The Two Kinds of Decay

The Vascular Surgeon

The vascular surgeon always brought bad news: that I was going to have vascular surgery.

After the third time, after he recognized that I would brood and sometimes cry after he delivered his vascular news, he finished the consultation and walked out of my room.

The neurology team stood assembled outside the door, waiting to come in and practice examining me.

The interns and residents adored me. This was a small hospital, and a case like mine was extremely rare. Months later I’d learn that there were only six people on the entire East Coast with my disease who were available to take part in a drug study.

That day, after watching me weep a little, and after walking outside to find a cluster of residents and interns waiting for him to finish talking to me, the vascular surgeon said something to them.

He told them I was the kind of patient who took things very hard. My door was still open. He didn’t care if I heard him say it.

He was about to do a third vascular surgery on me, and he knew I was twenty-one years old, and he knew that every time I recovered from a relapse of my disease, I was told I would stay well that time, and he knew I never stayed well.

And so the fourth time the vascular surgeon came into my room, expecting me to have remained the kind of patient who took things very hard, I had been practicing.

In my imagination I had been practicing the delivery of a line from a movie I loved. The line is spoken by a juvenile delinquent.

I had been practicing, and I didn’t say a word while the vascular surgeon gave his usual speech. His central line speech.

I didn’t say anything, and then he asked me if I had any questions, any concerns. He seemed to want me to continue to be the kind of patient who took things very hard.

But without even looking at him I said, What can I say — I’m thrilled.

He laughed like a high school kid, the way the science fair winner laughs when the guy with the police record insults the science teacher.