11
At the nursing station outside Assman and Mosby’s room, a kid in a “volunteer” smock approaches me. He’s a City College student from the neighborhood who believes he’ll someday go to med school and become a neurosurgeon. He wants to be the grandfather who works his whole life to establish the family fortune. And maybe he will be.
I know all this because I once asked him why he wears an Afro pruned into the shape of a brain.
“Hey, Dr. Brown—”
“No time,” I tell him.
“No sweat, just wanted to tell you I took that patient down to PT.”
PT is physical therapy. I stop. “What patient?”
The kid checks his clipboard. “Mosby.”
“Who told you to take Mosby to PT?”
“You did. It was in the orders.”
“Orders? F*ck. How’d you get him there?”
“Wheelchair.”
F*ck!
I turn to the nursing station. “Did somebody bring Mosby his chart, then take it back and put it in the orders rack?” All four people working there avoid my eyes, like they always do when something goes wrong. It’s like something from a nature documentary.
“Did you actually take him into PT?” I say to the kid.
“No. They told me to leave him in the waiting room while they found his appointment.”
“All right. You want to come on a trip?”
“Yes!” he says.
I turn to my med students, who are just now coming out of Mosby and Assman’s room. “Okay, guys,” I say. “Anyone asks where Mosby is, tell them he’s in Radiology. If they say they already checked Radiology, tell them you meant PT. In the meantime, steal me some antibiotics for when the lab reports back on that shit I just got stuck with. I want a third-generation cephalosporin, a macrolide, and a fluoroquinolone. I also want some antivirals*—everything you can get a hold of. Figure out some combination that won’t kill me. If you can’t, just use what I wrote for Assman, and double it. Got it?”
“Yes, sir,” one of them says.
“Good. Don’t be freaked out.”
I turn to the kid with the brain Afro and say, “Come with me.”
In the elevator I ask the kid his name again. “Mershawn,” he says. I don’t ask him to spell it.
I’ve made him put on his overcoat. I’m wearing a lab coat that has “Lottie Luise, MD,” stitched on the front of it. I don’t know who Lottie Luise is, but she leaves her coat in convenient places. Or used to.
“Mershawn, don’t get your tongue pierced,” I mention as we get to ground level.
“F*ck that shit,” Mershawn says.
In front of the hospital it’s snowing and sleeting and everything’s a mess. Visibility, as they say, is low.
I don’t know what I was expecting—well, wheelchair tracks in the slush, now that I think of it—but the sidewalk’s salted down and thirty people a minute are passing by. Plus there’s a big metal awning that runs for fifty yards along the front. The sidewalk is wet with black water.
“Which way did he go?” I say. Thinking: If he even came out this entrance, since there’s at least one on every face of the building.
“This way,” Mershawn says.
“Why?”
“It’s downhill.”
“Huh,” I say. “I’m glad I brought you already.”
Around the corner, the side street drops off toward the river even more steeply than the avenue we’re on now. Mershawn nods, so we head down it.
A couple of blocks along, there’s a twenty-five-foot patch of slush capable of holding prints. We know this because there are what look a f*ck of a lot like wheelchair tracks running down it. The tracks angle toward a graffiti-covered metal door in a building with the windows boarded over, but die out before they actually reach there.
I go and bang on the door. Mershawn looks up at the building dubiously. “What is this place?” he says.
“The Pole Vault,” I tell him.
“What’s that?”
“Are you serious?”
He just looks at me.
“It’s a gay bar,” I say.
The door gets opened by a fifty-year-old black man with graying hair and a barrel chest. He’s wearing a flannel work shirt and bifocals. “Help you?” he says, angling his head back to look at us.
“We’re looking for an elderly black man in a wheelchair,” I say.
For a moment the man just stands there, whistling a tune I don’t recognize. Then he says, “Why?”
Mershawn says, “Because neither of us got one for Christmas, and they’re all sold out at Elderly-Black-Men-in-Wheelchairs-R-Us.”
I say, “He’s a patient at the hospital, and he escaped.”
“Mental patient?”
“No. He’s got gangrene in his feet. Though he is demented.”
The man thinks for a moment. Again with the whistling.
“I don’t know why, but something about you idiots strikes me as well intentioned,” he finally says. “He went down toward the park.”
“Why’d he come here?” I ask.
“He asked for a blanket.”
“Did you give him one?”
“I gave him a jacket a customer left. Put it over him.” He looks around, and interrupts a new bout of whistling with a shiver. “That all?”
“Yeah,” I say. “But we owe you one. You should come in and let us check out your emphysema.”
The man squints down his nose at the “Lottie Luise, MD” monogramming on the front of my white coat. “Thank you Dr. Luise,” he says.
“I’m Peter Brown. This is Mershawn. We’ll get you in and out for free.”
The man gives a wheezy laugh that tails off in a choke. “Figure I got where I am today by not going to the hospital,” he says.
“Fair enough,” I have to say.
On the way down Mershawn asks me how I knew the guy had emphysema, and I list the physical signs he was showing. Then I say, “Teaching point, Mershawn. Who whistles?”
“A*sholes?”
“Okay. Who else?”
Mershawn thinks about it. “People who are thinking about something, then subliminally start thinking of a song about that thing. Like when you’re doing a cranial nerve exam and you start whistling ‘Keep Ya Head Up.’”
“Good,” I say. “But a lot of people also whistle because they’re subconsciously trying to increase the air pressure in their lungs, so they can force more oxygen through the tissues.”
“No shit.”
“Shit. You know the dwarfs in Snow White who work in a mine?”
“Yeah, okay.”
“If you had silicosis, you’d whistle your ass off too.”
“Damn.”
“That’s right.”
For the rest of the block I feel like Prof. Marmoset.
Duke Mosby, when we find him, is on a flagstoned pavilion overlooking the Hudson from the heights of Riverside Park. It’s a hell of a view, but the river’s charging heavily for it, spitting back a wet and flurrying wind. The kind you can feel through the vents in your plastic clogs. Snowflakes are skittering up from the ground at the same time they’re wheeling in from the sky. They’re lodged in Mosby’s hair and eyelashes.
“What’s going on, Mr. Mosby?” I shout to him above the wind.
He turns, and smiles. “Not much, Doctor. You?”
“You know Mershawn?”
“Sure do,” he says without looking at him. “Doctor, tell me this. Why is it so important to look at a river now and again?”
“I don’t know,” I say. “I think I may have missed that lecture in medical school.”
“I think it’s because we all have to see something God made once in a while. Like maybe if they put some plants around the POW camp, people wouldn’t break out so often.”
“If I have to see something God made,” Mershawn says, “I’d rather look at some p-ssy.”
“You see any p-ssy around here?” Mosby asks him.
“No sir.”
“Then I guess we’re stuck with the river.” Mosby notices Mershawn’s haircut, and says, “What the hell is that on your head?”
It occurs to me I might be losing my mind.
“Can we go back to the hospital now?” I say.
In the lobby I try Prof. Marmoset again, mostly as a reflex. I set my teeth for Firefly, but he picks up the phone himself.
“Yeah, hi, Carl —” he says.
“Professor Marmoset?”
“Yes?” He’s confused. “Who is this?”
“It’s Ishmael,” I say. “Hold on one second.” I turn to Mershawn. “Can I leave this on you?” I ask him.
“I can handle it, Doc,” he says.
“I believe you,” I say, looking in his eyes, which sometimes works. “Take him to PT, wait twenty minutes, ask why they haven’t called him for his appointment. When they tell you he doesn’t have one take him back up to the floor and say PT made a scheduling error. You got that?”
“I got it.”
“I believe you,” I say again. Then I turn away and uncover the phone. “Professor Marmoset?”
“Ishmael! I can’t talk long, I’m expecting a call. What’s up?”
What is up? I’m so happy to actually be talking to him that I can’t precisely remember where I’d planned to begin.
“Ishmael?”
“I’ve got a patient with signet cell cancer,” I say.
“That’s bad. Okay.”
“Yeah. A guy named Friendly’s doing the laparotomy. I looked him up—”
“John Friendly?”
“Yes.”
“And this is a patient of yours?”
“Yes.”
“Get someone else to do it,” he says.
“Why?” I ask.
“Because presumably you want him to live.”
“But Friendly’s the highest rated GI surgeon in New York.”
“Maybe in a magazine,” Prof. Marmoset says. “He inflates his statistics. He does things like bring his own blood supplies into the OR so he doesn’t have to report transfusions. If we’re talking about reality, he’s a menace.”
“Jesus,” I say. “He didn’t want the patient to have a DNR order.”
“Exactly. When your patient’s a vegetable, Friendly won’t have to report him as a fatality.”
“F*ck! How do I get him off the case?”
“Let’s think about it,” Prof. Marmoset says. “Okay. You call a GI guy named Leland Marker at Cornell. He’s probably skiing, but his office will be able to track him down. Tell his scheduler Bill Clinton needs a laparotomy and is hiding out at Manhattan Catholic to avoid the press. Tell him Clinton’s using a fake name, and give him the name of your patient. Marker’ll be pissed as hell when he figures it out, but by then it’ll be too late, and he’ll have to operate.”
“I don’t think I have time for that,” I say. “Friendly’s operating in a couple of hours.”
“Well, you could drop some GHB in his coffee, but from what I’ve heard he probably wouldn’t notice.”
I lean against the wall. There’s a ringing in one of my ears, and I’m starting to get vertigo.
“Professor Marmoset,” I say. “I need this patient to live.”
“Sounds like someone needs some distancing techniques.”
“No. I mean I need this patient to live.”
There’s a pause. Prof. Marmoset says, “Ishmael, is everything all right?”
“No,” I say. “I’ve got to see this patient through.”
“Why?”
“It’s a long story. But I have to.”
“Should I be worried about you?”
“No. It wouldn’t do any good.”
There’s another pause while he decides what to do with this.
“All right,” he says. “But only because I have a couple other calls coming in. I want you to call me when you can tell me about it. Leave a message. In the meantime, I think you should scrub in.”
“Scrub in? I haven’t done surgery since med school. And I sucked at it even then.”
“Right, I remember that,” he says. “But you can’t be any worse than John Friendly. Good luck.”
Then he hangs up.