Chapter 5
This was the way of it: He was Dr. Farrell, intern, responsible for lives. Agitated relatives waylaid him and the squawk-box pursued him. His irrevocable signature went on every record. Pray it wasn’t written as witness to a mistake he’d made! Best not to think about that, though; just step forward and begin, the way a child learns to walk.
The emergency room stayed in motion all night. One lived on black coffee. He slept on a cot or dozed off, rather, for a few minutes until a nurse came to shake him awake again. The doors would swing open, and another stretcher come rolling through. On the wards, the ominous nights were filled with sighs. Unbearable pain was unbearable to watch. He dreaded the terminal cancer patient most of all; the breakdown of personality in even the most stalwart was terrible. He had not known that desperate people, even the very old, call out for their mothers.
At times he thought he felt the weight of the pain-filled building, ten stories high, lying on his shoulders.
“What’s different about you?” Tom asked.
“I don’t know. What is?”
“You’re only half here. Is there some trouble with your father or something?” Martin had often said his father worked too hard and his blood pressure was too high.
“No, no, I’m just a little tense, I guess.”
There was no one in the world whom he could trust more than this friend who was searching him now with inquiring eyes, but he couldn’t, he didn’t want to, talk about Mary.
If only his mind were clear again as once it had been! If only the work were all he had to think about! But he trembled inwardly: trembled at seeing the name of the Meig plant in the weekly paper, forwarded from home; trembled at seeing a patient named Fern, a fat woman with a brogue and abscessed tonsils.
He trembled when the mail came. She sent a card from Lake Champlain: Visiting here for a few days. Love. He read it over and over, studying the shape of the words. She wrote in backhand. He wondered what that meant, whether it said anything about her personality. Then a card came that had a picture of an ocean liner. It had been mailed from Cherbourg. He imagined her walking in the rain on a cobbled street. He ached for her. It was a definite physical ache in the chest. One could understand why the ancients had believed that the heart was the seat of the emotions.
His own emotions came close to the surface. He broke off with Harriet, in a scene that he had wanted to keep gentle but that she made angry. His desire for her, for anyone but Mary, had drained away, as if a sluice had been opened.
A tragedy took place in the hospital when one of the nurses killed herself. She had been going with Dan Ritchie, resident in orthopedics; he had promised to marry her, then changed his mind. The horror of this shook Martin deeply. How the suffering must have cut to make a human being want to die! But he thought he could understand it. He felt that he had grown enormously in understanding.
And he was thankful for being overworked. It was the only way he would get through the winter.
What he saw first on the stretcher was a young girl in a tight pink sweater and skirt. It crossed his mind that she looked like a girl who would be named “Donna” or “Dawn.” And on a necklace of cheap beads her name was spelled out: Donna. She had been run over in the rain. Her face was gashed and her arms, which she must have flung out to save herself, had been crushed.
Standard procedure, he thought, accustomed as he was by now to quick judgment and quick action. Neurosurgery later to save the ulnar nerves. Useless hands, otherwise. Patch the face while waiting. Sedation, of course. Local anaesthesia. He called out orders. Black silk. Fine needle.
“This won’t hurt,” he said.
Never did this before. Where to find a surgeon Saturday night? Common sense. Trick is: very, very small stitches. Careful. Careful. Suture. Tie. Knot. Cut. Again. Suture. Tie. Knot. Cut.
When he was finished, the pathetic face was crisscrossed with black silk and he was sweating. He leaned down.
“Donna? I’m all through.”
She was, mercifully, half asleep. “Will my face be all right?”
“Yes,” he said confidently.
The mouth, large and cherry-colored, quivered. “Do you promise I won’t be scarred?”
“I promise.”
“Will I be a cripple, Doctor?”
“Of course not,” he said. And forgive me for the lie because I really don’t know.
They had cut the pink sweater off. Somebody began to cut the necklace.
“No,” Martin said. “Don’t do that.” And he pulled the clasp toward the front to unfasten the beads. They would be precious to Donna.
After she had been wheeled upstairs he kept thinking of her, and the next morning was still thinking of her. Mentally, as was his habit, he constructed her life. She lived in a walk-up and worked in the five-and-ten. For lunch she ate a tuna fish sandwich and a chocolate soda. She stood in line at the funerals of movie stars, chewing gum in wads. He felt an indescribable sadness. Some patients did that to him. What would become of her with paralyzed hands?
Dr. Albeniz was to operate in the forenoon. Martin arrived when it was all over and the doctors were back in the locker room.
“It was very close,” Albeniz said, replying to Martin’s question. “But I’m fairly sure she’ll be all right.” He seemed surprised. “Why, do you know the girl?”
“No. I was on duty when she came in. I sutured her face.”
“You did?” There was strong emphasis on the “you.”
Martin felt quick dread in the pit of the stomach.
“I’m afraid I’m the culprit.”
“Culprit?” Albeniz, who was tying his shoes, glanced up.
“On the contrary, I asked because it’s a superb job. By the looks of it she will have scarcely a scar.”
Martin swallowed, disbelieving. “I guess I was just lucky then.”
“You had your nerve, knowing nothing about it!”
“Yes, sir.”
“You have good hands. Are you interested in plastic surgery?”
“Not particularly.” He corrected himself, “No, I’m not.”
“Well, it was a superb job,” Albeniz repeated.
Martin flushed, both with pleasure and misgiving. What had he dared to do, knowing so little? He had just been awfully lucky! Very generous, though, of Albeniz to say what he had.
A week or two later, Albeniz ran past him in a corridor. Speed was his eccentricity. It seemed that all the greats had some eccentricity or other! Jeffers wore rubbers even when the sun was shining. Albeniz never took the elevator, preferring in his haste to run up three flights of stairs. When he saw Martin he stopped.
“Would you like to know how your patient is getting on?”
“Oh, yes,” Martin said, pleased at being treated like a colleague.
“Well, for a while I had my doubts, but she will definitely have usable hands. Also a presentable face, thanks to you.”
It seemed necessary to say something polite in return. “After what you’ve done for her, my suturing seems unimportant.”
“Not so. It’s not very good for one’s mental health to have scarred cheeks, you know.”
“But your work is vital. I’ve seen you work and I’ve been—I guess you could say I’ve been thrilled each time.”
Albeniz smiled. “Well then, I give you a standing invitation to come and watch whenever you’re free.”
* * *
The operating room was fitted out in porcelain and stainless steel, gleaming silver-gray. Beyond the great window, the winter sky was a darker gray. Albeniz and his resident, the anaesthesiologist, the nurses, the assistants and the subassistants moved quickly in an ordered pattern, their feet making no sound. It was a subaqueous ballet, a serious dance around the table on which the patient lay, his shaven head firmly clamped. The green curtain hanging on its frame separated his head from the rest of his body. A profusion of tubes was connected to various parts of that body; to someone who didn’t understand them it a
ppeared to be only a tangle of tubes. But they were the weapons of this little army which was fighting for the life of the man on the table.
The excitement was unlike anything Martin had ever felt before. He stood with the explorers, with Balboa sighting the Pacific Ocean and Magellan rounding the world.
Bare and exposed lay a human brain. Albeniz looked up from it to the X-ray, hanging directly in his line of vision. There the arteries turned and curved like grapevines or Virginia creeper. There lay the dark blot and clump of tumor. Martin’s heart pounded. He tried to remember what he had learned about the brain; neurons, axons, dendrites—and could only think: There somewhere in that roughly corrugated mass, that lump made of the same stuff as stomach or liver, ran the electricity of thought. Out of it came words, music and commands to clench a fist or kiss beloved lips.
“Clamp,” said Albeniz.
His hands in their pale gloves moved inside the patient’s brain, moved among those billions of neurons.
“Cautery,” he said. “Suction.”
Five and a half hours later it was over. Albeniz looked up. His eyes, above the mask, were weary.
“I think I got it all out.”
Martin knew he probably had, but no surgeon would ever say, “I know I have.”
He was awestruck.
A fine surgeon is an artist, thought Martin. All eyes are on him. He may be a simple, modest man like Albeniz or a bully like some others I’ve seen. But either way he is respected: he has a great gift. What I should wish is to be like Dr. Albeniz.
What am I dreaming of?
In such limited free time as he had, Martin observed Dr. Albeniz. He went to his laboratory and to his clinic. With curiosity and fascination he followed some cases through surgery and into ultimate rehabilitation—or else to postmortem. He asked questions, but not too many.
Someone asked, “You going in for neurosurgery? That why you’ve been hanging around Albeniz?”
Not very likely! Who could afford to go in for graduate work? Only very special people, types who could drift through Europe from clinic to clinic, spending a half year here and a half year there with the great authorities of Germany or England, steeping themselves, acquiring knowledge and finally, a name. For that sort of thing you needed independent means. Certainly you needed time. Probably too you needed a mentor to foster and advise.
He was about to go off duty one afternoon when he was summoned to Dr. Albeniz’s laboratory. Perplexed by the summons, he went at once. The doctor was hanging up his lab coat.
“I was wondering whether you like Italian food. There’s a place just a few blocks down Third Avenue.”
“I’ve never had any,” Martin said.
“Good! It’ll be a new experience, and everybody likes Italian food, even Spaniards like myself.”
Outside on the windy street Albeniz explained, “In case you’re wondering about this occasion, it’s just because I like to talk to the rising medical generation now and then.”
“It’s very good of you, sir.” Martin hoped he didn’t appear as awkward as he felt.
When they were seated with a clean, darned cloth and a basket of bread between them, Albeniz asked, “Would you like me to order for you?”
“Please do.”
“All right then. Clams oreganata to begin. Pasta, of course. Salad. Do you like veal? Veal pizzaiola, then. Isn’t it ridiculous to eat like this without wine? A fine, dry wine with the sunshine in it? You Americans are such Puritans with your Prohibition.” He sighed, rubbing his hands to warm them and was silent a moment. He took off his glasses and rubbed the bridge of his nose.
“You know, I’ve been watching you watch me these last months. You find my work interesting, don’t you?”
“Yes, I—” Martin began, but Albeniz interrupted him.
“Tell me why you wanted to be a doctor.”
Martin said slowly, “It always seemed, as far back as I can remember, the most exciting thing I could imagine.”
“Yes?”
“And I was curious. It’s like solving puzzles. You want to go to the next one.” He stopped, feeling the inadequacy of his explanation.
But the other man smiled. “I’m glad you didn’t say to help humanity,’ or ‘because I love people.’ Some such rubbish. I hear young men say that and I don’t believe them.”
Martin was silent.
“Of course you rejoice when you’ve done something good for another human being! And of course you feel pity when things go wrong! But if you feel too much pity, you break your heart. Or you go crazy.” He waved an admonishing finger. “You have to be disciplined, controlled and expert, a puzzle-solver, as you just said. Then, when the mind is beautifully clear and very cool, then you can really do some good. Sometimes. You understand me?”
“I think so.”
The clams were brought. Albeniz took a mouthful, then laid the fork down. “We know so little. Take my field. It’s only for the last thirty years or so that we’ve dared to go very far into the brain. Neurosurgery is a new discipline and most of what we know we’ve learned since the war.” He paused, picked up the fork and put it down again.
“Although, taking another point of view, it’s very old. Ancient, in fact. The Egyptians trephined the skull four thousand years ago, using sharpened stones.”
With a clean fork, he pressed a diagram into the tablecloth.
“You were in the war, weren’t you, Doctor?”
“I worked in a British military hospital. My clinical training I had taken in Germany before the war.” Albeniz shrugged. “Medicine knows no politics, or shouldn’t. But that early work was crude. There were too many infections. We’ve come a good way since then.”
“I see that.”
“Did you know we’re going to have a separate department starting in September? At last we’ll be removed from general surgery. And high time.”
“I didn’t know.”
“Well, it’s just been decided. Of course, that will be only a start What we ought to have, what I dream of, is an institute where neurosurgery and neurology could be combined. Then we could truly study the whole brain: its function, pathology, even the tie-in with what is called ‘mental illness,’ which has, I’ve long been convinced, a physical cause. Perhaps God knows how many physical causes.” He sighed. “But, as I say, that’s only my dream. I haven’t the money or the influence to make it come true. I’m no good at medical politics. I’ll just be grateful for this little new department and let it go at that.” He made a small pyramid with his fingertips. “I’m talking too much. Tell me, what do you think about what I’ve just told you?”
Martin shook his head. “I haven’t any right to think. I don’t know anything about it.”
“Well spoken! I like that! I detest these fellows who go on rounds and wisely nod their heads, pretending to know, when they haven’t the slightest idea what it’s all about. How do you like the veal?”
“Oh, great! Some change from the cafeteria!”
“I should hope so. Tell me, what are you planning to do when you finish in June?”
“Work with my father. He’s got a general practice upstate.”
Dr. Albeniz studied Martin. His austere face softened.
“Are you happy about it?”
No one had ever put the question like that. People assumed he was happy. You finished your internship; then you went into practice, and if you had one already waiting for you, why then, you were just very, very lucky indeed! So he waited a moment and then, for the first time, expressed the truth.
“No sir, I don’t think I am.”
“I see.”
“I guess I haven’t wanted to admit it, even to myself.”
He turned away, looking at an amateurish painting of Italy, candy-pink roses against a white wall and a gaudy blue sky.
“Have some more pasta. You’re thin enough to afford it.”
“Thank you, but I’m not all that hungry.”
“I’ve upset you with my ques
tions, haven’t I?”
“A little, maybe.”
“More than a little. You know, or maybe you don’t know, that I’ve been observing you? Ever since that time you sewed up the girl’s face. It’s strange that you should have come to my attention through work that’s not in my field, but I knew that the hands which could do that without having been taught could do much more.”
Martin waited. He became conscious of his heartbeat.
“And then you began coming to watch me, and you came to the lab and you asked intelligent questions.”
The beat accelerated.
“You’re aware, of course, that you’ve earned a reputation this year?”
“Well, I—”
“Come, come! Dr. Fields tells me you’re the best intern he’s had in his service in ten years.”
“I didn’t know that, sir.”
“Well, you know it now. So hear me. I’m coming to the point. In this new service that I’m to have, I can train two young men. I already have one coming from Philadelphia in the fall. I’m asking you to be the other.”
Martin looked at him dumbly.
“You understand what I’m driving at. I wouldn’t have to waste words with you. I’m doing a lot of talking now, but the fact is, I don’t talk much when I’m working. I’m an impatient man and I need people around me who grasp my meaning quickly. I could work with you, Martin.” He paused, then added thoughtfully, “I want a man who will grasp the whole concept of the brain, not just a skillful surgeon-mechanic. I want someone who has curiosity. That’s the key word, curiosity. What do you say?”
“Forgive me. I’m stunned.”
“Of course, it’s a new idea for you! This would be another world from the one you had been planning on—sore throats, measles and cut fingers. Not that we don’t need good men who’re willing to do that Men like your father. What do you think he will say to this?”
“Hell be terribly disappointed, I’m afraid.”
Sick over it. Dread sank in Martin like a stone.
“Yes, I can imagine. I’ve never had a son, but I can imagine your father would want you to come home. Still,” Albeniz said quietly, “there are always some who have to break the soft family ties no matter how it hurts. In a way it’s like being a soldier or a monk. I was forty before I got married. In Europe men marry later; it gives them time to develop. My wife knew she would come second to my work. Late at night, on Sundays if need be, I’m at the hospital. It is my devotion. Perhaps I express it badly, English not being my native language.”