Richard Powers - Operation Wandering Soul

Carver General — Angel City Charity — shows him things that remain obscene rumor everywhere else. Obsolete, vanquished, nineteenth-century ailments. Consumption. Botulism. Infections that the texts consign to nostalgia. Paint poisonings. Bizarre, abdomen-filling parasites. He has cured a boy of deafness by surgically removing a raw chick-pea jammed up his ear. Six months of public work put him in touch with disruptions of body and spirit not even hinted at in the random distribution he has left on the city map outside this window.

If it yielded no other therapeutic insights, the rotation system would still have provided him with this indispensable view from above, a key to the patterns of disease traveling through the city, the wake it traces through the addresses it devastates. Each new hospital adds to his hands-on conviction: something is afoot just off the free-way. Something undreamed of by the stay-at-homes.

But these private educational benefits are not the real reason he is here. Pedagogical payoff is ultimately the cover for an elaborate cost-sharing scheme. Conscript labor is the only sustainable way to staff a freebie hospital on this scale, an institution otherwise manned exclusively by alcoholics, incompetents, and saints. Comes down to power broking, horse trading. Folks up in the Hills will send their boys down only if they can secure in exchange two pros from Hollywood Pres plus a minor-league internal leech to be named later.

The knots of this kickback scam are mere ripples in a network of mutual blackmail that dwarfs even the city itself. The convoluted auction of goods and services depends on a trillion simultaneous back-scratches all coming off at once. Angel's palaces have been built largely on free riders, illegal taps into Central Power, unmet overdrafts, slumlording, vapor profits, safety paper documents erased with dollops of acid, and timely bankruptcies declared on imaginary underwritings. But for now, and for the next few moments, the whole poker-deck superstructure stands successfully shackled together on gum, safety pins, and signed agreements.

Kraft rustles up the children he must examine, hook by crook. Rounds squared away, it behooves him now only to complete clinic without passing into unconsciousness or its many equivalents. The best way to further this end is to avoid peeking at the afternoon OR schedule until too late for either hysterics or hypothetical Clinic is a three-hour, walk-through Decameron carved up into fifteen-minute segments during which he must play talk-show host to the afflicted, humoring illness's endless invention.

An aggressively built Latin woman hauls in her seven-year-old girl by both fists. She insists that Kraft excise the child's kidneys right there in the office. He flips rapidly through a pocket bilingual translating dictionary that he keeps by him at all times, as indispensable a tool these days as the stethoscope, although he suspects it of frequently capricious translations. A few confused imperfect verbs later, it becomes clear that the kid is a front: the real problem is a softball-sized lump — the big, sixteen-inch, kapok variety — in the mother's pelvic region. Kraft hooks her up with the proper department and, over her departing protests, buzzes in the next guest.

Who is, today, a return from two weeks ago — Turkish kid to whose parents Kraft failed to make clear (no dictionary) that the dressing had to be cleaned. Fourteen days of festering fuses the gauze into a scab-plasted mess more serious than the tumor the cut corrected. Kraft rasps at the leaking, Technicolor wound, picking at the putrid bits while trying to leave flesh, a fresco restorer unable to cut the grime without sponging off half the disintegrating plaster.

Throughout, he exchanges varying flavors of Englishes with the family — verbal bourse signals both opaque and disastrous. Clinic consists of Kraft's finding fifteen-minute ingenious synonym lists for "Excuse me?" Even when language is no barrier, the visitors often have a hard time explaining just what they've gotten themselves into. Exactly why did you leave a rubber band tightly constricted around your little toe for three weeks? Just how did this burned kitchen match come to lodge itself so deeply up your nasal passage?

For grotesqueries, Kraft may be perpetually one-upped by Plum-mer, with his Tales from the Emergency Zone. There simply is no matching live rats in plastic bags inserted up rectums, or even the relatively more mainstream erotic strangulations that get out of hand. Thomas tells with great relish accounts such as that of the woman who was shipped in covered with blood, her throat transversely knifed open. Starting big-bore IVs to stabilize her, they cut her clothes off to discover male genitalia, which doubtless explained the knife wound. No, there is no topping ER for sheer dramatic thrust.

Still, on two scores, Kiddie Karpentry exerts theatrical superiority. First, it is fabulously small, a technological feat of miniaturization. Simply straightening out the gross anatomy of a two-foot-long infant almost requires loupes. And second, Pediatrics — the next generation, wave of the future, America's hope for, etc. — provides the quintessential, unexpurgated view of just where Western Civ's whole project is really headed in its third thousand years.

By clinic's third hour, the traffic of juvenile misery drifting through his office begins to mirror the freeway's aimless lane change. It's as if Kraft's still on his commute here, a ball of fluid sucked along by capillaries' secret adhesions. Clinical existence carries no forward motion at all, only small perturbations, place-swaps, disturbances out on the edge of the crumbling empire. He lives in an afternoon when the old meliorist fantasy gives way to bare maintenance, if that. By clinic's end, Kraft has entered a long, intercalary dark age that lasts until he finds himself swabbing both arms with brown, lathery disinfectant in preparation for surgery.

The factory load is light today, the team relaxed. Somebody's hooked up the optics monitor to receive cable, and everybody stands around watching an infomagazine about how certain notorious prime-time bouffant bitches are really lovely, caring people who like to lend their megafame at low rates to assist the Third World. The current duffer intern — perfect man to send out to fetch the figurative falafel — switches between this and a big-budget docudrama about the colossal fireball death of America's space voyagers. Nothing is real until it's been fictionalized.

Opening a three-year-old's chest puts a damper on the party. Something Geppetto-like to manipulating this puppet — paste, papier-mache, hanging strapped by its face to the anesthesia mask like a fish on a barb. Its purple-coral organelles pump in unconscious coordination, racing all together now for some impossible finish line they can never reach, as if the whole, heaving mechanism needs to get someplace particular by daylight.

Poking inside the cavity, Kraft's fingers move about the place with pride of ownership: All my beautiful anatomical overlays — who dared fuck this perfection up? Even when he recalls that he did not design these inextricable meshes, Kraft's hands go on insisting that only those who have looked on the internal works, who patiently isolate the pulsing parts, who even go so far as to reroute or replace them, only this select club of God's on-site warranty service can begin to see through the cast of fantasy figures inhabiting the upper reaches of human consciousness where everyone else lives out his life.

It's all true, what the general public dares not suspect: no one can live with full anatomical knowledge. The heat and pressure of apocalyptic repair jobs transacted in wholesale volume every day of existence inevitably autoclave the heart. After a few hours of call, he does begin to see these needy, shivering bodies strapped to the monitors as so many deli cuts. These days, the freeze sets in as early as the instant he arrives in the theater.