The house of God

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,