The house of God

21

She was wrong. I was not a machine. I was not dead. I was alive. I was doing extremely well. My life was full. The PLONKA PLONKA of my feet on the bicycle path beside the river basin helped to beat out an affirmation of these reassuring thoughts. My head felt clear, like a sleek coronary artery lumen, a sleek woman in a maillot bathing suit, wet from a tropical sea.

That night was my masterpiece. A nurse and I had been told to do a marvelously difficult and intricate medical procedure. A young mother of two had been lingering toward death for months. Now, with endstage liver disease, she was finally about to die of massive infection and failure of her heart, liver, kidney, brain, and lung. She had been sent to the Unit, and we had been told to drain the infected fluid out of her belly and replace fluid in her circulation. Since the fluid that we put back into her circulation would, because of the low serum protein, soon migrate back into her belly, this procedure, if successful, would do no good. So what? Long ago I'd given up the idea that what I did to these bodies had any relevance to whether it did any good. I would do it well. Why should I mind being the final expiation for the failure of House medical care?

I put in big lines everywhere, monitored everything, and the nurse and I got ourselves rigged up, ready to launch. This would be my moon landing, my techno-Lisa, my grenade. Over the orange belly of the young mother of two we slaved away in erotico?synch, taking fluid out, putting fluid back, watching numbers, setting's dials, bathed in the eerie space light of the Unit, humming the melodies dished up by MUZAK. Hushed admiring others, doctors and nurses, dropped in to observe. Time turned timeless. The husband, having suffered the treatment and having lived with the death that the House red?hots had been denying his wife, informed us that he wanted us to stop, to do no more. Knowing that this last prolongation of life was worthless, done out of collective impotence and guilt, I convinced the husband to let us continue, assuring him-falsely??that her suffering would not be prolonged. Too enraged to cry, he left. I watched him go, huggin his little boy and little girl. They had quizzical looks in their eyes.

At about midnight the arrest alarm sounded in room 5, where a pithed?frog woman died. In confirmation Ollie spewed forth a flat?line EKG. I walked into her room. Her husband sat there, content with the illusion of life provided by the respirator inflating and deflating the corpse that had been his wife. I asked him let me see her. He looked at me and began to weep. I helped him up and led him out to a cup of coffee. A nurse asked me what to do. Heading back into young mother's room, I told the nurse to turn off pithed woman's respirator.

"I don't turn off respirators," said the nurse.

I was puzzled. Why not? She's dead. I looked at nurse in silence, trying to understand. I went into room with the body. I looked at it, a female, now turned a waxy death?white, without heartbeat or blood flow, dead?brained with a skull filled with clotted blood, the lungs rippled by machine: I searched through thewired undergrowth in back of the bed for the respirator plug. I paused. Bona fide dead. Saul the tailor flashed through. It was easy enough. I did it. Time turned timeless again.

The pleasing symmetry of the shape of that night continued through the next day, the day of the Marathon. I was doing extremely well. I felt extremely good for Pinkus, and planned to get off work early to watch him run up the worst hill, the Humbler. On rounds that morning, things went as smoothly as the MUZAK. A single incident, with the hepatitis woman, made it hard for me to do extremely well for a minute or two. Having spent much of the night completing the tricky hyro?digitotechnics of the Unit's equivalent of the moon walk, at about noon the nurse and I?she working a double shift out of compassion for this poor "salvageable" woman?were accosted by the husband, who get real red in the face and said, "I think you're both incredibly callous for keeping my poor wife alive!" The nurse burst into tears. I, in agreement with the husband, fell silent. The nurse and I stood there with the dying woman who stank of disinfectant and infection and bilirubin and ammonia, until the husband had done his punch?drunk catharting and left. For a few minutes I felt as if I were on the edge of some disaster, some abyss that seemed familiar from a nightmare. Then it passed, and again I felt calm.

From noon until I left, I was to work in my Outpatient Clinic downstairs. With some apprehension I left my Unit and entered the hopelessly inefficient world of the rest of the House of God. As I was going into my office, I ran into Chuck going into his. He looked even worse than usual.

"Well, man," he said, "bad news. I been found out."

"Found out! Found out what?"

"Well, you know how I always had the amazin' luck that the old ladies would never seem to show up at my Clinic, no matter what appointments they made?"

"Yeah, it was amazing," I said.

"Well, the reason they never showed up was that they was daid."

"Dead?"

"Un?hun, daid. See, I used to go over to the record room and pull charts, use daid names for appointments. Hardly any of 'em showed."

My own Clinic was ridiculous. I employed a useful anatomical concept for Clinic medicine, called Scruffy's Rhomboid Space, which was formed by unbuttoning the fourth button down on the shirt or blouse, forming a diamond?shaped opening for my stethoscope. With clever wrist action, the stethoscope could be rotated and pushed in such a way that all major organs could be examined without having the patient undress. Using this technique, I waded through my familiar patients with their trivial complaints, my mind filled with the precision and elegance of the techniques of the Unit, like popping a steel needle into a virginal radial artery. My outpatients seemed wary of me, and many of them kept asking me if I was sure I felt all right I told them I was feeling extremely well. One in particular, my basketballing Jehovah's Witness, was insistent: "Why, Dr. Basch, you nevah for months used that stethelscope on me. We allas used to jes' talk I knows in mah heart that there's sumpin' gone wrong What is it?" I told her there was nothing wrong, and finished ex aminin g her. Shaking her head, she left.

I muttered to myself as I walked through the fresh April afternoon toward the Humbler, all this education just to write prescriptions for padded bras withs pockets? What the hell was I in, anyway, ladies' lingerie?

The gaily colored marathoners began to pass. The first, the leaders, looked fit and eager even after these twenty miles, even facing the terror of the Humbler .The build of the leaders was like that of Pinkus: thin to the waist, solid below. They ran through waves applause. How jealous I was! The blur of color went on and on and after about five hundred had gone by, there came Pinkus, in a determined sure style that might well bring him in under three hours. I shouted "Go get 'em, Pinkus!" and he looked up, without waving or smiling, and trudged on up the Humbler, with calm, deliberate strides. He looked good. He was doing extremely well, and I watched him go wistfully, the GOTTA HAVE HEART on his rear end disappearing over the crest. My man Pinkus hadn't even broken stride. The Humbler? Ha!

Later that evening, at the high?school gym after playing some hoop, I ran into a Unit nurse, whose name I'd always forgotten and couldn't recall then. Wearing a tight black Danskin, she was working out with weights. I was surprised and delighted with her body and with her interest in her body. Dripping sweat, we chatted. I asked her out for a drink. In the bar we watched Nixon, who, even though Haig thought that Nixon "didn't sell on TV anymore," had gone ahead with a prime?time TV address from the Oval Office, something about "edited transcripts" of the tapes. The packaging was terrific! On a side table to which the camera intermittently panned were shiny black vinyl binders, each embossed with a gold presidential seal. "I am placing my trust in the basic fairness of the American people."

Nuzzling the nurse's sweaty neck, I said, "Damn good idea. It's about time. Get the goddamn thing straightened out, once and. for all." To me, the lockerroom aroma of this tough nurse was more enticing than perfume. I loved it.

After the drink, before the bedding, she went with me to an all?night sporting?goods store, where I bought myself my first ever fishing rod and reel.