Dr. Marsteller Chapter 20
20
-Okay guys what do you need me to do? asked Mrs. Viscane still wearing her dulled smile.
-I would like you to please take your
clothes off and put on one of these surgical robes. Do you have any questions?
Mrs.
Viscane was giddy with anticipation. She
thought they were making history.
Dr.
Marsteller stepped out into the hall and paced back and forth while thinking
how ridiculous it was for Mrs. Viscane to trust him. She has no reason not to; I’ve been loyal for
years, he thought. I can’t believe
they’re going along. I wonder if Dr.
Ramaswamy will back out. I almost hope
he will. But theoretically, the therapy
should work. And if it works think of
the scientific advancement this one night will produce. Dr. Reicher won’t back out. Dr. Reicher thinks I’ve made the greatest
discovery in the history of mankind - or maybe he doesn’t, but he’s getting
paid a ridiculous amount of money, and Mrs. Viscane thinks she’s going to live
forever. I just need to keep the poker
face and go along for the ride. Why
wouldn’t they do it?
The disinfectant in the hallway and the
cold pitiless floor and tile walls gave Dr. Marsteller the chills. He stared past the nurse’s station to the
darkened end of the corridor near the surgery rooms. He never liked hospitals. When he was in undergrad he had no desire to
go to medical school. The thought of
working with sick people for the rest of his life repulsed him. His advisor in undergraduate school had
advised Dr. Marsteller to become an M.D. but he turned his back on the
idea. He still wanted to help people; he
wanted to do something noble and decided research was the best route for his
inquisitive nature and imaginative mind.
Any time he had to go to the doctor for a checkup he was reminded of his
stint in the hospital for a broken arm when he was twelve. The pain and the anesthetics that made his
stomach drop. The ghastly steel tools
and other inanimate metal and plastic equipment surrounded him like a phalanx
of shrapnel. And he wanted the place to
explode. A nuclear bomb to be dropped in
the city and the wave of radiation pulsing through the window and the bowed
walls cracking and shattering and his flesh melted from his skin. Like a manmade north wind blowing away all
the implements for health and cleanliness.
He remembered going to the hospice care
when his mother died ten years before.
Her emaciated body stretched onto the bed. Her desultory coherency plucked him like a
starving man grabbing grapes. She lied
there as her body rotted. Alive like a
fly with its wings ripped off walking along a dining room table. He thought everyday he visited her for three
weeks that she was dead but alive in time and the walking purgatory of her
loved ones was more pain than she had in her life. Dr. Marsteller would walk down the tiled
corridor to get a snickers or peanut M & Ms from the vending machine and
listen to the moans and the ‘I’m sorry’s’ and the wails and the sporadic
laughter from the other hospice rooms and drink them in, knowing everyone in
those rooms would cross to the great unknown mystery of the other side
soon. The ones who couldn’t talk were
lucky.
The other men
exited the room and closed the door while Mrs. Viscane prepared herself for
surgery.
-Should we go get a wheelchair to
transport her to the surgery? asked Dr.
Ramaswamy, thinking of something the nurse would do.
-Yeah, you better, said Dr. Reicher. Bob, see if you can help Dipak find one.
They both hustled down the hall. Dr. Ramaswamy thinner and more purposeful
than Mr. Coveleski, stocky and languidly strolling down the hall, his brown
graying hair closely cropped on his head.
-So, what
do you think, Sly, are you ready for this?
Dr. Reicher
said it in a tone that was neither condescending nor distrustful. Dr. Marsteller knew he was only
double-checking because he didn’t want any weak links in the surgery. He wanted to get a feel for Dr. Marsteller’s
emotional state and make sure he was fit to be in the room.
-Yeah, I’m
fine. Don’t worry about me.
-Okay. When we’re in there and I ask you for
something and you don’t know what it is, tell me immediately and I’ll point to
it for you. This is probably self
evident, but I’ll remind you that if anything is sharp, to hand it to me with
the sharp edge facing away. If you touch
anything that isn’t sterile, make sure you change your gloves before touching
something sterile.
-Understood.
Dr.
Ramaswamy and Mr. Coveleski returned with a wheelchair. Mr. Coveleski smiled while walking beside Dr.
Ramaswamy pushing it up the hallway.
When they reached Dr. Marsteller and Dr. Reicher, Mr. Coveleski clasped
his hands together.
-You guys
ready to make some money, he said.
Dr. Reicher
laughed and slapped him on the shoulder.
-God,
you’re priceless Bob, I’m going to miss working with you.
Dr.
Ramaswamy and Dr. Marsteller didn’t smile.
Mrs. Viscane opened the door of the office now timidly like a mouse
sneaking out of its hole for a bite of cheese.
She held the back of her gown shut.
-I’m ready.
-Okay, step
back in the room and I’ll be in there in a minute.
She shut
the door quietly.
-Okay, here
we go, is everyone okay with this, I’ll give you one more chance to back out if
you don’t want to do it.
-I’m ready
to go, said Mr. Coveleski.
-Me too,
said Dr. Marsteller.
Dr. Reicher
turned to Dr. Ramaswamy.
-Dipak?
-I’m ready.
-Okay, you
guys head down to the room. I’ll take
care of Mrs. Viscane.
-I have to
grab the case, said Dr. Marsteller.
-Certainly.
They opened
the door and found Mrs. Viscane vulnerable on the cold table in the
office. The thin light gown draped
across her 70 year old body. Her legs
stuck out the bottom like two rotting branches lopped off trees in a
storm. Her fake breasts pointed out like
a sixteen year old girl’s. The skin on
her arms crossed over them bashfully sagged off her bones. Dr. Reicher breathed in quickly when he saw
her. Dr. Marsteller had seen her much
worse and simply bent over and picked up his case.
-Are you
ready Mrs. Viscane?
-Ready as
I’ll ever be, she said flippantly. Her
quivering voice betrayed her actual state of mind.
-If you can
please step down and take a seat in the wheelchair, said Dr. Reicher, situating
the chair so Mrs. Viscane wouldn’t have to expose her back to them. As they wheeled her down the hallway, Dr.
Marsteller and Mrs. Viscane talked about various dignitaries at the University
they knew in the rapid fashion people discuss the inconsequential in situations
of great stress. When they walked past
the nurse’s station, they again disregarded the nurse’s perplexed face.
They
wheeled her into the surgical room. Mr.
Coveleski and Dr. Ramaswamy had set up the equipment and were waiting. Dr. Reicher helped her onto the surgical
table and put on some nitrile gloves.
Mrs. Viscane stared at the ceiling and adjusted to the temperature of
the table.
-Okay, Mrs.
Viscane, you’re going to feel a little prick.
Dr. Reicher
swabbed her inner arm with alcohol and inserted an IV, drawing out the guiding
needle while blood filled the connector in her vein. He then attached her to a saline drip. Dr. Ramaswamy immediately injected anesthetic
through the tubing into her arm.
-Mrs.
Viscane, the anesthetic will take effect in about 30 seconds, said Dr. Reicher
as he consulted his watch.
-Don’t
start until I’m down, said Mrs. Viscane groggily.
-Don’t
worry, said Dr. Reicher smiling at her amicably.
After she
went under anesthesia, Dr. Reicher could restrain himself while observing the
mutilation Mrs. Viscane had done to her body with plastic surgery.
-Jesus, she
looks like some demon wearing an angelic mask.
Like she’s a spy sent by the devil trying to sneak into heaven or
something.
Dr.
Marsteller somberly nodded in agreement.
Mrs. Viscane lie on the metal table
breathing peacefully while they prepped her for surgery. Dr. Reicher applied betadine to her chest as
Mr. Coveleski stood by patiently with the heart-lung machine. The brown liquid oozed between her perfect
breasts like a rusty Colorado stream and Dr. Reicher’s intensity increased with
each movement. Dr. Ramaswamy performed
an endotracheal intubation and began ventilating her. He then filled a syringe with rocuronium and
injected it through the IV tubing so Mrs. Viscane would be unable to breathe
under her own power.
-Applying the rock.
Dr. Reicher made a precise midline
sternal incision and blood ran down her white skin. He then cut away some muscle and applied the
rib spreader. The metal apparatus fit in
snugly in place and he cranked it open to view the beating heart in her
peritoneal. He then nodded to Mr.
Coveleski who situated himself near Mrs. Viscane. They painstakingly attached the heart lung
machine through her vena cava and aorta.
-Applying
potassium said Dr. Reicher.
He drew back the plunger of the
syringe. Then he tipped the needle in
the air and examined the syringe for a bubble.
He pushed the plunger up until the bubble was expunged and a little
potassium squired out. Then he injected
it into the tubing of the heart-lung machine and it entered directly into the
heart. The heart feebly beat until it
halted.
-Turn the
ventilator off, said Dr. Reicher.
Dr. Ramaswamy reached over and flipped
the switch and Mrs. Viscane’s mutilated chest heaved one last time to a resting
position like settling leaves.
Dr. Reicher nodded to Mr. Coveleski and
the heart and lung machine began pumping oxygenated blood through her body
while removing carbon dioxide filled blood through the machine, performing all
the tasks of our heart and lungs without the live beating and breathing. The whir of the machine sounded out of place,
like someone had just brought some lawn care equipment into the surgery room.
-Okay Dr. Marsteller. Are you sterile?
-Yes.
-Okay.
Prepare for the injection of the therapy.
Dr. Marsteller removed the vial from the
case, sterilized it, and held it in his hands, waiting for the three-milliliter
solution to thaw. He then held it tight
while Mr. Coveleski drew out the solution with a sterile syringe. Dr. Marsteller analyzed Mrs. Viscane lying
prostrate with her chest cut open and heart and lungs stopped. She looked like an anorexic elongated albino
sow being slaughtered. He cringed as his
stomach lurched. The contents of it
surged up his esophagus but he tightened his throat and kept them down.
-Hold on, I want to inject it, said Dr.
Marsteller.
Mrs. Coveleski halted.
-Let me do it.
-All right, said Dr. Reicher, to be safe,
go wash up and get sterile again.
-Dr. Reicher, this is absurd, said Dr.
Ramaswamy.
-Listen, it’s his therapy, if he wants to
inject it, he can inject it.
Dr. Marsteller took off his gloves, went
over to the washbasins and applied the anti-bacterial soap up to his elbows and
around his hands. He then patted his
arms down with a sterile towel to dry them.
After putting on new gloves and a gown, Mr. Coveleski handed him the
syringe.
Dr.
Ramaswamy stared at him skeptically. Dr.
Reicher waited patiently as Mr. Coveleski showed him where the potassium was
injected to induce heart stoppage, and how this was also the spot to inject the
therapy. Dr. Marsteller wasn’t queasy
because of Mrs. Viscane naked and sliced open, he was queasy with the knowledge
that although his retroviral concoction should work in theory, it hadn’t in the
lab yet. But all the men there believed
it had and put all their faith in him.
Who was he kidding, they were getting paid handsomely. They wouldn’t care if he injected grape juice
into her heart. They’d still go along
with it. He smiled and took a deep
breath and injected the retrovirus into the tubing.
He removed the syringe and placed it in
the sharps bucket.
-Am I okay to go unsterile? he asked Dr.
Reicher.
-Sure, said Dr. Reicher attending to Mrs.
Viscane. Saline, please, he said to Mr.
Coveleski as Dr. Marsteller removed his gloves, mask gown and hat and deposited
them in the trash in the darkened hallway outside the lighted surgery room. A couple beams of light filtered through some
windows fashioned in a wall separating an empty observation room with the
surgery room. Dr. Marsteller sat down on
the ground half in the light and half in the dark, with the hallway to the
other surgery rooms darkening like a black hole. It was after midnight now. He sat like a seven-year-old elementary
student crouched against the wall for a tornado drill. He rubbed his forehead with his hand. Then he smiled and he thought about what he
had caused to happen and he was amazed.
He was amazed the impact one person could have if they just put their
mind to it. He was amazed that he’d done
a human trial with an anti-aging therapy he had devised. He started to chuckle. Then he laughed outright from his
stomach. The stomach didn’t feel empty
anymore. Now it felt great. He was famished though. He’d have to get a huge plate of ribs on the
way home. And he thought of her ribs and
he laughed a little more.
-Barbecued ribs, he hissed to himself and
giggled at the absurdity of his statement.
-TACOS! He screamed.
-Liver and onions! Then he was laughing hysterically.
This originally appeared in Dr. Marsteller