He clapped his hands together like cymbals. “All right, enough celebrating. Back to work. Where were we?”
I followed him out of the room and back to the computers. “Before you left you said you wanted me to guaiac someone.”
“Ah, yes. There are actually two treats in your future. Forgot to mention the M and M.”
“M and M?”
“Morbidity and Mortality. It’s a conference. Every so often we get the entire department together and go over a case where someone screwed up.”
My mind instantly went to Gladstone. Surely his situation was tailor-made for unpacking at a conference that made case studies out of botch jobs. Could the case have made its way up the chain already? I knew about a small mistake or two made by one of my fellow interns, but nothing on the level of Gladstone, certainly nothing else worth exploring at length. In my mind, someone was holding a file folder marked “M and M” with a lone sheet of paper chronicling my idiocy. I was certain they were going to talk about me.
I might be able to drown my constant thoughts of Gladstone and my shame from Sothscott’s phone call in the craziness of the CCU, but now I was forced to face the idea of a virtually public shaming in front of the entire department. What would the Badass think? Could any possible punishment or censure come out of it? My bowels shifted. I wondered if Baio could hear it.
“Jesus,” I murmured.
“It’s allegedly anonymous, but we can usually figure out who’s responsible. Makes for high drama. Tempers flare, egos are crushed.” Baio made a fist. “It’s tragedy with a healthy mix of unintentional comedy. I’m always on the edge of my seat.”
“Sounds awful.” How could he be so fucking cavalier?
“Don’t worry,” he said. “I’ll remind you about it later in the week. But back to the task at hand.”
“Yes. Point me in the right direction of the rectal exam. I’m ready.”
“Here’s some guaiac juice,” he said, handing me the developer that was to be applied to the stool. If blood were present, the brown fecal material would turn a brilliant blue.
“Thank you.”
“No, thank you.”
A nurse tapped Baio on the shoulder and whispered something in his ear. I applied a few drops of the developer to my finger to ensure there would be no mishaps with the actual stool sample. I sensed a moment to pick his brain.
“You said the lows this year would be really low.” I rubbed the developer between my thumb and forefinger.
“Yep.”
“But everyone says it gets better. Right? That it gets a bit better every year.”
He scratched his chin. “They do say that, don’t they? Well, I want you to know that they’re wrong.”
I wrinkled my brow. “Seriously?”
“All year people will reassure you that next year will be better. And the year after that. Trust me, it doesn’t get better.”
“Come on.”
“Nope.”
“I look forward to the day when I will actually feel like I know what I’m doing around here.”
“That day ain’t comin’. With more knowledge comes more responsibility.”
“I suppose.”
“You start taking your work home with you,” he said, staring blankly at the computer screen. I wanted access to his inner world. Was he struggling in a way I didn’t realize? Was he thinking of Carl Gladstone? Or was he just messing with me? I studied his face, but it offered no clues. Unlike so many doctors, Baio appeared unencumbered by anxiety or self-doubt. But what was beneath that highly competent exterior?
“Fine,” I said, “I’m fine with that.”
“Not fine. Okay, focus, Dr. McCarthy. I need you to rectalize room fourteen. Go with God, my friend.”
The elevator door was closing several days later as Baio and I approached. He extended a hand and sprang it open, revealing a dozen white coats on their way to M and M—the Morbidity and Mortality conference. I thought about what I might say if Gladstone came up. I’d be contrite, certainly, but not defensive. I would acknowledge my mistake and accept the punishment and embarrassment that came with it. What else could I do?
“You can tell what type of doctor someone is by what they stick in a closing elevator door,” Baio said as we squeezed inside.
“Oh yeah?”
“An internist sticks his hand. Surgeon sticks his head.”
“And a social worker,” said a woman in the back, “sticks her purse.”
A six-three, rotund, bearded man in jeans and unlaced white tennis shoes flashed a grin and placed his hands on Baio’s shoulders.
“Look who it is,” he said, grinding his hands into the base of Baio’s neck. “My first, my last—”
Baio wiggled out from underneath his grasp like a younger brother escaping a headlock. “What’s up, Jake?” Baio threw a thumb in my direction. “This is my intern, Matt. Big Jake here was my first resident. Taught me everything I know—”
“When this guy showed up last year,” Jake interrupted, placing a paw on my tricep, “he didn’t know his ass from his elbow!”
It was impossible to imagine. “It’s true,” Baio said. “I was a mess.”
“No,” I said breezily. “No way.”
“Oh yeah,” Jake said, laughing to himself, “this guy was a total disaster!”
The rest of the elevator remained silent as I tried to imagine what his incompetence would look like. Baio racing around with fear in his eyes instead of assurance. Baio fumbling helplessly with primary care patients. Baio sitting on the other end of that miserable phone call from Sothscott. No mental image would stick.
The elevator reached the ground floor, and as we stepped out I realized Jake looked more like an offensive lineman than a physician. Perhaps he had been a football player; Columbia was full of ex-athletes. He slapped himself on the knee. “And now,” he said to Baio, “you’re telling an intern, another doctor, what to do? Amazing.”
“Circle of life,” Baio said flatly.
Jake turned to me. “Did he tell you about M and M?”
“A bit, yes.” I didn’t know what to make of this enormous oracle. “He said people get worked up. Something about egos getting crushed.”
“And tears,” Jake said, “don’t forget about the tears.”
“I’ll keep my eyes peeled.”
“Piece of advice,” Jake said as he leaned in and nodded toward Baio. “Don’t believe a word that guy says.”
We took our seats in the auditorium, and I braced myself. Rapid-fire, shorthand conversations took place all around me, but a hush fell over the sea of doctors when a physician stepped onstage and tapped on the lectern’s microphone.
“Welcome,” she said, “to M and M.”
I looked around the room, searching for signs of distress. I prayed they would not be discussing Carl Gladstone. It’s been said that the first half of life is boredom and the second half is fear. If that’s the case, I’d just reached middle age.
“Today, we’re going to discuss a case with an unfortunate outcome. As always, I remind everyone that today’s conference is confidential and—”
My pager went off: LUNDQUIST FAMILY WOULD LIKE TO DISCUSS DISCHARGE PLANNING. RETURN TO UNIT ASAP.
I took a deep breath, and another. I had to go but I couldn’t get up. My ears were perked as the speaker ran through generalities pertaining to the M and M conference, tuned to any mention of the words “Gladstone” or “anisocoria.” But the intro just dragged on. Baio looked over at me as I scanned the room, searching for other sets of eyeballs that might have drifted in my direction. The pager buzzed again. I had to go. I showed the message to Baio, shrugged, and excused myself, wondering if I was about to be lambasted in absentia.