THE INSTITUTE, MAY 1975
THE ENTRANCE FOYER IS ENORMOUS, AND WARDROBE RACKS are lined up on the marble floor, each tagged with a sign bearing a name. Clothes hang from each of them—uniforms is perhaps a better word. Shiny black jumpsuits. I take one and hold it up in front of me. It appears to be a perfect fit. There are slippers, too, and scrubs, cotton shirts, blankets, and pillows on a shelf below. I notice a Dopp kit and pick it up. Inside are toiletries—toothbrush, mouthwash, shampoo, and soap. I look around at the others. Everyone has the exact same provisions. Our hosts have thought of everything.
Our driver clears his throat, and we all turn to look at him.
“You may follow me. Pull your rack behind you. We’re going to your quarters.”
His face is as expressionless as it was when he first picked us up, and I wonder at his lack of affect. I have an urge to reach out and poke him, try to provoke a reaction. But of course, I don’t. I make my face a mask and follow along with everyone as if this is the most natural thing in the world. We are led to an elevator and line up to go down in groups. No one speaks while we wait our turn. I have to pee but am too embarrassed to ask. He comes for my group, and we descend six floors, and when the elevator opens, we are faced by a steel door. A woman stands next to it, in a black jumpsuit, and smiles.
“Good evening, students. Welcome.” She is pretty, not much older than me, and her eyes look kind.
Gratitude rushes through me at her warmth, and I feel myself relax.
She opens the door, and we push through with our new belongings.
There are beds lined up on each side of the room, army barracks–style, and others have already staked their claims and are sorting their things.
“Marianna, you’re over here.” She turns to me and puts a hand on my arm, then leads me to a bed at the end of one of the rows.
“Please, call me Maya.”
She tilts her head. “Maya?”
I smile. “My sister couldn’t pronounce Marianna when she was little, so she called me Maya. It stuck.”
“Maya it is. I’ll make sure to let your instructors know. I’m Evelyn. I’ll be your coordinator for this session. Anything that you need, any problems you have, you can come to me.”
“Thank you,” I manage, my voice cracking. I look around. “Are we all staying in here?”
“Part of being here is learning how to think differently. Does it matter, when you treat a patient, if the person is male or female? Certainly male doctors examine females, just as female doctors examine males. Would you refuse to examine a male patient?”
I shake my head.
“Of course not,” she says. “And you would find it absurd if a male patient refused to let you examine him because you are a woman.” Her hand sweeps across the room. “It is no different here. This is where you all sleep, no matter your sex.” Then she laughs. “Trust me, at the end of the day, the only thing that will be on your mind is sleep.”
* * *
Today is the first day of classes. We are awakened early, though I don’t know the exact time, as I no longer have my watch. There are about thirty of us in the room, and I dress silently in my black jumpsuit and slippers, averting my eyes to avoid looking at the other half-naked bodies in the room and hoping they are doing the same. Despite my conversation with Evelyn, I am still unnerved to be quartered with the men and didn’t sleep well last night. I whisper to Amelia, the woman assigned to the cot next to me. “Don’t you think they should separate the men from the women?”
She doesn’t turn to look at me but casts a glance in my direction out of the corner of her eye and answers, her words barely audible, “Shh. They’ll hear you.”
I bite back my retort, disappointed to realize that she’s a rule follower, and that I won’t be finding any companionship in her. We were told during initiation to keep to ourselves and focus on one thing only—being chosen as one of the final twenty. The competition is going to be fiercer than anything we’d experienced at medical school. Our ability to display a singular focus and to shut out everything around us is one of the things we will be judged on. I can see that Amelia is as serious as I am about being admitted to phase two.
The bell rings, and we walk single file behind our training coordinator to begin a day filled with lectures. I am excited, wondering when I will get to meet him. We are taken in groups of five to the elevator and back up six floors, where we are ushered into a classroom. It is nothing special, could be any classroom in any high school, with a large screen at the front. But then a man walks in the room, and I bite my cheek to refrain from gasping. It is him—Dr. Strombill. He is shorter than I expected, almost diminutive, and I wonder if this can be the man who has written with such passion and brilliance. He stands in front of us, silent, assessing, and seems to examine each of us before he finally opens his mouth to speak. When he does, all my doubts dissolve, and his passion is so palpable I almost believe I can reach out and touch it.
“Welcome. The fact that you are here is evidence of your extraordinary talent and dedication.” His Austrian accent is slight, melodic. “But more will be required. Innovation. Three-dimensional thinking. You must be able to see into the future and stride into the unknown. You have spent years being indoctrinated into the established way of viewing medicine. But we are to revolutionize the face of medicine, to see the big picture and make the difficult decisions that will advance medicine and treatment far above where it is today.”
He walks from the front of the room, pushes a tape into the VCR and presses play. Without another word he turns off the lights. The screen comes alive, and we are looking at an older man lying in a hospital bed. I watch as the man on the screen gasps and wheezes in a vain attempt to get air into his lungs. His sallow skin is stretched tautly over his skeletal face, and his pained grimace reveals brown teeth. He croaks out a hoarse request.
“Nurse.” It comes out as a whisper.
His bony fingers press repeatedly on the call button as a look of distress fills his face. When there is no response, he sags backward, and his head hits the pillow in despondent resignation. The nurse finally appears, then frowns when she sees that the sheets are wet. She sighs.
“Let’s get you cleaned up, Mr. Smith. Lemme get some help in here.”
Two medical aides appear with another bed, and together they move the frail body into it. The man she called Mr. Smith grimaces in agony as they jostle him, and he cries out.
“Leave me in peace! Why can’t someone make the pain stop?” His anguished cries are punctuated with bouts of coughing and gasping.
The screen goes black, and light floods the room.
“What you have just seen can be prevented.” Dr. Strombill leans forward and peers over the dais at the students in the front row.
His voice rises. “You must be the voice of that poor man. It is up to you to make sure that a human being does not endure that kind of suffering. It is your moral imperative, your sacred duty as doctors, as purveyors of mercy, to spare your patients from this degree of pain and indignity.”
He scans the faces and looks pleased. “Who of us wants to spend our last days on earth filled with pain, fighting in vain for every breath? No. It is indecent. We cannot allow people to linger indefinitely until their disease-ridden bodies finally give up and free them from their torment and anguish.”
A timid hand waves.
“Yes, you.” He points at Amelia.
“What is the alternative? If we don’t give any treatment, the patient will still suffer from the effects of the disease.”
He looks at her, and a frown pulls at his mouth. “I assume you have heard of euthanasia?”
A look of shock appears on her face. “Are you suggesting that we actually kill people? Put them down like dogs?”
“And are you suggesting that a dog has more right to compassion than a human being? What is the benefit in prolonging the life of someone who will be left with nothing but pain and indignity?”
I hold my breath. Can’t she see she’s making him angry?
Her cheeks are flushed. “But it’s illegal.”
He walks toward her. “It is now. But that is changing, and we must lead the charge.”
“But sometimes a terminal patient does recover. How are we to know which are hopeless cases and which are not?” She looks around the room, waiting, I think, for someone to come to her defense. No one does.
Dr. Strombill’s cheeks grow red, and a vein throbs in his forehead. He shakes a finger at her.
“That is what is wrong with this country. Overindulged children who grow up to be spoiled adults. The world does not have at its disposal the resources to squander on lost causes. Have you considered the financial and emotional toll on the family? Do you have any idea how difficult it is to watch someone you love wither before your eyes until they are nothing but an empty shell?” Spittle flies from the corners of his mouth, and his eyes are slits.
Every eye in the room is on her. With tears streaming down her face, she stumbles to her feet and runs to the door, leaving her notebook on the desk.
Dr. Strombill turns back to the class. “She won’t be needing this anymore.” He knocks the book to the floor. “I trust no one else has any questions?”