DANGEROUS DOCTORS by John Gamel
I was not disturbed to find a giant man sitting alone in our waiting room, even though the Stanford Eye Clinic was not scheduled to open for half an hour and, the week before, an early morning intruder had accosted two nurses in the OB-GYN clinic down the hall. Nor was I disturbed that the man sat cross-legged on a prayer mat, eyes closed, wrists on knees, thumb and index finger pinched together – the asana posture – humming a long, steady mantra. This yogi was the tallest person I had ever seen. Even with his butt on the floor, his head came almost to my chest. He had a gaunt face and scraggly auburn beard. His sandy hair, tied in a ponytail, hung to the middle of his back. I felt myself in no physical danger, since the new-age radicals who swarmed over the San Francisco Peninsula during the 1970s were a peaceful lot, but one item disturbed me: he wore a white coat.
Bad news. It was the first Monday of the month, thus the white coat meant this might be our new medical student, come to spend a four-week elective in the Stanford Eye Clinic. As the chief resident, I had to deal with any problems that arose among our crew of two clerks, two technicians, three residents, and any students who happened to be hanging about.
Mine was already a troublesome job. At Stanford during that era, competent staff was hard to find, since official policy, in keeping with the liberality that flowed over Northern California like the cooling Pacific breeze, forbade the firing of anyone for any cause short of a felony conviction. As a result of such indulgence, ungifted employees wandered from clinic to clinic, descending the academic pyramid until they reached that department with the flabbiest political muscle. Thanks to our chairman, an overfed teddy bear, years of attrition had given the Stanford Eye Clinic a depressing assemblage of workers.
There was Bea Chalmers – Little Bea – our appointment clerk, a faded woman the color of soap, a grandmother at forty and already beginning to shrivel. She had a sweet rosebud smile and the perspicacity of a hammer. When a huckster in Texas announced that he had performed the world’s first eye transplant – a gross exaggeration, in truth nothing more than an extra-large corneal graft – the San Francisco Chronicle ran a front-page headline: “Hope for the Hopelessly Blind.” Our appointment phone rang for hours, with Little Bea assuring every caller, “Oh, yes, our doctors here at Stanford do those new eye transplants.” Over the next few days, I found our waiting room filled with guide dogs and white canes. Dozens of hapless patients had been sucked in by Little Bea’s abysmal naïveté. When told the terrible truth, some left in tears, others purple with rage at being so cruelly misled.
Then there was Althea, a technician who faked the visual fields she was meant to perform at each visit by copying the fields from previous visits, a ploy that saved her time but sabotaged the treatment of many glaucoma patients. The chairman fired Althea after discovering her dangerous ways, but Stanford’s grievance committee harassed him with paperwork and obligatory meetings until he hired her back.
Sylvia, our other technician, had brassy red hair straight from the jar and a pathologically soft heart. When patients wept in frustration because they couldn’t read a line on the visual acuity chart, she would coo, “Oh, poor thing. Tell me, honey, do those letters look like an S and an L?” If the patient replied, “Yes, yes, that’s it!” she would dutifully record their vision as 20/200. One unfortunate patient – moments after Sylvia had recorded his acuity as 20/400, the big E on the eye chart – broke a tooth when he walked headlong into a doorjamb.
Bea, Althea, and Sylvia kept me frazzled enough. I didn’t need a giant medical student who laid out his prayer rug in the waiting room and entertained our soon-to-arrive patients by humming his mantra – “ooohhhhmmm . . . ooohhhmmm . . . ooohhhmmm” – in a buzzing vibrato that rumbled like the bass pipe of a church organ. I waited. At last he fell silent and opened his eyes.
“Morgan Gillman,” he said, leaping up to shake my hand. “How do you do? How do you do? How do you do?”
His enormous hand was cool and damp. I tilted my head back to gaze up at his lean bearded face. The man towered above me, every bit as tall as I had feared. An inadequate tie, bright with polka dots but soiled and badly knotted, hung halfway down his rumpled shirtfront. His Lincolnesque face was long and narrow, with hazel eyes that flitted about, fixing on my chin, my ear, my belt buckle, never on my eyes.
“You our new student?” I asked.
“Yes yes yes,” he said, still pumping my hand, until at last I pulled it from his moist grip. He squatted to roll up his prayer mat. At that moment, Doug Jacobson grabbed my arm.
“Let’s go,” he said. “How many cases we got on this morning?”
Jacobson was no taller than a twelve-year-old. His high forehead and long, dark hair gave the startling impression of a Napoleonic dwarf. Before I could answer, he staggered back, gazing at Morgan as he rose to his astonishing height with the prayer mat tucked under his arm.
“How do you do? How do you do? How do you do?” Morgan said, leaning down to pump Jacobson’s hand, nodding to and fro with each pump.
“I’m fine, thank you,” Doug said, freeing his hand from Morgan’s grip. He stared for a moment at Morgan’s dirty necktie, which hung level with his eyes. “Oh, my,” Doug mumbled under his breath, shaking his head in disbelief.
Morgan and I followed Doug into the laser room, which contained the Coherent Model 800. Morgan stopped in his tracks when he heard the eerie whine and saw the coffin-like console lurking in a shadowy corner.
“Ugh,” he grunted, pointing at the console. “My God, what’s that?”
“It’s OK,” I said. “Calm down. Just don’t touch anything.”
While a nurse led in the first patient and seated him at the laser slit-lamp, I explained to Morgan that during the treatment, the two of us would take turns viewing the patient’s retina through a tubular eyepiece attached to the slit-lamp microscope. A volley of clicks from the switch beneath Jacobson’s right foot signaled the beginning of the treatment. With each click, a blue-green flash struck the retina, cauterizing it into a chalky white dot. Flash followed flash, click-click-click-click, as the white dots wove their way through a complex array of veins and arteries.
Morgan hunched down to look through the eyepiece, but the visual spectacle seemed to strain his nervous system. From his cavernous lungs came grunts, groans, and an occasional sigh. An anxious body odor filled the room – was it Morgan or the patient? A foreboding tingle crept up my spine, yet things kept clicking and moaning and sweating along until it was my turn at the eyepiece. When the moment arrived, Morgan stepped aside, lifted his foot to prop it on the yard-high laser console, then leaned his elbow on the delicate tube that focused the beam on the patient’s retina. Through the eyepiece, I watched the laser beam skitter across the patient’s retina.
Jacobson shouted, “Jesus Christ!”
I tugged at Morgan’s bony shoulder and rose on tiptoe to whisper in his ear.
“Get down!” I warned. “Stay away from that console.”
“I’m sorry, I’m sorry, I’m sorry,” Morgan said. He took his foot from the console. A minute later he put it back and leaned on the tube.
Jacobson shouted, “Jesus Christ!”
I pulled at Morgan’s shoulder and whispered another warning, but only moments later his mind wandered again. For the third time, his enormous foot thudded onto the laser console.
Jacobson shouted, “Jesus Christ! Get that man out of here!”
Jacobson’s strident voice carried all over the clinic. I grabbed Morgan’s arm and led him into a waiting room filled with startled patients. “That’s one of my problems,” he said, wringing his hands as he followed me into the clinic’s coffee alcove. His long torso trembled. He clenched his jaw and backed into a corner, squirming against the walls. His face grew damp with sweat. “I just can’t keep my mind focused. I took my medicine today, but only one pill. Doctor Cheever’s very nice. We . . . we talked on the phone last night . . . I’ve been looking forward to ophthalmology ’cause I love eyeballs. Can . . . can I have lunch with you?”
“Doctor Cheever?” I said. “Isn’t he in hematology?”
“Yes yes yes. He looks after me.”
“Looks after you? You’ve got something wrong with your blood?”
“No, but he’s a nice man. Very nice. He takes care of me.”
Morgan’s beard trembled inches above my forehead. I looked up into his sallow, anxious face. The poor man had no idea how normal people were meant to behave. He seemed desperate to flee – flee that clinic, that building, perhaps all of humanity. The two of us stood in silence. At last Doug Jacobson stepped into the alcove, blushed when he saw Morgan, then took my arm and tried to steer me aside, but Morgan thrust himself between us.
“Thank you, thank you, thank you,” he said, pumping Jacobson’s hand.
Jacobson jerked his hand away, rushed down the hall to his office, and slammed the door behind him. For the remainder of the morning, I let Morgan follow me around while I saw my patients. During the first three or four exams, he lurked in a corner, wringing his hands, silent except for an occasional hum or sigh. Then I examined a patient who had gone blind in his right eye the day before. My ophthalmoscope showed lumps of dark, clotted blood distorting the central retina. In the patient’s other eye, a yellow scar had destroyed the central retina years before, and now all hope of useful vision was lost. I summoned Jacobson to confirm my findings. He examined the patient, an old farmer whose bald head was covered with liver spots, then stepped into the waiting area to gather the man’s son, daughter, and grandson into the exam room. Morgan and I stood in the doorway.
“Sometimes,” Jacobson said, laying his hand on the patient’s arm, “macular degeneration gets away from us . . . and when the eye hemorrhages, blood clots block the laser beam. There’s nothing we can do. No treatment, no treatment at all.”
The room fell silent. The patient’s son, as bald and almost as wrinkled as his father, pressed his hand against his mouth. The patient’s daughter sniffed and wiped her eyes. The grandson, a six-year-old in shorts and a blue beanie, sat perched on his mother’s knee, staring at Jacobson with a solemn frown. The patient remained quiet, nodding his head as though to say, “Yes, I suspected as much.”
Then came a noise – a deep, raucous explosion – right in my ear. It was Morgan. At first I thought he was choking on phlegm. “Uh hu hu hu hu . . . Uh hu hu hu hu . . .” He wrung his hands, writhed his body, rocking to and fro in wild gyrations. My God – Morgan was laughing! “Uh hu hu hu hu . . .” Everyone turned to stare. I stood paralyzed. At last I grabbed Morgan’s arm and pulled him into the hall, leaving behind a room filled with black silence.
The rest of the morning passed in a daze. Lunch came at last. I found myself in an open courtyard of the hospital cafeteria, seated at a table with Bea, Sylvia, two junior residents, and Morgan. There in the glorious sunshine of a California spring – amid potted ferns, hanging planters, and the aroma of enchiladas and black bean soup – I racked my brain: what was I going to do with Morgan? For the moment, he seemed safe from mischief, seated beside me at the deserted end of the table. My companions, in an effort to stay far away from this strange creature, had crowded themselves down at the other end.
I forced a smile, laughed loudly, told jokes, struggling to engage my sane companions. At some point, Morgan turned away to chat with a passing acquaintance. Out the corner of my eye, I saw his head bobbing, his scarecrow arms gesturing as he spoke. It was a relief to have him distracted, but midway through one of my excellent tales, my audience drifted away. They gaped, staring at something just to my right. Sylvia gave an ambiguous snort, something between a giggle and a scream. Little Bea, her eyes bulging, murmured, “My . . . my . . . my . . . “
I turned, and there sat Morgan – cheerful, verbose, more animated than I had ever seen him – talking to a potted fern. He laughed, slapped his knee, rocked back and forth.
“Uh hu hu hu hu . . . very good, Doctor Cheever . . . very good. . . . Uh hu hu hu hu . . . I agree . . . I agree . . . “
His eyes remained fixed on the fern, a man-sized plant drooping toward him from a concrete pot. That was it. I emptied my tray, ran upstairs to the eye clinic, and called the Office of Student Affairs. Busy. I called again. At last a woman answered.
“I need to talk to someone,” I said. “It’s about Morgan Gillman.”
“Oh my God,” she said. “Not him again.”
* * *
Nancy Lyon was an administrative assistant in her late thirties, a stout albino with a round face and straight white hair. We had never met, but as she led me to her office, I felt a sense of intimacy – the shared trauma of two soldiers under attack by the same appalling enemy. The manila folder clutched under her arm proved a formality, lying unopened on the desk while she told Morgan’s terrible story. He had been a brilliant college student, a physics major who graduated summa cum laude from an Ivy League school. His letters of recommendation described flawless grades and stunning achievements. His score on the Medical College Admissions Test was among the highest in the nation.
“When he decided to come to Stanford,” Nancy said, “our admissions committee went ballistic. Everybody thought for sure Harvard would get him.”
Stanford’s labs and lectures posed no problem for Morgan. After breezing through the first two years of medical school, he broke the curve on Part I of the Medical Board Exam, but his first clinical rotation pushed him over the edge. On the pediatric ward, as his team gathered at the bedside of a child in the terminal stage of leukemia, Morgan announced that the FBI was transmitting threatening messages through a gold crown on one of his molars.
Three months on the psych ward and massive doses of Thorazine finally brought him back to earth. A week after his discharge – coherent and clear-eyed, at least for the moment – Morgan cut a deal. If he spent a year in psychotherapy, the dean of Stanford Medical School would allow him another chance to get his MD. But when the year of leave ended, Morgan was nowhere in sight. Even his parents had no idea what he was up to, but two years after his departure, Morgan knocked on the dean’s door and declared himself healed, recovered, ready to begin again.
Where had he been all that time? In therapy, perhaps? Yes, Morgan said – at a peyote commune in Southern Mexico. The commune’s “therapist,” a Kadohadacho shaman, had insisted that Thorazine distorted Morgan’s karma and put his chi into a tailspin. From now on, Morgan declared, he might or might not take his medicine, depending on the messages he received each day from the ether spirits.
Morgan’s reenrolment in medical school brought a flurry of calls to Office of Student Affairs. Neurology, then orthopedics, then pediatrics, all made frantic inquiries: who was this giant weirdo who showed up on their service in a white coat and declared himself a medical student? Morgan’s demeanor, though always bizarre, remained fluid, evanescent – depending, I suspect, on the dose of Thorazine he had taken that day. On the orthopedics ward, he was Bartleby the Scrivener, aloof and withdrawn, standing motionless in a corner until someone led him away. In the pediatric clinic, amidst all those squalling infants, he arrived agitated, trembling and glassy-eyed, so obviously deranged the chief resident ordered security to take him straight down to the psych ward, where a four-week course of Thorazine brought him under control just in time to begin his ophthalmology rotation.
During the two years since his escapade at the peyote commune, Morgan had attempted six clerkships. Nancy was horrified because the dean had let this debacle drag on for so long, more horrified yet to learn Morgan had gotten credit for two of those clerkships. At this rate, in another year or two, he might have enough credits to graduate.
“He’s insane,” Nancy said. “How the hell can a lunatic get credit for a clinical rotation?”
How, indeed, especially at Stanford, one of the most prestigious medical schools in the country? A misadventure suffered by Dave Edwards, arguably the best student in my class (Stanford MD, 1971), might offer some insight into this debacle. A graduate of Cal Tec, David had been an aeronautical engineer before medical school and was the only student in our class who attended every single lecture. His fellow classmates loved him, since he allowed the slugabeds among us to photocopy his immaculate notes. Dave’s straight-A career suffered a setback when the Stanford Cardiology Department awarded him a gentleman’s C for his rotation. Though all his previous evaluations had been filled with lavish praise, this one noted only that he was an “adequate student.” Dave’s career could survive a minor blemish like that, but one fact disturbed him: he hadn’t taken the cardiology elective.
In all likelihood, his evaluation form was sent to cardiology by mistake, and when no one in the department remembered him, an intern or resident copped out with a noncommittal grade. A lucky break for a student who signs up but never shows up or who shows up but gets chased off the first day because of his bizarre behavior. Then there was the jumble of red tape that fell about the neck of anyone brave enough to fail a student, as I discovered when I refused to give Morgan credit for his ophthalmology rotation.
Nancy assured me that if I didn’t fill out all the proper forms, or if I failed to show up for scheduled meetings with the dean’s Student Committee, any breach in the protocol would be judged in the student’s favor. Thus a persistent student, however inept or insane, might accumulate enough credits to graduate, provided every now and then, as he blunders through his clinical rotations, a harried resident or intern fails to do her duty. And there was Morgan, creeping ever closer toward a license to practice medicine.
But I did my duty, and my persistence paid off. Almost. After I described Morgan’s fiascoes to the dean’s Student Committee, they gave him a failing grade for the ophthalmology elective. During this process I met Doctor Cheever, Morgan’s special advisor, a soft-spoken professor of hematology. No doubt his kind smile and warm grey eyes gave comfort at the bedside of his dying patients. I suspected someone in his family had suffered a disability, since he volunteered to be Morgan’s adviser and served as his advocate at countless meetings. He spoke of Morgan’s illness with passion in his voice.
“I’ve always felt the handicapped deserve special consideration. We can’t blame Morgan for his failures. He’s doing the best he can.”
* * *
A year after finishing my residency, I returned to Stanford for a visit. Nancy had moved to San Diego, but Cheever was in his office. He greeted me with a forced smile that suggested anything but pleasure. We chatted for a while – where was I living, what was I up to?
“Well,” he said at last, “I suppose you’ve come to hear about Morgan.”
“Yes,” I said, and remained silent, looking him the eye. I didn’t say, “Why did you dimwits keep tormenting the poor man with fantasies of becoming a doctor,” but I thought it, and Cheever’s defiant frown suggested he was reading my mind. The frown and the silence went on for a long time. Finally he dropped the bomb.
“Morgan got his MD last fall.”
“What!” I blurted. “But . . . but . . . he’s crazy as a loon. He won’t take his medicine. My God, can you imagine . . . “
“Well, aren’t you mister nice guy,” he snarled, his face contorted with anger, as though I had shouted a string of racial epithets. “What would you have me do with the poor fellow? Say, ‘Look, Morgan, you’re crazy, and crazy people can’t be doctors’? I’m not that kind of bastard. You can’t blame the patient for his disease.”
* * *
Cheever had a point: it wasn’t Morgan’s fault. No man would choose the torments that lurked behind those wild, jittery eyes. He had a special gift, but this gift carried with it a terrible burden. During the first year of medical school, he had aced a biochemistry midterm by regurgitating the Krebs Cycle down to the last minute detail, a feat no one in his class could match. According to a campus rumor, when asked how he accomplished this, Morgan replied, “I looked it up.” Which is to say, he looked up the answer in the copy of Basic Biochemical Pathways recorded page by page in his photographic memory. His was a soaring intellect – indeed, a monstrous intellect. Perhaps a mind that records every pixel of the world around it is doomed to collapse from toxic overload. Or perhaps, by a cruel, immutable law, some geniuses must pay for their gift by hearing the blades of grass scream in agony when trodden underfoot.
Yet I must confess my sympathies do not lie entirely with Morgan Gillman. I cannot help but wonder: where is he now, and what has he done to his innocent patients?
John Gamel’s essays have appeared in The Gettysburg Review, Epoch, Boulevard, The Antioch Review, and The Kenyon Review. His essay, “The Elegant Eyeball,” first published in Alaska Quarterly Review, was featured in The Best American Essays 2010. This is his third appearance in Alaska Quarterly Review.