myself.'
'But with Sophie it's fraud.'
'Of course it is. Not only that, it means work for you, and Putzel is the one making the money. It sucks.'
'It's crazy,' I said.
'It's doing medicine the House of God way.'
'So what can I do about it?'
'Start by not talking to her. If you talk to these patients, you'll never get rid of them. Then sic your BMS on her. She'll hate that.'
'Is she a gomer?'
'Does she act human?'
'Of course she does. She's a nice old lady.'
'Right. A LOL in NAD. Not a gomere. But you're sure to have a gomer on your service. Here, let's see. Rokitansky. Come on.'
Rokitansky was an old bassett. He'd been a college professor and had suffered a severe stroke. He lay on his bed, strapped down, IV's going in, catheter coming out. Motionless, paralyzed, eyes closed, breathing comfortably, perhaps dreaming of a bone, or a boy, or of a boy throwing a bone.
'Mr. Rokitansky, how are you doing?' I asked.
Without opening his eyes, after fifteen seconds, in a husky slurred growl from deep down in his smushed brain he said: PURRTY GUD.
Pleased, I asked, 'Mr. Rokitansky, what date is it today?'
PURRTY GUD. .
To all my questions, his answer was always the same. I felt sad. A professor, now a vegetable. Again I thought of my grandfather, and got a lump in my throat. Turning to Fats, I said, 'This is too sad. He's going to die.'
'No, he's not,' said Fats. 'He wants to, but he won't.'
'He can't go on like this.'
'Sure he can. Listen, Basch, there are a number of LAWS OF THE HOUSE OF GOD. LAW NUMBER ONE: GOMERS DON'T DIE.'
'That's ridiculous. Of course they die.'
'I've never seen it, in a whole year here,' said Fats.
'They have to.'
'They don't. They go on and on. Young people-like you and me?die, but not the gomers. Never seen it. Not once.'
'Why not?'
'I don't know. Nobody knows. It's amazing. Maybe they get past it. It's pitiful. The worst.'
Potts came in, looking puzzled and concerned. He wanted the Fat Man's help with Ina Goober. They left, and I turned back to Rokitansky. In the dim half-light I thought I saw tears trickling down the old man's cheeks. Shame swept over me. My stomach churned. Had he heard what we'd said?
'Mr. Rokitansky, are you crying?' I asked, and I waited, as the long seconds ticked away, my guilt moaning inside me.
PURRTY GUD.
'But did you hear what we said about gomers?'
PURRTY GUD.
I left, and stopped by to listen to Fats on Ina Goober.
'But there's no indication for the bowel run,' Potts was saying.
'No medical indication,' said Fats.
'What else is there?'
'For the House Privates, a big one. Tell him, Basch. tell him.'
'Money,' I said, 'there's a lotta money in shit:'
'And no matter what you do, Potts,' said the Fat Man, 'Ina will be here for weeks. See you on Visit Rounds in fifteen.'
'This is the most depressing thing I've ever done,' said Potts. lifting up a pendulous breast as Ina continued to shriek and attempt to whack him with her tied-down left hand.
Under the breast was greeny scumlike material, and as the foul aroma hit us, I thought that this first day must be even worse for Potts. He was a displaced person, from Charleston, South Carolina, to the North. He came from a rich Old Family who owned a dream house on Legare Street amidst the magnolias and yellow jasmine, a summerhouse on Pawley's Island, where the only competition was between waves and winds, and an upriver plantation, where he and his brothers would sit out on the porch of a cool summer night and peruse Moliere. Potts had made the fatal mistake of coming north to Princeton, and then compounded his mistake by coming to the BMS. There, over the stiffs in the Path course, he'd met a classy female BMS from Boston, and since up till that time Potts's sexual experience had consisted only of 'an occasional recreational encounter with a schoolteacher from North Charleston who was fond of my blue?steel throbber,' he'd been assaulted by the female BMS in both intellectual and sexual terms, and, like a false spring in February when all the bees hatch and are killed by the next frost, there had blossomed in these two BMSs something each called 'love.' The wedding had been held just prior to both internships, his in medicine at the House, hers in surgery at the MBH?Man's Best Hospital?the prestigious BMS?affiliated WASP hospital across town. Their on?call schedules would rarely coincide, and their joy of sex would curdle to their job of sex, for what erectile tissue could stand two internships? Poor Potts. Goldfish in the wrong bowl. Even at BMS he'd seemed depressed, and each choice since then had served only to deepen his depression.
'Oh, and by the way,' said the Fat Man, poking his head in again, 'I've written an order for this.'
In his hand was a Los Angeles Rams football helmet.
'What's that for?' asked Potts.
'It's for Ina,' Fats said, strapping it on her head. 'LAW NUMBER TWO: GOMERS GO TO GROUND.'
'What does that mean?' I asked.
'Fall out of bed. I know Ina from last year. She's a totally demented foxed?out gomere, and no matter how securely restrained, she'll go to ground every time. She cracked her skull twice last year, and was here for months. Till we thought of the helmet. Oh, and by the way?even though she's dehydrated, whatever you do, do not hydrate her. Her dehydration's got nothing to do with her dementia, even though the textbooks say it does. If you hydrate her, she stays demented, but she gets incredibly abusive.'
Potts's head turned to watch the Fat Man go, and somehow, her left hand free, Ina slugged him again. Reflexively Potts raised his hand to hit her, and then stopped himself. The Fat Man nearly keeled over with laughter.
'Ho ho, did you see that? I love 'em, I love these gomers I do . . .' And he laughed his way out the door.
The manipulation of her head intensified Ina's screams: GO AVAY GO AVAY GO AVAY . . .
And so, leaving her tied down six ways from Sunday, the ram horns curling around her ears, we proceeded to Visit Rounds.
Being an academic House affiliated with the BMS, the House of God had a Visit for each ward team: a member of the Privates or the Slurpers, who held teaching rounds every day. Our Visit was George Donowitz, a Private who'd been pretty good in the pre-penicillin era. The patient presented was a generally healthy young man who'd been admitted for routine tests of his renal function. My BMS, Levy, presented the case, and when Donowitz grilled him about diagnoses, the BMS, straight from the library of obscure diagnoses, said 'amyloidosis.'
'Typical,' muttered the Fat Man as we gathered around the patient's bed, 'typical BMS. A BMS hears hoofbeats outside his window, the first thing he thinks of is a zebra. This guy's uremic from his recurrent childhood infections that damaged his kidneys. Besides, there's no treatment for amyloid, anyway.'
'Amyloid?' asked Donowitz. 'Good thought. Let me show you a bedside test for amyloid. As you know, people with the disease bruise easily, very easily indeed.'
Donowitz reached down and twisted the skin on the patient's forearm. Nothing happened. Puzzled, he said
