“Fuck,” I say out loud.
Sure enough, a woman five doors down is flat-out dead, with a look of screaming horror on her face and a vitals sheet that reads “Temp 98.6, Blood Pressure 120/80, Respiratory Rate 18, Pulse 60.” Even though her blood’s so settled at the bottom of her body that it looks like she’s been lying in a two-inch pool of blue ink.
To calm myself down I go start a fight with the two charge nurses. One’s an obese Jamaican woman busy writing some checks. The other’s an Irish crone cruising the Internet. I know and like both of them—the Jamaican one because she sometimes brings in food, and the Irish one because she has a full-on beard she keeps shaved into a goatee. If there’s a better Fuck You to the world than that, I don’t know what it is.
“Not our problem,” the Irish one says, after I’ve run out of things to complain about. “And nothing to do about it. We had that pack of Latvian cuntheads on the overnight. Probably out selling the lady’s cell phone by now.”
“So fire them,” I say.
It makes both nurses laugh. “There’s a bit of a nursing shortage on,” the Jamaican one says. “Case you haven’t been noticing.”
I have been noticing. Apparently we’ve used up every nurse in the Caribbean, the Philippines, and Southeast Asia, and now we’re most of the way through Eastern Europe. When the white supremacist cult Nietzsche’s sister’s founded in Paraguay re-emerges from the jungle, at least its members will be able to find work.
“Well I’m not filling out the certificate,” I say.
“Sterling. And fuck the Pakistani, eh?” the Irish one says. Her face is remarkably close to the computer screen.
“Akfal’s Egyptian,” I say. “And no, I’m not leaving it for him. I’m leaving it for your Latvian shitheels. Stat.”
The Jamaican one shakes her head sadly. “Won’t bring the lady back,” she says. “You ask them to do the certificate, they’re just going to call a code.”*
“I don’t give a fuck.”
“Párnela?” the Jamaican one says.
“I neither,” the Irish one says. “Dim bitch,” she adds, sort of under her breath.
You can tell by the way the Jamaican one reacts to this that she knows the Irish one is talking about me, not her.
“Just tell them to do it,” I say, leaving.
I feel better already.
But even after that I have to take a slight break. The Moxfane I chewed up half an hour ago, along with some Dexedrine I found in an envelope in my lab coat and ate in case the Moxfane took too long to kick in, is making it hard for me to concentrate. I’m peaking a little too sharply.
I love Dexedrine. It’s shield-shaped, with a vertical line down the middle so it looks like some vulvae.† But even on its own, Dexedrine can sometimes make things too slippy to focus on, or even look at. On top of a Moxfane it can make things start to blur.
So I go to the medicine residents’ call room to chill out, and maybe take some benzodiazapines I’ve got hidden in the bed frame.
The second I open the door, though, I know there’s someone in there in the darkness. The room stinks like bad breath and body odor.
“Akfal?” I say, though I know it can’t be Akfal. Akfal’s aroma I will take to my grave. This is worse. It’s worse than Duke Mosby’s feet.
“No, man,” comes a weak voice from the corner with the bunk bed.
“Then who the fuck are you?” I snarl.
“Surgery ghost,”* the voice says.
“Why are you in the Medicine call room?”
“I...I needed a place to sleep, man.”
He means, “Where no one would look for me.”
Great. Not only is the guy stenching up the call room, he’s using the only available bunk, since the upper one is covered by a complete run of Oui magazine from 1978 to 1986, which I know from experience is too much of a pain in the ass to move.
I consider just letting him stay. The room smells unusable for the foreseeable future anyway. But I’ve got that Moxfane Edge,™ and there’s always deterrence to think about.
“I’ll give you five minutes to get the fuck out,” I tell him. “After that I’m dumping a bottle of urine on your head.”
I turn the lights on as I go.
I’m feeling slightly more focused now, but still not focused enough to talk to patients, so I go and check labs on the computer. Akfal has already copied most of them into the charts. But there’s a pathology report on a patient of Dr. Nordenskirk’s who actually has insurance, so Akfal hasn’t touched it. Dr. Nordenskirk doesn’t let anyone who’s not white or Asian interact with patients with insurance.
So I scan the report on-screen. It’s a bunch of bad news for a man named Nicholas LoBrutto. The Italian name alarm in my head goes off, but I’m pretty sure I’ve never heard of this guy. And anyway mobsters—like most people with options—don’t come to Manhattan Catholic. It’s why I’m allowed to work here.
The key phrase in the pathology report is “positive for signet cells.” A signet cell is a cell that looks like a ring with a diamond (or a signet, if you’re still sealing your letters with wax) on it, because its nucleus, which is supposed to be in the center, has been pushed to the wall by all the proteins the cell can’t stop making because it’s cancer. Specifically, either stomach cancer or cancer that was stomach cancer and has now metastasized, like to your brain, or your lungs.
All stomach cancers suck, but signet cell is the worst. Where most stomach cancers just drill a hole through your stomach wall, so you can have half your stomach cut out and conceivably live, just not be able to shit solid, signet cell cancer infiltrates the stomach along the surface, producing a condition known as “leather bottle stomach.” The whole organ has to go. And even then, by the time you’re diagnosed it’s usually too late.
The CT scan of Nicholas LoBrutto’s abdomen is inconclusive about whether his cancer has spread or not. (Although, helpfully, he now has a 1 in 1200 chance of contracting some other form of cancer just from the radiation of the scan. He should live so long.) Only surgery will say for sure.
And in the meantime, at six thirty in the morning, I get to go tell him all of this.
Mr. LoBrutto? There’s a call for you on line one. He didn’t say, but it sounded like the Reaper.
Even for me, it’s early to be wanting a drink.
LoBrutto is bedded down in the Anadale Wing, the tiny deluxe ward of the hospital. The Anadale Wing tries to look like a hotel. Its reception area has wood-patterned linoleum and a schmuck in a tuxedo playing a piano.
If it really were a hotel, though, you’d get better healthcare.* The Anadale Wing actually does have hot 1960s nurses. I don’t mean they’re hot now. I mean they were hot in the 1960s, when they first started working at Manhattan Catholic. Now they’re mostly bitter and demented.
One of them shouts out to ask where the hell I’m going as I pass the charge desk, but I ignore her on my way to LoBrutto’s “suite.”
When I open the door I have to admit it’s pretty nice for a hospital room. It’s got an accordioning wall, now mostly retracted, that divides it into a “living room”—where your family can come eat dinner with you at an octagonal table covered with vinyl that looks easy to clean vomit off of—and a “bedroom” with the actual hospital bed. The whole thing has floor-to-ceiling windows, with a view, at the moment, of the Hudson River just starting to catch light from the east.
It’s dazzling. They’re the first windows I’ve looked out since I got to work. And they backlight LoBrutto in his bed, so he recognizes me before I recognize him.
“Holy shit!” he says, trying to crawl away from me up the bed, but held back by all his IV and monitor lines. “It’s the Bearclaw! They sent you to kill me!”
2
One summer when I was in college I went to El Salvador to help register indigenous tribes to vote. A kid in one of the villages I was visiting got his arm pulled off by an alligator while he was fishing with a hand line, and would have died in
front of me if it hadn’t been for one of the other American volunteers, who was a doctor. Right then and there I decided to go to medical school.
This never actually happened, thank the Christ, and in fact I barely went to college, but it’s the kind of thing they tell you to say when you apply to med school. That or how you had some disease growing up that was so brilliantly cured you can now work 120 hours a week and be happy about it.
What they tell you not to say is that you want to be a doctor because your grandfather was a doctor and you always looked up to him. I’m not sure why this is so. I can think of worse reasons. Plus, my own grandfather was a doctor, and I did look up to him. As far as I could tell, he and my grandmother had one of the great romances of the twentieth century, and were also the last truly decent people on earth. They had a humorless dignity I’ve never managed to come close to, and an endless concern for the downtrodden that I can barely stand to think about. They also had good posture, and what appeared to be a sincere enjoyment of Scrabble, public television, and the reading of large and improving books. They even dressed formally. And although they were citizens of a vanished type, they showed forgiveness toward people who weren’t. For example, when my stoned-out mother gave birth to me, on an ashram in India in 1977, then wanted to go on to Rome with her boyfriend (my father), my grandparents flew over and took me back to New Jersey, where they raised me.
Still, it would be dishonest to place the origins of my becoming a doctor in my love and respect for my grandparents, since I don’t believe I even considered going to medical school until eight years after they were murdered.
They were killed on October 10, 1991. I was fourteen, four months away from being fifteen. I came home from a friend’s house around six thirty at night, which in West Orange in October is late enough that you need the lights on. The lights weren’t on.
At the time, my grandfather was doing mostly nonsurgical, though medical, volunteer work, and my grandmother was volunteering at the West Orange Public Library, so they both should have been home by then. Also, the glass pane next to the front door—the kind of glass they call “pebbled”—was broken, like someone had smashed it to reach in and open the lock.
If this ever happens to you, leave and call 911. There could be someone still in the house. I went in, because I was afraid someone would hurt my grandparents if I didn’t. You’ll probably go in too.
They were on the border between the living room and dining room. Specifically my grandmother, who had been shot through the chest, was on her back in the living room, and my grandfather, who had doubled forward after being shot in the abdomen and hence was face down, was in the dining room. My grandfather had his hand on my grandmother’s arm.
They’d been dead for a while. The blood in the carpet sucked at my shoes, and later, when I was lying down in it, at my face. I called 911 before I went and put my head down between theirs.
In my memory the whole thing is in vivid color, which is interesting, because I now know that we don’t actually see color in low-light situations. Our minds imagine it for us and paint it in.
I know I put my fingers in their gray hair and pulled us all together. When the EMTs finally got there, the only thing for them to do was pull me off so that the cops could photograph the crime scene and let City Services remove the bodies.
The particular irony of my grandparents’ story is that they had survived a much more elaborate attempt to murder them fifty years earlier. They had met, legendarily, in the Białowieża Forest in Poland in the winter of 1943, when they were fifteen, barely older than I was when I found them dead. They and a bunch of other newly feral teenagers were hiding out in the snow and trying to kill off enough of the local Jew-hunting parties so that the Poles would leave them alone. What this precisely involved they never told me, but it must have been pretty ferocious, because in 1943 Hermann Göring had a lodge at the southern end of Białowieża where he and his guests dressed as Roman senators, and he must have been aware of the situation. There’s also the question of a straggler platoon of Hitler’s Sixth Army that disappeared in Białowieża that winter en route to Stalingrad. Where, to be fair, it would have been wiped out anyway.
What finally got my grandparents caught was a scam. They got word from a man in Kraków named Władysław Budek that my grandmother’s brother, who had been working in Kraków as a spy for the Bishop of Berlin,* had been captured and sent to the Podgorze “Ghetto,” which was a holding pen on the rails to the Camps. Budek claimed he could get my mother’s brother out for 18,000 zlotys, or whatever the fuck money they were using then. Since my grandparents had no money, and were suspicious anyway, they went to Kraków themselves to check things out. Budek called the police and sold them into Auschwitz.
It was typical of my grandparents that they later described being sent to Auschwitz as a stroke of luck, since not only was it better than being shot by Polish crackers in some forest, it was better than being sent to a death camp.* At Auschwitz they were able to contact each other twice through smuggled notes— which, to hear them tell it, made surviving until liberation easy.
Their funeral was near my Uncle Barry’s place. This was my mother’s brother, who had freaked out and become an Orthodox Jew. My grandparents had certainly considered themselves Jewish—they had visited and supported Israel, for example, and were dismayed by the world’s quick demonization of it—but to them being Jewish meant they had certain moral and intellectual responsibilities, not that religion was anything other than a bloodstained hoax. My mother had burned through every traditional form of rebellion before Barry could even get started, though, so dressing like a shtetl dweller in 1840s Poland was probably his only recourse.
My mother attended the funeral and asked me if I needed her to stay in the U.S., and whether I wanted to move to Rome. My father did me the favor of not pretending: he just sent me a rambling, slightly touching letter about his relationship with his own grandparents and how as you go through life you never really feel any older.*
Barry adopted me to keep Child Protective Services off my back, but it was easy to convince him to let me stay in my grandparents’ house. At fourteen I was physically enormous and had the mannerisms of an elderly Polish Jewish doctor. I liked to play bridge. Plus, Barry and his wife weren’t crazy about exposing their own four kids to someone who’d been abandoned at birth and then come home one day to find his foster parents dead by violence. What if I became dangerous?
What indeed. Smart move, Barry and Mrs. Barry!
I sought out the dangerousness and refined it. As any other American child would, I picked Batman and Charles Bronson in Death Wish as role models. I didn’t have their resources, but I didn’t have much in the way of expenses, either. I hadn’t even had the carpets changed.
I felt I had no choice but to take on the case myself. I still feel that way, really.
I know from experience, for instance, that if you go into the woods and shoot a handful of survivalist pedophile pimps—men who have destroyed the lives of literally hundreds of children—then the police will go apeshit trying to find you. They will check the drains in case you washed your hands after running them through your hair. They will cast for tire tracks.
But if the two people you care about most get brutally murdered by some scumbag who rifles a couple of cabinets and takes the VCR, it will all be a fucking mystery.
Did they have any enemies?
Any enemies who needed a VCR?
It was probably a crackhead.
A crackhead with transportation, and gloves, and a fuck of a lot of luck not to be seen by anybody.
We’ll ask around.
We’ll let you know.
And it will be obvious to you just how justice will get served: by you or by nobody.
What kind of choice is that?
The different martial arts all share an interesting gimmick. (I went from tae kwon do to sho ryu karate to kempo, one foot-smelling dojo much like another, as I followed the traditional Jap
anese directive to spend more time training than sleeping.) You’re supposed to act like an animal. I don’t mean in the abstract: you’re supposed to model your strategies on those of real, specific creatures. Using “crane style” for precise, fast, distance attacks, for instance, or “tiger style” for aggressive, in-close slashing. The underlying idea is that the last animal you’d want to emulate in a violent situation is a human being.
This turns out to be true, by the way. Most humans are instinctively terrible fighters. They flinch, they flail, they turn away. Most of us are so bad at fighting that it has actually been an evolutionary advantage, since before the mass production of weapons people had to think to truly hurt each other, so the smart had a fighting chance. A Neanderthal would kick your ass and then eat it, but try finding one to test this.
Alternately, consider the shark. Most species of shark hatch live inside their mothers and start killing each other right then and there. The result is that their brains have stayed the same for 60 million years, while ours kept increasing in complexity until 150,000 years ago, at which point we became able to speak, and therefore human, and our evolution became technological instead of biological.
There are two ways of looking at this. One is that sharks are vastly evolutionarily superior to humans, since if you think we’ll last 60 million years, you’re insane. The other is that we’re superior to sharks, because they’ll almost certainly be extinct before we will, and their demise, like ours, will be thanks to us. These days a human’s a lot more likely to eat a shark than vice versa.
On the tiebreaker, though, sharks win. Because while we humans have our minds and our ability to transmit the contents of them down through the generations, and sharks have their big ol’ teeth and the means to use them, sharks don’t appear to agonize about the situation. And humans sure as hell do.
Humans hate being mentally strong and physically weak. The fact that we get to take this planet down with us when we go brings us no joy whatsoever. Instead we admire athletes and the physically violent, and we loathe intellectuals. A bunch of nerds build a rocket to the fucking moon, and who do they send? A blond man named Armstrong, who can’t even say the line right when he lands.