Doctors

As a nod to my ongoing effort to keep things in perspective, here's a story about a man who has lost all perspective.

*****

Doctors

  “Oh my god. Oh my god, thank you. What did you do? How did you save my baby?” The baby’s mother and her husband are sitting in comfortable chairs, on the other side of my desk, in my office. The husband doesn’t say anything. He just sits there with his hands on his face, his elbows on his knees, shaking. The mother is sobbing hysterically.            

                I, on the other hand, am relaxed. I lean back in my chair and light a cigarette. I am a doctor; I have hysterical people in my office all the time.

                “How did I save your baby?” I pause, take a pull on my Marlboro, and consider my words. “To start with, I sewed his arm back on.” Of course it’s more complicated than that, but she’s a social studies teacher, for Christ’s sake. He’s a computer programmer. What am I supposed to tell them -- the brand of thread I used?

                After that there are more thank yous and tears, and the mother hugs me tightly over my arms. I always try to be sensitive, but I don’t like being touched, so I extricate myself from her quickly. Once they’ve both pulled themselves together, I give them directions to the ICU and move them out the door.

 * * *

                A little before noon I pop my head into Chad’s office, two floors down, and ask if he has plans for lunch. He folds up the morning paper, grabs his jacket, and we’re on our way. I light another Marlboro in the elevator and Chad asks if he can bum one. I have more than half a pack left so it’s not really a big deal, but lately Chad has been making a habit of mooching. Sometimes I want to shake him: You’re a cardiologist, Chad! Can’t you afford to buy your own cigarettes once in a while?

                We eat at a little bistro not far from the physicians’ office building. Right away Chad starts flirting with our waitress, but she’s not receptive. It’s a desperate kind of flirting; he laughs loud for no reason, and his eyes bulge like a lunatic’s. Chad got married last fall and he’s terrified that it’s made him invisible and irrelevant. I’m a trauma surgeon, not a psychiatrist, but I’m willing to bet that at the end of lunch he’ll tip the waitress thirty percent, and it will make him feel both ashamed and aroused.

                As we eat, Chad tells me about his trip to the consumer electronics trade show in Las Vegas. Next winter, he tells me, there’s going to be a one hundred-inch hi-definition plasma TV on the market. There was a demo model on the trade show floor playing scenes from Top Gun, and Chad says it kicked ass. He glances around, leans forward, lowers his voice and says, “There was a second demo TV...” Then, raising an eyebrow, he mouths, upstairs.

                The upstairs he’s referring to is the second floor of the Las Vegas convention center. The first floor is crowded with kiosks displaying the latest innovations in home entertainment: TVs, video cameras, home theater systems... The second floor -- the floor that gets three times as much foot traffic -- is home to the world’s largest annual porno convention. Directors rub elbows with producers and distributors. Stars and starlets promote new releases by signing glossy, 8x10 black-and-white head-, chest-, ass-, and crotch-shots. There are TV monitors mounted everywhere, with the hundred-inch plasma as a kind of centerpiece. “You would not believe the video they were showing on that screen,” Chad says, smiling wickedly. “Amazing.”

               I nod as he talks, but Chad has told me about the trade show many times before, and I’m preoccupied with the baby I sewed together this morning. It’s the kind of thing I do every day, but sometimes -- lately more often than not -- I can’t stop thinking about how implausible it is that a person like me can do such inhumanly powerful things. All these messes of skin, muscle, fat, blood and bone that we clean up on a daily basis....  I’m not one of those doctors who think he’s a god, but I wonder sometimes: if there is a God, is He even relevant anymore, with people like Chad and me around?

              “I don’t even know how she got it all in there!” Chad says gleefully. He’s still talking about the video. The way he goes on about these movies, you’d think he was a gynecologist.

             Our waitress comes to clear our plates. Chad stops talking abruptly and I seize the opportunity.

             “How’s Stephanie?” I ask him. He looks at me hatefully. In the deepest parts of my brain, I am stitching Chad’s mouth shut, no anesthesia.

* * *

               I have only one afternoon appointment: a follow-up with a seventeen-year-old boy who was in a car wreck a couple of weeks ago. He was drunk or fell asleep at the wheel or something, and ended up flipped over in a ditch on the edge of some farmer’s lot. I was able to staple most of his face back onto his head, but he had been driving with the window down, so his arm was a lost cause. It was missing for five days after the accident, until the farmer’s dog showed up with it at the back door. By then it was four-and-a-half days too late.

                In the office I shake the kid’s remaining hand and exchange pleasantries with his parents. We’re all sunshine and smiles -- except for the kid, who won’t be able to smile for another week without the risk of his face falling back off. I suppose I'm jealous he has such a solid excuse.

                The kid is horrifying to look at, but only compared to a person with a normal face. Compared to how he looked before I got hold of him, I’m almost telling the truth when I say to him brightly, “Lookin’ good....”

                I have him sit down while I light a cigarette, and then I begin my examination. I squat in front of him and lay my thumbs on his cheekbones, my fingers splayed out and resting on the metal sutures running from his temples down his jawline. Very gently, I prod and massage his face. The flesh is rubbery and pale, and still very loose; it gives slightly, and slides just the tiniest bit across his skull. I could tease his face into any number of hilarious expressions that would be impossible to produce on a healthy human, but I took an oath when I received my license, and that oath says that such displays of broad physical comedy are unethical. Sometimes I think the loneliest thing a person can be is a doctor.

                I know pretty much immediately that the surgery didn’t take. The kid’s face will turn yellow, then purple, then a moldy black. It will fall off sooner rather than later.

               Sometimes, that’s how it goes.

               The best I can do now is get the kid a rubber mask like the one Tom Cruise wore in Vanilla Sky. I’m not a social worker.

               I finish the exam with a wink and a playful little slap to the kid’s cheek because, honestly, at this point it’s not like I’ll hurt anything. I sit back down behind my desk, take a long drag, and exhale.

               I could think of this as a tragedy -- this kid who will soon lose his face, whose arm was found in a ditch by some hillbilly’s dog. I could stay up late tonight thinking: Could I have placed the staples closer together, or farther apart? Should I have used more gauze? If you let them, these things will eat you up. So I don’t let them.

               The kid and his parents are looking at me. Their expectation -- that dumb, nervous hope -- sets my teeth on edge. The really unfair thing is that they don’t know about the baby I sewed together this morning, and because of HIPAA laws, I can’t tell them.

               “Well?” the kid’s father asks me. The way the kid is looking at me behind his swollen and discolored face, I’d guess he already knows. A rubber Tom Cruise mask won’t look so bad on him.

               “Well…” I pause to snub out my cigarette, and I consider my words carefully before I address the parents. “He’ll be fine.”

                I smile at the kid. “You’ll look just fine.”