A week later, Baio was in our lounge drawing a grid with the word SHOCK at the top when I decided to ask him a question that had been gnawing at me since we’d met. “How do you know so much shit?”
He kept writing, putting the finishing touches on his grid.
“It’s like in one year,” I went on, “you’ve—”
He spun toward me. “Okay, five minutes on the basics of shock.”
“Photographic memory? Read a bunch of textbooks? What?”
“Flattery will get you nowhere, Dr. McCarthy. And sadly, medicine changes so fast most textbooks are irrelevant the day they’re printed.”
I thought of the textbook chapter I had slaved away at for months in medical school. “So what is it?” I persisted. Why was he being so opaque? I wanted to know what intern year had done to his psyche and how he’d apparently emerged unscathed.
Baio shrugged and stared out the window at a ship sailing south down the Hudson. “I guess you just see a lot intern year. And these little teaching things help. They help. You have to know your shit if you’re going to teach.”
“Definitely.”
He slapped me on the shoulder. “Have to prepare yourself for all sorts of stupid questions.”
“You know what they say,” I said, “there are no stupid questions.”
“Just stupid people,” he concluded with a chuckle. “You know, you should be teaching.”
“Me? Who?”
“Teach the medical student something. Anything. And never underestimate,” Baio said, still fixated on the ship, “the power of humiliation. I still clam up when I see Jake. When I see some of the other docs. But they taught me so much it’s absurd.”
Was it enough to just show up every day? Were the daily experiences so dynamic and transformative that you had no choice but to learn medicine? I hoped so.
“I’ll be right back,” Baio said, leaping toward the door.
A moment later, Diego entered. He grunted in my direction and spent the next thirty seconds trying to decide if he wanted to eat an apple muffin or a cluster of grapes. I watched him from across the room. Diego commanded a lot of respect in our group. His not being Baio or the Badass put him in a position above me without quite being in charge of me, and though we didn’t have a close relationship, I admired his intelligence. Diego’s research had been published in some of the most prestigious cardiology journals in the world, but he preferred not to talk about it, telling me once that his work was “mostly boring bullshit.”
Suddenly I heard myself speaking.
“Diego, do you, ah, do you remember Carl Gladstone? The professor from a few weeks ago?”
Diego selected the muffin and spun in my direction. “I do.”
I held my breath, feeling like I’d just plunged deep underwater without an oxygen tank. Diego took a seat next to me.
“Do you know what happened to him?” I asked.
“Indeed, I do.” His eyes grew wide, breaking through the squint. I waited for him to continue, but he didn’t. I had considered every conceivable response to this question but still wasn’t prepared for the answer.
“Is he okay?” I finally asked.
He put down the muffin and sighed. “Do you realize, Matt, that I was in the ER when Gladstone first arrived, or that I was the one who wheeled his ass to the cath lab or that I was the one who first noticed the pupils and called neurosurgery?”
I flinched and took in a short, quick breath, almost a gasp. “I had no idea.”
Diego was right, I wasn’t really sure how the CCU admission process worked. And I wasn’t certain what Diego did with his day other than correct me on rounds. So what was Sothscott yelling about? Why that awful phone call?
“I got a call from one of the neurologists,” I said meekly.
“Who was probably very fucking confused after reading your note. It was nonsense.”
I tried to put the pieces of that first evening back together. Why hadn’t Diego told me? Why hadn’t I brought it up the next day?
“Why are you asking about him now?” Diego asked. “This went down weeks ago.”
“I don’t know.” Why had it taken so long? Shame and insecurity.
Diego folded his arms and leaned back in his chair. “There’s layer upon layer of supervision here, Matt. Even when you don’t think anyone’s watching…”
I folded my arms, mirroring him. “When did the neurosurgery consult happen?”
“While you were bullshitting with Benny.”
Pressure rose in my head; my breathing became irregular as I thought of Gladstone’s wife, Sasha. Things still weren’t adding up. “What about my presentation on rounds? The Badass said to scan his head.”
“I told him to cancel it. It had already been done.” I recalled them whispering during rounds. “He went to the operating room right after your presentation—”
“Were you going to tell me any of this?”
Diego lowered his head. “Were you going to ask?”
I looked out of the window, thinking of Gladstone’s pupils. What was the point in not telling me? It would’ve saved weeks of torment, weeks of anxiety. Was it just a test? Proving some kind of point? “Look, Matt,” he said, “I’m not going to scream. I’m not going to throw things. But it’s ridiculous that it took this long for you to ask about Gladstone.”
I wanted to disappear. “I’m really sorry,” I murmured. “I was embarrassed. I thought about Gladstone all the time.”
Diego stared out onto the Hudson and took another bite of the muffin. “You have to ask yourself some tough questions in this job. But before you can do that you have to ask yourself a very basic one: Who are you looking out for?”
I slouched in my chair.
“Yourself?” he asked.
I extended my neck and shook my head. “Of course not. I—”
“Your reputation?”
“I just—”
“Or the patient?”
Searching for words, I thought about the promising medical student I had once been. I recalled the look on Charlie McCabe’s face when I first sutured up the banana peel in his office and the disappointment, months later, when I told him I did not want to be a surgeon. And as I sat there, head in hands, I realized I had forgotten to send flowers to McCabe’s funeral service, which had taken place earlier in the week.
As I sat there trying to process it all, Baio reentered the room.
Diego shook his head and stood up. “You really think we’re gonna leave all the decisions to you two bozos?”