'Look, Jo,' said Pinkus, 'he went out in perfect, normal sinus rhythm. With class. Yes, he went out the House of God way.'
I thought of a House LAW: THE PATIENT IS THE ONE WITH THE DISEASE. It was his heart, not mine. I was immune from responsibility or concern. My world was for running, eating right, and staying calm. I left Jo to puzzle it out, and tended to the others of the Unit. Later that afternoon I said goodbye, wished Jo good luck, and on the four?mile run home filled my mind with Pinkus and God. I had done all I could, and Dr. Binsky had died. To get anxious about it, to eat away at myself, would only increase my stress, and boy did I know about the risk factor, stress. Personality Type A, the cardiac grenade. No thanks.
After dinner that night, Berry and I were walking home. She was surprised at my energy, given the fact that I'd been averaging only three hours' sleep a night since I'd begun in the Unit.
'Pinkus says that within limits, fatigue is mental,; not physiological. Every other night is not bad. I kind of like it.'
'Like it? I thought you hated being in the House at night.'
'Outside the Unit, I did. Inside the Unit, I like it. In fact, I almost could say I love it. Like the surgeons say: 'The only drawback to being on call every other night is that you only get to admit half the patients' That's how I feel too. I might become a cardiologist.'
Berry stopped, grabbed me by the shoulders, forced me to look at her. She seemed far away as she said, 'Roy, what's the matter with you? For months you've been telling me how the internship is wrecking your life?your creativity, your humaneness, your passion. What the hell is going on with this Unit anyway?'
'Don't know. Lotta deaths. Jo cracked. Cried. High anxiety level. Type A. Even with estrogens, bad news for her.'
'Jo cracked? And what about the effect of these deaths on you?'
'These deaths? So what?'
'So what?' asked Berry, in a tone that came from the bottom of a well, far off, ringing of dismay and regret, 'I'll tell you what?the more deaths, the less human you become.'
'You shouldn't worry. Like Pinkus says, 'anxiety's a killer.' '
That night in bed, as I turned to her and touched her shoulder, I could feel her tension. She stopped me and said, 'Roy, I'm worried. I could understand your shutting yourself off from grieving Potts's death, but this is too much. You're isolated. You never see your friends, you never even mention Fats or Chuck or the policemen anymore.'
'Yeah. I think I've left them all behind.'
'Listen to me: you don't love the Unit, it's a defense. You don't love Pinkus, it's a defense. You're hypomanic, identifying with the aggressor, idolizing Pinkus to save yourself from falling apart. It may work in the House, but it won't work with me. For me, tonight, you're a dead man. There's no spark of life.'
'Gee, I dunno, Berry. I feel healthy and alive.' Thinking of Hal, the computer in 2001, I said, 'Things are going extremely well.'
'How much longer does this MICU rotation last?'
'Ten days,' I said, and caressed her hair, thinking calmly of our supreme primeval exercise, sex. She pulled away, and I asked why.
'I can't make love to you if there's this distance between us.'
'You mean you can't stand the thought of another woman? Because that's all ov?'
'NO! I can't stand you! I've just about had it with trying to get through to you. I've got to start thinking of myself. I'll give you the benefit of time, let you finish the Unit, to see if you can snap out of this. Otherwise, it's all over. After all this time, we're through. In your terms, it's ROR, Roy, ROR.'
As if from far off, I heard myself saying, 'Better ROR than anxiety, Berry. Better that than Type A.'
'Goddamn you, Roy!' she screamed, in tears. 'You are a jerk! Don't you realize what's happening to you? Answer me!'
'At this point in time,' I said, trying to remain calm in the face of all this turmoil of emotion and stress, 'that's all I have to say.' Berry let out a hissing sound, like a train makes braking into a station, and she said, 'You're not a jerk, Roy. You're a machine.'
'A machine?'
'A machine.'
'So what?'
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.
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
