all. It was terrible. The smell was that of lingering death: sickly-sour, feverish, sliding away far off on a horizon I could barely see. I didn't want any part of it. I would not touch these putrid ones, no. It was all too sad for me.
Not for Jo. At each room she riffled her three-by-five cards and rattled off numbers, and then had the nurse hoist the body up to sitting, so she could listen to the chest. Pinkus looked distractedly out the window, unable to ask or tell about hobbies, and I felt dead inside. Jo asked me didn't I want to listen to their chests, and reflexively, I did. The last was a second-year BMS student who, while on a pediatrics rotation, had caught a cold from a kid, which turned into a cough, then a flu, then a something beyond the realm of the known or the treatable that had hit his lungs, heart, liver, and kidneys and left him driven by respirator, pacemaker, and kidney machine. Despite this, despite the MICU's '4?plussing' him?going all out?he was dying. The stubble on his cheeks was blond. Jo had the nurse hoist him up, put her stethoscope on him, and motioned for me to join in. I said I'd pass.
'What?' asked Jo, surprised. 'Why?'
'I'm afraid of catching what he caught,' I said, leaving.
'What? You're a physician, you've got to. Come back here.'
'Jo, get off my back, huh?'
Later, Pinkus and I went down to lunch, leaving Jo to tend to the Unit. Pinkus always 'brown?bagged' it brought his own?so he could regulate his diet while in the House. As he picked gently at his cottage cheese, alfalfa, and fresh fruit, he inquired first about my hobbies, telling me his were running for fitness and fishing for calm, and second about my attitude toward the cardiac?risk factors. In one lunch-time I learned more about how I was destroying my life, narrowing my coronary arteries, falling prey to the endemic atherosclerosis sweeping America, than I'd learned in four years at the BMS. Pinkus suggested that, given my clear family history, I had an obligation to exert as much control as possible over my cardiac destiny, by refraining from eating what I liked (doughnuts, ice cream, coffee), smoking what I liked (cigarettes, cigars), doing what I liked (lazing. around), and feeling what I felt (anxious).
'Even coffee?' I asked, not aware of this risk faotor.
'Cardiac irritant. Latest
Finally, after a lengthy discussion of running, informing me that he was up to sixty miles a week at present in preparation for the Marathon in three weeks, Pinkus invited me to his office to feel his legs. We adjourned there, where he directed my examination.
From the waist up, he was toothpickoid; from the waist down, Mr. Olympia. His
Returning to the MICU, repulsed by the disease and boggled by the machines, I had an urge to escape. Jo cornered me, insisting that I learn how to pop a big needle into the radial artery of the wrist, a brutal, dangerous, and more or less unnecessary procedure. After that, I escaped as far as the staff room, saying I had to read up on the patients. I picked up the chart of the BMS with the total body wipe?out of unknown etiology, and started to read. He'd started with a sore throat, a cough, a cold, a slight fever. I had a sore throat, a cough, a cold, a slight fever. My red throat was a plowed field, getting a viral seeding from the BMS. I would catch what he had. I would die. I looked around me and realized it was the nursing change of shift. The nurses came in in their street clothes and used an alcove off the staff room, where there were lockers, to change. Since there was a mad crush at about three, when everyone rushed in, there were too many nurses for the alcove, and with a nonchalance, a few spilled out into the room, slipping out of their blouses and skirts or jeans, radiating the light of their bras and panties and other undies into the staff room, and then wrapping around the green cotton MICU uniform. Even the braless ones would spill out and change in my sight, smiling at my gawking, and I was thrilled with that ease of body I'd grown to know so well, that was somehow connected with doctors and nurses who dealt, day after day, with the decay of other human flesh.
I left. As I drove through the chill April rain, my mind stuck on the Unit. What about it had been so different?
Quintessence. That was it. The Unit was the quintessence. There, after all the sorting had been done, lay the closest representation, in living terms, of death.
That was to have been expected. That was the bronze Zock plaque on the wall. And there, also, lay the closest representation, in living terms, of sex. I could not fail to notice. I did not pretend to understand. Amidst the dying, these nurses were flaunting life.
Berry asked me how it had been, and I told her that it had been different, high?powered, kind of like being part of the manned space program, but that it was also like being in a vegetable garden, only the vegetables were human. I was down about it because of course they were young and would die, but that didn't matter because I too was going to die from whatever tropical virus had attacked the little BMS. Berry suggested that my fear of dying was yet another 'medical?student disease' and that she was more worried about my heart. Thinking of Pinkus, I said, 'Oh, yeah, how'd you know I was going to key more on controlling my cardiac-risk factors?'
'No, I don't mean the mechanics, I mean the feelings. It's been weeks since Potts's suicide, and you haven't said anything about it. It's as if it didn't happen.'
'It happened. So?'
'So he was a damn good friend of yours and now he's dead.'
'I can't think about it I got a new job to do, in the Unit.'
'Amazing. In spite of everything that happens, there's no past.'
'What's that supposed to mean?'
'You and the other interns obliterate each day, in order to start the next one. Forget today today. Total denial. Instant repression.'
'Big deal. So what about it?'
'So nothing ever changes. Personal history and experience mean nothing. There's no growth. Unbelievable: all across the country, interns are going through this, and going on each day as if nothing had happened the day before. 'Forget it; all is forgiven; come home; love, the Medical Hierarchy.' It rolls on, greater than anyone's suicide. That's what makes a doctor. Terrific.'
'I don't see what's so wrong with that.'
'I know you don't. That's what's so wrong. It isn't the medical skills you learn, it's the ability to wake up the next day as if nothing had happened the day before, even if what happened is a friend killing himself.'
'There's a helluva lot new to learn in the Unit. I can't afford to think about Potts.'
'Stop it, Roy?you're not some dumb clod, you're a person.'
'Look, I'm not your red?hot intellectual anymore. I'm just a guy out to learn a trade and make a buck, OK?'
'Wonderful. All the shadows have been taken from your sun.'
'How can you ask me to think, when tomorrow I'm gonna die?'
19
I awoke the next morning with my throat more sore. I drove to the House coughing, oblivious to all. but the tightness in the center of my back. I was about to follow the BMS into a premorbid coma. Jo had just completed examining the night's excretia, but before we started on work rounds, I insisted she listen to my chest. She said it was clear. Despite this, I was so worried I couldn't concentrate, and TURFED myself to X Ray for films. I went over them with the radiologist, who said they were normal. I got beeped to the unit for a cardiac arrest, and ran on up.
It was the BMS. Fifteen people had crowded into his room: a Messarabian breathing him; a nurse perch on her knees on top of the bed pumping his chest every systolic compression lifting her skirt to her waist; the Surgical Chief Resident with wiry black chest hair curling up over the V?necked green scrubsuit; barely in the room, Pinkus and Jo. Pinkus had been paged from his morning trot, and was in track shoes and gym shorts, looking distractedly out the window. Jo was all icewater, eyes riveted to the EKG machine, choosing medications, barking orders to the
