Page 13 of Doctors


  He could hear the groans. Maury was alive. But how alive? As he drew nearer, he saw his classmate lying almost inert on the ground.

  ‘Quick, help me,’ the doctor barked. ‘Hold his head – keep it in a midline position. We don’t want to give him a cervical fracture if he doesn’t already have one.’

  ‘How is he?’ Barney asked, as he knelt down and carefully took hold of Maury’s head, hoping that his rapidly beating heart would not unsteady his hands.

  ‘Classic jump case,’ Rubin commented matter-of-factly. ‘Heel and lumbar-area fractures for sure.’ He shone a flash-light into Maury’s eyes and then added, ‘Doesn’t look like he’s herniating.’

  ‘What does that mean?’

  ‘His brain stem seems to be okay. No apparent neurological damage. He’s a damn lucky fella.’

  That’s one way of looking at it, Barney thought.

  Maury suddenly began to shiver violently. Barney quickly wrapped the blankets around him.

  ‘Livingston, is that you?’ he asked in a tone that sounded as if each syllable was painful.

  ‘Yeah, yeah, just take it easy, Maury. You’re gonna be all right.’

  ‘Oh, shit,’ his injured classmate gasped. ‘My father will give me hell for this. Probably say I can’t do anything right.’ He made a sound that seemed to come from the no-man’s-land between laughter and tears. Then he groaned again.

  ‘He’s in a lot of pain,’ Barney said pleadingly to the doctor. ‘Can’t you give him a shot of something?’

  ‘No, it would dull the sensorium. He’s got to be as lucid as possible till we determine the extent of the damage.’

  Lights flashed. Both the university police and an ambulance had materialized almost simultaneously. Barney had not even heard the sound of the motors. There were soon half a dozen people surrounding Maury, speaking in preternaturally calm whispers.

  Barney sensed that they had played this scene so many times before and knew their roles so well, there was no need for dialogue.

  The attendants placed a splint on Maury’s neck to protect his spine, and were readying him for a stretcher when Dean Holmes arrived. It was an eerie epiphany, his face vanishing and reappearing in the on-and-off flashing beams of the ambulance.

  Holmes bent down to look at Maury, and with a borrowed penlight satisfied himself that there was no cranial injury. He gave a slight nod, permission for the patient to be transported to the hospital.

  As they were lifting him inside the ambulance, Maury cried out feebly, ‘Livingston, are you there?’

  ‘Right here, Maury.’

  ‘My pages. Please take care of my pages.’

  ‘Sure, sure. Don’t worry.’

  The ambulance doors closed noiselessly and moments later it dissolved into the night.

  Now there were only three of them out there on the lawn. All the windows of Vanderbilt Hall were dark. Barney glanced at the luminescent hands of his watch. It was 3:45 A.M.

  He did not know what to do. He somehow felt he needed their dispensation to return to his room. So he kept standing, a weary but obedient foot soldier, while his superior officers conferred. Now and then he could distinguish a few words.

  ‘Eastman … know his father … brilliant chap … making arrangements.’

  At last Rubin nodded, turned on his heels, and headed back for his last few hours of duty at Health Service. Quite possibly, there were other messages of distress awaiting him.

  Holmes walked up to Barney.

  ‘I’m sorry, I didn’t get your name.’

  ‘Livingston, sir, First Year. I live down the hall from Maury. That is … where Maury used to live.’

  The dean nodded. ‘Livingston, I want you to understand that even as a doctor-to-be, you are bound by the ethics of confidentiality not to mention this to anyone.’

  ‘Of course not, sir.’

  ‘I mean not even in conversation with your closest friends. It’s one of the more difficult aspects of our profession. Besides, this could have unsettling repercussions on your classmates. I’m sure you see my point.’

  Barney nodded, as much in fatigue as in assent.

  ‘But sir, sooner or later people are bound to notice that Maury isn’t around anymore.’

  ‘Let me handle that. I’ll just circulate a little memo – something to the effect that there’s been an illness in his family.’

  ‘Yes, sir. May I have your permission to go now? It’s very late and I—’

  ‘Of course – Livingston, is it?’

  ‘Yes, sir.’

  ‘From what Dr Rubin tells me, you’ve been a brick tonight. I appreciate that and I am sure Eastman will appreciate it as well.’

  ‘Well, Maury really is a sweet guy. Maybe a bit oversensitive—’

  ‘I mean Dr Eastman – his father.’

  ‘Oh. Yes, sir. Goodnight, sir.’

  Barney had gone a mere five paces when the dean stopped him. ‘Oh, Livingston.’

  Barney stopped and turned. ‘Yes, sir?’

  ‘What were those pages young Eastman was referring to?’

  Barney hesitated, then angrily decided that something of Maury Eastman should remain inviolate.

  ‘I don’t know, sir. I guess he was delirious or something.’

  Dean Holmes nodded, which Barney took to be his license to retire. He began his weary way back into the dorm.

  As he passed Maury’s room, Barney noticed the door was still ajar. He turned on the light and entered. There was a half-filled page in the portable typewriter. Barney leaned over to read it. Thoughts of the narrator after his initial day of medical study:

  This was our first encounter with a representative of the Other World. Curiously, we looked inside him and found everything in order. Nothing was missing. What then does Death take away?

  Hard-nosed scientists would simply say electric impulses; religious men might say a body spirit. I am a humanist and what I saw today I took to be absence of his soul.

  Where did it go?

  Barney gathered up the dozen or so pages of his classmate’s ‘book,’ turned off the light, and walked sadly toward his room. He felt a desperate need to shut off his thoughts.

  ‘Christ, Livingston, are you sick? You look like you’ve been up all night.’

  ‘I was up all night,’ Barney answered hoarsely, trying to coordinate a junction between the muffin in his left hand and the jelly on the knife in his right. There were three cups of black coffee on his tray.

  ‘May I sit down, or is this table for grinds only?’

  ‘Sit, Castellano, sit.’

  Laura sat across from him, drumming her fingers. ‘Well, are you gonna tell me what happened or what?’

  ‘I was studying epithelial tissue and it was so exciting that I got carried away. The next thing I knew it was dawn.’

  Laura reached over, appropriated one of his coffees, and retorted, ‘Bullshit. I know damn well what really happened.’

  Barney’s drooping eyelids opened to near-normal width.

  ‘You do?’

  She nodded, smiling. ‘You had an unexpected romantic encounter. Who was the lucky girl, Livingston – a nurse?’

  ‘Come on, Laura, do I ask you about your sex life?’

  ‘Yes. And I usually don’t hold out on you.’

  ‘Well, this is different. I’ve sworn a kind of medical oath. Please don’t push.’

  He was longing to share his feelings of pain and confusion with her. But he dared not break his word. Not for fear of Holmes, but out of respect for Hippocrates. He took a swill of coffee, commenting, ‘God, this stuff is awful.’

  ‘In my considered judgment,’ Laura concluded lightheartedly, ‘you and Grete finally got on the same wavelength.’

  Barney forced a tired smile. ‘How did you figure it out?’

  ‘Deductive logic, Barn. Grete didn’t come in till after two and you look like an unmade bed. I mean, you haven’t even shaved.’

  ‘I haven’t?’ He felt his cheek. ‘Thanks,
Laura, I really didn’t notice. Now will you do me a favor before leaving me in peace?’

  ‘Sure.’

  ‘Get me another cup of coffee to replace the one you stole.’

  As she amiably rose to fetch a further dose of caffeine, Barney’s headache was compounded by heartache.

  Is this what confidentiality is all about? he wondered. I mean, not being able to talk to my best friend in the whole damn world?

  ‘Bad news, Barney – we’ve lost Alison.’

  At first he was taken aback. But the twinkle in Bennett Landsmann’s eye reassured him that it was not by a misadventure similar to Maury’s.

  ‘Apparently some guy at Seth Lazarus’s table had to leave school suddenly. And the minute our partner heard, she sweet-talked Lubar into reassigning her—’

  ‘Probably by promising not to make a pass at him.’

  ‘That was rather ungallant. True, but nonetheless ungallant.’ Bennett smiled. ‘Word has it that Seth wields a scalpel second only to Errol Flynn. So Alison wanted to hone her skills with a master.’

  ‘Okay with me. Except that leaves us with a cadaver named Leonardo. Do you think we could change it?’

  His partner nodded. ‘How about “Frank”?’

  ‘Pretty common name,’ Barney observed. ‘It could refer to anything from FDR to a hot dog.’

  ‘Come on, Livingston, to a true sports fan the only real Frank is Gifford, the New York Giants’ immortal half-back –’

  Barney’s tired face lit up. ‘Actually, after a real pileup, Frank’s looked worse than this.’

  They could delay no longer the inevitable return to the mutilation of human flesh. They propped Gray’s open and began slicing carefully down toward the epicardium.

  After they had been working twenty minutes or so in silence, Bennett whispered, ‘You know, I didn’t get much sleep last night.’

  ‘You too?’

  ‘I kept thinking about this lab. About this guy whose guts we’re so blithely pulling apart. Somehow I can understand why it was illegal for so many centuries.’

  Barney nodded. ‘I know. It’s like a sort of intrusion on his privacy.’

  ‘Yeah,’ Bennett agreed. ‘And this smell we can’t wash off – it’s like the mark of Cain.’

  ‘Stay loose,’ Barney replied, ‘just remember we’re not invading the guy’s soul.’

  Bennett looked at his lab partner with gratitude. ‘That’s a nice way of looking at it, Livingston. It kind of eases my conscience.’

  As they returned to the relentless infiltration of Frank’s vital organs, Barney thought guiltily, I’m sorry, Maury, I should have quoted you.

  ‘The strain is starting to get to me, Barn.’

  ‘Already? For God’s sake, Castellano, it’s barely been a week – and Biochem has yet to rear its hydra-headed formulae.’

  They were sitting by themselves, lunching on gelatinous lumps of unknown origin camouflaged by an unidentifiable brownish solution.

  ‘Why does everybody have to lean on my shoulder?’ Laura complained.

  ‘Who’s leaning?’

  ‘The whole Deanery – it seems like.’

  ‘Well, now maybe you know how I feel when people choose me as a father-confessor.’

  ‘But you like it,’ she protested.

  ‘Yeah, sure. Actually I get real satisfaction from helping my friends sort out their problems. Besides, it’s kind of a dress rehearsal for being a psychiatrist.’

  ‘Okay,’ she conceded, ‘friends are one thing. But I don’t have to advise every girl on the corridor. I mean, I hardly know Alison Redmond.’

  ‘Ah, dear old Alison. She jumped ship from my Anatomy table – lured by the legendary silver scalpel of one Seth Lazarus.’

  ‘That’s not the real reason, Barn. She was – how can I put it? – overstimulated by a certain person’s body.’

  ‘Mine or the cadaver’s?’ he quipped.

  ‘Bennett’s,’ she answered with a smile.

  ‘Oh Well, actually I can’t be jealous. He’s a really cool guy. But why should that drive Alison away?’

  ‘You figure it out, Dr Freud. She’s scared about getting involved.’

  ‘That’s a rather unrealistic fantasy. I mean, why should Bennett even look at a rodent like her?’

  Laura was not amused.

  ‘He was two years ahead of me at Harvard and I can testify that, regardless of how the package was wrapped, he tended to go for brains.’

  ‘How come he didn’t get to you?’

  ‘None of your business,’ Laura replied. But she was blushing slightly.

  ‘Well,’ Barney continued, ‘even if he was that undiscriminating – which I still doubt – what’s Alison’s objection?’

  ‘The truth?’ Laura asked. ‘The honest-to-God truth is she doesn’t want anything to distract her from her studies. She’s absolutely obsessed about being Number One. It’s only the beginning of the term and she’s already taking pills to stay awake and study.’

  ‘She’s a loon. Anyway, spare me any more details.’

  They were interrupted by the arrival of Hank Dwyer.

  ‘Say, Barn, can you spare a few minutes?’

  ‘Sure,’ he replied congenially, ‘sit down and join us.’

  Hank nodded uneasily to Laura and then answered uncomfortably, ‘It’s sort of private, Barney. Would it be okay if I drop by your room sometime tonight?’

  ‘Tonight? Okay, yeah – fine, great. Is eleven-thirty okay?’

  ‘Couldn’t it be a little earlier? I like to hit the sack about then.’

  ‘Sorry, Hank, but I’ve got a shitload of work and I really couldn’t spare a second before eleven-thirty.’

  Dwyer nodded with gratitude – and then respectfully decamped.

  As soon as he was out of earshot, Barney quickly turned to a more burning issue.

  ‘Now, Castellano, I want a simple yes-or-no answer: is Grete Andersen a total nymphomaniac or not?’

  Laura shook her head. ‘I’m sorry, that’s not a yes-or-no question.’

  She rose. The consultants’ consultation was over.

  It is something of a paradox that Biochemistry, which, literally defined, is the study of the life process, is probably the most deadening course a medical student has to take. For living function is reduced to inanimate diagrams and complex formulae scrolled on the innumerable handouts.

  ‘Life is impossible,’ Professor Michael Pfeifer began dramatically, ‘without the organic compounds known as amino acids. They are the building blocks of which proteins are constructed, as well as the end product of protein digestion.’

  Then Pfeifer went on to cast his net a little wider: ‘There are approximately eighty amino acids in nature. Only about twenty are needed for human metabolism or growth. The ones provided by food are called “essential”. The others, which can be manufactured by the body, are known either as “nonessential” or “glycines”. I’ve listed both groups on the board. But don’t bother to write them down.’

  At this dispensation from note-taking, the students breathed a collective sigh of relief.

  ‘I’ll just read them,’ said Pfeifer casually. And he did: ‘Histidine, isoleucine, leucine, lysine, methionine, cysteine, phenylalanine, tyrosine, threonine, tryptophan, valine.’

  Pfeifer then turned to the second blackboard and reeled off the names of the ‘nonessential’ group, adding, ‘Naturally, we will be getting back to this in detail later.’

  Hey, this guy is really easygoing, Barney thought. So much for the myth about Biochem being a horror show. And then it happened.

  On either side of the room, assistants began distributing thick sheaves of paper on which – as the students soon discovered – were detailed drawings of structures of everything that Pfeifer had so briefly and amiably touched upon.

  If there was such a thing as a collective freshman psyche, it had fallen into a complete collective depression. The room resonated with an echolalia of groans. And then came Pfeifer’s che
ery coup de grâce.

  ‘Just to keep us on our toes, I think we’ll have our first little quiz three weeks from today.’

  There was a bizarre silence. For a few seconds every single student had stopped breathing. They knew there was a vital question to be asked and all watched to see which of them had the courage to voice it. At this moment Laura raised her hand.

  ‘Yes, Miss … your name, please?’

  ‘Laura Castellano, sir, I just wanted to ask if we’ll be expected to have this handout memorized?’

  Over a hundred heads craned forward, the better to entrap the professor’s answer.

  ‘Well, Miss Castellano, that’s jumping the gun a bit. We will be covering a lot more material between then and now and it will all be a matter of priorities. After all, can one say that twenty-odd amino acids outweigh the fifty-eight proteins we have in blood?’

  ‘Thank you, Professor.’ (You sadistic sonovabitch.)

  ‘Any other questions?’ Pfeifer asked magnanimously.

  Barney, sitting in the back row with Bennett Landsmann, whispered to his lab partner, ‘Ask him where he parks his car so we can bomb it.’

  As the class dispersed, Barney called out, ‘Good going, Castellano, that was guts ball. Now none of us will be able to get a night’s sleep.’

  Barney was angry.

  Angry at the way the dean had sworn him to silence about Maury. Angry about Pfeifer’s senseless demands upon his flagging memory. About the prospect of having to interrupt his studying to hold unofficial ‘office hours.’ He felt almost angry enough to throw a punch at someone. But he settled for the next best thing.

  He hastened to his room, whipped off his loafers and jeans, donned shorts and sneakers, and – to warm up – double-timed it downstairs to the gym in the basement.

  A full-court basketball game was in progress. He did not know any of the players, except for Bennett Landsmann. Most of them looked like older guys, probably interns or residents. He watched from the sidelines for a few minutes, gaining some vicarious relief from the fact that the contest was being fiercely fought. Obviously, he was not the only guy around this place who needed physical catharsis.