House of God

by Samuel Shem

  Later that afternoon, Berry and I, ROR, were driving out into the countryside to relax. I was reading a letter from my father.

  . . . Your experience undoubtedly is stimulating and I am sure that you are totally absorbed. Soon it will be over and you will have to decide about your future life . . .

  ‘You know,’ I said to Berry, ‘after all these years of disagreement with him, I finally think he’s right.’

  We sat on the edge of a park, the spring blushing chaotically all around us. The swath of green, lush with a fresh rain, swept across in front of us, from the pond reflecting the mansion on the left, past the hundred-year-old oak under which the WASPs held their weddings, to the stone wall and in back of it, the symmetric and rooted old houses. A dog came up to play, dropping a twig closer and closer until I threw it and he chased it. After a while I got tired, and he sensed it, and left. My mind, like a missile, kept homing to the Unit.

  On the drive back, I felt restless, and Berry noticed and asked, ‘What’s the matter, Roy? You’re done with the hardest part of the year.’

  ‘I know. I miss it. It’s hard to relax. Even fishing would be easier than this. Did I tell you I bought a rod and reel? You know, I need your help. With your psychological expertise, maybe you could tell me how I can change.’

  ‘Change what?’

  ‘My personality. I want to go from Type A to Type B.’

  Berry didn’t comment. We separated, planning to meet again that night. We had tickets to see Marcel Marceau.

  I was restless. I missed something. I was not doing well. I didn’t want Marcel Marceau, I wanted the Unit. It would be strange if I went back there tonight, my first night off. After I had finished. But wait: Jo had done it. My first day there, she’d spent the night with Mrs. Pedley. I would do it too. Under the guise of concern for the old lady in V Tach, I would go and spend the night on the Unit. It wasn’t until the hermetic doors slushed shut behind me, and I heard the ethereal ‘Around the wurrld in aay-tee dayzz . . .’ and I had settled into a chair in Pedley’s room, that I felt calm again.

  This calm was not to last. Berry appeared, dressed to kill, and said, ‘Roy, what the hell are you doing here? We’re supposed to see Marcel Marceau. You bought the tickets, remember?’

  ‘Here, feel this,’ I said, indicating my gastrocs.

  ‘What about Marcel Marceau?’

  ‘Inoperative.’

  ‘All right, Roy, it’s either this or me: take your pick.’

  I heard myself say, ‘It’s this.’

  ‘That’s what I thought you’d say,’ said Berry, ‘and I don’t buy it, ‘cause you’re sick!’ She made a motion out into the hallway, and in walked the two policemen, Gilheeny and Quick. Following them were Chuck and the Runt.

  ‘A good evening to you from the depths of my nervous stomach,’ said the redhead, limping in. ‘We have not seen you since you became a red-hot intern in this weird Unit.’

  ‘We have missed you,’ said Quick. ‘Finton here, with his bolloxed leg, cannot pursue your company as once he could.’

  ‘What the hell are you doing here?’ I asked. suspiciously.

  ‘Your girlfriend said that you have been crazy and were refusing to leave this Unit and go to the show with her,’ said Gilheeny.

  ‘I’m not going,’ I said. ‘It’s ROR with her and me. Face it. We’re through.’

  ‘Hey, man,’ said Chuck, ‘you don’t want to stay here with these pitiful patients. You’re done with this Unit shit, get out, get on down.’

  ‘They’re not pitiful. They’re salvageable.’

  ‘Roy,’ said the Runt, ‘you’re acting like a donkey.’

  ‘Thanks a lot, my fairweather friends. I’m staying here. None of you can understand me anymore. Please leave me alone.’

  ‘Trespassing is an offense,’ said Gilheeny, ‘and so we shall remove you. Boys, let’s begin.’

  With a good deal of furious struggling and cursing on my part, under Gilheeny’s direction Quick, Chuck, the Runt, and Berry hoisted me up and carried me out, ushered me down the stairs, and helped me into the police car, which, sirens blaring, raced through the downtown traffic and delivered Berry and me to the theater door. I sat there, bullshit. While I thought I’d escape when left alone with Berry, once again I had underestimated these policemen.

  ‘You’re coming in with us?’ I asked, amazed.

  ‘We are admirers of true genius,’ said Gilheeny, ‘and true is the genius of M. Marceau, a Jew of the French Catholic denomination, combining the better attributes of both.’

  ‘How the hell did you get tickets on such short notice?’

  ‘Graft,’ said Quick simply.

  With Berry and me sandwiched tightly between the bulky Gilheeny and the sinewy Quick, I realized I was trapped, and I resigned myself to sitting there until intermission. I watched as the lights dimmed and the mime began. At first I was indifferent, my mind on the Unit, and yet, as Marceau went on, with Berry pressing my hand and the policemen reacting with all the spontaneity of kids, I couldn’t help getting interested The first mime was the Balloon Seller, giving a free balloon to a child, who, clutching it in his hand, is floated up and up out of sight. Everyone around me laughed. On my left I heard a chortle, erupting into a roar, and I realized from the smell of fat and sweat from a uniform that it came from Gilheeny. A hefty elbow slammed into my ribs, and the redhead turned to me, flashed his huge hippo smile, and screamed, flooding me with onions and hash. I laughed. Next, a mime I’d seen Marceau do in England: in thirty seconds he walked through the successive stages of youth, maturity, old age, death. I sat, hushed, with the others, touched, enthralled, as we recognized our lives ebbing past us in a matter of seconds. Blasts of applause crackled through the theater. I looked at Quick. Tears were in his eyes.

  All of a sudden I felt as if a hearing aid for all my senses had been turned on. I was flooded with feeling. I roared. And along with this burst of feeling came a plunging, a desperate clawing plunge down an acrid chasm toward despair. What the hell had happened to me? Something in me had died. Sadness welled up in my gut and burned out through the slits of my eyes. A handkerchief was placed in my hand. I blew my nose. I felt a hug.

  The last mime skewered me: The Maskmaker switched back and forth a smiling mask, a crying mask, faster and faster, until finally the smiling mask got stuck on his face and he couldn’t remove it. The human struggle, the frantic effort to be rid of a suffocating mask; trapped, writhing, wearing a smile.

  The theater erupted. Ten encores, twelve. BRAVO!

  BRAVO! we screamed, and flowed out with the rejuvenated crowd. I blinked, confused. Inside me, all was chaos. My calm had been the calm of death. More than anything, I wanted to jackboot Pinkus in his plump pink soleus. Thank God for Berry, for my orthodox samaritans, my policemen. As we parted from them, Gilheeny, touched, said, ‘Good night, friend Roy. We’d been worried that we’d lost you.’

  ‘We’ve seen it happen before to interns,’ said Quick, ‘and if it had happened to you, it would have been a singular loss. God bless.’

  Later, Berry welcomed me back to her, and I felt her caring arms around me as if for the first time. Awakening. I began to thaw. I began to feel a trickle, then a rush of feeling that was scary and overwhelming. Choked up, I began to talk. On and on into the night I talked about the things I’d blotted out. The theme, over and over, coating my bedroom walls with a grayish-white mottled skin, was death. I talked about the horror of the dying, and the horror of the dead. Guiltily I told her about injecting the KCL into Saul. She couldn’t hide her shock. How could I have done that? Even if my head told me, Yes; it had been for the best, my heart cried out, No! I hadn’t done it for him, for the humanity of it, no. Angrily, to shut him up and to get back at them, I’d done it for me. I’d killed a human being! How that phrase would haunt me, tail me like an Israeli agent a Nazi, search me out when I was least suspecting, clamor after me in sleepy tropical courtyards of my new life where I’d thought that I’d f
ound peace. Finding me, it would accuse me, and I would say: ‘I must have been out of control, crazy.’ Coldly, rightly, it would say: ‘That can be no excuse.’

  I talked on, about the families of the patients in the Unit, coming in, searching my eyes for hope. What had I done? I’d done everything I could to avoid them. I had been as far from the world of humans as I could get. Disgusted, I talked about how, in the face of suffering, I’d been professionally nonchalant. Where compassion had been needed more desperately than any medicine, I had been sarcastic. I’d avoided feeling everything, as if feelings were little grenades blasting off a fingernail, a toe, a fragment of a heart. Tears in my eyes, I asked Berry, ‘Where have I been?’

  ‘Regressed. I thought I’d lost you for good.’

  ‘Why? Why did I get like that?’

  ‘The more the hurt, the more the fantasied need for defenses. Potts’s death rocked you. You imagined yourself to be so fragile, you wouldn’t let yourself grieve. Like a two-year-old scared of the dark, you locked onto rituals—your machines, your crazy idolization of Pinkus—to protect you.’

  She was right. Since Potts’s suicide, all of us had gone around like zombies, stunned, numb, too scared to cry. Each of us had been strung out trying to save ourselves, fighting against going really psychotic like Eddie or really killing ourselves by leaping from real buildings and splattering on a real parking lot eight stories below. We knew that it could have been any of us. Lethal, this becoming and being a doctor! Denying hope and fear, ritualized defenses pulled up around ears like turtlenecks, these doctors, to survive, had become machines, sealed off from humans—from wives, kids, parents—from the warmth of compassion and the thrill of love. I realized that it wasn’t just that they’d kept on riding Potts about the Yellow Man, no. They’d ignored his suffering, his months of fatal depression. And because I felt helpless and didn’t know what to do, I’d ignored it too.

  ‘This internship—this whole training—it destroys people.’

  ‘Yes. It’s a disease. The kind of stress you’re under, unless you can find some safety, some caring, you’ve got only a few choices: kill yourself, go crazy, kill someone else. Potts had no one, no way to survive.’ Berry paused, took my head in her hands, and more seriously than I’d ever seen her, said, ‘Roy, you’re a survivor. You’ll make it now, to bear witness, to record the ones who didn’t survive.’

  All across the country, interns were killing or going crazy, trying to survive. The medical hierarchy would continue. The new residents would say to the new interns: ‘We did it, now you do it.’ It was the scaly underside of the American Medical Dream. It was Nixon, in these ‘edited transcripts’ shocking Americans with ‘I don’t give a shit what happens, I want you to stonewall it . . .’ And it was my own arrogance in the face of the most feeling human events: a loved one’s sickness, a loved one’s suffering, a loved one’s death. No more. I would not pay the price. Having felt the first tantalizing suckings of this leech, this doctor’s disease, I’d burn the fucker off. How?

  ‘I’m here, Roy,’ said Berry. ‘Don’t shut me out. I care, and your friends care too. Sharing the experience is what will get all the rest of you through.’

  ‘Fats!’ I cried out. Apprehensive, worried that by fighting with him in Gomer City and by avoiding him while in the Unit I’d wrecked something with him, I got up. I had to see him right away and tell him. ‘Gotta see the Fat Man,’ I said, heading for the door. ‘Gotta tell him before it’s too late!’

  ‘It’s three A.M., Roy. What do you want to tell him?’

  ‘That I’m sorry . . . And that I like him . . . And thanks.’

  ‘He won’t like it if you wake him in the middle of the night.’

  ‘Yeah. Damn,’ I said, sitting back down, ‘I hope that there’s still time.’

  ‘There will be. There always is, with people like him.’

  That was a beginning. To repair, to re-create the human took some time. And it wasn’t for many months—no, years—that I was free from a recurrent nightmare: strapped down upon an icy metal slab, writhing back and forth to break free, running and running and running away, in a marathon race, from death. As I began to repair, I asked myself what had been missing. From another time, another, almost tropical country plagued by civil war, like a man with his chest thrown out proudly toward a firing squad who thinks back to a clear young summer and a gilded beribboned love letter ringed with doves, I realized that what had been missing was all that I loved. I would be transformed. I’d not leave that country of love again.

  23

  ‘What are you going to do on July the first?’ I asked Chuck.

  ‘Who knows, man, who knows? All I know is I don’t want to do no more of this.’

  It was May Day. I was in the on-call room of my final ward rotation, 4-South. I was lying in the top bunk. This was unusual. The tern always used the bottom bunk so that he wasn’t at risk of GOING TO GROUND from the Orthopedic Height and breaking his hip. For some reason I’d had the urge to lie in the top bunk, up under the ceiling, far back from the leading edge. I’d gathered pillows, climbed the ladder, and settled into a peaceful horizontality, snuggled up against the back wall, staring at the pea-green, sea-green ceiling. Very nice. I wished that the top bunk had side rails, like a gomer bed or crib. I wished food, a breast, a nipple, why not?

  There I was to stay. Others would try to move me, and at times, others would succeed, but I had work to do. Having recognized the doctor’s disease, I wasn’t sure that I could escape. Oh, yes, I had work to do, on compassion, on love. Like a park attendant with a steel-tipped stick, I had to patrol the darkening seaside summer park, browsing around the bandstand in the wake of the wedding, stabbing, stabbing, collecting the shredded scraps of self scattered among the rainbow of confetti, ruffled in the breezes from the bay. From my top bunk I could see in through the windows of the fleshed-out Wing of Zock. With the spring, the workers seemed renewed, and in the plush GI radiology suite across from me, imitation gold toilet fixtures lay scattered on the thick green carpet like mushrooms. This pristine Wing of Zock offered hope, for the House of God, for the People. My hope was to finish the year in one piece.

  On July the first, the medical profession acknowledged its only game, musical jobs. You had to play this game in advance. All of us terns in the House of God had tacitly agreed not only to the one-year ternship, but to the second year as residents. For some of us, like Howie, this was terrific, two years of being ‘a real doc’ being twice as good as one. Smiling, puffing, Howie seemed to love the ternship. Cautious, indecisive, Howie was acknowledged to be the worst tern. Terrified of harming patients or of taking risks, he practiced a homeopathic, almost phantom medicine.

  ‘You know,’ I said to Chuck, ‘that dose of antibiotic Howie was giving that woman downstairs is like giving a millionth of an aspirin.’

  ‘It’s like pissin’ in the wind, man, is what it is. It’s amazin’, though, he’s still happy in Gomer City.’

  ‘Impossible.’

  ‘No it ain’t. I came in this mornin’ and Howie was whistlin’. He went there a month ago, whistlin’, and he’s still whistlin’. Puffin’ that pipe and whistlin’. They won’t break that dude, no way. He loves it.’

  Others of us felt differently. Hooper, Eddie, the Runt, Chuck, and I clung together in our disillusionment. Having agreed to do another year come July the first, we were sure of one thing: we did not want to do another year in the House of God. None of us knew what to do. What would we say to Leggo when he called us in to ask us—thinking he already knew the answer—what were our plans for July the first?

  The two months to decide were to be spent on ward 4-South with Chuck and the resident, a shade named Leon. Leon, finishing two years in the House, had perfected the technique of the LP—Low Profile. Leon’s profile was so low that no one saw him, ever. Having watched people screw up their life plans at the House by being visible, Leon had perfected invisibility. Slim, common-featured, commonly and neatly dress
ed, Leon reckoned on only two more months of LP-ing it until musical jobs and the ultimate city, Phoenix, the ultimate Fellowship, Dermatology. On 4-South, outside myself, only the most extraordinary could hold my interest. The extraordinary took shape in 789 and Olive O.

  789 was my new BMS. A mathematician who’d gone to Princeton, and who’d done his senior honors thesis on the numeral 789, he’d been nicknamed by Chuck and me ‘789’ or, for short, ‘Sev.’ A bepimpled intellectual prodigy with few social skills—just the kind of draft pick the BMS adored—789 always had a scared-rabbit look in his eyes. A rare genius for numbers, he was a dullard in common sense. His body coordination was beneath contempt, and all but the most loxed-out gomers soon banished him from doing any procedure upon their bodies.

  Olive O. was just as rare. Olive O. was a gomere extraordinaire, who’d been TURFED to the House in some secrecy by her family. Told by flunky Marvin in Admitting that there was a TURF from Orthopedics, I’d sent Sev to investigate. Sev had looked through Olive’s chart, had talked to the surgical resident, and had found out that for some godforsaken reason the surgeons, overcome with an early-summer rutting zeal, had made Olive the proud recipient of a hemipelvectomy—they had ripped off half her pelvis—which had left her with only one leg. They had used the orthodox TURF-tool from surgery—replacing too little blood—which had made Olive the proud recipient of an MI, and in need of medical care. Proudly showing me a series of EKG traces, Sev explained to me, with vector diagrams and with herds of those imaginary numbers that had outgrazed my IQ in grade eleven, how he had succeeded in obtaining an electrophysiologically sound EKG using three of Olive’s extremities, the fourth being in a can in the morgue. How could I fail to have been impressed? Sev and I, proud son, proud father, went on down to Ortho.