run Dale off. They acknowledged that he didn’t do much but answered all queries with, “Where would he go?” He’d try at the brandings, all right, but he always got knocked down and Gladys would have to make him a poultice of some hallowed if useless sort. When I thought about Dale post-Gladys, I foresaw my ending up with him in some way. I kind of hated that.

Dale had a resonant baritone that over the years had more than once forestalled discovery of his shiftless nature. No one hearing that deep timbre say, “We’ve got a day’s work ahead of us!” would ever suspect that Dale had no intention of doing much of it. My mother was taken with his voice too and made him sing in the choir at her crazy church. She had him all dressed up and booming out of the loft before Wiley demanded he give it up. It broke Dale’s heart to be back on the manure spreader Sunday mornings. Strangely enough, his deep voice and sauntering gait encouraged Wiley to believe that Dale’s problem was that people undervalued him; so Wiley stole him away from a neighboring rancher named Grey Gaitskill. Many’s the time I saw Gaitskill beat the dust out of the back of Wiley coat, shouting, “He’s yours, Wiley! Not ’til death do you part!”

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