Like many people oriented towards the humanities I did well in school in all areas except for math and science. Thanks to a close friend who seamlessly loved Homer, Joyce and advanced mathematics I never developed the stereotypical negative attitude regarding science also common to those who identify with the liberal arts. This, combined with a terror of all things medical due to deep unconscious voodoo feelings of complicity in my mother's early death and my father's ill health some years afterward, kept me a great distance from one of the exceptional attributes of the human being.
And then an odd swirl of circumstances occurred in my late twenties that led to a return to college one summer to study physics and chemistry, an experiment to see whether my problem with science was one of nature or nurture (it turned out to be the latter), which then led to my applying and being accepted at the medical school in Granada, Spain where I was living at the time. The entire exercise was mainly the result of a counter-phobic initiative suggested to me in therapy, to stop running away from some very primal fears by facing them instead. Chekov and William Carlos Williams became my role models, and hey, even Joyce had gone to medical school for a time.
I was ten years older than my fellow students and older than two of my professors. To earn a living I taught English to faculty members and worked for the head of the department of neuroanatomy, a wonderful man epitomizing the sort of 19th Century physician I was aspiring to. He was writing a textbook on neonatal deformations and one of my tasks consisted of performing autopsies on stillborn infants to try and ascertain the cause of death. Sometimes it was grotesquely obvious but often it was not. I wrote about it once some years ago:
It is spring and raining hard and I stand in the dissection hall of the Anatomy Department wearing a surgical mask and latex gloves. The hall is cavernous and covered with beige tiles. It has tall, narrow, arched windows like those one might find in a cathedral. Rising up from the floor like baptismal fonts stretched flat are eight dissection tables that stand in a row, made from marble with shiny brass drains. Cabinets line the far wall containing old transparent apothecary jars where amber toned fetuses float in suspension next to large wooden mock-ups of organs once used for instruction. Each piece is a different color and each has a little hook and eye to hold it to the next ... the lungs, the liver, the eye, the heart. Today's stillborn girl rests upon a green sterile cloth placed in a Pyrex baking dish. I have cut and pulled down the skin just above her forehead. I have opened her skull. I have carefully severed and lifted her little brain into my hands. I am just about to weigh it. I turn to the nearest window open to the rain and look out across an empty lot where a family of Gypsies stand about a fire holding bits of cardboard above their heads. I can see the bullring, wet and closed. All the trees are heavy with blossoms.
After completing three years of the six-year program I moved back to New York City to work at the Memorial Sloan-Kettering Cancer Center; in a lab during the day and then going on rounds seeing patients in the evening. I saw what top-notch contemporary physicians did, day in day out. I returned to Spain at the end of each semester to take exams and thus began a way of life, living between these two countries, that continues to this day. One evening, towards the very end of my training, the following occurred:
We found ourselves at the end of the night in a corner room on the 17th floor with a fine view of the East River, Queens and the 59th Street Bridge. The spring evening had grown stormy and it was raining hard by then and thunder clouds showed lightning near where I knew La Guardia Airport to be. The patient was an overweight black woman in her fifties being treated for an acute bout of diabetes. She was there at the cancer center because she had had her larynx removed the year before and the research minded faculty at Sloan-Kettering had a rule of following their patients' every turn.
"My, my. Come look at this," said Harold Edelman, professor of oncology and internal medicine, and avid sailboat competitor. I came away from the large window and joined the other interns by her bed. "Somebody turn off the lights," Edelman said. And then he said to the woman laying on her back, almost as an afterthought, "You don't mind, do you? It'll just be for a moment. You've got a crystal clear example of a rare condition and I'd like these young doctors here to see it." She looked up at him with a nervous smile, granting permission. It was hard for her to speak. I could see she felt at the mercy of these doctors, this hospital, these diseases that had come to define her. And yet she seemed glad for the attention and for the company at that hour of the night even as it made her feel afraid.
The room went dark as Edelman took a small, pen-shaped flashlight out of his lab coat pocket. It projected a small beam of red light. He widened one of her eyes with his free hand and aimed the beam there. "Here," he said to us, "Look at this. The fat content in her blood is so elevated you can actually see it in the arterioles of her cornea." And so it was. The tiny vessels that irrigated the white of her eye, though colored by the blood they carried, were colored too by minute globules of white grease.
Each of the interns stared intently, and each asked a pertinent question, and each I knew would make a point of reading up on the condition in the library that very night or the following day while this hands-on viewing was still fresh in their minds. And I looked as well, even as I realized I had no interest whatsoever in the physiological elements in motion there. What I was gripped by was the scene itself, the entire thing. The darkened corner room up above the river, the storm outside, the wind and rain and the thunder and lightning and the lights of the bridge and the lights on a tugboat heading to harbor. The light at the tip of Roosevelt Island and the reflections on the dark currents of the river and the moving clouds and the trees below surrounding Rockefeller University heavy with new leaves and blossoms blown to the wet walkways. The dedicated men next to me did not notice what I was noticing at all. I wanted to thank them for their dedication and encourage them to continue. I wanted to take the woman's hand and hold it and tell her not to fear. I wanted to capture the moment somehow for posterity and to include the river smell and the way the earth under the Manhattan asphalt was moistening with spring and the way the river flowed to the Atlantic between two islands that once upon a time had been rife with woods and clearings and animal tracks. But what I no longer wanted, was to be a doctor.