Abraham Verghese - Cutting for Stone

“B. C. Gandhinesan,” he said sticking out his hand.

“Marion Stone.”

“Excellent! Call me B.C. or Gandhi,” he said squeezing my hand. “Or call me Captain. Do you—?”

“Wicketkeeper,” Pomeranz said, triumphantly. “And opening batsman.”

B. C. Gandhi struck his forehead and staggered back. “God is great! Wonderful! Can you keep wickets for a pace bowler? A genuine fast bowler?”

“That's the kind I like best,” I said.

“Smashing! I'm a fourth-year resident. Chief Resident–to–be next year. Deepak is our Chief Resident. I'm also captain of Our Lady's First Eleven. Winners of the interhospital trophy for two years. Until those chutyas from a residency program I shall not name brought in a batsman from Hyderabad last year. Test-level player. I lost big money on that. It took me all year to get out of debt.”

“Jerks,” Louis said, his face dark, referring I think to the other program. “They should have forfeited that last game.”

“Turned out their star's a batsman all right, but not really a doctor,” B.C. said. “The bugger was a photocopy expert. But on paper, by the statutes of New York, he was a doctor when we played, Lou. So we don't get our money back.”

“Cocksuckers,” Lou said. “They killed us.”

“This year we have our own secret weapon,” B.C. said to me, a consoling arm around Lou. “I personally flew to Trinidad with one of our Old Boys to recruit him. You'll meet him soon. Nestor. Tall, strong fellow. Six foot four. Fast bowler, new-ball bowler, seam bowler, body-line bowler. But none of us can keep wickets for him—ferocious pace. Now, with you, we will kill those chutyas, and the trophy will be ours. Go get some rest, Marion. We shall see you at batting practice in twenty-four hours.”

PATIENT IS UNDER. What are we waiting for? Who is doing the case?” Dr. Ronaldo asked.

“I am,” I said.

Ronaldo spun a dial on the anesthesia cart, as if this news mandated a change in the gas mixture.

“Deepak is supervising me,” I offered, but Ronaldo ignored this.

Sister Ruth, the scrub nurse, unfolding her tray, shook her head. “I'm afraid not. Popsy just called. He wants to operate. Marion, you'd better come over to this side.”

“Popsy! God help us,” Dr. Ronaldo said, slapping his palm to his cheek. “Take the clock down. Call my wife, tell her I'll be late for dinner.”

I picked up the scent of Brut and then Winston tobacco, and seconds later B. C. Gandhi was at my shoulder. He must have had a last drag in the locker room.

“I know. I heard,” he said before I could say anything. “I'm doing that gallbladder in the next room. Listen, Marion. In case Deepak doesn't get here before Popsy, your job is to contaminate the old man as soon as he picks up the scalpel.”

“What? How?”

“I don't know. Scratch your butt and touch his glove. You're a smart bugger. You'll think of something. Just don't let him get past skin, okay?” Gandhi walked off.

“Is he serious?” I asked.

Ronaldo said, “Gandhi is never serious. But he is right. Contami nate him.”

I turned to Sister Ruth, hoping she could help.

“Pray for the intercession of Our Lady,” she said. “And contami nate him.”

IT WAS THE TWELFTH WEEK of my surgery internship at Our Lady of Perpetual Succour.

Little did I know that the thirty-minute drive from the airport to the Bronx would be the only glimpse of America I would have for three months.

After just a week in the hospital, I felt Id left America for another country. My world was a land of fluorescent lights where day and night were the same, and where more than half the citizens spoke Spanish. When they spoke English it wasn't what I expected in the land of George Washington and Abraham Lincoln. The bloodlines from the Mayflower hadn't trickled down to this zip code.

Three months at Our Lady of Perpetual Succour had gone by at lightning speed. We were severely shorthanded, compared with the norm in other American hospitals, but I didn't know the norm. At Missing, there were only four or five doctors at the best of times; here we had three times that number of physicians in surgery alone. But at Our Lady of Perpetual Succour, we saw more patients. We kept so many complicated trauma patients alive on ventilators in the ICU, generated so many lab tests and so much paperwork, that the experience was completely different from Missing, where Ghosh or Hema rarely made more than a cryptic entry in the chart, leaving the rest to the nurses. I learned those quiet, long American cars, those floating living rooms on wheels, caused monstrous injuries when they crashed. The ambulance crews brought the victims to us before the tires on the wreck stopped spinning. They salvaged people we'd never see in Missing, because no one would have tried to bring them to a hospital. Judging someone to be beyond help never crossed the minds of police, firemen, or doctors here.

AT OUR LADY, we pulled every-other-night call. I had no time to be homesick. My typical day started in the early morning, when I made rounds with my team leader, B. C. Gandhi. Then my team and the other surgical teams came together to make formal rounds with Deepak Jesudass, the Chief Resident, at 6:30 a.m. On operating days, which were Tuesdays and Fridays, we interns manned the wards and the emergency room. We worked till early evening. Then if I was on call, I simply worked on through the night admitting patients from the emergency room while caring for my existing patients and those of the interns who were not on call. Our chances to assist or even to operate as interns came when we were on call. It was rare to get any sleep on call nights. I didn't even try. The next day we kept going till the late afternoon, when I was finally off. For my off night all I could do was fall on the bed in my quarters and sink into a deep sleep. The next morning, the cycle started again. My senior resident, B. C. Gandhi, asked me late one night when we were both punch-drunk from lack of sleep, “Do you know the disadvantage of every-other-night call?” It was an imponderable question. I shook my head. He smiled and said, “You miss half the interesting patients.”

The schedule was brutal, dehumanizing, exhausting.

I loved it.

At midnight, when the corridors became deserted, there were places in the hospital where the lights dimmed and where I could see traces of Our Lady of Perpetual Succour's past glory; it showed in the gold filigree work above the archways, in the high ceilings of the old maternity wing, in the marble floor of the administrative foyer, and the stained-wood cupola of the chapel. Once the pride of a rich Catholic community, and then a middle-class Jewish community Our Lady of Perpetual Succour went the way of the neighborhood: it became poor in catering to the poor. B. C. Gandhi explained it to me: “The poorest in America are the sickest. Poor people can't afford preventive care or insurance. The poor don't see doctors. They show up at our doorstep when things are advanced.”

“Who pays for all this, then?” I asked.

“The government pays with Medicaid and Medicare, from your taxes.”

“How come we can afford a helicopter and a helipad if we're so poor?” The bull's-eye atop the newer four-story part of Our Lady, with the blue flashing perimeter lights and the shiny helicopter that came and went, seemed incongruous for our setting.

“Salah, you don't know about our claim to fame? Our number one industry? Sometimes I forget you just got off the boat. Man, that helipad was paid for by hospitals that are the opposite of ours. The helicopter is really theirs, not ours. Rich hospitals. Taking care of the wealthy, the insured. Even if some of them take care of the poor, they have a big university or a university private practice to underwrite their costs. That kind of ‘taking care of the poor’ is noble.”