by Samuel Shem
‘Not too much,’ I said, realizing that this was true.
‘Of course not. People expect perfect health. It’s a brand-spanking-new Madison Avenue expectation. It’s our job to tell them that imperfect health is and always has been perfect health, and that most of the things that go wrong with their bodies we can’t do much about. So maybe we do make diagnoses; big deal. We hardly ever cure.’
‘I don’t know about that.’
‘Whaddaya mean? Have you cured anyone yet? In six months?’
‘One remission.’
‘Terrific. We cure ourselves, and that’s it. Well, let’s go. You’re gonna lose me in that crowd, Basch, so MEEERYY CHRISTMAS and always watch out for where you stick your finger next.’
Puzzled once again and feeling that he’d shaken my brain like he usually did and that he was probably right, I stood there for a moment and watched him approach his crowd. When they saw Fats, they shrieked with delight and engulfed him. Many of them had been coming to him every week for a year and a half, and almost all of them knew each other. They were one big happy family, with this fat doctor as its head. Smiles were smiled, presents were presented, and Fats sat down in the middle of the waiting room and enjoyed himself. Occasionally he’d take a kiddie on his knee and ask what he wanted for Christmas. I was touched. Here was what medicine could be: human to human. Like all our battered dreams. Sadly I went into my office, a kid not invited to play at the Fat Man’s house.
And yet, having been primed by the Fat Man, I was surprised to find my Clinic being fun. Relieved to think that my compulsion to try to cure was the only real disease in my patients, I sat back and let them, as people, bring me into their lives. What a difference! My basketball-playing arthritic black woman, when I ignored her aching knees and asked about her kids, opened up, chatted happily, and brought her kids in to meet me. When she left, for the first time she forgot to leave a Jehovah’s Witness pamphlet. Many of my other patients brought me gifts: my LOL in NAD with the taped-up eyelids brought me her niece, a knockout sabra with a tanned face and shoulders like a fullback and a smile as enticing as a Jaffa orange; my artificial breast brought a bottle of whiskey, and my Portuguese artificial foot brought me a bottle of wine. These gifts were for ‘helping’ them. The only way I’d helped them was by not TURFING them elsewhere. That was it: with the delivery of medical care this swiftly revolving door, with every doc on the planet frantic to BUFF and TURF elsewhere, these people had gotten expert at finding a static center and hanging on. They could spot a Fat Man a mile away. These people didn’t give a damn about their diseases or ‘cures’; what they wanted was what anyone wanted: the hand in their hand, the sense that their doctor could care.
I did. I brought my patients to the Fat Man’s affair.
In the E.W. as well, the jolt of feeling human refused to fizzle. I felt good, proud of my skills, excited. I didn’t resent going to work, and outside the House, I could bear to think about inside the House. Sitting in the E.W. was like sitting on a bench in the Louvre: a human tapestry, ever unraveling under my eyes. Like Paris, the E.W. was a place unlimited in time: I’d leave it, and it would go on without me until I returned. An immense, humbling eternity of disease. With the luxury of the TURF, I began to live the fantasy ‘doctor’ of my father’s letters, competent to handle whatever unraveled at the end of the ambulance ride and came at me through those doors.
One Saturday afternoon before Christmas, in the lull before the Saturday-night storm, Gath and I sat at the nursing station. Crazy Abe had disappeared for two nights, and everyone was a little discouraged about his absence. The nurses were snappier, and even Flash, the orderly, used old parts of his brain, in irritation. Heavy wet snow had fallen, and I’d already treated the first of several expected myocardial infarctions, as the middle-aged out-of-shape suburban fathers shoveled their driveways clear. I told Gath that he looked kind of down, and he said, ‘Yeah, I am. It’s Elihu—he don’t know his ass from his elbow, so I’m supervisin’ all his work. Suturin’. A man of my skills, suturin’. But if I let Elihu loose, it’d be a slaughterhouse down here. It’d be like when we had the old Chief of Surgery, Frannie. You know what they said about him?’
‘What?’
‘Killed mo’ Jews than Hitler. Ah we’re not gettin’ the big stuff in heah anymo’. No gunshots, accidents, it’s all belly pain, suturin’, and twats. Makes me sick.’
The nurse handed us each a clipboard. Gath glanced down, and wearily covering his eyes with his hand, said, ‘You know what’s on heah, boy? A twat. A sick twat. I may be a racist ‘Bama cracker, but for Chrissakes, Lord, give me some big stuff for a change. All this sick twat is ruinin’ this po’ boy’s sex life.’
On my own clipboard was a thirty-three-year-old white toothpick brought in from the streets outside the public library where he’d gone to use the toilet. Zalman was six-four and weighed in at eighty-two. Looking concentration-campish, he was all buttock, rib, and jaw, too listless to do anything but talk: he didn’t want to eat meat because animal souls transmigrated like humans, he was an unemployed philosopher, the world was full of incompetence, his typical dinner was a single seedless grape. Fascinating. TURF to psychiatry. My call to the psych resident was interrupted by my second snow-shoveling MI, about to die. Gath and Elihu and I trundled him back to life.
During the time it had taken to save the snow shoveler, the clipboards had piled up. The first nonswimmers, caught in the incoming Saturday night tide. As I picked up some charts and headed back into the rooms, I was stopped by a balding guy my age, dressed in jeans and a black turtleneck.
‘Dr. Basch, I’m Jeff Cohen, psych resident. I’ve just said hello to your anorexic, Zalman.’
‘Glad to meet you. The policemen have told me a lot about you. Yeah, Zalman—he’s incredible. He needs your services.’
‘Tell me about him,’ Cohen said, sitting down, interested.
‘I don’t have time right now,’ I said.
‘OK, later. We want him, but not yet. We don’t touch patients until they’re cleared medically. We never touch patients physically.’
‘You don’t? Never? You never touch bodies?’
‘You’re surprised. No physical contact—it inflames the transference. Well, I see you’re hassled, and I’m on my way upstairs to do some reading. Let’s talk about him later, if you’ve got the time. Male anorexics are rare, and fascinating. Just page me, OK? See you later.’
I watched him go. He was different: he listened. In the House of God, like in other Jewish houses, when someone talked, no one listened. I got the feeling Cohen had been interested in what I had to say. Like the Fat Man, but without the Fat Man’s cynicism. And he was interested in his patients! I could see that: Zalman’s bones were nowhere near as interesting as his story. Even I had listened, enthralled. And Cohen had time to read while on call? Far-fucking-out.
I reentered the revving-up Saturday night. A young woman was brought in from a party, over her boyfriend’s shoulder, not breathing, turning blue. In a twinkling—PRESTO—Gath and I metamorphosized her from a Dead on Arrival overdose to a puking hysterical underdose, TURFED to Jeff Cohen. As I attended a Santa with acid indigestion, I saw Gath coaxing a young man farther inside the doors. The young man stopped and stood there, peering at us suspiciously from under a pair of pink silk women’s panties he was wearing on his head. Cohen reappeared and tried to talk with him, but gave up, and when I asked him what was going on, he said, ‘Paranoid homosexual panic: stay away from him. Tincture of time. We wait.’ Cohen started in on a ‘Jesus Christ’ and I went to see a ‘Son of Charlie Chaplin’ who had intractable headache and demanded codeine and whom I TURFED back out to the street. I began to realize how many of these people needed Cohen more than they needed me. During a break, as I watched Elihu using what he called ‘the standard method’ of awakening a Pantagruelian drunk Norwegian—shoving ice cubes against his balls—the nurse said there was a man I’d better see right away, his blood pressure being ‘p
atent pending over 150.’
‘Patent pending over 150? What the hell’s that?’
‘At the top of the scale where the mercury ends, the machine says “patent pending.” The highest it goes.’
A new House record. The Norwegian awoke from his stupor, screamed YOU BASTARD YOU KISS MY ROYAL NORWEGIAN ASS, and began to chase Elihu around the nursing station. Gath and I hoped he would catch him. I went and saw the man with the patent-pending blood pressure. He was a fat black guy with a nervous look iii his eyes, swollen ankles, wet lungs, and a terrible headache. He let me put in an IV and when I informed him that at any moment his brain-stem arteries could explode, he agreed to come into the House. He then ripped out my IV, and spurting blood, said that first he had to ‘take care of some business’ involving a silver Cadillac and two women, and ambled out. Claiming the House record for the highest blood pressure TURFED to the street did not harm my reputation as a WALL.
Toward eleven, something marvelous happened: a run of erotica. One of the few true pleasures of doctoring, when, with the excuse of a medical degree I could move past the fantasy of mentally undressing sexy women, and really do it. I started with a Persian princess and ended with a lonely oral collegian who, unable to choose between her father and her boyfriend, had suddenly developed difficulty swallowing, which obtained for hear on this lonely Saturday night one young Jewish doctor, making bona fide medico-erotic contact with her mouth tongue tonsillar pillars naso-oro-pharynx neck throat clavicle rib cage breast even nipple, why not?
The most remarkable woman was Danish. Glittering white of tooth, blond of hair, blond of eyelash, which meant blond of pubic hair, pink of chill winter cheek, blue fjord of eye, she was dressed in a slinky gold wraparound which left one shoulder bare, two nipples poking. And a partridge in a pear tree. Her chief complaint: ‘crick in my neck, going around to my breast.’ Delight delight. I joked, flirted, asked the history of this crick and this breast. I had to decide whether or not to have her undress for me. I hesitated. The tension rose. In the silence she looked at me quizzically. Now I’d really blown it. I blushed, but said, ‘I’d better have a better look. Would you mind changing into this hospital gown?’
She looked me in the eye, and paused, and I thought, Oh, no, big trouble, now I’ve done it, she’s gonna report me to somebody, and I saw tomorrow’s headline: NORWEGIAN SAILOR SLAYS TERN IN HOUSE OF GOD—CRIME DE. PASSION ALLEGED BY STATUESQUE DANE.
‘But of course,’ she said, smiling a blue blond smile.
She knew and was going to play along! I went to the other side of the curtain, where there was another young woman, with a nurse, and I asked what the trouble was, and the nurse said, ‘Overdose of dog food.’
‘Oh?’ I asked cockily. ‘And what’s the usual dose of dog food?’
I started to examine the dog food, who presented a different erotic aspect: drowsy, stripped unashamedly to the waist, she was vomiting. As I put my stethoscope on her chest, something in the mirror between the curtains caught my eye: I could see into the other cubicle, where the Dane was undressing. Carefully, delicately, she unhooked her clinging gold dress and unwrapped it. She sat there on the stretcher, naked but for her gold panties, and then she stretched out her arms in a yawn. The pounding in my temporal arteries seemed to echo off the tile walls. She shivered in the chill, and hugged herself. Her nipples were tense brown buttons in the smooth silk flow of her breasts. Just before she reached for the House nightie, she looked down at her nipples, a child looking at two exciting toys, and with a feather-down touch gave each nipple a slow circular caress, the slow circular movement of a pelvis, of a thigh. Well, at that touch everything—her nipples, my putz, the House stethoscope—leaped up ensemble like hungry Jews at the last prayer of the fast of Yom Kippur. Suffused with a lover’s anticipation, I prolonged the dog-food exam and then walked into the room containing the Dane and found myself ridiculously asking, ‘How are they?’
‘They?’
‘The pains in the neck?’
‘Oh, yes. The same.’
‘Let me undo this,’ I said, untying her House nightie and dropping it to her waist. ‘Let me examine you.’
As I let myself enjoy her, my hands and head wandered. I felt the sexual attraction bubbling up around us, reflecting prismatic elastic soap bubbles of erotica floating around us, glistening and gliding, straining and popping, all in an act of love. My palm on her pink cheek, testing the pain when the trapezius contracts; her hand on my forearm, holding as I checked the rotator cuff, feeling the lovely soft hollow of the deltoid insertion, for bursitic pain. My fingers on her ribs, her breast, yes, even brushing those erect itching nipples, for how could I avoid? Was it ethical to pick her up? Norman, the Runt’s roommate at BMS, had picked up a premarin widow named—what else—Suzie in some E.W. one spring and had come away with a season box at the ballpark.
‘Dr. Basch,’ she said as I reluctantly finished, and watching her cover her breasts again, told her to take two aspirin and wanted to tell her to call me in the morning, ‘can I ask you something?’
ANYTHING. PERHAPS THAT NEAT YOUNG KIPPER IN MY PANTS.
‘Is it hard for you to see so much . . . disease all the time?’
‘Yes, it is,’ I said, struggling with how to ask her out.
‘You’re attracted to me, I can tell.’
WELL, YA FOUND ME OUT!
‘And I like you. You have good hands: gentle, but strong.’
IT’S FINALLY GONNA HAPPEN LIKE IN THE BOOKS.
‘What a shame I’m flying to Copenhagen tomorrow, yes?’
OWWWwww.
‘Wal, rump buddie, how’d ya like ’em, eh?’ asked Gath, sitting down with me at the nursing station.
‘Incredible. What a run of luck, eh?’
‘Luck, hell. I was out theah triagin’—above the waist to you, below the waist to Elihu. All this greeny creamy twat cain’t hurt his sex life none, can it? Hot damn! Would you look at that—Crazy Abe came back! Abie baby is back!’
He was. With that electric glint in his eye, Abe waved to us from just inside the automatic doors. Flash ran up and hugged him, and the spirits of the nurses lifted. What a wonderful night! When a lost old man finds his way out of the wilderness into the House of God, who could not be glad?
Before midnight, I was sitting with the policemen. Cohen joined us, filling out the data on a young schizophrenic who had come in comatose, having inhaled the contents of an aerosol can of Ban spray deodorant.
‘Hello, Dr. Jeffrey Cohen,’ blared Gilheeny, and then, turning to me, said, ‘You will forgive us focusing on Cohen, but we must take advantage of his being on call only once per seven nights. A much more human schedule than yours, Dr. Basch, proving Dr. Cohen’s wisdom in choosing psychiatry, and proving the maxim of Dr. Cohen’s hometown: “You can take the boy out of South Philadelphia, but you can never take South Philadelphia out of the boy.”’
Stunned by the idea of being on call once in seven nights, I listened as Gilheeny asked Cohen, ‘What remarkable depth of the human mind have you plunged tonight? And what is your total idea about our young schizoid inhaling the Ban?’
‘Problems of closeness,’ said Cohen, ‘define schizophrenia. All of us, as Freud noted, suffer egodystonic neurotic conflicts.’
‘As you have told us,’ said Quick, ‘you never outgrow your need for neurosis.’
‘True,’ said Cohen, ‘but the schizophrenic’s struggles are much earlier, pregenital, centering around personal boundaries—how close to get to someone before being consumed. I gave him some Stelazine.’
‘And as for the suicidal motive for the Ban?’ asked Gilheeny.
‘Easy,’ said Cohen, ‘BAN TAKES THE WORRY OUT OF BEING CLOSE.’
‘It would not be a bad thing,’ said Quick, ‘for the entire police force to come to you, Dr. Cohen, for a large group therapy.’
‘We’ve heard all about the police,’ said Cohen, winking at me, ‘buncha queers.’
‘Oh, Dr. Cohen!’ said Qu
ick. ‘You can’t generalize like that.’
‘The thing is,’ said Gilheeny, ‘that we live in constant fear of our lives. It makes the blood pressure elevate like an Arabian geyser, and the tension headaches we get would knock the balls off a bull with the twist in the maxillary sinuses themselves.’
‘I have to confess,’ said Quick, ‘that I have developed a strange passion for bendy, kinky plastic straws. And when my wife yelled at me the other night, I told her to “bite a fart.” What is wrong with me?’
‘See?’ said Cohen, turning to me again, eyes twinkling. ‘Just like I told you: homosexuals, the lot.’
Eat My Dust Eddie arrived to relieve me. I’d had such a great time, I didn’t want to go. In the waiting room I was met by Abe, who ventured out of his corner, in which was to be found, in addition to his shopping bag, the young man with the pink silk women’s panties on his head, who was scanning me with suspicion.
‘Are you glad I came back?’ asked Abe.
‘Yes, I am.’
‘So far you did good. I made a friend, over there in the corner. You know sometimes it can get lonely in this room on the slow nights but I don’t like it too crowded neither. That guy’s strange but he’s a friend. Won’t talk to anyone but me so he’s my friend. My friend. Be careful driving it’s slippery with snow good night.’
I was filled with hope. The sixteen hours had been the way it was supposed to, in the novels, in the texts. It had been a textbook. In itself.
Glitter and glide. Under the colored lights, the spangled couple swirled and sparked in patterns stored and practiced, and now effortlessly performed. Her costume was minuscule, the straps holding sequined breast cups and crotchpiece hidden by the darkness of the ice rink. Gliding on big strong legs around and around, in intricate figures to enhance the sexual ballet. And then, for the finale, he lifted her high up and carried her in a final glide around the ice-white, the spotlights slicing off her skate blades, man and woman motionless, a climax as smooth and as violent as the ice. As often happened, I was caught in a detail: his thumb, dimpling her gluteal fold, stretching sensitive nerve endings in the labia, the clit—
