The View from the Vue (31 page)

I took Jack into the resident’s room. “Jack,” I asked gently. “What the hell are you going to do when you graduate from med school?”

Apparently Jack thought I was offering vocational counseling rather than a commentary with respect to my perception of his inadequacy. “I’m going to be a pediatrician,” he said. “I’m going to have my office in the same building where I grew up and still live.”

“With your mother and father,” I sighed.

Jack brightened. “Yes, that’s right,” he said. “How did you know?”

God, I was depressed. I could hear the old ladies, who had known him since he was a lad in knickers, burbling at him how nice it would be when he had his own office right there in the apartment building. I saw them patting him on the head. How proud his mother and father must be. How nauseated I was.

Well, a few years ago, our medical school alumni magazine had a squib to the effect that Dr. Jack A. Fields had opened his office for the practice of pediatrics at such-and-such an address in New York. Success was his.

Next to put me to the rack was Herman Morgan. Herman probably was the most enthusiastic person I’ve ever met. They must have given him the dose of self-confidence and verve that they had withheld from Jack Fields. But as is frequently the case, his outstanding characteristic was both his strong and his weak point.

Herman Morgan could and would do anything. Not only that, he’d invariably do it well. Even better, he was not cursed with that dreadful overconfidence that can lead to one’s trying something he really doesn’t have the know-how to carry off. In business, that’s great; if you fail, you fail. But in medicine, it’s the patient who pays the price of such foolhardiness, Herman always knew when to call for help, and it never troubled his ego any to do so.

Now to the debit side: I think that Herman’s problem may have only been apparent while he was doing obstetrics. His image is perpetually engraved on my cerebrum, leaning over a woman in labor, up to his armpit in her vagina.

Now I know full well that Herman Morgan really did not do pelvic examinations up to his armpit; that is an anatomic impossibility. But for three weeks I could be anywhere on the labor floor when I’d hear, “Larry! Hey—Larry, com’ere.” This would be accompanied by a female shriek of fire-engine proportions. My shoulders would sag and I’d drop what I was doing to go and disimpact Herman from a vagina.

The scene never varied. I’d run into the labor room. Herman would be there, his surgical cap at a jaunty angle, his freckled face bent into an enthusiastic grin, which was accentuated by his widened eyes. His right hand would be lost to view, rammed to the hilt in the birth canal, while the parturient in question was loudly and vigorously trying to wriggle free. The words never varied either, “Hi, Larry. I think she’s ready. Would you check me out?”

Herman impressed me as a reasonable man, so I tried to point out to him that his overly vigorous vaginal examinations were both unnecessary and painful. He never failed to be impressed by my descriptions, and would look properly crestfallen. Among his other virtues, Herman was a very kind person, and the last thing he ever intended to do was to hurt a patient. But he got so carried away at the prospect of an imminent delivery that he literally couldn’t let go.

After a few of these episodes I gave up. When the call would come resounding through the labor room, I’d just shrug and go to check out Herman. I learned rapidly that he was one of the very few beginning students who were never wrong about an imminent delivery. When he said she was ready, she was indeed ready. So he was a little rough, so what? What the hell, we’ve all got idiosyncrasies. Maybe it was better that I couldn’t cool his enthusiasm. I don’t know where Herman Morgan is or what he’s practicing, but I am certain he is doing it with vigah.

Immediately after the time I first disengaged Herman Morgan, I staggered out of the room in the direction of the water cooler. On the way I met a new student, a tall, thin serious-looking fellow with horn-rimmed glasses. “All right,” I snapped. “What do you do?”

He looked at me with an expression that seemed to say that maybe the dodo wasn’t dead after all. “What do you mean?” he asked quietly. “I’m one of the third-year medical students and I just got an admission, so I came to work her up. My name’s Louis Schwartz.”

“Hello, Louis,” I said. “I’m Larry Karp; I’m the resident. What I mean to ask you is what your specialty is.”

“I haven’t decided yet what I want to go into,” he answered.

“That’s not what I mean,” I said. “In the last night and a half, I have been tortured by a guy who does eye exams in the dark while ladies deliver on the stretchers. I have been set upon by a fellow who has a deathly fear of introducing his fingers into a birth canal, and now I have encountered a grown man who apparently harbors an insuppressible desire to return to the womb—even one that is already occupied and in which the traffic is moving in the opposite direction. Now I’ll ask you again—what is your particular function within this group?”

Louis Schwartz favored me with a smile that was simultaneously knowing and demoniacal. At last he understood.

“I’m the straight man,” he said.

The next three weeks proved him to be a man of his word. As the action in the three rings whirled around me, I knew I could always look for Louis. He could be counted on to provide a convenient reference point by which to measure reality. How this one normal individual ended up amid that incredible batch of zanies, I will never know, but I’ll be eternally grateful. I don’t know what specialty Louis finally chose, but if his year with that gang and his three weeks with me didn’t lead him into psychiatry, nothing did.

My encounter with Louis Schwartz reassured me to some extent, but I should have known better. My next recruit was Arturo Gaglione, a very big fellow with shining red cheeks, long wavy hair, and a pair of cheerful, sparkling eyes. Art came into the labor suite and took things over. He did an amazingly efficient job of working up his first patient and got her all set and ready in the labor room in short order. I checked him out and told him to give me a call should he need any help. He cheerfully assured me he would, turned to the patient, and boomed, “This’ll get rid of your pain, Mama,” zapped her in the arm with a dose of narcotic, and sat himself down at the bedside, his hand on her contracting uterus.

A while later I was finishing up in the delivery room with another student and his patient when a rich baritone voice sang out from the doorway, “Oh, Doc-tor Ka-a-a-rp, oh, Doc-tor Ka-a-a-rp.” There was Art standing in the doorway, a grin on his face. I began to wonder where the nearest supply of aspirin was kept. “Yes, Art,” I said weakly. “What’s up?”

Art threw out his chest and sang again, “Oh, Doc-tor Ka-a-rp! The baby has come, the baby has come, the baby has come. Lal-la la-la. Yes! Yes!” It sounded rather like a Gilbert and Sullivan production of
La Traviata
. Suddenly even aspirin would have done me no good. I ripped off my delivery gown and went charging past Art into the labor room where his patient had been.

She was lying quietly, cooing into the face of her newborn infant. When she noticed me, she smiled up and said, “You late. D’udda doaktore, he do alla job.” Then she smiled at Art Gaglione, who was standing behind me beaming. “He’s good doaktore,” added the patient. Art just beamed harder.

I restrained my urge to throttle him, primarily because I was certain that as good-natured as he was, under sufficient provocation he’d have been capable of neatly separating me into my component molecules. It turned out, though, that Art really had done a good piece of work. The lady’s labor had progressed much faster than he had expected—not an unreasonable thing in view of the fact that this had been his first obstetrical patient—and he suddenly had found himself face to face with the erstwhile fetus. Instead of panicking, fainting, or cutting loose with a screech, any one of which would have been considered
de rigueur
for brand-new students, Art calmly ascertained that I was not going to be of much help to him, so he grabbed hold of our labor room nurse, a former midwife from Jamaica whose delivery skills exceeded those of any resident on the service. Between them they completed the bedside delivery without incident. Only then did Art, flushed with triumph and pride, seek me out.

The reason for his unusual method of announcement, it further developed, was that Art was a raging opera nut. His knowledge of the field was extraordinary, and opera was usually the uppermost thing in his mind. He apparently considered it inappropriate that his moment of glory be celebrated with anything less than a full-fledged aria.

For the rest of the three weeks, I always knew when Arturo Gaglione had a patient in labor. Women labored and babies were born to the accompaniment of choice selections from Mozart, Verdi, Rossini, and Wagner. What the hell, I figured; they say it soothes savage beasts and makes cows give more milk.

The sixth member of the group I have saved for last, not because I met him last, but because all the other lunacies perpetrated by the members of this group paled beside the accomplishments of this one gentleman. Oscar Goldberg could never be encored. There were times when I wondered whether he could even be tolerated.

In retrospect, I think Oscar was simply bored and uninterested in obstetrics. At the time, however, I seriously questioned his sanity. He was a large, lumbering fellow whose shambling walk, thin, unruly hair, and large, protuberant eyes combined to scream DISORGANIZATION at an observer. To say that Oscar was somewhat disorganized would be like saying that Texans are a little boastful. Oscar could never seem to put it all together. One day he’d forget to check a patient’s blood pressure. I’d mention this to him, and he’d wholeheartedly agree it was not a good thing to forget. So the next time he’d check the blood pressure, but he’d forget to test the urine. The time after that, it would be the blood count that was missing. Or maybe the birth certificate. One thing I’ll say for Oscar, he never made the same mistake twice. But the range of his malfeasances was truly staggering.

His most irritating habit was his wandering. One night I responded to a shriek from a labor room to find a patient lying in the bed, surrounded by blood and amniotic fluid, with her newborn babe doing the Australian crawl between her thighs. After tending to her immediate needs, I went out in search of the culprit. Oscar was pacing slowly down the corridor, eyes up in the air, and hands clasped behind his back. I dragged him into the resident’s room for a conference.

He listened quietly to the riot act. “I’m sorry,” he said, when I finished. “I just got tired of sitting in there.”

I explained that should such be the case, he really ought to arrange for someone to take over temporarily for him. Eyes wide, he promised faithful adherence to the rules in the future.

The next night I looked out into the corridor, and there was Oscar again. I walked over and said hello to him. He glanced at me and said, “Oh, hi. I was just thinking.”

“Who’s with your patient?” I asked.

“No one,” he said. “I just felt like taking a little break.”

“Would you like it on the fifth or the sixth rib?” I asked.

He peered at me, totally puzzled. “Huh?”

“Forget it,” I said. “Look, Oscar, I thought we agreed that you wouldn’t leave your patients alone.”

“Well, it shouldn’t hurt to take a little break for just a minute.”

In our present state of enlightenment, we have learned that to force such issues is fruitless. When faced with latter-day Goldbergs, we try to fill their time on obstetrics with work they will enjoy. A psychiatry-bound student may spend his time interviewing unwed mothers to try to find reasons for contraceptive failures. A budding internist will be assigned to help in the care of those pregnant women with diabetes or heart disease.

However, since in Oscar’s day students were still invariably indentured in the labor suite for three weeks, I persevered. At least once nightly I would drag Oscar Goldberg back to his assigned bedside. It became sort of a game. After a while Oscar would see me coming, put his hands behind his head, march back into the labor room, and sit down for a while longer.

Oscar’s greatest deed was accomplished one ghastly night when we had in labor a patient with chicken pox pneumonia (who died), a patient with hepatitis (who almost died), and five or eight other women just having babies. About 2
A.M.
, Oscar’s patient foaled. Quickly reviewing the chart, I noticed that she was Rh negative. I drew a tube of blood from her and one from the baby so that the blood bank could test them to see whether she and her baby had incompatible blood types, in which case the baby might have needed a transfusion. I carefully handed the tubes to Oscar. “Take them to the blood bank,” I said. “Give them the tech there.”

“Sure, Larry,” he said.

“And for God’s sake, Oscar,” I added, “be sure to label which tube is which.”

He assured me he would do this, and I went back to see to some of the other patients.

About a half hour later, women were dropping babies right and left, and I was charging back and forth between delivery rooms, when the phone rang. The nurse answered it, and hollered, “Dr. Karp, come and see what this guy wants.”

“Jee-sus Christ!” I hollered, and tore over to the desk. Before I had finished saying hello, my eardrum was nearly ruptured by a bellow of “What in holy hell are you doin’ up there?”

Now, I was not easily taken aback by odd happenings at Bellevue Hospital, but I will admit that this threw me for a bit of a loss. I thought for an instant and decided to handle the matter with patience and diplomacy. “Who in holy hell are
you
, anyway?” I screamed into the mouthpiece.

It worked. I could hear the gulp at the other end. Then came a forced, controlled voice. “I am the blood bank technician,” it said. “And I want to know what is wrong with you crazy bastards up there.”

“Why don’t you just tell me what’s the matter,” I said. “I don’t know what you’re talking about.”

“These…these…these God damn tubes you sent for Rh testing,” he spluttered.