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Authors: Samuel Shem

BOOK: House of God
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‘How do you know that much about me?' I called after them as they were disappearing through the automatic doors, thinking that only the computer that matched me for my ternship knew that I'd listed the MBH ahead of the House of God, and had gotten turned down there. The computer matching was renowned for its secrecy. ‘How come you're so sure?'
Gently, wafting back through the whoosh of the closing doors and settling on an imaginary hook in the air as gracefully as a magician's silk scarf, came their reply:
‘Would we be policemen if we were not?'
12
Santas were everywhere, punctuating the real world of welfare and mugging with commas of fantasy and remembrance. There was a Salvation Army Santa, a militant clanging his bell in front of the mandatory tubercular trombonist; there was a rich Rubensian pasha of a Santa in a chauffeured Caddy at rush hour; there was even a Santa, a schizoid-looking Santa but a Santa nonetheless, riding a chilly elephant through the park. And of course there was a Santa in the House of God, spritzing joy amidst the horror and the pain.
The best Santa was the Fat Man. To his gaggle of outpatients in his Clinic, he was a Fat Messiah. Given his brusque manner and raucous laugh, it was a surprise to me to find out how much his patients loved him. One afternoon before Christmas, I was walking with him to our Clinics.
‘Sure they love me,' said Fats, ‘doesn't everyone? All my life—except for the ones who were jealous—everyone has always loved me. You know the kid in the center of the kids on the playground? The kid whose house the others come over to? Fats in Flatbush, always. So now it's kids we call “patients.” Same thing. They all love me. It's great!'
‘As crass and as cynical as you are?'
‘Who said? And so what?'
‘So why do they love you?'
‘That's why: I'm straight with 'em and I make 'em laugh at themselves. Instead of the Leggo's grim self-righteousness or Putzel's whimpering hand-holding that makes them feel like they're about to die, I make them feel like they're still part of life, part of some grand nutty scheme instead of alone with their diseases, which, most of the time and especially in the Clinic, don't hardly exist at all. With me, they feel they're still part of the human race.'
‘But what about your sarcasm?'
‘So who isn't sarcastic? Docs are no different from anyone else, they just pretend they're different, to feel big. Jesus, I'm worried about this research project, though—you know my trouble?'
‘No, what?'
‘Conscience. Would you believe it? Even ripping off the federal government at the VA Hospital makes me shiver. It's loony. I'm only making forty percent of what I could. It's awful.'
‘Too bad,' I said, and then, as we approached the Clinic, I felt that sinking feeling of having to deal with these husbandless hypertensive LOLs in NAD with their asinine demands for my care, and I groaned.
‘What's the matter?' asked Fats.
‘I don't know if I can stand trying to figure out what to do for these women in my Clinic.'
‘Do? You mean you try to do something?'
‘Sure, don't you?'
‘Hardly ever. I do my best nothing right in my Clinic. Wait—don't go in there yet,' he said, and pulled me aside, hiding behind the door. ‘See that crowd there?'
I did. There was a crowd of people in the waiting room, a mélange looking like a bar mitzvah at the United Nations.
‘My outpatients. I do nothing medical for them, and they love me. You know how much booze, hot merchandise, and food there's gonna be in that crowd as Hannukah and Christmas presents for me? And all because I don't do a goddamn medical thing.'
‘You're telling me again that the cure is worse than the disease?'
‘Nope. I'm telling you that the cure is the disease. The main source of illness in this world is the doctor's own illness: his compulsion to try to cure and his fraudulent belief that he can. It ain't easy to do nothing, now that society is telling everyone that the body is fundamentally flawed and about to self-destruct. People are afraid they're on the verge of death all the time, and that they'd better get their “routine physical” right away. Physicals! How much have you ever learned from a physical?'
‘Not too much,' I said, realizing that this was true.
‘Of course not. People expect perfect health. It's a brand-spanking-new Madison Avenue expectation. It's our job to tell them that imperfect health is and always has been perfect health, and that most of the things that go wrong with their bodies we can't do much about. So maybe we do make diagnoses; big deal. We hardly ever cure.'
‘I don't know about that.'
‘Whaddaya mean? Have you cured anyone yet? In six months?'
‘One remission.'
‘Terrific. We cure ourselves, and that's it. Well, let's go. You're gonna lose me in that crowd, Basch, so MEEERYY CHRISTMAS and always watch out for where you stick your finger next.'
Puzzled once again and feeling that he'd shaken my brain like he usually did and that he was probably right, I stood there for a moment and watched him approach his crowd. When they saw Fats, they shrieked with delight and engulfed him. Many of them had been coming to him every week for a year and a half, and almost all of them knew each other. They were one big happy family, with this fat doctor as its head. Smiles were smiled, presents were presented, and Fats sat down in the middle of the waiting room and enjoyed himself. Occasionally he'd take a kiddie on his knee and ask what he wanted for Christmas. I was touched. Here was what medicine could be: human to human. Like all our battered dreams. Sadly I went into my office, a kid not invited to play at the Fat Man's house.
And yet, having been primed by the Fat Man, I was surprised to find my Clinic being fun. Relieved to think that my compulsion to try to cure was the only real disease in my patients, I sat back and let them, as people, bring me into their lives. What a difference! My basketball-playing arthritic black woman, when I ignored her aching knees and asked about her kids, opened up, chatted happily, and brought her kids in to meet me. When she left, for the first time she forgot to leave a Jehovah's Witness pamphlet. Many of my other patients brought me gifts: my LOL in NAD with the taped-up eyelids brought me her niece, a knockout
sabra
with a tanned face and shoulders like a fullback and a smile as enticing as a Jaffa orange; my artificial breast brought a bottle of whiskey, and my Portuguese artificial foot brought me a bottle of wine. These gifts were for ‘helping' them. The only way I'd helped them was by not TURFING them elsewhere. That was it: with the delivery of medical care this swiftly revolving door, with every doc on the planet frantic to BUFF and TURF elsewhere, these people had gotten expert at finding a static center and hanging on. They could spot a Fat Man a mile away. These people didn't give a damn about their diseases or ‘cures'; what they wanted was what anyone wanted: the hand in their hand, the sense that their doctor could care.
I did. I brought my patients to the Fat Man's affair.
In the E.W. as well, the jolt of feeling human refused to fizzle. I felt good, proud of my skills, excited. I didn't resent going to work, and outside the House, I could bear to think about inside the House. Sitting in the E.W. was like sitting on a bench in the Louvre: a human tapestry, ever unraveling under my eyes. Like Paris, the E.W. was a place unlimited in time: I'd leave it, and it would go on without me until I returned. An immense, humbling eternity of disease. With the luxury of the TURF, I began to live the fantasy ‘doctor' of my father's letters, competent to handle whatever unraveled at the end of the ambulance ride and came at me through those doors.
One Saturday afternoon before Christmas, in the lull before the Saturday-night storm, Gath and I sat at the nursing station. Crazy Abe had disappeared for two nights, and everyone was a little discouraged about his absence. The nurses were snappier, and even Flash, the orderly, used old parts of his brain, in irritation. Heavy wet snow had fallen, and I'd already treated the first of several expected myocardial infarctions, as the middle-aged out-of-shape suburban fathers shoveled their driveways clear. I told Gath that he looked kind of down, and he said, ‘Yeah, I am. It's Elihu—he don't know his ass from his elbow, so I'm supervisin' all his work. Suturin'. A man of my skills, suturin'. But if I let Elihu loose, it'd be a slaughterhouse down here. It'd be like when we had the old Chief of Surgery, Frannie. You know what they said about him?'
‘What?'
‘Killed mo' Jews than Hitler. Ah we're not gettin' the big stuff in heah anymo'. No gunshots, accidents, it's all belly pain, suturin', and twats. Makes me sick.'
The nurse handed us each a clipboard. Gath glanced down, and wearily covering his eyes with his hand, said, ‘You know what's on heah, boy? A twat. A sick twat. I may be a racist ‘Bama cracker, but for Chrissakes, Lord, give me some big stuff for a change. All this sick twat is ruinin' this po' boy's sex life.'
On my own clipboard was a thirty-three-year-old white toothpick brought in from the streets outside the public library where he'd gone to use the toilet. Zalman was six-four and weighed in at eighty-two. Looking concentration-campish, he was all buttock, rib, and jaw, too listless to do anything but talk: he didn't want to eat meat because animal souls transmigrated like humans, he was an unemployed philosopher, the world was full of incompetence, his typical dinner was a single seedless grape. Fascinating. TURF to psychiatry. My call to the psych resident was interrupted by my second snow-shoveling MI, about to die. Gath and Elihu and I trundled him back to life.
During the time it had taken to save the snow shoveler, the clipboards had piled up. The first nonswimmers, caught in the incoming Saturday night tide. As I picked up some charts and headed back into the rooms, I was stopped by a balding guy my age, dressed in jeans and a black turtleneck.
‘Dr. Basch, I'm Jeff Cohen, psych resident. I've just said hello to your anorexic, Zalman.'
‘Glad to meet you. The policemen have told me a lot about you. Yeah, Zalman—he's incredible. He needs your services.'
‘Tell me about him,' Cohen said, sitting down, interested.
‘I don't have time right now,' I said.
‘OK, later. We want him, but not yet. We don't touch patients until they're cleared medically. We never touch patients physically.'
‘You don't? Never? You never touch bodies?'
‘You're surprised. No physical contact—it inflames the transference. Well, I see you're hassled, and I'm on my way upstairs to do some reading. Let's talk about him later, if you've got the time. Male anorexics are rare, and fascinating. Just page me, OK? See you later.'
I watched him go. He was different: he listened. In the House of God, like in other Jewish houses, when someone talked, no one listened. I got the feeling Cohen had been interested in what I had to say. Like the Fat Man, but without the Fat Man's cynicism. And he was interested in his patients! I could see that: Zalman's bones were nowhere near as interesting as his story. Even I had listened, enthralled. And Cohen had time to read while on call? Far-fucking-out.
I reentered the revving-up Saturday night. A young woman was brought in from a party, over her boyfriend's shoulder, not breathing, turning blue. In a twinkling—PRESTO—Gath and I metamorphosized her from a Dead on Arrival overdose to a puking hysterical underdose, TURFED to Jeff Cohen. As I attended a Santa with acid indigestion, I saw Gath coaxing a young man farther inside the doors. The young man stopped and stood there, peering at us suspiciously from under a pair of pink silk women's panties he was wearing on his head. Cohen reappeared and tried to talk with him, but gave up, and when I asked him what was going on, he said, ‘Paranoid homosexual panic: stay away from him. Tincture of time. We wait.' Cohen started in on a ‘Jesus Christ' and I went to see a ‘Son of Charlie Chaplin' who had intractable headache and demanded codeine and whom I TURFED back out to the street. I began to realize how many of these people needed Cohen more than they needed me. During a break, as I watched Elihu using what he called ‘the standard method' of awakening a Pantagruelian drunk Norwegian—shoving ice cubes against his balls—the nurse said there was a man I'd better see right away, his blood pressure being ‘patent pending over 150.'
‘Patent pending over 150? What the hell's that?'
‘At the top of the scale where the mercury ends, the machine says “patent pending.” The highest it goes.'
A new House record. The Norwegian awoke from his stupor, screamed YOU BASTARD YOU KISS MY ROYAL NORWEGIAN ASS, and began to chase Elihu around the nursing station. Gath and I hoped he would catch him. I went and saw the man with the patent-pending blood pressure. He was a fat black guy with a nervous look iii his eyes, swollen ankles, wet lungs, and a terrible headache. He let me put in an IV and when I informed him that at any moment his brain-stem arteries could explode, he agreed to come into the House. He then ripped out my IV, and spurting blood, said that first he had to ‘take care of some business' involving a silver Cadillac and two women, and ambled out. Claiming the House record for the highest blood pressure TURFED to the street did not harm my reputation as a WALL.
Toward eleven, something marvelous happened: a run of erotica. One of the few true pleasures of doctoring, when, with the excuse of a medical degree I could move past the fantasy of mentally undressing sexy women, and really do it. I started with a Persian princess and ended with a lonely oral collegian who, unable to choose between her father and her boyfriend, had suddenly developed difficulty swallowing, which obtained for hear on this lonely Saturday night one young Jewish doctor, making bona fide medico-erotic contact with her mouth tongue tonsillar pillars naso-oro-pharynx neck throat clavicle rib cage breast even nipple, why not?

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