The house of God

That night is the worst. I awaken, bolt upright, at attention, drenched in sweat, screaming, as the church bell tolls three. My mind is filled with horrific images of the year in the House of God. My screams awaken Berry, and I say, "I finally saw where they keep them."

"Keep who?" she asks, half?asleep.

"The gomers. They call it a 'Hospice.' "

"Calm down, love. It's over."

"It's not. I can't get them out of my mind. Everything reminds me of the year in the House. I don't know how to forget. It's wrecking my whole life. I never realized it would be so bad."

"Don't try to forget, love. Try to work it through."

"I thought I had."

"No, it takes time. Here," she said, holding me, "talk to me, tell me where it hurts."

I tell her. Again I tell her about Dr. Sanders bleeding out in my lap, about the look in Potts's eyes that night before he jumped, about my pushing the KCL into poor Saul. I tell her how ashamed I am for turning into a sarcastic bastard who calls the old ones gomers, how, during the ternship, I'd ridiculed them for their weaknesses, for throwing up their suffering in my face, for scaring me, for forcing me to do disgusting things to take care of them. I tell her how I want to live, compassionately, with the idea of death clearly in sight, and how I doubt I can do that, ever again. As I think back to what I'd gone through and what I'd become, sadness wells up and mixes with contempt. I put my head into Berry's folds and weep, and curse, and shout, and weep.

". . . and in your own way, you did. Someone had to care for the gomers; and this year, in your own way, you did."

"The worst thing is this bitterness. I used to be different, gentle, even generous, didn't I? I wasn't always like this, was I?"

"I love who you are. To me, underneath it all, you're still there:" She paused, and then, eyes sparkling, said, "And you might even be better."

"What? What do you mean?"

"This might have been the only thing that could have awakened you. Your whole life has been a growing from the outside, mastering the challenges that others have set for you. Now, finally, you might just be growing from inside yourself. It can be a whole new world, Roy, I know it. A whole new life" Eyes wet with tears, she said, "I'm going to love you even more, Roy, because I've been waiting a long time for you to begin."

Overwhelmed. Speechless. Excited, even happy. Yet it seemed too easy. "I want to believe you, but it all seems so painful. The whole year seems like a nightmare now."

"Not all of it. There was pleasure in it, too: the pleasure of the mastery of medicine, the pleasure of your group of guys, of latency."

"Latency? What's latency?"

"Latency is the lull before adolescence. Latency is the time of clubs, groups, teams, when baseball is the most important thing in your life and the days are too short for all that you want to do. Latency is caring. This year's been a latency trip: during your internship, with all of you scared and brutalized, the caring in your bunch of guys sustained you:"

Cradled in her arms, I think back to then, to the tree house in the overgrown shallow ravine, to the early summer nights ru

THE END.

LAWS OF THE HOUSE OF GOD

I. GOMERS DON'T DIE.

II. GOMERS GO TO GROUND.

III. AT A CARDIAC ARREST, THE FIRST PROCEDURE IS TO TAKE YOUR OWN PULSE.

IV. THE PATIENT IS THE ONE WITH THE DISEASE.

V. PLACEMENT COMES FIRST.

VI. THERE IS NO BODY CAVITY THAT CANNOT BE REACHED WITH A #14 NEEDLE AND A GOOD STRONG ARM.

VII. AGE + BUN = LASIX DOSE.

VIII. THEY CAN ALWAYS HURT YOU MORE.

IX. THE ONLY GOOD ADMISSION IS A DEAD ADMISSION.

X. IF YOU DON'T TAKE A TEMPERATURE, YOU CAN'T FIND A FEVER.

XI. SHOW ME A BMS WHO ONLY TRIPLES MY WORK AND I WILL KISS HIS FEET.

XII. IF THE RADIOLOGY RESIDENT AND THE BMS BOTH SEE A LESION ON THE CHEST X?RAY, THERE CAN BE NO LESION THERE.

XIII. THE DELIVERY OF MEDICAL CARE IS TO DO AS MUCH NOTHING AS POSSIBLE.

GLOSSARY

Admission: a patient entering the House of God; two types: emergency, through the emergency room; elective, scheduled.

Agonal: just before death, as in "agonal" respirations.

Amyloidosis: chronic degenerative disease with increasing deposits of a starchy substance, amyloid, in many organs; rare; incurable.

Anal: pertaining to the anus, as in fissure (tear), sadism (a Freudian concept whereby a sadistic urge is related to early anal activity), and Mirror (cf. Dr. Jung's).

Aneurysm: a ballooning out of a vessel, especially an artery, before it bursts.

Angina pectoris: a pattern of cardiac pain, often felt in the chest, signaling severe disease of the coronary arteries, often a prelude to a heart attack.

Ascites: fluid in the abdominal cavity, always abnormal, often associated with liver disease or infection, resulting in distended belly.

Attendings: private doctors affiliated with the House of God.

A?V node: Atrio?Ventricular node, a collection of pacemaking cells in the heart, between the atria and ventricles, which can, if the normal sinus node fails, take over the initiation of the heartbeat.

Black Crow: the House Award given to the intern who collects the most postmortem permissions in the course of the year; prize is a tiepin and a free trip to Atlantic City, for AMA meetings.