Adult patients didn’t seem to care how you dressed as long as you avoided extremes of grooming and demeanor. Some were even comforted by the image the lab coat imparted.
Clinical rites, priestly vestments. Here’s an expert.
If they only knew.
A few minor crises kept him working past noon, and he stretched the day farther by extending his bedside contacts, taking time to sit down with the nursing staff, charting carefully, with atypical legibility.
A page-message from Angela said, “Sorry about today, got called in.”
A major crisis arose just before three: man with a gun near the Ob-Gyn Clinic, and the page operator was adamant that Dr. Carrier was needed.
The threat turned out to be the husband of a hysterectomy patient who’d been spotted by a nurse with a telltale bulge under his sweater and now sat alone and smoldering in a vacated waiting room.
Security had been called, the charge nurse informed Jeremy. The husband was an angry man, he’d always made her nervous. Hospital regulations said someone from Mental Health needed to be there, and the department said he was next up.
The affair turned out to be sad rather than frightening. Against everyone’s advice, Jeremy entered the room before the guards arrived. The man was unshaven, red-eyed, and under the influence of depression. Jeremy sat down and talked to him and listened and when the man said, “Why’s everyone so nervous?” Jeremy pointed to the bulge.
The man laughed and lifted his sweater and shirt. Underneath was a colostomy bag. The man said, “They can frisk me if they want. At their own fucking risk.”
He laughed harder, and Jeremy joined in. The two of them talked some more, and the poor fellow got into topics he’d never opened up about to anyone. Raged about his illness, his wife’s, the prospect of childlessness; there was plenty to be angry about. After an hour, he seemed calm, but Jeremy wouldn’t have been surprised if next time he did show up armed.
When the two of them exited the room, three members of the useless security detail the hospital employed were standing by, trying to look competent.
Jeremy said, “Everything’s under control. You can go.”
The biggest guard said, “Now, Doc-”
“Go.”
The time he spent with the poor man cheered him. Someone else’s problems. He’d snapped to attention like the faithful member of the mental health army he was. Any good soldier knew the key to efficient battle: death of the individual in service of the greater good.
Feeling noble and depersonalized, he returned to his office.
Angela had called thirty minutes earlier. He paged her, was transferred to Thoracic Medicine, where a ward clerk told him Dr. Rios had just been called to an emergency lung surgery.
That puzzled him. Angela was a medical resident, not a cutter. No doubt, there’d be an explanation.
He glanced at the sheaf of scolding papers, left to collect his mail. A hefty stack, today; he sorted through the usual memos, solicitations, announcements of conferences and symposia, came to a large, brown interoffice envelope at the bottom.
This one had been sent from the Department of Otolaryngology. No name in the recipient blank. He’d last consulted on an ENT case several months ago- an inner ear tumor that had proved fatal- wondered what they wanted, now.
Inside the envelope were photocopied pages that had nothing to do with ears, noses, or throats.
A seventeen-year-old article reproduced from an ophthalmology journal.
Ablation of corneal tissue using the CO2 Vari-Pulsar
4532 2nd Generation Laser Scalpel…
The authors were a surgical team headquartered at the Royal Medical College of Oslo. An international team- Norwegian names, Russian names, English names. None of them meant a thing to Jeremy.
Obviously a mistake; he’d gotten someone else’s mail, not a rare occurrence for the parcels that zipped through the mail tubes veining the hospital’s moldy walls. Perhaps some secretary had confused psychology with speech pathology.
He phoned Otolaryngology and spoke to a male secretary who hadn’t the faintest idea what he was talking about. Tossing the article in the trash, he put aside the envelope for further use. Fiscal responsibility and all that. Financial Affairs had issued yet another order to tighten up.
As he folded it, something rattled inside. Something had wedged at the bottom, and he pulled it out. A small, white index card, a typed message.
For your interest.
He took another look at the envelope. No name in the recipient blank; this had to be a mistake. He rarely saw eye patients, couldn’t recall one in ages- the last, he was fairly certain, had been five years ago, a blind woman who’d decided to curl up and die. After two months of psychotherapy, Jeremy believed he’d helped her, and no one had told him different. No, there could be no connection to this. Why in the world would he have an interest in lasers?
He retrieved the article from the wastebasket, read it, found it to be typical medical jargondygook, stuffed with numbers and tables, barely comprehensible. He cut to the summary. The main point was that seventeen years ago laser scalpels had been judged to be a good, clean way to cut.
Cutting techniques… Humpty-Dumpty… no, that was silly. If his mind hadn’t been addled by the last night’s booze and confusion and pontification about criminality, he’d never have stretched that far.
What a strange night. In retrospect, comic and surreal. He smiled painfully, remembering his acute bout of neediness. Why had he ever cared what a group of elderly eccentrics thought of him? Even if they asked him back, he wouldn’t accept.
Tomorrow was Tumor Board. He was curious how Arthur would treat him.
Then a thought occurred to him: Perhaps Arthur had sent the article.
No, the pathologist handwrote with a fountain pen, used that heavy, blue rag paper. A traditional man- an antiquarian, as witnessed by the vintage suits, the old car, the quaint vocabulary.
A typed message on anything so mundane as an index card would be out of character.
Unless Arthur was being coy.
The obliqueness fit- that would be just like the pathologist. Gregarious one day, frosty the next.
A game player, everything a puzzle. Was this a challenge to Jeremy to figure out?
Ablation of corneal tissue? Laser eye surgery? Had Arthur assumed Jeremy would share his eclectic interests? The old man hopped around from butterflies to carcinomas to Grand Discussions of Issues That Matter, so why not lasers?
Still, his approach to Jeremy hadn’t been scattershot. On the contrary, Arthur had sought to find common ground between the two of them. Pathology and psychology converging. Sharing the cold, black space where twisted minds brought about bloody deaths.
The roots of very, very bad behavior.
Arthur had had a very clear focus, and Jeremy had been right about his invitation to supper having something to do with that.
He recalled the pall that had set upon the room after someone- the writer, Maynard, he was pretty sure- had said, “Expediency trumps virtue.”
“Yet again,” the woman judge, Balleron had added.
Then, the silence. Nothing weighty was being discussed- something about fruit, grapefruit- those other things- pomelos. Sweet taste, but they shipped poorly.
Yet, for just a few moments, the mood in the room had changed.
Expediency trumps virtue.
What a strange bunch, no point wasting any more time on them.
Same for this- laser scalpels… just a postal snafu; he was making too much of it.
Filling his head with a flotsam of random thoughts because he was avoiding his chapter.
Still, his thoughts shifted back to Arthur. Treating him coolly for no apparent reason- rudely, really.