“But why? Can’t you give him a pill?” she asked with a naïveté that touched my heart, which was still excited by the sight of her eyes—eyes that I had seen without their glasses only when I had made love to her. “Of course,” I said confidently. “Why not? Even if it’s only a slight temperature, why should he suffer?”
But I was not worried about Lazar’s temperature. My thoughts turned stubbornly around the possibility of ventricular tachycardia, which could suddenly turn into ventricular fibrillation. The charts at the foot of Lazar’s bed contained the records of a considerable number of EKGs that had been done since his operation. I picked them up to examine them in the full moonlight of the autumn night and immediately noticed longer runs of a rapid, ectopic beat, five to six in a row, whose shape was obviously different from the regular and dominant sinus rhythm, which made me think they were of ventricular origin. Imperfect as it was, my knowledge of cardiology was enough to arouse my fears and give me a powerful urge to photograph these EKG strips and take them with me to the library tomorrow to study them, or even to go up to Jerusalem after my night shift and show them to Professor Adler, to hear what the master had to say. Perhaps for the first time since I had begun work at the hospital, I felt so powerfully convinced of something that it was only my youth and inexperience that prevented me from getting in touch with Professor Hishin right then, in the middle of the night, and expounding my interpretation of the data to him, an interpretation that was so obviously right that only it could save us from the catastrophe threatening to descend. But I had left my post in the emergency room for some time and was concerned that I might have been missed. I went to the nurses’ station at the end of the corridor and signed an order for two paracetamols for Lazar and one 5 milligram of Valium for his wife, and after seeing them swallow the pills I left them with the promise to come again tomorrow afternoon, because I knew that in spite of the confidence they felt in their professor friends in the hospital, they had also developed a kind of hidden dependency on the young doctor who had accompanied them to India.
Therefore, after waking up late the next morning, I did not drive to Jerusalem as I had promised to help my parents with Shivi, who, although my mother assured me she had been no trouble at all and was giving them a lot of joy, was still a handful for two older people to look after by themselves. I phoned them and apologized profusely. And since I didn’t know how to explain, even to myself, the nagging anxiety I felt about Lazar and the need I felt to stay close to the hospital, and I didn’t want to lie to them, I told them the truth without going into any medical details, and these two rational and realistic people had to be content with mysterious premonitions and to rely on the trust that they were accustomed to having in me. Six hours before my shift began I was already back at the hospital, where I went to the library to consult the EKG and arrhythmia teaching manuals used by nurses in cardiac intensive care courses. But no clear conclusions emerged from my reading. It appeared that there were atrial beats which could look like ventricular beats. The uncertainty only increased my anxiety, whose source was now less clear than ever. I went to the coronary intensive care unit and looked at the EKG strips of patients with acute myocardial infarction taken over the past few hours, and when there was a quiet moment I asked the doctor in charge to show me EKGs showing clear runs of ventricular tachycardia. Equipped with these strips, I went up to the ninth floor to see how Lazar was doing. In the cafeteria I had already heard from two psychiatrists who had visited him that morning that he looked and acted “like a man-eating tiger,” and that tomorrow or the next day he would probably be sent home, and the week after that he would presumably be back in his executive chair with his hands once again on the reins.
The two psychiatrists spoke about him with anger and bitterness, for Lazar had turned their well-meaning visit into a power struggle over his new initiative to do away with the psychiatric department in the hospital and turn it into an outpatient clinic—a community mental health service. “Let them take their mental illnesses somewhere else, we don’t need them here,” he said, smiling from his bed, when I told him about the psychiatrists’ angry reaction to his ideas for their department. The private room, which I had last seen bathed in moonlight, full of the intoxicating scent of flowers, had already been transformed into a kind of office, with two telephones on the floor and a pile of files next to his food tray. Levine was still trying to keep the stream of visitors at bay, but Hishin, who was standing next to Lazar’s bed as large as life and twice as tall, was perfectly satisfied with the new energy displayed by his patient. Lazar’s temperature had gone down, the bandages had been removed, and through the hospital pajamas the straight row of neat stitches was clearly visible. Dori was sitting in the corner, listening smilingly to Lazar’s secretary’s chatter. She was heavily made up, wearing an elegant suit and high heels; it seemed that she had already spent a few hours in her office and had also done some shopping, judging by the plastic bags heaped at her crossed feet. I suddenly turned to her, rudely interrupting the secretary. “Are you going to spend the night here again?” She nodded her head in surprise, as if I should know that she preferred the discomfort of sleeping in an armchair to being separated from her husband and spending a lonely night in her bed. A consoling thought crossed my mind, light as the touch of a feather. In spite of everything, there had not yet been one ugly moment between us. And a powerful wave of love swept over me for this middle-aged woman, who boldly took out a cigarette and lit it in the closed room, to the horror of Professor Levine, who came into the room at that moment and held out both his hands to her in an imploring gesture, to stop her from poisoning us all.
Was it possible that in the depths of my heart I wished for Lazar’s death? This secret thought, which held a certain sweetness, and which had been stubbornly simmering inside me ever since the flight home from Rome, now seized hold of me again and forced me to go out to the little balcony and bend over the railing as if I wanted to spew it out of me once and for all. Levine drew Hishin onto the balcony to show him the results of some tests which had just arrived, including the left ventricular function using a technetium radioactive scan. Hishin took off his glasses and ran his eyes rapidly over the results. He looked completely calm. “It’s so predictable,” I heard him exclaim in his loud, confident voice. “You don’t need to be a cardiac surgeon to know that the heart muscle is still stunned from the surgery and the prolonged use of the cardiopulmonary bypass machine. That explains the poor function.” But Levine, whose voice was too low for me to hear his arguments, appeared to be insisting on something. Hishin listened attentively, but without appearing to be convinced. “All right,” he said, “we’ll keep him until the end of the week and repeat all the tests in ten days’ time. And if the cardiac function is still unsatisfactory, we’ll take him to Jerusalem to Bouma and see what he has to say.” Levine nodded, but he didn’t seem satisfied. Suddenly he fixed his blue eyes on me standing in the corner of the balcony, the EKG strips in my hand, and trying not to look as if I were dying to intervene in their conversation. Levine beckoned me to approach. I took a few steps, and to my astonishment he touched my arm in a friendly gesture, and in his deep, serious voice, his eyes on the strips in my hand, he said to Hishin, “Listen to what Dr. Rubin has to say, Yosef. You were the one who was so impressed with him that you chose him out of all the residents in the hospital to go to India. Tell Professor Hishin what you think about Lazar’s arrhythmia.” I was so overwhelmed by Levine’s gentle touch on my arm and by the friendly tone in which he spoke that at first I was confused and stammered incoherently, but gradually I organized my thoughts and even added a few new elements I had picked up a couple of hours before in the coronary intensive care unit. Hishin listened to me with a paternal smile, but he seemed to be enjoying the vigor with which I expounded my views rather than following what I had to say. “And you let a resident like Benjy slip through your fingers?” he said to Levine when I had concluded my argument. “It wasn’t up to me,�
� said Levine in tone of real regret. “It was up to him.” And with this the medical debate ended before it had even begun, just as Lazar’s two children, Einat and the boy, now a soldier in uniform, entered the room and were enthusiastically greeted by all those present.
It turned out that Einat, who hugged and kissed her father with a certain hesitation, had just arrived from the United States, and her brother had met her at the airport. As she turned to her mother, who came up to hug her, she caught sight of me and waved. I shook my finger at her in mock reprimand. “You sleep at our house and leave without even saying good-bye?” She blushed, laughing and apologetic, and then explained to her parents how rushed she had been during her short stopover in London. I felt surrounded by warmth. In the room crowded with the Lazars’ family and friends, I felt as if I were planted deeply among them. The unexpected reconciliation with Professor Levine added to my joy. But I didn’t have much time to bask in these good feelings, for everyone was in a hurry to go somewhere except Einat, especially the rather sad and alienated son, who kept his distance from me. He had to get back to his base, and his mother had to drive him to the bus station and then rush home to prepare herself for another night at the hospital with her husband. Now she stood next to his bed to say good-bye and make various arrangements, and as she patted her hair lightly into place and asked him what to take home and what to bring back with her, I noticed that his hand, still blue from the hematoma caused by the infusion needles, was groping for hers, which was stroking his hair, both in order to stop her from caressing him in public and to draw it to his chest, perhaps to hint at a new, nagging pain which he was loath to trouble his doctor friends with.
And so we all parted from the administrative director except for Einat, who looked exhausted from the flight but insisted on believing, according to the biological clock inside her, that it was still morning. We went out into the corridor, where a clear and wonderful light poured through the big ninth-floor windows directly from the sea, streaming toward us over the roofs of the houses—the soft, pink autumn light of the afternoon hours, when the whole hospital was taken over by the visitors who crowded the elevators and flooded the rooms of the wards, who used the flowers, the fruit, the evening papers, and the boxes of chocolate which they strewed about them to banish the medical staff with their instruments and medications and instill new hope into the hearts of the sick people huddling beneath their blankets. Although Dori had her son on one side of her and her husband’s secretary on the other, I still hoped that I would be able to snatch a word or two with her in private, but I was prevented from doing so by Hishin. I had sensed that he wanted to talk to me in Lazar’s room, as if the information I had gathered and expounded to him and Levine on the balcony about the irregularities in the EKG had led him to believe that I had succeeded in finding a new lead to the wayward heart of Lazar, which apparently had him worried as well. Perhaps he even regretted letting me go so easily. In any case, he signaled me to wait for him, went over to the nurses’ station, and held a short telephone conversation with the head nurse of his department, who in spite of his pleas refused to let him off an operation that had already been postponed from the morning. Then he turned to me and asked me in a friendly way if I was going home before my shift. I looked at my watch. It was half-past four, and my shift began in two hours’ time. If I’d still had my motorcycle I wouldn’t have hesitated to go home in order to take a shower and rest before the long night ahead of me, and especially to call my parents again. But crawling along in the Tel Aviv evening traffic and finding parking for the car was another matter. “In that case,” he said firmly, as if he were still my patron, “come and keep me company in an operation that won’t take long but can’t be postponed any longer. Lazar tells me that in the hospital in London they let you operate as much as you wanted to. The English apparently like cutting up their patients slowly and delicately.” He winked at me and laughed loudly. I laughed too, not only because of the friendliness he had displayed toward me since my return from London but because of the feeling of victory and self-esteem that had filled me ever since the sudden reconciliation with Professor Levine. Who knows, I said to myself, the wild thought popping into my mind, perhaps Amnon was right and one day I will be the head of a department here, or perhaps even the director of the hospital. Thus, wrapped in premonitions of greatness, which sometimes carried me away, I generously agreed to begin my night’s work then, in that clear and rosy hour of the afternoon, and followed Hishin down to the surgical wing. I took the last green shirt and trousers left on the cart, and while the anesthetist began the preparations for the “takeoff” of a very young woman who looked at us sadly and accusingly, I succeeded in persuading the switchboard operator to give me an outside line to call my parents. They had been trying to get in touch with me to tell me about a call from Michaela, who had phoned that morning from Glasgow, where she had spent the night at my aunt’s with Stephanie on their way to the Isle of Skye. It was surprising and annoying to know that while we were all steeped in worries and cares, Michaela found the time to go off on a jaunt to Scotland and visit the places my mother had known as a child. I asked them about Shivi, and they said that she had vomited twice in the morning and they had called in old Dr. Cohen, the pediatrician who had taken care of me, and he had examined her and prescribed some medication but mainly reassured them. They read the name of the drug to me over the phone and asked my permission to give it to Shivi. Although she was apparently feeling better, it was obvious that they were nervous and wished that I would come and get her.
I promised that I would drive to Jerusalem first thing in the morning, as soon as my night shift was over. As I entered the changing room, I saw Dr. Vardi, my short and sturdy rival-friend, standing in a blood-soaked green uniform, with the mask still tied around his neck emphasizing the burning seriousness of his eyes as he looked at us. Hishin asked him about the operation that had just been concluded, and Vardi began to answer with his usual compulsive thoroughness, until Hishin seemed sorry that he had asked. He appeared distracted and troubled, as if his mind were somewhere else. “Do you want me to assist you?” asked Vardi, who seemed upset by my sudden presence at the side of his patron. “No, there’s no need. You’ve done enough today, you can go home,” said Hishin, and laid his hand on my shoulder. “I’ve got Benjy here, as both a former surgeon and a present anesthetist, and as a friend, and that’s quite enough.” We went into the operating room, washed our hands, put on gloves and masks, and suddenly he asked me if I could manage the anesthesia alone. I answered confidently in the affirmative, although formally speaking I was not yet supposed to be the only anesthetist present at an operation. He told the anesthetist that he could go, after getting some necessary information from him, and turned to the white stomach of the woman, which as always gave rise to tender feelings of compassion in me. With a swift and precise movement he cut a thin, firm line from her navel to her pubic hair, which for a moment seemed on fire in the ray of light filtering through the round porthole in the door. Although the bypass operation I had witnessed a week before by far surpassed the abdominal surgery now being performed by Professor Hishin, who suddenly seemed a little like a butcher, in its medical-technological complexity and even its aestheticism it was impossible not to admire his precision and skill, and also the human warmth and intimacy of his long fingers as they felt their way among the tissues opening up in front of him, not only to see but also to sense what needed to be done.
There were three of us in the operating room, Hishin and I and a new nurse whom neither of us had seen before, with a face as fresh and pure as an angel’s. After half an hour, when the critical stage of the operation was approaching, the internal telephone fixed to the wall rang. I went to pick it up and immediately recognized Levine’s voice, asking urgently to speak to Hishin. At first, in the wake of the reconciliation between us, I wanted to identify myself, but Levine sounded so agitated that I decided against it and confined myself to saying that I didn’t thin
k Hishin would be able to come to the telephone now and would call back as soon as he could. But Levine insisted, and Hishin, who was listening with half an ear to the conversation, asked me to find out what was the matter. Still without saying who I was, I said that Hishin couldn’t come to the phone now and wanted to know what the trouble was. A note of hesitation came into Levine’s voice, and he asked who was speaking. After I identified myself, his agitation increased, and he said in a deep voice, “I think that you were right, Dr. Rubin, about Lazar’s arrhythmia. His condition has deteriorated—at the moment he’s being mechanically ventilated. There’s a cardiologist from coronary intensive care with him now. He’s diagnosed ventricular tachycardia and is considering an electric shock, but it’s very important to me for Hishin to come up here at once to see him, because he knows his general condition better than anyone else.” And he put the phone down. From the tone of his voice I realized that Hishin’s presence was important to him not for the reason he gave but because he wanted him by his side in this emergency in order to share the responsibility for any catastrophe. I immediately filled Hishin in on the picture. He froze in his place and raised his two bloody hands in the air as if he wanted to hold his stunned head between them. He knew that Lazar was now fighting for his life upstairs, and he knew that there was no way he could leave the operating room. He couldn’t even send me to find out what was going on. Suddenly I saw that his hands were trembling, and I sensed that he was losing his intense inner concentration. He tried to go on working, but immediately stopped and asked me to go out and see if Vardi was still around to take over from him, and when he saw that I was hesitating, unwilling to abandon the anesthesia machine, he added angrily, “Don’t worry, I’ll look after it while you’re gone.”
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