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From: New England Review
Volume 34, Number 3-4, 2014
pp. 31-37 | 10.1353/ner.2014.0029

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For An Hour The Doctor Could Think Of Nothing Worth Doing and no reason to rise from his chair, so he sat in a corner of the coffee shop in downtown Minneapolis, four blocks away from the hospital, with the newspaper’s sports section spread out in front of him, unread, the evening traffic outside going by with the characteristic hiss of tires on wet pavement, a sibilant personal sound like whispering. He gripped a double espresso but did not drink it. Wind gusts whipped the decorative downtown trees. That day on rounds he had checked in on one of his patients, a little girl whom he had diagnosed with Eisenmenger’s syndrome. She had developed endocarditis, an infection of the heart that had not been caught before some damage to the valves had occurred. This infection had been followed by a stroke. The family had gathered in the ICU’s waiting area, and one aunt had said loudly to the assembled relatives that her niece, lying there, was unrecognizable, and the doctor could tell—from years of similar scenes—that she, the aunt, was eager to assign blame to someone, starting with the pediatrician (himself), and then, advancing up the scale of responsibility, to the radiologist, the surgeon, and at last God. With each new step the accusations would grow more unanswerable. Nevertheless, the arias of blame would soon begin and they would have their predictable and characteristic melodies of resentment, rage, and malpractice. They were unstoppable. The lawyers would accompany her and provide the harmonizing chorus. For now, thinking of his patient, Dr. Jones could not go home nor move in any direction, and, once again, sitting with his back against the coffee shop’s brick wall, the newspaper in front him detailing the Twins’ latest loss to the Royals, he considered pediatric medicine the very worst of all specialties, a curse upon every physician who had ever practiced it, a field that he should never have gone into and would like to quit for some other better job, like selling boats. People were unusually happy when buying boats. Boat salesmen were dispensers of cheer. By contrast, the observance of pediatric medicine put the insane cruelties of God fully on display. His teachers in medical school had warned him about these psychic difficulties, but they had not warned him sufficiently, and just today one of his colleagues asked him whether he had started “laying crêpe” with the girl’s relatives, doctor-talk referring to prepping family members for the patient’s untimely demise.

He had been hoping that his friend, Benny Takemitsu, the hack architect, might stop by the coffee shop on a break from his evening run, but there was no sign of him, so with great effort, Dr. Jones, who was a bit stout, at last found some resource of energy and rose from his chair and headed toward the Mississippi River, where lately he had been granted certain . . . visitations. The visitations were products of his exhaustion. He’d considered talking to his psychiatrist friend, Dr. Gloat—his actual name—about his hallucinatory visitors, but Gloat would probably prescribe an anti-psychotic like clozapine or aripiprazole, part of that class of drugs that were chemically like a wrecker’s ball set loose in the brain. Or he could call on another pal, a gerontologist, who might diagnose him with Lewy body dementia, an affliction that included voices and full-scale hallucinations of the sort that Dr. Jones had been experiencing. With a diagnosis like that, they’d put you in the bin. Despite his visitations, he recognized inwardly, as the spirals of intuition turned gently and logically, that he wasn’t demented any more than he was psychotic. Nor was he delusional. He was just seeing things as the shamans once did, the holy men and women. He was becoming a holy man. Such a change was unprecedented in his professional experience. The prospect of going mad, or holy, did not seem to be that much of a catastrophe to him as long as he could keep calm while the specters appeared. Perhaps some bed rest would be indicated. The trouble with mad people was...

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