House of God

by Samuel Shem

  Day passed, night came. Gilheeny made it through. Quick went home. Abe was gone. I stumbled through the night and finally at about two A.M., just before falling into a deep sleep, I thought that that moment, a kind of ecstasy of escape, would have been the perfect time to die. Not dead, I was awakened at three. I tried to focus on the clipboard: Twenty-three-year-old married woman; chief complaint: I was walking home and I was raped. No. Come on, will you? It’s ten below out there. I went and saw her: at eleven that night she’d been walking home from her friend’s house, a man jumped out of a driveway, held a gun to her head, and raped her. She was in shock, dazed. She hadn’t been able to go home to her husband. She’d sat in an all-night diner and finally had come into the House.

  ‘Have you called your husband yet?’

  ‘No . . . I’m too ashamed,’ she said, and she lifted her head up for the first time and looked me in the eyes, and first her eyes were dry cold walls and then, to my relief, they broke apart into wet pieces, and she screamed, and screamed out sob after sob. I took her in my arms and let her cry, and I was crying too. After she’d quieted some, I asked for her husband’s number, and after I did the workup for rape, I called him. He’d been worried stiff, and was glad she was not dead. He couldn’t know, yet, that part of her had died. In a few minutes he was there. I sat in the nursing station as he went in to see her, and sat there as they came out to leave. She thanked me, and I watched them walk down the long tiled passage. He went to put his arm around her, but with a gesture that I knew was her disgust at the ruination of her body by a man, she pushed it aside. Separate, they walked out into the savageness. Disgust. Revulsion. That was how I felt—revolted, enraged, pushing the hand away, because the hand can’t ever help, because it’s a myth that the hand can touch the part that’s dead.

  The finale that night was an alcoholic homosexual addict with a potentially lethal overdose of something unknown. In white pants, white shoes, a white sailor outfit with a red kerchief and a white sailor hat, his fingernails painted white, he was comatose, near death. I thought of methadone, and gave him, IV, a narcotic antagonist. He came out of his coma and became abusive. He took a knife from his pocket. I thought he was going to come at me, but no. He grabbed the IV tubing and cut it. He stood up and walked to the automatic doors. To be sure I’d be able to save him if he’d started to go down the tubes, I’d put in a large-bore needle, and now the blood flowed easily out, dripping in big red globules onto the polished floor, and I said, ‘Look, at least let me take your IV out before you leave.’

  ‘Nope,’ he said, flashing the knife, ‘I’m not leaving. I want to bleed to death, right here on your floor. You see, I want to die.’

  ‘Oh, well, that’s different,’ I said, and I called the Bouncers from House Security.

  We sat there, afraid to jump him, watching as the red dots on the floor coalesced into blobs, small pools. He smeared the blood around with his cute white shoes. When it became a puddle, he splashed it at us, leaving lines of blood reaching out toward us like rays from a Mayan sacrificial sun. I’d ordered four pints of blood, typed and crossed, and Flash was waiting in the blood bank for my call, ready to rush the blood down. As I sat there engorged with despair, I tried to get the arms of my mind around the savageness of the day. I could not. I waited for him to faint.

  Berry and I were in Our Nation’s Capital, visiting Jerry and Phil, who’d been at Oxford with me as Rhodes Scholars. While I’d chosen the fanaticism of American med school, they’d chosen that of law. At present they were each clerking for Supreme Court Justices, an ‘internship’ similar to mine. There were many parallels. The Chief Justices, like the House docs, were a mixed lot, some borderline incompetent, some alcoholic, some dummies, and a few just plain nonfolks like the Leggo and the Fish. Jerry and Phil were delegated the task of making the highest law of the land, just as I was the one dealing with the actual bodies and deaths. Their main job was to periodically wind up their particular Justice and ‘launch’ him on a particular side of a decision that would affect millions of great Americans. In fact, they spent much of their time at the de facto ‘highest court,’ the basketball court on the top floor, directly above the slightly lower, de jure Supreme Court chambers. One of their main thrills was throwing elbows at a body-beautiful Commie-hunting Nixon Court appointee.

  Despite my newfound penchant for viewing all persons as sick and despite their newfound penchant for viewing all persons as defendants, things went well for a while. Walking through the echoing marble Court, we laughed at various farces making the gossip columns, the choicest being the rumor that a reporter, using high-powered binoculars from a hidden vantage point on the bluffs over San Clemente, while watching Nixon and Bebe Rebozo walking along the beach in their dark suits, had seen the President stop, turn, and kiss Bebe squarely on the lips.

  And yet neither friendship nor a weekend away from the House could contain my rage. Feeling free, more like a person, made the contrast even more painful. I carried my suspicion and contempt with me. At one point Jerry and Phil were surprised at my vehemence, and at how far I’d moved, from English Socialist Left to Alabama Right a la Dwayne Gath. For some reason my friends’ cynicism did not extend into the realms of paranoia. The trip turned sour, and on the plane back, Berry said, ‘You’ve got to be socialized all over again, Roy. No one can be that angry and be in this world with anyone else. Your friends are really worried about you.’

  ‘You’re right,’ I said, thinking how every part of my life had suffered from my experience in the House of God, and how, from all the awful venerealia, even my sex life had curdled and quit.

  Things got only worse. At the New Year’s Eve party which I had to leave early because I had to report, for the last time, to the House E.W. at midnight, and at which I got pretty drunk, Berry blew up at me: ‘I hardly know you anymore, Roy. You’re not like you were before.’

  ‘You were right about this time of year,’ I said, leaving. ‘It’s sick, and it’s crazy, and it sucks. So long.’

  I walked out the door into the bitter cold, through the frozen snow and over a snowbank turned black from the city dirt, to my car. That terrifying empty space between what was love and what is no more loomed large. I sat there disgusted, alone, the blue mercury arc lamps adding to the surreal night. Berry appeared, trying to pull me back to the human. She leaned in through the window, hugged me, kissed me, and wished me a Happy New Year, and said, ‘Look at it this way, the New Year means you’re halfway through.’

  Feeling that I’d been cheated, promised a life and then saddled with death, I went into the E.W., drunk, searching for whoever it was who had cheated me. At precisely midnight, as the old year rolled over and showed its white underbelly and the new year starting sucking at its first black morning, a naked drunk celebrated by vomiting something awful into his lap. I sat at the nursing station surrounded by the futile attempts of the nurses to make a party out of the place. As I watched Elihu do a hip-swinging, clog-clacking campy rendition of the horah with Flash, I thought of ‘The Follies’ at Treblinka. And then I thought about the pictures of the camps, taken by the Allies at liberation. The pictures showed emaciated men peering through the barbed wire, all eyes. Those eyes, those eyes. Hard blank disks. My eyes had become hard blank disks. Yet there was something in back of them, and, yes, that was the worst. The worst was that I had to live with what was in back of them, and what I had to live with, the rest of the world must never see, for it separated me from them, as it had just done with my former best friends and with my one long love, Berry. There was rage and rage and rage, coating all like crude oil coating gulls. They had hurt me, bad. For now, I had no faith in the others of the world. And the delivery of medical care? Farce. BUFF ’n TURF. Revolving door. I wasn’t sitting at the end of the ambulance ride, no. There was no glamour in this. My first patient of the New Year was a five-year-old found in a clothes dryer, face bloodied. She had been hit by her pregnant mother, hit over and over with a bludgeon of pantyhose stuf
fed with shards of broken glass.

  How could I survive?

  14

  I had high hopes that the Fat Man would save me.

  Chubby, pumped up, bubbling with all the fresh optimism of a baby rocking in the cradle of the New Year, the Fat Man was back, ward resident in the House of God. During his long swing through the various Mt. St. Elsewheres and the Veterans Administration Hospital, I had missed him. Of course he had loomed large always, and in frantic times, his teachings had pulled me through. For months we had been in touch mostly through rumor. According to Fats, things were going great. Yet, the more I got to know him, the more contradictions there seemed to be. While laughing at a system that cherished Jo and the Fish and Little Otto and the Leggo, Fats seemed not only to be able to survive but also to use it for himself and even to enjoy it.

  Among the rumors that had floated in from Fats’s long road trip were several about Dr. Jung’s Anal Mirror, including one that allegedly had Esquire publishing its listing of ‘The Ten Most Beautiful Assholes of the World.’ Yet whenever the Fat Man talked about his invention, it was always in the subjunctive tense, ‘would’ and ‘could,’ not ‘will’ and ‘can’. Gregarious inside the House, when Fats left it, he disappeared. In spite of my offers, I never saw him outside. Although inside the House he was doing something erotic with Gracie from Dietary and Food, there was no word of female relationships outside. Ambitious, Fats wouldn’t let women stand in his way. Even his goal in life, to ‘make a big fortoona,’ was complicated: whenever I’d ask him how it was going, he’d get a wistful look in his eye and say, ‘I’m just not crooked enough,’ and tell me that he’d passed up opportunities that would have made ten fortoonas in the past year alone. ‘If only I had the hearts and minds of the Watergate Boys,’ he’d sigh, ‘if only I was G. Gordon Liddy.’

  I knew for sure that he was going into a GI Fellowship, that he was the only graduate of Brooklyn College ever to make it to the House of God, and that he was the only true genius I’d ever met. Now, fat and snappy and with a small gold ring on a fat finger of a fat hand and a sparkling gold chain around a huge rubbery neck that barely existed at all, given the way the fat, sleek, black-haired head seemed to rest entirely upon the rolling mound of shoulder, now the Fat Man’s good cheer seemed a strange contrast to the searing winter that held the city in its frozen tongs from January until the thaw. I knew from what other terns had said that this ward—ward 4-North—would be the worst. With Fats as our resident, I hoped that it would not be the worst.

  ‘This ward will be the worst,’ said Fats, chalk in chubby fingers scrawling THE WORST on the black-board of the on-call room. ‘This ward has taken fine young men and broken them.’ BROKEN THEM went up. ‘And yet, last year, I made it through, and this year, with me for these three months, you guys will make it through OK.’

  Hyper Hooper, one of the other terns, asked, ‘What makes this ward the worst?’

  ‘Name it,’ said Fats.

  ‘The patients?’

  ‘The worst.’

  ‘The nurses?’

  ‘Salli and Bonni—they both wear caps and tin nursing-school badges like meter maids—who say things to the gomers like, “Now we eat our custard, sport.” The worst.’

  ‘The Visit?’

  ‘The Fish.’

  The third tern, Eat My Dust Eddie, let out a long slow groan of despair. ‘I can’t stand it,’ he said, ‘I can’t stand having the Fish. He’s a gastroenterologist and I can’t stand any more talk of shit.’

  ‘To hear you,’ said Fats, ‘you’d think no one ever shits in California.’ Then, getting serious, he leaned forward and said, ‘That reminds me—my Fellowship Application. I’m trying to get my GI Fellowship for July the first. The Leggo still hasn’t written the crucial letter of recommendation. He says he’s waiting to see how I run this ward. Don’t screw me on that letter, hear? This is a “Protect the Fat Man’s Fellowship” ward rotation, see?’

  ‘Where do you want to go for your fellowship?’ asked Hooper.

  ‘Where? L.A. Hollywood.’

  Eat My Dust groaned and covered his face with his hands.

  ‘“The Bowel Run of the Stars,” ’ said Fats, stars sparkling in his dark eyes.

  Fats was into money. He’d grown up poor. His mother, during the High Holy Days, even though there wasn’t anything to make soup from, had put pots of water on the stove to boil, so that if anyone dropped in, the illusion of soup would be there. Nourished by his family as being a true genius, he’d shot up like a Flatbush meteor, barreled through Brooklyn College in science, cutthroated through Einstein Med, and arrived at the best internship of the Best Medical School, the House of God. Now, as he said, he was ‘going all the way to the top,’ and it seemed that from Flatbush, the top was Hollywood: ‘Imagine doing a sigmoidoscopy on Groucho Marx?’ he’d said, ‘on Mae West, on Fay Wray, on Kong! On all those stars who think that the colon is filled with cologne.’

  I tuned back in as Fats was saying, ‘This ward is a GI Man’s Heaven, and even for a GI man, it’s Hell. How are you terns going to survive?’

  ‘By killing ourselves,’ said Eddie.

  ‘Wrong,’ said Fats seriously, ‘you are not going to kill yourselves. You are my A Team, you all know what you’re doing by now. You will survive by going with it.’

  ‘Going with it?’ I asked.

  ‘Right. Like in the card game: finesse, men, finesse.’

  Finesse? I driffed off, thinking that this was a little bit different from what Fats had said before. How would this ward be the worst? There would be no hiding our doing nothing from Fats, and after what I’d been through on the wards and in the E.W., there would be no doubts about my ability to handle just about anything. I guessed it would be the worst because the gomers would try to torment us by holding up their end of the delivery of medical care by camping in the House, and the Slurpers and the Privates would try to torment us as well, each in his own fail-safe way. It would be the worst precisely because there would be no duplicity or pretense, but only the eternal, almost ecological struggle to do revolving-door medicine the House of God way.

  ‘Remember,’ said Fats, finishing, ‘if you don’t do anything, they can’t do anything to you. Believe it or not, guys, we’re gonna have a ball. OK, now we’re ready to go on out there. Let’s break!’

  We broke with all the enthusiasm of a high-school football team breaking from the locker room knowing they were going to get creamed and leaving their guts in the toilet bowls behind. Ward 4-North was yellow-tiled, smelly, and contorted like a gomer. We went from room to room, and in each there were four beds and on each bed was a horizontal human being who showed few signs of being a human being except being on a bed. No longer did I think it crazy or cruel to call these sad ones gomers. Yet part of me thought it was both crazy and cruel that I no longer thought so. In one male room a gomer was spasmodically tugging at his catheter and moaning something like PAZTRAMI PAZTRAMI PAZTRAAAH—MI and at that, Eat My Dust began making dog-vomiting noises in my ear. We went into the hallway and saw two more males, side by side, the only difference being their mouths, which were:

  The Fat Man asked the BMSs—the terrified, eager, and idealistic BMSs—what the inspection of these two men would produce as diagnoses, and they had no idea. Fats said, ‘These are classic signs: the O SIGN on the left and the Q SIGN on the right. The O SIGN is reversible, but once they get to the Q SIGN, they never come back.’

  We proceeded down the corridor. Suddenly there they were: side by side in armchair recliners sat two patients, the same two patients Chuck and I had turned back from that first day, Harry the Horse (HEY DOC WAIT HEY DOC WAIT) and Jane Doe (OOOO-AYYY-EEEE-IYYYY-UUUU). Still there! We stood in front of them, mesmerized.

  ‘Come on, come on,’ said Fats, dragging us away down the corridor. ‘This is the worst, the Rose Room. This room has taken fine young men and broken them. There should be an antidepressant dispenser at the door. Always remember, when you leave the Rose Room
and feel like killing yourself, remember that it is they of the Rose Room, and not you, who are ill. THE PATIENT IS THE ONE WITH THE DISEASE.’

  ‘Why is it called the Rose Room?’ we asked.

  ‘It is called the Rose Room because it invariably happens that the four female beds contain gomeres named Rose.’

  In hushed silence we stood in the middle of the dimly lit Rose Room. All Was still, spectral, the four Roses horizontal, at peace, barely dimpling their swaddling sheets. It was all very nice, until the smell hit, and then it was disgusting. The smell was shit. I couldn’t stand it. I left. From the corridor I could hear Fats continue to lecture. Out came EMD, gagging. Still Fats talked on. Out came Hyper Hooper, snorting. On and on Fats talked. The three fresh BMSs, holding to the fantasy that if they left the Rose Room before the Fat Man, their grade would plunge down toward that deadhouse, middle C, stayed. Fats droned on. Yelping and retching, handkerchiefs to their mouths, out ran the BMSs. As Fats rattled on to himself and to the gomertose Roses, the BMSs threw open a window and hung out their heads, and the burly construction workers who were riveting together the Wing of Zock pointed to them and laughed, and the laughter seemed to come from far away. I wished I could have been a robust hardhat, far from the smell of shit. Fats droned on to himself. The next one out, I mused, would be a Rose. Finally, out came our leader, asking, ‘What’s the matter, guys?’

  We told him the matter was the aroma.

  ‘Yeah, well, you can learn a lot from that aroma. With luck, in three months you’ll be able to stand in the middle of that room and give the four diagnoses as the different bowel odors smack your olfactory lobes. Why, just today there was a steatorrheac malabsorption, a bowel carcinoma, a superior mesenteric insufficiency giving rise to bowel ischemia and diarrhea, and last? . . . yes! Little packets of gas slipping past a longstanding fecal impaction.’

  ‘Hey, Fats,’ said Hooper, ‘how about having a box with postmortem permission slips here at the doorway of the Rose Room?’