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I awoke the next morning with my throat more sore. I drove to the House coughing, oblivious to all. but the tightness in the center of my back. I was about to follow the BMS into a premorbid coma. Jo had just completed examining the night's excretia, but before we started on work rounds, I insisted she listen to my chest. She said it was clear. Despite this, I was so worried I couldn't concentrate, and TURFED myself to X Ray for films. I went over them with the radiologist, who said they were normal. I got beeped to the unit for a cardiac arrest, and ran on up.
It was the BMS. Fifteen people had crowded into his room: a Messarabian breathing him; a nurse perch on her knees on top of the bed pumping his chest every systolic compression lifting her skirt to her waist; the Surgical Chief Resident with wiry black chest hair curling up over the V?necked green scrubsuit; barely in the room, Pinkus and Jo. Pinkus had been paged from his morning trot, and was in track shoes and gym shorts, looking distractedly out the window. Jo was all icewater, eyes riveted to the EKG machine, choosing medications, barking orders to the nurses. In the midst of all this, the BMS was meat.
Despite all efforts, the BMS continued to die. As usual at arrests, as if at a dud party, after about an hour people got bored and wanted to stop and it a day and let the patient really die, the heart following after the dead brain like a car motor stopping a few internal combustions after the ignition had been turned off. Jo, angered at the idea of failure, shouted out: "With this kid we're four?plussing it, all the way!" and wouldn't stop. When the heart finally did stop, Jo ordered the broiling of the chest, and when four shots of that didn't work, she paused, at the end of her medical bag of tricks. This was where the surgeons began, and the Chief Resident, sensing the chance to turn carnage into drama, got hot and said, "Hey, want me to open the chest? Manual cardiac massage?" Jo paused, and then, in the hush, said, "You bet. This kid walked in here. We're going all out. Four?plus!" The surgeon ripped the chest from armpit to armpit and spread the ribs. He grabbed the heart and began to pump it with his hand. Pinkus left the room. I stood, frozen. It was clear that the BMS was dead. What they were doing was being done for them. The surgeon, hand tired, asked me if I'd like to take over. Foggy, I did. I got my hand around the back of the young lifeless heart and squeezed. Tough, slippery, the sinewy muscle was a leather bag, filled with blood, rolling in the steamy chest cavity, tied to the tubes of the major vessels. Why was I doing this? My hand hurt. I gave up. The heart lay like a grayish?blue fruit on a tree of bones. Sickening. The face of the BMS was blue, turning white. The gash in his chest was bright red, turning to a clotted black. We'd ruined his body, even as he'd died. As I left the room, I heard Jo yell out with crisp authority: "Any BMS students here? This is a chance you don't often get in your training, to learn to massage the heart. Great teaching case. Come on." Sick, I retreated to the staff room, where the nurses were chattering, eating doughnuts, as if nothing had happened outside.
"Glad to see you're not wrecking your coronaries with doughnuts, Roy," said Pinkus. "I've tried to tell the girls, but they won't listen. They're lucky, of course, in that the estrogens lower their incidence."
"I'm not hungry," I said. "I think I've caught why the BMS had. I'm go
"Die?" asked Pinkus. "Hmm. Say, did that BMS have a hobby?"
The head nurse picked up the chart, turned to the special section created by Pinkus, called "Hobbies," and said, "Nope. No hobby:"
"There," said Pinkus. "See? No hobby. He didn't have a hobby, do you understand? Do you have a hobby, Roy?"
With some alarm I realized that I did not, and said so.
"You should have at least one. See, my hobbies are directed to the care of my coronary arteries: fishing, for calm, and ru
"Really?"
"Yes. Look: if you're not fit, your heart beats like this," and Pinkus made a motion with his fist, slowly moving his fingers toward his palm as if he were slow motion waving someone good?bye. "But if you run, your cardiac output goes up dramatically, and you really pump and I mean PUMP! Like this!" Pinkus clasped and unclasped his fist so hard that his knuckles turned white and his forearm musculature bulged. It was dramatic. I would be converted. I grasped his hand and asked, "What do I have to do to start?" Pinkus was pleased, and went right to shoe size. Instead viruses and atherosclerosis, my mind filled with New Balance 320s, anaerobic glycolytic muscle metabolism and a subscription to Ru
Except for frolicking in the occasional erotic fondle I spent the rest of the day avoiding Jo and ru
Just before the ten?o'clock meal, I was called to the E.W. for my first admission, a forty?two?year?old man named Bloom, with his first MI. He was coming to the Unit because of his age. If he had been sixty-two, he would have been fending for himself on the wards, his chances of immediate survival halved. Bloom was lying on his stretcher in the E.W., white as a sheet, puffing with anxiety and cardiac pain. His eyes showed the terrified longing of a dying man wishing he'd spent his last days differently. He and his wife turned to me, their hope. Uncomfortable, I was surprised to find myself thinking of Pinkus, and asking Bloom if he had a hobby.
"No," he gasped, "I don't have a hobby."
"Well, after this you might think of developing one. I'm taking up ru
The risk factors were weighted against Bloom. He'd suffered a serious MI, and for a period of four days he'd camp on death's door, courtesy of the Unit. I wheeled him into the MICU, where the nurses swarmed over him, wiring him for sound, light, and whatever else they could grab onto. Ollie's face lit up with Bloom's ratty EKG. What was I doing for poor Bloom's heart? Not much. Watching for when Bloom stopped.
The Runt and Chuck, knowing what a strain my first night on call in the Unit would be, stopped by to talk. Even though it had gotten increasingly hard to make contact with each other, what had happened to Eddie and Puts had made us try to be with each other more. I said to the Runt, "I always meant to ask you, Runt, what's the matter with Angel's language centers. I mean, she starts to talk, fades out, and waves her hands around. What's it all about?"
"I never noticed," said the Runt. "She seems to talk fine to me."
"You mean you still haven't talked about anything?"
Thinking it over, the Runt paused, and then broke out in a wide grin, walloped his knee, and said, "Nope! Never! HA!"
"Damn," said Chuck, "you sure come a long way from that poet."