Richard Powers - Operation Wandering Soul

But Dr. Thomas is up and long since in the trenches. The ER looks like the war zone it is. A chaos of attendings — Milstein, Garber, even Flores — a couple anesthesiologists, scrub nurses running in and out, and Kraft's man himself standing frighteningly composed with his hands horribly enlarged on the TV monitors, poking about in somebody's lumbar, bouncing around flecks of metal confetti like slap shots at the puck in that little boys' table hockey. Kraft rescrubs and checks out the scene.

Plummer greets him, grinning, Cheshire. Always the last anatomical bit to disappear. "See those cops up in the observation gallery? They're waiting to charge this guy with the sexual battery of a woman. I'd like to be charged with the sexual battery of a woman. How 'bout yourself, Dr. Krafty? Say, uh, as long as you're scrubbed and not doing anything to justify your existence …"

Kraft stands dumbly, makes him spell it out. "Would you mind bailing for a bit, buddy? Here; just hold this thread. It'll only take a minute."

Less than a month of seniority at this outfit, and he's already garnered a reputation. Not just a reputation, which might have been damage-controllable. Kraft's saddled with several. Interesting how a person's public persona varies so insanely from service to service. Whole behavioral morphologies erupt from first impressions and a gentle audience nudge. He finds it too tough to disabuse people of their pet projections. Infinitely flexible, Kraft is. That is, cowardly by another name. Comes from having grown up all over the globe. No matter; for half a year, he can sustain any personality anyone might type him with.

Something about him must emanate this Mr. Potato Head plasticity. Chief of Surgery Burgess, dying a slow, half-century death in this city where reading span is sorely stretched by the instructions on microwave popcorn, instantly imagines that in Kraft he has found a kindred literate spirit, a simile son. Dr. Purgative, as Plummer rechristens him, keeps farming out these convoluted, epistemological novels by Kraft's obscure, young contemporaries. Plow through and report on, over sherry this afternoon, a postmodernist mystery thicker than the Index Medicus where the butler kills the author and kidnaps the narration. Damn thing includes its own explanatory Cliffs Notes halfway through, although the gloss is even more opaque than the story. What the hell; it's a break from booking for the next wave of board exams.

At the same time, Dr. Milstein, pediatric attending, has been led by Kraft's enthusiastic head-bobs to believe that the new floater resident is a great sailing buff. The man running-bowlines Kraft outside the cafeteria, presses him for a date when they can head out to the islands on Milstein's thirty-seven-footer. Kraft falls back on the ingenious perfect put-off: "I've got call all week." That gives him time to get out to the nearest Books-'n'-Stuff to secure a how-to manual. Between Purgative and the Millstone, it's quite the contretemps keeping Madeira straight from port straight from starboard.

Of the remaining permanent staff, Drs. Kean and Brache — Father Kino and Miss Peach — seem to want him for a whipping boy, a willful child in need of restraint. When we were residents, they used to stick us with hatpins until we suppurated. Loved every minute of it. Made us the exemplary physicians you see before you. Spare the rod and spoil the ortho. Well, no, we don't really need you to do seventy-two continuous hours of call. Oh, so you can't do three T-and-A's, a small bowel, an appendix, and a gallbladder in one day? Of course, if you want to go into family practice, we can always write some nice letters of rec for you. With these folks, Kraft grins a lot and asks for second helpings of everything they dish out.

And the pede nurses: the sweet cheats somehow conclude, based perhaps on Kraft's baby-face, beardless, brown-eyed prettiness, that he is totally depraved. Whatever the objective truth in that, he cannot match their own aptitude on this score. He skirts past their station on rounds; one of them says into the phone, "Wait a minute. He's just passing. I'll put him on." She hands him the receiver and hello, hello?

It takes a minute to realize that they've connected him to Dial-a-beat-off, and there's this growling feminine monstrosity on the other end beseeching him with weird invocations to zipper her skin. Another ward nurse locks him in the supply closet with her, makes him watch as she downs massive doses of cold medicine, then demands to be wrapped in seventy-five yards of surgical gauze. "Come on. Like I've been dead a hundred thousand years and you just happened across me in some pyramid?"

To Tommy Plummer, whom Kraft worked with at Kaiser across town, he is a conspiratorial, blasé fellow-sufferer. Your patient, Doctor. Survival requires, as they gather for Morbidity and Mortality, that the knot of his fellow residents, all fast approaching Jesus Christ's age at crucifixion and still in school, hover together by the coffee machine (vicious substance; inotropic agent and elevator of them gastric juices), compare massacre stories and crack bad-taste jokes about the jelly bismarks offered up for public sacrifice. Ritual fortification for the coming ordeal, when they must one by one stand up in front of the assembled surgery staff and announce: forty-two admissions, thirty-three discharges, five complications, one serious. One fatality. And say why they lost that case.

Kraft takes the spotlight, begins the lowdown on a chart that, by the slimmest of roulette-spun grace, stayed on this side of the pale, kept him from having to announce a fatality for his service this week. No blame to itemize; an instructive combination of anomalies, really. Nobody could have anticipated, before opening the kid, that we'd find…

Father Kino, the meeting's weekly host, cuts him off. "What ever made you think you could do elective surgery on a child with a potassium level that low?"

Well, how low is low? Isn't that context dependent? I mean, are there guidelines at this hospital for suitable…?

"No one cuts unless K-level is normal. That's N-O-R—"

Yes, but I wouldn't have thought…

"You didn't think. That's the problem. Consequently, you very nearly killed this boy. As it is, do you know what you've condemned him to for the next sixty years?"

The monotone recital of probable complications drowns out the slighted protestant in Kraft, the voice in the wilderness screaming, You slimy self-righteous son of a bitch. April 23. Robinson, fifty-one-year-old black male. Guy comes in with kidney stones and goes out on a platter. Your patient, Dr. Kean. Kraft ejects the internal heckler in him at the first impulse to shout. Letting himself feel anything, least of all legitimate rage, is self-destructively futile. They have all the emotions countered, covered. Say so little as I made a judgment call, and you're wiped all over the canvas.

Kean really gets into the whole TV-doctor shindig, baiting him, waiting for him to utter the first whimper of self-defense. When Kraft refuses to give in to anything but the bare minimum Hippocratic contrition, Father Kino issues a mock absolution that falls flat over the entire room: "Go and sin no more."

Plummer corners him afterward. "Nice show, Dr. Kraft. What ever possessed you…?" The rib incorporates a complex mix of sympathy and further abuse. What ever, indeed. Why put up with this horseshit harassment? Five years of eighty-hour weeks at half the salary of a bank loan officer, an aggravated sense of galloping inadequacy and a running ulcer, annihilated private life, dosed out on the varieties of punitive torture, all for the privilege of being publicly humiliated. Where did it take hold, that public-service conviction, the sense that he personally had to hold back the tide of human slaughter? Where did it come from, the terrified certainty that he'd end up squalid and starving to death in the gutter unless he amassed the thickest bulletproof moral bankroll known to man?