M*A*S*H Goes To Maine

by Richard Hooker

  The Big VA Hospital turned out to be in a deadfall which the natives of the place called East Orange. This was located in North Jersey, which is just north of a place called South Jersey.

  Hawkeye’s first day on his new job was devoted to filling out various forms and questionnaires. A secretary assigned to assist him was happy to see the last of him. He had bought a second car, a ’41 Chevy, from a kid brother who was in jail. On the appropriate form he described the vehicle as a ’41 Corvette.

  The secretary had never heard of a ’41 Corvette but accepted the explanation that it was the only one of its kind. She was less happy when Hawkeye asked, “Hey, who’s the Chief Surgeon in this oversized cement mausoleum? Dr. Hyde?”

  “I don’t know any Dr. Hyde,” she told him.

  “Ma’am, if I knew anything would I be here? I gather they got some nice pig farms in Secaucus. Is that anywhere around here?”

  “I’m afraid I don’t know.”

  “You ever been to Newark?” Hawk asked.

  “Of course.”

  “You ever been to Maine?”

  “No, sir, I haven’t.”

  “What a pity,” observed Hawkeye.

  Hawkeye, who had been his own boss in Korea and Spruce Harbor VA, had accepted responsibility beyond his years. He was not in the habit of taking much, guff from anybody, particularly the likes of Jimmy Gargan, the Chief of Thoracic Surgery at East Orange VA. Jimmy, a black Irishman about half the size of big blond Hawkeye Pierce, was a perfectionist who criticized everything Hawk did, right down to how he got into an operating-room gown.

  After four days in the OR, Hawkeye decided to kill Jimmy Gargan. The only thing he couldn’t decide was” how to go about it. After two weeks, Gargan let Hawkeye do an easy right upper lobectomy—he took out the upper third of the right lung—and harassed him from start to finish.

  By this time Hawkeye had rejected homicide and decided that although Gargan wasn’t his type he was an all-pro chest cutter. He decided to swallow his pride.

  After Hawkeye’s first lobectomy, Gargan said over coffee, “You don’t like me, do you, Pierce?”

  “Not particularly.”

  “Few people do. In fact I drive half my residents away within three months. How long do you think you’ll last?”

  “The whole year. As far as I’m concerned you’re a little bog-Irish mammy-jammer. But I’ve learned more from you in two weeks than I ever learned anywhere else in six months. You’ll have to fire me before I’ll leave.”

  “I don’t think I will. I’ve been trying to get a rise out of you. I keep getting all kinds of big blond prima donnas that the Maxie Nevilles and their kind send in here. They can’t take the kind of crap I deal out.”

  “You come on like a son of a bitch but you seem to be a pro. I came here to learn how to jerk out lungs, so I’ll take anything you can dish out as long as I figure I’m gaining on something.”

  “You’ve got me on the defensive, now. No one’s done that in quite a while. But I don’t like being called an S.O.B.”

  “Oh, Christ,” Hawkeye said. “Your trouble is that you obviously don’t think there’s anything important in the world besides hearts and lungs, so I just can’t identify with you. I’ll pick your brain and take your shit for a year and go on my way and you’ll still be here when I’m back in Maine doing what you’re doing and living like a human being in the bargain.”

  “Do I read you right?” Gargan asked. “Do you really feel superior to anyone who is happy to live and is interested in doing a good job in northern New Jersey?”

  “In a way,” said Hawkeye. “Let’s just say I feel luckier. For Chrissake, that middle-income housing development someone’s stuck me into is an insult. The whole joint smells like someone boiled a goat, hair and all. Any tarpaper shack with an outdoor john in Maine would be better.”

  Jimmy Gargan sipped his coffee and reflected a moment before saying, “By the way, the Chief Surgeon asked me to mention that he doesn’t liked to be called ‘Dad.’”

  “Who in hell is the Chief Surgeon? I thought you were.—

  “Dr. Rizzo is the Chief Surgeon, and you certainly must know.”

  “Which fat guinea is he?” asked Hawkeye.

  “I don’t think you really mean everything you say,” Jimmy Gargan said. “But either way, I have an idea we’ll get along.”

  Jimmy Gargan and Hawkeye Pierce avoided friendship but achieved mutual respect. Maxie Neville, who visited East Orange as a consultant every two weeks, was pleased with Hawkeye and relieved that Trapper John’s recommendation was based on more than friendship.

  Thoracic surgery in 1954 and 1955 when Hawkeye was in East Orange was still a young specialty. A lung was removed successfully for the first time in 1933 by Evarts Graham and J. J. Singer. A handful of young men went into thoracic surgery after that. By 1955 these men were in their fifties and, although not old, they were patriarchs of a specialty which did not establish a certifying board of its own util 1948. The patriarchs, of whom Maxie Neville was one, examined new candidates for the club with extreme care and ran their specialty with the autocracy of Cosa Nostra chieftans.

  Maxie Neville had the build and the walk of a middle-weight fighter, which he had been. He had thick curly gray hair and chiseled features which looked weather beaten. Maxie attributed his appearance to a weekly ferry ride to the Public Health Service Hospital on Staten Island. Maxie had a pair of half-glasses which, if he wore them at all, he peered over more often than through. His blue eyes were always moving and missed very little, particularly females between the ages of twenty and fifty. Jimmy Cagney could have played Maxie Neville in the movies but the chances are that Maxie, himself, could have done it better and he wouldn’t have needed a stunt man to do the surgery.

  Maxie reduced the selection of new club members to a very simple formula. First, they had to come with strong recommendations from someone he knew and respected. In Hawkeye’s case, he knew Trapper John, the boy wonder of Boston, and Trapper’s old boss, Billy Morrow. Step number two was to give the candidate a year on one of the farm clubs, like East Orange VA. If the candidate survived eight months of that year, Maxie seriously considered him for a year on his service at Saint Lombard’s in New York. This year, in addition to hospital duties, involved participation in Maxie’s private practice, which was a high-class practice in every respect, including price. Many patients came to Maxie from Europe, South America and from every state in the union. Maxie did not want helpers who could not adjust to his clientele.

  So, at the eight-month point, Maxie took a personal look. This was known as Maxie’s final exam and the stories about it varied. Those who failed maintained that he accepted or rejected people purely on whim without consideration of ability, hard work or anything else that should be meaningful. Maxie started his in-depth investigation of Hawkeye Pierce by questioning Jimmy Gargan.

  “How about this clamdigger from Maine? Do you like him?”

  “I don’t dislike him. Maybe I’d like him if he liked me. All I can say is he’s the best man I’ve had here. He’s all business. He’s teachable. The patients all like him. They like him better than me. I can talk to a patient and tell him he needs surgery and he’ll say no. Pierce can go in half an hour later and have the guy begging for an operation.”

  “Why doesn’t he like you?” asked Dr. Neville.

  “This guy really hates cities. I think he really believes he is a member of a master race because he grew up in the country. Hell, I’ve hardly ever even seen a cow and I like cities. I’ve never been out of one. I think Pierce reacts to me in the same way he reacts to cities.”

  Maxie Neville, who’d grown up on a ranch in Wyoming, chuckled. “Can you spare Pierce for a while?” he asked. “I think I’ll take him to lunch.”

  An hour later Hawkeye Pierce, having completed the finger fracture of a mitral valve with Dr. Neville looking over his shoulder, was told by Dr. Gargan that the time had come. Lunch with Maxie. The final exam. />
  “Meet him in the parking lot at twelve thirty. Good luck.”

  “You mean that, Jimbo?”

  “I wish you wouldn’t call me Jimbo. Yes, I mean it, Pierce.”

  “Hey, Jim,” said Hawkeye. “Just for the record. If I blow this exam, no hard feelings. I know what you told Maxie.”

  “How do you know?”

  “I know because I know that, although you’ve led a disadvantaged life, you are solid to the core. In fact, I’m quite fond of you. If you’d learn to speak English, instead of the local dialect, I might even take you to my heart.”

  “Go!” roared the small thoracic surgeon.

  Dr. Pierce was apprehensive as he approached the parking lot. He had invested almost a year in this adventure and it would be wasted if Maxie didn’t give him the next year at Saint Lombard’s. He would have to go home, no richer, with some chest training but not enough to qualify for the thoracic boards. Trapper John was confident Hawkeye would pass but had not leaned on Maxie because Maxie always called the final shot. Nor had Trapper coached Hawkeye. He had faith in Hawk’s managerial instinct. Be loose, Hawkeye told himself as he approached Dr. Maxie Neville’s Cadillac convertible.

  “You drive,” Dr. Neville ordered. “I have to go to the hospital in Passaic. Couple people over there I want you to meet.”

  “Okay.”

  “What would you like to talk about?” asked Dr. Neville. “Thoracic surgery or fucking?”

  “Which are you best at?”

  “Pull up in the middle of the next block in front of that beer joint. Double park if you have to.”

  Hawkeye parked and followed Maxie into the small dark beer parlor where the great surgeon ordered two beers and two sausages which were floating in a foul liquid in a big grimy jug. Maxie looked at Hawkeye and said, “I’m from Wyoming. I don’t know why I am here. I understand you’re going back to Maine.”

  “Uh-huh.”

  “Are you leaving soon or are you willing to spend a year with me at Saint Lombard’s?”

  “I shouldn’t wonder,” agreed Hawkeye.

  “You shouldn’t wonder what?”

  “I’d like to spend a year at Saint Lombard’s and I shouldn’t wonder but what I could use another beer, as long as you’re buyin’.”

  “Make it fast,” said Maxie, “and drive back to the hospital. The examination is over.”

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  DR. and Mrs. Pierce decided that a year in New York for Mary and the kids, on top of a year in East Orange, would be cruel and inhuman torture. Hawkeye managed to get off the month of June and they all returned to Crabapple Cove. A whole beautiful month in the State of Maine. Leisure, fresh air, saltwater, clams, lobsters, golf, no responsibility, even a little money in their pockets, because Daddy had passed the general surgical boards and the VA had increased his salary to eleven grand a year.

  At the end of June, Hawkeye Pierce, alone and unhappy at the thought of leaving his family, departed for New York City in the ’41 Corvette to spend a year with Dr. Maxwell Neville and Dr. John Francis Xavier McIntyre at Saint Lombard’s Hospital. “I must be out of my jeezly skull,” Hawkeye (who talked to cars) said to the Corvette as he aimed it down the Maine turnpike.

  A few weeks later, Hawkeye was sure he was out of his mind. His problem, though, was deciding whether he liked it or not.

  Dr. Pierce found himself in surgical excitement and competition and challenge which relatively few, in any profession, experience. Looking back years later, he was amused by it, but in 1955 he was excited. Heart surgery, the thoracic surgeon’s new frontier, was a thrilling adventure.

  When he was out of it and time had passed, Hawkeye named the world he’d left the Cardia Nostra. It worked very much like Cosa Nostra. It all started back in ’49 when Big Billy in Boston and Big Charley in Philly both operated on a diseased nonfunctioning valve, the mitral, which separates the left atrium of the heart from the left ventricle. They did these operations and got away with them (which means a live, rehabilitated patient) on the same day. Each claimed priority and fame with the passion and tenacity of a pair of hoods who might have, firing simultaneously, shot J. Edgar Hoover. The Cardia Nostra was divided into families, each headed by a patriarch, or don, like Big Billy in Boston, Big Maxie in New York, Big Charley in Philly and Big Mike in Houston. Each don had lieutenants and varying numbers of soldiers (residents). In New York, Big Maxie’s lieutenant was Trapper John. Hawkeye Pierce, a soldier, was soon half-soldier half-lieutenant because of his good connections.

  Until the late forties, the chest was a tough place in which to work for many physiological reasons. The original thoracic surgeons, like most adventurers and pioneers, were smart, egotistical and piratical. Like Columbus, Leif Ericson, Jacques Cartier, they wanted to get somewhere first. Maxie Neville wanted to be the first man to resect the aortic arch, the big artery just north of the heart where blood starts its journey to every nook and cranny of the body. He never made it, nor did several patients, even though Hawkeye Pierce broke all speed records transporting calves’ aortas, with which Maxie hoped to replace human aortas, from a kosher butcher shop on the Lower East Side to Saint Lombard’s Hospital.

  “I ain’t a surgeon,”. Hawk complained to Trapper John one day. “I’m just a driver. I drive calves’ aortas to beat hell. That don’t learn me no surgery.”

  “If you don’t like driving calves’ aortas,” counseled Trapper John, “why don’t you go home and milk your old man’s cow?”

  The whole clue to successful surgery inside the heart is a pump and oxygenator which will take the place of the heart and lungs long enough for the surgeon to do his bit. In 1955 all the dons had their lieutenants and soldiers working on such rigs and many industrial types were working with the various families and everyone had a slightly different pump oxygenator. Everyone wanted to come up with the best and the number of dogs knocked off in this experimental race could equal the number of human lives saved, prolonged or made easier. Maxie told one of his soldiers, at a chest club in Brooklyn, to make a gas-permeable membrane which could supply oxygen to blood circulated through it. The soldier complied but, four months later, Maxie looked at the membrane oxygenator and said: “Orville, you’re grounded. That won’t fly.”

  In this instance, Orville, never a happy soldier, blew his bankroll on cab fare to the Jersey side of the George Washington Bridge and hitchhiked to Cleveland with the membrane oxygenator cradled like a baby in his lap. In Cleveland the paterfamilias of the Cardia Nostra was Big Amos, a don somewhat younger than Big Maxie. Big Amos saw hope for Orville’s membrane oxygenator and soon Orville was a lieutenant in the organization of Big Amos, who derived great pleasure Out of one-upping Big Maxie. This engendered a certain amount of ill feeling and Orville was prohibited from taking the Thoracic Surgical Boards for ten years, but otherwise he prospered and is now the don of a small family of his own in upstate New York.

  In 1947 the heart was surgically unapproachable.

  Twenty years later hearts could be transplanted with technical, if not immunological, success. Dr. Hawkeye Pierce, caught in the excitement of it all, came to enjoy it, despite separation from his family and intense dislike for New York City. Dr. Maxwell Neville, who watched all his soldiers closely, found that Pierce, while clearly lacking Trapper John’s superintelligence, was a competent, efficient, reflective surgeon who could, if the situation called for it, abandon his Maine accent and gain the confidence of Maxie’s diverse and very sick clientele. This made life easier for Maxie and this is what good soldiers are for.

  Three or four times a month Hawkeye would be sent off by plane or car to spy on Big Jimmy in Washington, Big George in Pittsburgh, or Big Charley in Philly. He would be met by a soldier from one of these families, have a drink or even dinner with the don himself and spend a day in his operating room and laboratory. This was not called spying. It was called an exchange of ideas. Big Charley in Philly was the most flamboyant of the dons. Big Charley had more soldiers than an
y other don and many of them were Filipinos. America, then, was the hotbed of cardiac surgery, and young surgeons from all over the world enlisted in the Cardia Nostra. In Hawkeye’s opinion, every Filipino who wasn’t a mess boy in the navy was a soldier in the army of Big Charley, who at that time worked in a very old hospital with very small operating rooms.

  Big Maxie Neville was extremely anxious to exchange ideas with Big Charley, so Hawkeye visited Philly quite often.

  “Let me know about that pump of his. Will it do everything he says, or is he just bullshitting everybody?” said Maxie.

  After four trips to Philly, Big Charley addressed Dr. Pierce as Hawkeye and invited him to scrub in on the resection of a left ventricular aneurysm, a partial blowout of the main chamber of the heart. That made it four surgeons, three scrub nurses, two circulating nurses, Big Charley’s pump-oxygenator which was the biggest in the Cardia Nostra and the eight Filipino soldiers who made it run.

  Driving back to New York that night Hawkeye realized that he’d probably never get smart enough to understand all the intricate physiology, hydraulic engineering and physics involved in this game. He stopped for a drink in a little town off the Jersey Turnpike. He sat at the bar and chuckled over a double Scotch. Eight. Count ’em. Eight Filipinos to run the jeezly pump.

  Next day, during a pneumonectomy, removal of a lung, Maxie asked, “Well, tell me. Has Chancy got anything?”

  “Max,” said Hawkeye, “as far as I can tell all he has is some kind of maze with Filipinos crawling around in it. I was right there assisting him and I couldn’t tell whether it was an operation or a Huk insurrection.”

  And so it came to pass that, after six months in the Cardia Nostra, Dr. Benjamin Franklin Pierce of Crabapple Cove, Maine, was considered to have lieutenant potential. The paths open to him included permanent association with Big Maxie, association with Big Julius in Dallas, or taking over Big Maxie’s already established cardiac surgical concession at a large hospital in North Jersey.