The house of God

16

"OK, Hooper, let's hear about the postmortem on Rose Budz. Let's hear what you with your one little needle shot have done."

Fats was flipping cards as we lay in the icy ventric of dead February as it lay in the corpse of the year. There was no question that Eddie and Hooper and I were on our knees and that they were breaking us. Most of the House hierarchies hated us. Gomer City was turning out to be the worst. Far from taking care of it, it was beginning to take care of us.

"The post on Rose Budz confirmed what we thought from when they sectioned the needle I used," said Hooper in a tone of contrition mixed with a certain professional satisfaction. "I got spleen, lung, stomp heart, and . . . and liver:" Hooper paused, watching the Fat Man drum his fingers on the desk, and went on, "In other words, Fats, all the organs " named the other day, plus a helping of liver and stomach as well. I think it's a new world record for most organs hit with a single needle shot."

"Liver? The liver's nowhere near where you went in."

I thought back to that day when Hyper Hoops presented his attempt to tap the Chest of Rose and had told us that "there had been a little bleeding." If a Californian isn't enthusiastic, it means a disaster has occurred, and Hooper meant that Rose was dying. He'd sent her to the MICU, and Fats, concerned and thinking malpractice, brought his Gomer City A Team to the MICU to see where the needle had gone in. The hole in Rose's chest was in the front, right over her heart. Fats had said, "Come on, Hooper, you didn't really put your needle in there, did you?" and Hooper had said, "Yup, that's what Roy's manual said, unless I had it upside down." Although Hooper had seemed a bit contrite when the Fat Man had said, "You never tap a chest from the front because things like the heart get in the way," Hooper had brightened right up and said, "It's OK, Fats, it's a great family for the post.

"I know there's usually no liver," said Hooper, "but it seems as how in this case there was an aberrant lobe."

"Messy TURF, Hooper, messy TURF," said Fats solemnly, slowly ripping Rose Budz to shreds. Again Hooper had managed to snatch defeat from the jaws of victory. Holding up another card, Fats called out, "Tina? Eddie?"

"Dead," said Eat My Dust.

"What?!" shouted Fats. "Tina too? How? Who killed her?"

"Not me," said Eddie, "all I did was get her to sign for dialysis. The Leggo's crack dialysis team did the rest."

Tina had died by being inadvertently murdered by a nurse in dialysis who'd mixed up the bottles. Instead of diluting Fast Tina's blood, the machine had concentrated it further, and all the water had been pulled out of Tina's body and her brain had shrunk and rattled around in her skull like a pea while the nurse sat and read Cosmopolitan. Tina's pea?brain had rattled and stretched until one of the arteries straining between her neck and thalamus burst and she had hemorrhaged to death.

"Sorry to say this, Hooper," said Eddie, "but since Tina was my patient, it's another postmortem for the kid."

"Stop!" said Fats. "Tina was the Leggo's patient. No Post."

"But the Leggo loves posts. He called them the flower?"

"Not when they prove malpractice!" said Fats in a tone that would hear no answer, all the while ripping Tina's cards to pieces. "Next? Jane Doe?"

"Hey, doin' great," said Hooper. "I coulda sworn that today she sat up and gave me a big hello?"

"Never mind," said Fats, irritated. "That woman's never given any intern a big hello and she's not gonna start with an intern like you, slobbering after her corpse. Any bowel activity yet?"

"Nope. No bowel sounds at all. Bowel might be dead. No nuthin' since you slipped her that 'extract' of yours last month."

"That stuff is dynamite," said Fats. "Keep running in the VA antibiotic, Hooper. We've got to turn her on again. Next."

We waded through all the rest and ended with the Lady of the Lice, and Fats asked Eat My Dust if he'd found the cancer or the allergy.

"Who knows?" said Eddie. "I'm OTC."

"OTC? What the hell's OTC?"

"Off The Case," said Eddie. "New concept."

"Stop it. Pull yourself together. You can't be OTC."

"Why not?"

"Because you're her doctor, that's why, get it?" said Fats, mopping his brow. "Jesus. Did you ever find the cancer or the allergy?"

"Nope," said Eddies BMS, "the only thing we found was the sperm. Her last three urinalyses have come back 'sperm.' "

"Sperm? SPERM? In a demented seventy?nine?year old gomere?"

"Sperm. We think it's from Sam Levin, your pervert with diabetes."

That morning, the Fish was taking us on a field trip. Hooper had gotten paged to see the Leggo, and while we waited for him, wondering whether the Leggo had paged Hooper to castigate him for killing poor Rose Budz or to congratulate him for obtaining Rose's tricky postmortem, Eddie and I continued to torment the Fish in our usual ways until, eyeing us suspiciously, he left to make final arrangements. When Hooper reappeared, the Fish loaded us into his station wagon for our field trip. On the way, he talked sincerely about Hooper killing Rose Budz: "You know, you can't possibly learn medicine without killing a few patients. Why, I myself have killed patients. Yes, every time I killed a patient, I learned a little something from it."

It was hard to believe that he was actually saying that, and I drifted off, imagining the Fish saying, "Killing patients is a special interest of mine. I have recently had the opportunity to review the world literature on killing patients. Why, it would make a very interesting research project . . ." and by the time I snapped out of it, we were in the office of the Pearl.

This was our second field trip: The Fish took us on field trips to get us out of the House, to minimize the damage we were doing to his Chief Residency year and his career. The first field trip had been a ghetto health center, where the Fish had seemed ill at ease. This was the opposite. The Pearl had risen up through the House Slurpers as easily as the Fish might have wished, and by this time had become the richest Private in the House, the city, perhaps the world. In his office all was automated and set to Muzak. The Muzak played Fiddler on the Roof. The place was jam?packed: LOLs in NAD getting their blood drawn humming in tune with SUNRISE SUNSET, waiting to move on around the corner where the tech and the LOL in NAD could hum TRADISHUNNNN as the EKG was done, and then, further along past the sign that said "This way to Annatevka," sure enough, there where the LOL in NAD had to give a urine sample wouldn't she be bathed in the rippling bittersweet strains of ANNATEVKA, the song about the Fiddler's lost home. Lastly, we and the LOLs in NAD got a personal guest appearance by the Pearl in his private office, where he sat perusing the computer?processed results of the tests. Muzak played IF I WERE A RICH MAN, and there, behind a dual flagholder in which were both Israel and the USA, sat Pearl, surrounded by original Chagalls and what looked like the original Hippocratic Oath. He was sweet and kind and generous and seemed like the best damn doc and he told us he was seeing an average of one hundred and nineteen LOLs in NAD per day. No gomers. On the ride back I calculated that the Pearl made my yearly intern's salary in two days. Turning to the Fat Mound next to me on the back seat, I said, "Fats, that was Money City."

"Of course. Even in the bowels of the nonstars, one can find the big fortoonas."

After the ten?o'clock meal I went to see Molly on floor six. She was mad at me for forgetting it was Valentine's Day and not getting her a gift. She yelled at me and I felt guilty because I did like her and I even found myself dreaming about her, which must have meant that I sort of loved her, and I really loved making love to her because she still moaned like a moist Mesopotamian every damn time. Theoretically I had just as much interest in her, and I still saw her as a short?skirted majorette from St. Mesopotamia High marching along throwing her tan kneecaps first at one curb and then at the other and masturbating the longest baton in the band between those far?flung thighs producing MIS in the senile Legionnaires lining the route, but I had been bombed on Gomer City and my sexual stride had been broken. I knew I'd been screwing her partly to affirm life, and the uneasy thought occurred to me, syllogistically, that since now I was not screwing her much, did that mean I'd ceased affirming life? I listened to her telling me I was getting dull and acting thirty, and I realized that in some ways I was, because it seemed like such an effort to go out in the razored wind and blasting cold to see her, despite my desire when I was with her and my jealousy that maybe some other guy was wearing gold cleats and getting the hot oil and myrrh all over him. I began to warm to her, and see her as sexy and loving right then and there, and I reached out and put both my hands under her boobs all tight?lifted and beruffied in her cute nursing costume and I flashed on her blond pubic hair in which I'd nuzzled and laid my head and I levered her to me and kissed her and remembered the round?the?town movements of her hips and lips and we began to get as excited as we used to get in bed. I began to ask myself where that part of me that was willing to make the effort had gone, and I began to scheme about sleeping with her that night, but she pulled away and asked me to do her a favor, to check out a patient having agonal respirations.

"Agonal respirations mean death. Is he supposed to die?"

"That's just it: I'm not sure. He's got end-stage multiple myeloma and renal failure and he's been in coma for weeks, but Dr. Putzel has never told the family and there's an argument about his dialysis continuing and about when he's supposed to die. It's all confused."

I went and saw him. It was too much. Young man, gray and dying, filling the room with his stale ammonium breath, His human centers of respiration were dead and phylogenetically he was breathing like a stranded fish. I went back to Molly and said, "He'll be dead in fifteen minutes. He's not in any pain?"

"No. The Runt's been giving him morphine all night."

"Good." Overcome with tenderness because she and I were young and not dying but one day would die, filled to our gills with morphine if we were lucky, I said, "Go draw his curtain, love, and come sit down with me and talk.

The House of God found it difficult to let some young terminal guy die without pain, in peace. Even though Putzel and the Runt had agreed to let the Man With Agonal Respirations die that night, his kidney consult, a House red?hot Slurper named Mickey who'd been a football star in college, came along, went to see the Agonal Man, roared back to us and paged the Runt STAT. Mickey was foaming at the mouth, mad as hell that his "case", was dying. I mentioned the end?stage bone cancer, and Mickey said, "Yeah, but we've got an eight?grand dialysis shunt in his arm and every three days the dialysis team gets all his blood numbers smack back into line perfect." Knowing there was going to be a mess, I left. The Runt came out of the elevator, fuming, and ran down the long corridor, his stethoscope swinging side to side like an elephant's trunk. I thought of the bones in multiple myeloma: eaten away by the cancer until they're as brittle as Rice Krispies. In a few minutes the Man With Agonal Respirations would have a cardiac arrest. If Mickey tried to pump his chest, his bones would crunch into little bitty bits. Not even Mickey, seduced into the Leggo's philosophy of doing everything always for every patient forever, would dare call a cardiac arrest.

Mickey called a cardiac arrest. From all over the House, terns and residents stormed into the room to save the Man With Agonal Respirations from a painless peaceful death. I entered the room and saw an even bigger mess than I'd imagined: Mickey was pumping up and down on the chest and you could hear the brittle bones snap, crackle, and pop under his meaty hands: a Hindu anesthesiologist pumped oxygen at the head of the bed, looking over the mess with a compassionate disdain, perhaps thinking back to the dead beggars littering dawn in Bombay; Molly was in tears, trying to follow orders, with the Runt shouting, "Stop! Don't resuscitate him!" and Mickey cracking and crunching and shouting, "Go all?out! Every three days his blood numbers are perfect!"

And yet the most sickening part of it was when Howard, pipe clenched like a bit between his teeth, ran into the room, with a nervous smile decided to take charge, and just like the tern in the How I Saved the World book, shouted out, "Gotta get a big line into this guy; STAT!" grabbed a homungus big needle, saw a pulsating vessel in the forearm, which happened to be the surgically constructed, meticulously protected shunt between artery and vein, which was Mickey's dialysis team's pride and joy, and, eyes glittering with big?time?intern excitement, Howie rammed the needle home, destroying forever Mickey's continued attainment of perfection every three days. When Mickey saw this, he stopped crunching, his eyes got fierce as a linebacker's, and he went bananas, screaming, "That's my shunt! You asshole, that's my shunt! Eight grand to make it, and you wrecked my shunt!" That was it for me, and I left, thinking to myself, Well, at least they'll end it here and not transfer the Man With Agonal Respirations And Crushed Bones to the MICU.

They transferred him to the MICU, where Chuck was the tern on call. When I went to see Chuck, I saw the family outside the MICU, weeping as Mickey explained things to them. Chuck was drenched in blood, bent over the residual mess of the Man With Agonal Respirations, who now had no respirations at all except those generated by a respirator. Chuck looked from the mess and said, "Hey, man, great case, eh?"

"How are you doing?"

"Pitiful. You know what Mickey said to me? Just keep him alive till tomorrow, for the family.' Sumthin' else."

"What the hell are we doing this for?"

"Money. Man, I want to be so rich! Black Fleetwood with gangster whitewalls and a funeral wreaff in the back winda."

We sat down in the staff room and nipped at Chuck's Jack Daniels. He leaned back in his chair and crooned his falsetto "There's a . . . moone out too-nahht . . " and as I listened, I thought how our friendship was becoming as wispy as Chuck's dream of being a singer. Chuck was having a terrible time adjusting to his new city, one reason being he couldn't figure out where the graft was. Stopped for speeding and using the standard Chicago practice of handing the cop his driver's license with a ten?dollar bill had gotten him a stern lecture about "bribing an officer of the law" and the maximum fine. Puzzled, displaced, he spent his time at home sleeping and eating and drinking and watching TV. His suffering showed in his waistline and his hangovers. I'd tried to talk with him about it, but he'd get that blank look on his face and say to me-to me! "Fine, fine." Each of us was becoming more isolated. The more we needed support, the more shallow were our friendships; the more we needed sincerity, the more ?sarcastic we became. It had become an unwritten law among the terns: don't tell what you feel, 'cause if you show a crack, you'll shatter. We imagined that our feelings could ruin us, like the great silent film stars had been ruined by sound.

The Runt came into the room, apologizing to Churk for TURFING the Man With Agonal Respirations, but Mickey stormed in and asked how the Man was.

"Oh, fine," said Chuck, "jes' fine."

"Right. He never should have gotten that morphine," said Mickey.

"He was terminal and in pain," said Runt, getting mad, "he?"

"Never mind. I'm leaving. Just keep him alive til morning."

"Till what time?" I asked nonchalantly.

"Till about eight-thirty, quarter to . . :' Mickey began, and then, realizing what a fool he looked, he stopped, cursed us, and left.

We sat, finishing the bottle, as the Runt drifted off into his thing, sex. Identifying him, isolating him from the trauma of the ternship and the hurt he felt inside, his sloshing around in genitalia at times got out of hand. At one point I'd found him on the phone, red in the face, screaming into the receiver: "No I haven't been home for a while and I'm not going to tell you where I've been staying. It's none of your business." Capping the phone, the Runt had grinned his hall?of-mirrors grin and said it was his parents, and went on, "How's my analysis going? I quit . . . June? I quit her too . . . I know she's nice, Mother, that's why I quit her. I got a nurse now, a hot one you should see her . . ." I'd promised myself that if the Runt started to tell his mother what Angel did with her mouth, I'd grab the phone and take over. "Goddamnit, Mother, stop it! . . . All right, you wanna know what she does? Well, you should see what she does with her"

"Hello, Dr. Runtsky?" I said, snatching the phone from the Runt. "This is your son's friend Roy Basch." Two doctors' voices said hello. "There's nothing to worry about, folks, Harold is doing just fine."

"He seems very angry at me," said Dr. Mrs. Runtsky.

"Yeah, well, it's just a little primary?process stuff," I said, thinking of Berry, "just a little regression. But what the hell, eh?"

"Yes," said the two analysts en chorale, "that must be it."

"I know this nurse, she's very nice. Don't worry. So long."

The Runt had been furious at me, saying, "I've been waiting to do that for ten years."

"You can't do that."

"Why not? They're my parents"

"That's why not, Runt, 'cause they're your parents."

"So?"

"So you can't go around telling your parents about some nurse sliding around on your face!" I'd screamed. "Christ Almighty, don't you use your higher cortical centers anymore at all?"

The Runt had become pure testosterone. Neither Chuck nor I wanted to hear the latest thunderous Harold Runtsky fuck, and so we started to leave. Before he left us, the Runt asked if we noticed anything different about him. "I'm not yellow," he said. "It's been over six months since I got stuck with the needle from the Yellow Man, and I'm not yellow. The incubation period's passed. I'm not going to die"

While it cheered me to think that Runt was not dying, except at the rate we all were dying, I thought' of Potts and what a terrible time he was having.

Yellow Man was still in coma, neither alive nor dead.

Potts had suffered one disappointment after another, the most recent being his having to handle his mother as she raged at his father's funeral. Last time I'd seen him, he'd said he was down, that he felt like he used to feel as a kid when his family closed up the Pawley' Island summerhouse for the winter, with his mother emptying his room of all the things he loved, and him looking back before leaving, at the bare floor, the sheet over his chair, his one?eyed doll propped up on the brass railings of his bed. Although he was contemptuous of the North, he was too polite to put his bitterness into words. He became more quiet. My questions, my invitations, seemed to echo in his empty rooms. He made it hard to be his friend.

Leaving Chuck in the MICU, I said, "Hey, you got a great voice. Not a good voice, Chuckie baby, a great, great voice:"

"I know it. Be cool, Roy, be cool."

It was hard to be cool in Gomer City that night. The usual horrendous things had gone wrong with gomers. At midnight I was hunched over a Rose Room Rose, slamming the bed with my fist and hissing, I HATE THIS I HATE THIS over and over again. But it was Harry the Horse who did me in. Humberto and I had planned carefully: assuring Harry he could stay, we planned that night to zonk him with Valium and the next morning drive him to the nursing home ourselves. We had told no one of this, not even Fats. Early in the morning I was awakened by the nurse saying that Harry was in a crazy cardiac rhythm having a chest pain and looking like he was dying and should she call a cardiac arrest? I yelled, awakening Humberto from the top bunk, shot to my feet, started to race out the door with Humberto following close behind, stopped suddenly so that Humberto slammed into me like a Keystone Kop, and said to him, "Stay here, amigo. At your stage of training you shouldn't see something like this." I raced to Harry's room, where he was saying HEY DOC WAIT and clutching his chest, and eye to eye with him I screamed, "Who told you, Harry? Who told you you were going back to the home?" Knowing that now he could stay in the House, Harry said:

"P . . . P?p?p . . . Putzel."

"Putzel? Putzel's not your doctor, Harry. Little Otto is your doctor. You mean Dr. Kreinberg, right?"

"No . . . P?p?p?p . . . . Putzel."

Putzel? And so Harry had succeeded in infarcting just enough more of his ventricle to stay in Gomer City for another six weeks, which was two weeks longer than me or Eddie or Fats or Hooper, and so he'd have fresh new terns and residents whom he could fool much more easily because they probably would inform him when he was about to be TURFED out and he could go into his infarcting rhythm with plenty of time to spare. I had lost. Harry the Horse had won.

On the way back to bed I passed the room with Saul the leukemic tailor. My tormenting him with my attempt, against his will, for a second remission had made him much worse. Comatose, by most legal criteria he was dead. He would not recover and yet I could keep him alive for a long time. I looked at the pale form. I listened as the pebbles of phlegm ebbed and flowed in his waves of breath. He could no longer beg me to finish him off. His wife, suffering and spending their retirement income, had become bitter, saying to me, "Enough is enough. When will you let him die?" I could finish him off. I was tempted. It was impossible to shut out. I hurried past his doorway. I tried to sleep, but the phantasmagorical night whirled on, and by dawn so many things had happened to shatter me that I found myself standing at the elevator door waiting for it to come down so I could go up to Gomer City for the day's cardflip, enraged, and about to blow.

The elevator wasn't moving. I waited and bashed on the button and still it wasn't moving. All of a sudden I went kind of nuts. I started banging on the elevator door, kicking the polished metal at the bottom, and hammering the polished metal at the top and screaming; COME ON DOWN, YOU BASTARD, COME ON DOWN. Part of me wondered what the hell I was doing, but still I kept banging and kicking and screaming like an acromegalic cretin in labor screaming her fetus COME ON DOWN, YOU BASTARD, COME ON DOWN!

Luckily, Eat My Dust Eddie came along and guide me to the cardflip. When I asked him if be though I'd gone off the deep end he said, "Deep end? Ha Roy, I think you were giving that elevator just what the fucker always deserved!"

That morning at the cardflip, thinking of how Putzel had putzeled my discharge of Harry the Horse, I decided to counterattack, to start a rumor. I asked Eddie if he'd heard the rumor about how some tern had threatened to assassinate Putzel, to put a bullet through his brain, and Eddie said, "Hey, high?powered medicine! Just what the fucker always deserved!"

"Why a bullet?" asked Hyper Hooper. "Wire his sigmoidoscope: when he presses the starter button, it explodes!"

"Listen to me, you guys," you've got to lay off Putzel. Kill this rumor right here and now."

"You worried about your fellowship?," I asked, taunting him.

"I'm worried about my A Team. If you keep doing what you are doing, you're not going to make it through. Believe me, I know. I was there."

"Go for the jugular," said Eat My Dust, as if he hadn't heard a word Fats had said, "go for the boobytrapped scope. Ka?boom." As he thought it over, Eddies eyes got big, and he licked his lips, and then he yelled, "KAA?BOOOMM!"

Two nights later, when I was on call again, Berry insisted on coming in. Concerned with what she called my "manic" behavior and my "borderline" descriptions of what the gomers were doing to me and I to them, she thought that seeing for herself might help. She also wanted to meet Fats. Humberto and I took her around Gomer City. She saw them all. At first she tried to talk with the gomers as she would human beings, but recognizing the futility, she soon became silent. After our last stop, the Rose Room, where I insisted she listen through my stethoscope to the asthmatic breathing of a Rose, she looked shell?shocked.

"Hey, a great case, that last Rose, eh?" I said sarcastically.

"It makes me sad," said Berry.

"Well, the ten?o'clock meal will cheer you right up."

At the ten?o'clock meal she watched as we interns played "The Gomer Game," where someone would call out an answer, like "Nineteen hundred and twelve," an answer given by a gomer, and the rest of us would try to come up with questions to the gomer that might have produced that answer, such as, "When was your last bowel movement?" or "How many times have you been admitted here?" or "How old are you?" or "What year is it?" or even "Who are you?" "Who am I?" and "Yippeee?"

"Sick," Berry said afterward in a somber, almost angry tone, "it's sick."

"I told you the gomers were awful."

"Not them, you. They make me sad, but the way you treat them, making fun of them, like they were animals, in sick. You guys are sick."

"Ah, you're just not used to it," I said.

"You think that if I were in your shoes I'd get that way too?"

"Yup."

"Maybe. Well, let's get it over with. Take me to your leader."

We found Fats on Gomer City doing a manual disimpaction of Max the Parkinsonian. Double?gloved and surgically masked to filter out the smell, Teddy and Fats were digging at the endless stream of feces in Max's megacolon, while from Max's huge purple-scarred bald head came an endless stream of FIX THE LUMP FIX THE LUMP FIX THE LUMP. From Teddy's radio poured Brahms. The smell was overpoweringly fresh shit.

"Fats," I said from the doorway, "meet Berry:"

"What?" asked Fats, surprised. "Oh, no. Hello Berry. Basch, you schlemiel, you don't want her to see this. Get out of here. I'll be with you in a minute."

"I'm here to see," said Berry, "tell me what you're doing."

She went in. Fats began to tell her what they were doing, but when the waves of smell hit her, Berry covered her mouth and rushed out of the room.

Fats turned on me angrily. "Basch, sometimes you act like a marine at `brain rest,' a retard. Teddy, finish up. I've got to talk to the poor woman saddled with young numbskull Basch."

When Berry came out of the Ladies', she looked like she'd been crying. Seeing Fats, she said, "How . . . how can you? It's disgusting."

"Yeah," said Fats, "it is. How can I? Well, Berry, when we get old and disgusting, who's gonna doctor us? Who's gonna care? Someone's got to do it. We can't just walk away." Looking sad, he said, "Seeing you react this way brings back just how disgusting it is. It's awful; we're forced to forget. So? So come on," he said, putting his thick arm around her shoulders, "come on into my office. I got a special stash of Dr. Pepper. At times like this, a Dr. Pepper helps."

They started for the on?call room, and I followed, saying, "Great case, Fats. You know, Berry, most people are like you and me, they hate shit, but Fats loves it. Going into GI work himself."

"Stop it, Roy," Berry snapped.

"When a GI man is looking up the barrel of a sigmoidoscope, you know what you got?"

"STOP IT! Go away. I want to talk with Fats alone."

"Alone? Why?"

"Never mind. Go away"

Angry and jealous, I watched them walk off, and I yelled after them, "You got shit looking at shit, that's what!"

Fats turned and angrily said, "Don't talk like that."

"Hurt your feelings, Fats?"

"No, but it hurts hers. You can't use our inside jokes with the ones outside all this, the ones like her."

"Sure you can," I said, "they need to see?"

"THEY DON'T!" yelled Fats. "They don't need to, and they don't want to. Some things have to be kept private, Basch. You think parents want to hear schoolteachers making fun of their kids? Use your damn head. You got a good woman here, and believe me they're not easy to find and keep, especially if you're a doctor. It makes me angry to see the way you treat her."

An hour later they paged me to come in. It felt like a military tribunal. Berry said she and Fats were worried about me, about my bitter sarcasm and rage.

"I thought you told me to express what I feel," I said.

"In words," said Berry, "not in acts. Not in taking it out on patients and doctors-Fats told me about your rumor about Dr. Putzel."

"They'll get you, Roy," said Fats, "you'll get it in the neck."

"They can't do anything to me. They can't run the House without interns. I can do whatever I want. I'm indispensable. Invulnerable"

"It's dangerous. Externalization is a brittle defense."

"Here we go again," I said. "What's externalization?"

"Seeing the conflict as outside of you. The problem isn't outside of you, it's inside. When you see that, something's going to snap:"

"That's the way it's gotta be, to survive."

"It's not. Look at Fats?he's got a healthy way of dealing with this incredible situation. He uses compassion, humor. He can laugh."

"I can laugh," I said, "I laugh too:"

"No you don't. You scream."

"You're the one who used to call him cynical, sick. And he's the one who taught me to call these nice of people 'gomers.' "

"He hasn't killed off the caring part of himself. You have."

"Look," said Fats seriously, "let's stop, eh? We can't tell him what to do. If you can imagine it, last year, I was a helluva lot worse than him, and nobody could tell me anything. Even last July I was worse. This year is yours, Roy. I know how it is?it's hell."

"This Putzel thing scares me," said Berry.

"Because every day he stands in front of his mirror and straightening his bowtie, he says to himself: You know, Putzie?poops, you are one great physician. Not a good physician, no. A great physician.' I hate him. You think you're scared? You should see him. Shaking in his shoes! Ready to crackl HA!"

"It's not Putzel, it's you," said Berry. "You hate something inside of you. Get it?"

"I don't, and it's not. Fats knows what an asshole Putzel is."

"Don't do it, Roy," said Berry, "you'll only hurt yourself."

"Fats?"

"Putzel's a turkey," said Fats, "a money?grubbing, incompetent piece of dreck. True. But he's not the monster you make him out to be. He's a harmless wimp. I feel sorry for him. Lay off. Whatever you're planning, don't do it."

I did it. I'd given the rumor a week to gnaw on Putzel. My time had come. I found Putzel holding a Rose's hand, and I crept up in back of him. I whispered in his ear: "I've had it with you, Putzel. Within the next twenty?four hours, I swear it, I'm going to do you in."

Putzel leaped up off the bed, gave me a panic-stricken look, and ran out of the room. I walked out into the corridor and watched the little emperor of the bowel run, keeping his back to the walls and intermittently ducking into doorways as if he were afraid of a bullet, race off down the hall. I ambled off toward rounds.

I never made it. Two Bouncers from House Security attacked me, twisted my arms behind me, and carried me into the on?call room. They stood me up against the wall and frisked me for a weapon and sat me down facing Lionel, the Fish, Fats, and, quaking in a corner, Putzel. "Hey, what the hell's going on?" I asked. Everyone looked at Putzel until he said, "I heard a rumor about some intern was going to kill me and then . . . and then he whispered in my ear that in the next twenty?four hours he was going to do me in."

I waited until the silence had become unbearable and then in a calm voice I said, "What did you say?"

"You said you were going to . . . to do me in."

"Dr. Putzel," I asked incredulously, "have you gone mad?"

"You said it! I heard you say it! Don't deny it to me!"

I denied it to him, said that anyone who thought that an intern in the Hous of God would threaten to kill a Private Doctor of the House of God had gone mad and told the Bouncers to let me go.

"No! Don't let him go!" screamed Putzel, hugging the wall like a terrified maniac.

"Look," I said, "I'm just an intern trying to do my job. I can't take responsibility for that nut. See you later, eh?"

"NO! NOOooo!" wailed Putzel, rolling his eyes like a nut.

"What do you think we should do?" the Bouncers asked the Fish.

"I don't know," said the Fish. "Fats?"

"I've never seen anything like this," said Fats. "One thing's for sure: Dr. Putzel is acting mighty strange."

"It's the strangest thing," said the Leggo, as I sat in his office, which was the only place they'd decided it was safe to send me, "yes, the strangest . . :" and he drifted off into that place out his window where the answers to strange things might be found. "I mean, you didn't in fact threaten to kill?no, of course you didn't!" said the Leggo, his consternation turning his horrific birthmark even more purple.

"How could I have, sir?"

"Exactly. It's extraordinary."

"Can I speak in confidence?"

"Fire away," he said, bracing himself for yet another shock.

"To me, this means that Dr. Putzel is a sick man:"

"Sick? A House Private sick, Roy?"

"Overworked. Needs a rest. And who doesn't, sir? Who doesn't?"

The Chief paused, as if perplexed, and then brightened and came up with the answer: "Why, no one doesn't. No one doesn't at all. I'll tell Dr. Putzel he needs a rest just like everyone else. Thanks, Roy, and keep right on in there plugging."

"Plugging? For what?"

"For what? Why . . . why, for the Awards. Yes, keep plugging for the Awards."

I felt good. Maybe I even felt grand. My only twinge of regret was that I had stepped out on my own, leaving behind Berry and Fats, the ones who claimed to care, the ones I'd counted on to save me.