An overworked pre-med student struggles to please everybody, risking his own sanity.
|I am very tired, too tired in fact to be of any real use to anyone, actually.
It is two o'clock on a Sunday afternoon in early November. I can barely keep my eyes open as I look through my microscope, examining blood smears. I have been up most of the night typing and cross-matching blood for an accident victim who was brought into the emergency room shortly after midnight. She has type B Negative blood, not the most common type, and locating enough blood within the entire state to meet her needs has been a most difficult and frustrating task.
I am working too hard, both here and in school. I am in my sophomore year in college and am carrying eighteen credit hours this semester. Most of my courses are accelerated courses and they are very difficult. They're difficult because I don't like them. I don't like my major--I don't like pre-med--and I don't want to be a doctor; but I have no choice--Father tells me this is what I will be--he pays my tuition. I have no choice.
Every time I try to tell him, explain to him, why this is not my choice, he says, "Don't argue, Sandy. It's best this way. Work hard, you'll make it. Let's not talk about it now-it'll upset your Mother."
So I don't talk about it. I listen. I always do what he says. I am obedient. But he doesn't understand what is happening to me. Nobody does.
I wish I were more like my brother John. John is three years older than me. John never went to college; he didn't want to. John doesn't live at home anymore.
My parents don't know where John lives; he doesn't stop by much anymore. Twice during the summer he came by our house on his motorcycle, both times he had his girlfriend riding on the back of his Harley. Both times John and Father got into an argument. Mother began to cry like she always does. She's a very nervous person, everything bothers and upsets her. Father protects her from everything-especially from John, who always upsets her even though he never means to.
I am Father's favorite. I don't argue with him; I agree with everything he says, even though I don't want to. And most of all, I don't upset Mother.
Sometimes, like today, I feel like a zombie. My life is too filled with things that I don't want to do. I have no friends, there isn't time. I spend all my time studying or in class, or, here at the hospital working in the laboratory.
Dr. Auchenchloss tells me that I am very lucky. Dr. Auchenchloss is the chief pathologist. He is also Father's most important client and best friend. He hired me to work weekends in the laboratory. I was hand-picked from a number of other students in my class who applied for the position. They're in pre-med too. He told me that he would train me in all facets of clinical laboratory medicine and this would give me a great advantage over the other students when I get into medical school.
Dr. Auchenchloss also has me working in the autopsy room. I hate and fear this more than anything, but when I told him that I didn't want to do this, he became extremely angry and told me that I was unappreciative of everything he was doing for me. He told me there were a lot of other students that would give their right arm to have this unique opportunity. I wanted to tell him to hire them instead of me--but naturally I didn't.
I am Hamlet and Dr. Auchenchloss is the ghost of my father. He is driving me deeper and deeper into myself. I am depressed and melancholy, but he does not see this. He thinks that he's doing me a favor.
He's wrong. Very wrong.
Marlene walks into the hematology lab where I am sitting. Marlene is a medical technologist who works in the chemistry lab. I like her. She is the only person in the lab who treats me like I want to be treated--like the kid I am, rather than some genius-freak, which I am not.
She tells me there is a call for me on her extension. I am uplifted. It may be John--he sometimes calls me at work just to talk and ask about how things are going at home.
I thank her for telling me this and she smiles and asks me if I want a Coke from the coffee shop. I tell her I would like one very much and offer her some change from my pocket. She waves me away and tells me that this one is on her. I thank her and make my way to her lab.
The voice on the other end of the phone is not John's.
"Hello, Sahndee," it says.
"Yes," I say, knowing full well that it is Dr. Vihngee. My mood changes at once. There is only one reason Dr. Vihngee would call me, and that is to tell me that there is autopsy to be performed.
Dr. Vihngee is one of the resident pathologists. He is from India and sometimes his speech is very hard to understand. He speaks in a sing-song way that reminds me of some whacked out maharishi of the sixties. He's really a nice guy though. I only wish that I could talk with him about things other than autopsies.
"Sahndee, this is Dr. Vihngee," he continues. "We have to do a post mortem this afternoon."
"But it's so late," I say, looking at my watch.
Usually autopsies are never done after one or two o'clock on Sunday afternoons. Generally when people die after noon in the hospital, the body is brought to the morgue where it is kept over night and is autopsied early Monday morning when the full pathology staff is on duty. In some cases for religious purposes like when the person is a Jew, or in police cases when foul-play is suspected, exceptions are made.
"I know," says Dr. Vihngee, "but this is a medical-legal case. Dr. Auchenchloss himself is coming in. You will prepare the autopsy room--yes?"
What choice do I have? I think to myself. If it were only Dr. Vihngee I had to deal with, maybe I could convince him into letting it wait until tomorrow, but with Dr. Auchenchloss coming in--well-I have no choice.
I tell Dr. Vihngee that I will get things ready. He can tell by my voice that I am really upset by the idea and he tries to make things a little easier for me by telling me that he doesn't like the whole idea any more than me. But I know he's lying.
He thanks me and tells me that he will be in in about twenty minutes. We hang up.
I am supposed to go home at four. Mother is expecting me for dinner at five and I am already hungry but I know that I won't be when I get finished doing the autopsy. And even if things go smoothly, which they never do, I won't get home until after seven at the earliest.
I dial an outside line and call home. Father answers the phone and I tell him that I will be late for dinner. He asks me why and I tell him what I have to do. He sounds very pleased, very proud that his son has such great responsibility. He tells me that Mother is making corn beef and cabbage, which is one of my favorites, and says they will wait for me to get home so that we can all eat together. I tell him it may be after seven before I arrive and that they shouldn't wait for me; I may not be hungry. He laughs a little and says that's it's alright, they'll wait, but that I shouldn't talk about the autopsy to Mother. It may upset her. I tell him that I won't and we hang up.
Marlene comes back with the Coke and hands it to me. Suddenly I am not thirsty anymore but I take it from her anyway and pop open the top.
"Bad news?" she asks knowingly.
"Yeah," I say despondently.
I nod my head yes and force down a gulp of the soda. It fizzes so much as it goes down my throat that it almost burns.
"You know, Sandy, it's none of my business of course. But a kid your age shouldn't be doing this kind of crap. You should be out with the other guys playing football...goin' to the movies...or porkin' some chick. These are your best years and you don't even get a chance to enjoy them. There's plenty of time for all this work. You'll be an old man before you're even a young one," she says.
"I know. But what can I do? Everyone tells me what I should do. Everyone is helping me with my 'brilliant career.' It's all for them," I say, "but I'm stuck in the middle."
Marlene looks at me with compassion and hurt in her dark eyes. She forces a little smile and pats me on the butt as I saunter out of the chemistry lab. "See you next weekend," I say.
"Sure. Take care-and don't take any crap from anyone, ya' hear?"
My job in the autopsy room isn't glamorous. Sure, Dr. Auchenchloss is right, it's a great position for a medical student, being a denier, or an anatomical technician as it is usually called. But like I said before; I don't want to be a doctor. I want to be a playwright or a writer. Sometimes I wonder how I ever got myself into such a mess. John would never let anything like this happen to him, he's such a free spirit. It amazes me how two brothers can be so completely different.
The hospital where I work is a mammoth sprawling, nine-story building connected to the university medical school. Patient rooms occupy the second through ninth floors. The basement and first floors contain the laboratories, administrative offices, X-ray department, and admitting office. The autopsy room and morgue are in the sub-basement, an extremely remote, nearly impossible to find area of the hospital where nobody but pathology staff members are allowed to go. The orderlies who transport dead bodies to the morgue must first stop by the admitting office to pick up and sign for a key that will allow them entrance to this land of the dead. And since I am not really an official pathology staff member, I too must first go the admitting office and pick up a key. My key, however, is different. With it I can access both the morgue and the autopsy room-and, I don't have to indicate on a record sheet how long I have it. This, says Dr. Auchenchloss is a privilege, it shows how much I am trusted and how important my work is.
Somehow or other this has never impressed me.
When I arrive at the admitting office there are a lot of people in the waiting room waiting to be processed. These patients are the pre-op patients who are going to have surgery in the morning. Most of them seem to be in fine health, smiling, joking, and carrying on with family members. The waiting room is always crowded this time of day and it amazes me why people who are in such seemingly good health would ever want to come to a hospital where, tomorrow at this same time, they will all be absolutely miserable. Some, still zonked out from the affects of the anesthesia, others, not quite so lucky, will be fully awake and in excruciating pain begging for Demerol as a result of the surgeon's invasive procedure performed earlier in the day.
The girl at the admitting desk is bright and cheerful, she is not much older than myself and she smiles when I enter her office. She is busy taking down insurance information from a new admit when I enter. "Hi, Sandy," she says pleasantly, "I'll bet I know what you want."
I nod my head and she reaches into a desk drawer and removes a key ring and a clipboard. We are both careful not to mention the word 'morgue' or 'autopsy' in front of the new admit. Our business is done silently, efficiently, unemotionally.
Death is not something hospitals advertise.
The new admit, a man about forty years old, is busy talking to his wife about tomorrow's procedure. He's going to have a cyst removed from his colon. His manner is upbeat and optimistic and if I were to hear his voice anywhere but here, I'd guess it would be the same one he'd use if he were buying tickets for an amusement park ride. There is, after all, nothing to fear but fear itself.
I excuse myself for the interruption and as far as the new patient is concerned I am probably just some ancillary hospital worker picking up the keys to the laundry room. And that, I guess, is the way it should be.
The walk to the autopsy room is a long one.
On my way I pass dozens of visitors coming and going, asking directions from the candy-stripers how to get to room such and such, or how do you get to Intensive Care. I pass by the cafeteria where nurses and aides, and some visitors, have stopped by to grab a quick something to eat before going to their station or to visit with a patient.
I am walking slowly. My feet ache and I can feel my feet sweating inside my buckskin shoes. My underarms are not too dry either. I hate this walk. Apprehension and fear fill my mind. If I had the courage to do so I'd walk right out of here and never come back-never!
Dr. Auchenchloss has told me that in order to be a good physician you have to be unemotional, clinical, scientific. He has told me that when we 'process' a body, it is only that, a body. It is no longer a patient still capable of feeling pain. It is no longer a living being capable of any kind of emotion, totally insensitive to and unaware of its surroundings. It is, for all intents and purposes, nothing more than an elaborate, beautifully designed system of hydraulics, capacitors, and electro-chemical transistors that have all stopped working. And that I should treat this machine with no more feeling than does a skilled watchmaker disassembling a fine timepiece.
I try to believe what he says. But something inside me makes me feel differently. I don't know exactly what it is-but I cannot do what he says without first preparing my mind in my own stupid, sophomoric way.
To function like he says takes a great deal out of me. I need to plunge myself into a state of semi-consciousness, or unconsciousness, that is less than human.
The final sixteenth of a mile of my walk to the autopsy room is all underground. I look at the mucus-green walls with disgust. I can hear my footsteps echoing through this underground labyrinth, and I can detect the pungent odor of formalin inextricably woven into the stench of death beginning to stifle my breathing.
There are no cute little candy-stripers with their peppermint dresses down here; there are no visitors laughing and talking cheerfully; the red and black checkerboard tile under my feet is not spit-polished like it is elsewhere throughout the hospital. There is no one here but me-and whoever it is who awaits me behind the door, just several feet ahead now.
To my surprise the door that leads into the morgue is ajar, and when I walk through it I hear some banging and shuffling. It can't be Dr. Vihngee so soon, I didn't take that long to come down here. But I may have; I think I have lost all sense of time.
"Hello," I say somewhat sheepishly, not knowing who or what may answer.
"Yeah. In here," calls back a voice.
It is Todd, one of the orderlies who work in the emergency room. He is just getting ready to roll the shroud-covered body into one of the compartments in the two-tiered, stainless-steel refrigerator.
"Oh, it's you, Sandy," he says. "Glad you're here, now I won't have to put this thing into the box."
"No," I say nonchalantly, "you can wheel it right into the autopsy room."
I help Todd wheel the stretcher down the hall from the morgue, unlock the autopsy room, and together we roll the stretcher close to the autopsy table.
The autopsy room is quite small. There is only one door, and of course there are no windows. The cold, steel table takes up much of the room. A cabinet containing the various dissecting instruments takes up a good deal of space as does another free-standing metal shelf, holding crocks of pickled brains, jars of liver and lung tissue, and assorted body parts all in various stages of the 'fixation' process.
I turn on the water at the foot end of the table and with the hose that is also an aspirator, I wash down the table so that the body will slide across it more willingly. I place a wooden headrest at the other end and help Todd unwrap the shroud.
"Brought in DOA by police ambulance," says Todd, "as a 'John Doe'. Don't really have a lot of information, but the police suspect something-drugs probably."
Todd hands me the thin patient chart from the emergency room. I look through it and there's not much there. Under the stretcher there is a plastic bag containing the personal affects of this person: underwear, flannel shirt, jeans, socks, sneaks, a sweater, a set of keys, and two bottle openers. There is no wallet or identification.
The body is totally unclad now having only a morgue tag attached to the great toe of the right foot. It reads, 'John Doe'.
I thank Todd for helping me get the body onto the table and he tells me not to mention it. It was me, he says, that helped him. Todd leaves and I am alone with this machine that for whatever reason, soon to be discovered, has stopped working.
I cover the face and genitals with two green towels and retrieve all the necessary instruments: knives, scalpels, saws, probes, and rulers from the cabinet.
The air in this room is acrid with the sting of formaldehyde. And there is no sound except for my own labored breathing and the constant running water at the foot of the table. There is a hollowness, an emptiness all around me despite the smallness of the room.
I walk to the far end of the room where there is a small changing-room, I strip down to my shorts and put on a loosely fitting pair of green surgicals and a heavy-duty rubber apron. I powder my hands with talc and slide a pair of rubber gloves over them. I am now physically and mentally prepared to do what I must.
In a matter of minutes I can hear voices coming down the corridor. Dr. Auchenchloss's basso profundo voice resonates through the hollowness while Dr. Vihngee's sopranino voice struggles to be heard. There is a third voice, an unfamiliar one, that mediates the other two.
When the trio enter they are all smiles. Dr. Auchenchloss removes the stub of a cigar from his mouth, pats me on the back with an over-zealous 'Attaboy' façade, and introduces me to the third man, a Detective Moran from homicide. Dr. Vihngee says nothing.
Dr. Vihngee now stands to the right of the autopsy table and attaches a small microphone to his apron, adjusts the foot switch on the Dictaphone, and prepares to begin. Dr. Auchenchloss is going to supervise, he is still in his street clothes but he wears a pair of rubber gloves. The detective stands next to Dr. Auchenchloss silently, and I stand opposite Dr. Vihngee with scalpel poised in hand.
The procedure begins:
"Presented for post mortem examination is the body of a well-nourished, adult male approximately twenty to twenty-five years of age, measuring seventy inches in length, weighing an estimated one hundred and sixty-five pounds. The irises are blue, the hair brown, the genitalia are adult male. There are no obvious surgical scars visible, no lacerations, contusions or abrasions..." Dr. Vihngee's external examination is thorough and rigidly routine.
While Dr. Vihngee is conducting the first stage of the autopsy, Dr. Auchenchloss swabs the inside of the nasal cavity with a cotton-tipped applicator. He is looking for drug residue. The detective watches diligently. I know for certain now that they suspect a drug-overdose of some kind, the question is whether it was self-induced, accidental, or involuntary. Difficult questions to answer. This is going to be a long procedure and I also know that they will not have their answer today because in cases like this, unless something completely unexpected shows up in the gross anatomical examination, the actual cause and mechanism of death can only be determined by toxicology studies-and they won't be available for about three or four days.
I insert an eighteen gauge needle attached to a syringe into the iris of the left eye. It collapses as I withdraw a small amount of vitreous fluid. We will take samples of all body fluids and tissues. They will be carefully labeled for further study.
Dr. Vihngee is especially thorough today, slower than usual. He acts like his entire career is in the balance. Dr. Auchenchloss watches his every move like a vulture hovering over carrion. He asks probing questions. I can tell by the perspiration beading on Dr. Vihngee's dark forehead that he is under a great deal of pressure.
No one speaks to me. I am an automaton performing my duties like the watchmaker I'm supposed to be. It is only when Dr. Vihngee tells me to remove the brain do I begin to feel something resembling human emotion.
I do as I am instructed. It takes me about twenty minutes to extricate this three and a half pound mass of tissue from its tightly sealed vault. I cannot help it; it always bothers me tremendously when I hold this particular organ in my hands.
The brain is still warm. Protected from the coldness of the external environment by its hard shell, I now hold in my hands what was, just a few short hours ago, the very essence of a human life. If what is on the table in front me is but a watch, I now have in my grasp its escapement. This marvelously constructed repository of all human passion, intellect, emotion, hopes, successes, failures, and dreams now sits lifelessly, unknowingly in my inept hands. I am a thief stealing what is not mine to have. But even this I block out. My own brain is now not unlike the one I hold in my hands. I look at it in awe.
At six-thirty we are finished. The two doctors and the detective thank me for my assistance. They gather their papers, remove the blue belt from the Dictaphone, and take a few test tubes with them.
Before he leaves Dr. Auchenchloss awards me with another 'Attaboy'. I guess that I'm supposed to be impressed--I'm not.
By seven o'clock I have things tidied up in the autopsy room. I have already placed rubber tubes into the carotid and femoral arteries so that the undertaker can more easily embalm the body. I have washed the body down and covered it with its shroud, and placed the remains into a bottom compartment of the cooler. The instruments are washed and the floor is mopped. I am now ready to go home and enjoy a corn beef dinner with my family.
Outside the hospital the November night air is cold and biting. As I walk to my car the crispness causes my nostrils to stick together and I have to breathe through my mouth. I am awakening from my self-imposed anesthesia now. I am coming back to life.
I have work to do when I get home. There is an exam tomorrow for which I am not yet prepared. I dread the thoughts of another 'all-nighter' but somehow or other I'll do it-I have no other choice.
When I arrive home there is a warm, friendly fire in the fireplace, I can smell the corn beef and cabbage wafting through the air. Mother and Father are watching television but they are happy to see me. Father smiles a proud, cocky smile; Mother walks over to me and gives me a hug. Her frail embrace both strengthens and weakens me.
"You must be starved by now," she says lovingly.
I tell her that I am, even though I'm not.
I go upstairs to the bathroom and take a hot shower. I meticulously scrub my fingernails clean being sure to remove all traces of the talc that has caked under them. I feel refreshed-almost human again.
Downstairs the dining room table is set and two dinner candles provide a charming glow. There is only the three of us but a fourth place is set. Mother always sets a place for John.
After we say grace Father begins to slice the corn beef.
Mother looks at me and asks sweetly, "Did you hear from your brother today?"
I watch Father slice the lean, red meat.
I cannot tell her how I had spent all afternoon with John--THAT would surely upset her.
God, I wish I were more like John--even now!