We never figured out why Dan Masterson died shortly after walking in to the emergency room. But before she left the hospital, I handed Darby Masterson a list of diseases she needed to be tested for and I also gave her my cell phone number and told her to call me if she ever wanted to talk. I had a strange union with her—I wouldn’t call it a bond—and felt vaguely responsible for making sure things turned out okay for her. I knew I would remember Darby Masterson’s bloodcurdling screams the rest of my life and suspected she might remember me, the ghastly messenger, for just as long.
About ten days later, as I staggered toward the subway after a thirty-hour ICU shift at the Allen, Darby called to tell me that every test had come back negative, including hepatitis C. I didn’t tell her all that I’d heard about her husband because it was largely unconfirmed. I never saw his test result, and he’d died before one had been done at our hospital. Instead, I asked her to follow up with the physician who’d been caring for her husband, the one who had his medical records and could give her real answers. I wasn’t sure if it was the right way to handle the situation, but it was a tremendous relief knowing she wasn’t infected.
The remainder of my stint at the Allen Hospital ultimately lived up to its billing. The nights were exhausting and difficult—the tears for Dan Masterson weren’t the only ones I shed that month—and those four weeks in the ICU were a crucial part of my development as an autonomous physician. I felt like I had assimilated medical knowledge with technical skill, empathy with tact, and somewhere along the way, perhaps around week two, I finally stopped hearing voices. When I examined my patients, I no longer thought of Don or Baio or Ashley, because I didn’t need to. I knew what to do when I encountered a new patient, and I didn’t need to be reminded. And if something stumped me, I was able to seek help and find the answer. Finally, after nearly a year of being an apprentice, I felt like I was ready to supervise another, less experienced doctor.
At the end of the month at the Allen, I was contacted by Dr. Petrak—the one with the Lithuanian eyebrows who once said I was working under a microscope—who told me that he’d heard about a clever diagnosis I had made and wanted to celebrate over a cup of coffee. He was referring to the frail Italian man, the one with the unexplained fevers that had confused my team for days. After poring over his records, I had discovered that his primary care doctor had recently placed him on a new medication and that drug, rather than an infection, had induced a fever. I relayed a bit of the story over the phone—“when I stopped the drug, the fevers just went away!”—but told Petrak I’d explain the rest in person. He was delighted, and without saying it, I knew that the microscope had been switched off.
Intern year ultimately drew to a close on a swampy day in June, one that forced Ali to wear something resembling shorts for the first time all year. On the subway ride to work, he appeared to be wearing lederhosen and was raising money for a group called Boys for Tots, which, according to his artisanal business card, sought to connect underprivileged young men with overprivileged yuppies in need of a babysitter.
It was a strange feeling walking into the main hospital on that final morning, knowing it would be my last as an intern, my last with the benefit of a second-year supervisor, and my last as a guy who could be forced to go on a predawn Starbucks run. Internship had been all-consuming, and my concern for what was happening in the world had gradually diminished as I’d thrown myself deeper into my work. (I was only vaguely aware that we were in the grip of a global recession and that mysterious things called subprime mortgages had been responsible for it.) Medicine had become my life. Everything else, everything that was not a matter of life and death, was now secondary. In some ways I was like a piñata, my insides scooped out and replaced with something new—something special—while my exterior had grown accustomed to taking a beating.
This year of sleepless nights had taken its toll on me. I had more gray hair on my head, several extra pounds around my waist, and two new chins. My eyes were hollowed out, and I’d developed the disturbing trait of occasionally falling asleep in mid-sentence. I looked quite a bit like Axel did when I met him.
Scenes from the year flashed before my eyes as I glided through the hospital’s lobby on that bright June morning: Learning that Carl Gladstone was back at home plotting out his summer curriculum; trashing my stash of condoms after my HIV test had come back negative; consuming more Frostys than was safe for any human. One of the highlights had been hearing that Peter and Denise Lundquist had walked out of the hospital together, holding hands. The only thing missing, of course, was a heart for Benny.
More than once I had made the Wizard of Oz comparison in his presence. He was the Tin Man, in need of a ticker, and I was the Scarecrow, in need of a brain. Or at least a better one. But as the year progressed, I’d largely stopped seeing my life through the lens of a camera; I’d stopped viewing my work as a movie, one in which I just happened to have a starring role. This was not The Truman Show. As I became more comfortable doing my job, I felt less like an actor, less like someone playing a part. Medicine was a job and I was now comfortable doing it. I didn’t need a script to follow.
The terrifying, inspiring year at Columbia had filled my brain with all sorts of knowledge—medical information, certainly, but so much more—things I wouldn’t fully be able to process for years. I was still trying to work out a reasonable work-life balance, and through that struggle I had come to view my job like a new family member, an unpredictable stepbrother whom I mostly adored but, on occasion, couldn’t stand.
Donning my white coat on that final day in June, I thought about something Baio had said much earlier in the year. Everyone breaks. Had I broken? Possibly. Probably. But then what? He and I never discussed what came after that. I had probably broken many times over, but now I felt like I had been reassembled, delicately patched back together, like they tried to do with Humpty Dumpty. The cracks were evident—they would always be there—but I was whole again, just in a slightly different iteration. The patchwork had been done by those close to me—my colleagues, my family, my friends, my advisers—those who wanted me to succeed. Overall, I was in a good place, relieved that the sleep deprivation and mental anguish hadn’t done more lasting damage. I had survived intern year at Columbia, and now, when I said, “Amazing things are happening here,” I meant it.
Mostly.
Despite those first few bumpy months, it had been the right choice to ditch surgery, to say good-bye to Axel and McCabe and MGH and move to Manhattan. I wasn’t meant to suture up lacerations or remove gallbladders; I was meant to do whatever the hell you’d call the extraordinary stuff we did at Columbia. Intern year had fundamentally changed me—it had altered the way I viewed the world and myself—and it was unquestionably the most fun I never wanted to have again.
Now that I could make decisions quickly and confidently, I had more time to empathize with my patients, to see things from their perspective. To explore what might otherwise go unsaid during a brief visit in the hospital or in my clinic. And after a year of abandoning myself to medicine, I could now answer Diego’s question with confidence: I was looking out for my patients, not myself.
As I was skipping up to the second-floor cafeteria, my thoughts turned elsewhere, to a conversation I’d had with Petrak a few days earlier about the storm that was building in higher education. Powerful educators were now claiming that medical school could plausibly be reduced from four years to three. In broad strokes, the argument was that so much of medicine was learned on the job and that medical school debt was driving many of the top minds into other fields. It was a highly contentious topic, and I had mixed emotions about it.
I learned very little physiology or pharmacology from Jim O’Connell, but the life lessons I absorbed from him would stick with me the rest of my career. How does one objectively measure the value of something like that? Would I have had time to wander the streets of Boston with Jim if medical school had been crammed into three years instead of four? As I loaded a stack of pancakes onto my plate on that final day, I heard a voice call out my name.
“Matisyahu!” Mark said, as he strutted toward me. “We made it!”
“We did,” I replied, with a touch of relief and a touch of regret. I wondered what emotions he was experiencing. Was Mark broken? If so, the goofy grin on his face did a nice job of concealing it. I really didn’t know what was going on inside his head. He and I were work friends, but that was about it. Our schedules so rarely overlapped that most plans to grab a beer and get to know each other were inevitably canceled. And it was more often my fault than his.
“Coming to karaoke tonight, Matty?”
“Of course.” Tonight the senior residents were covering the interns’ overnight shifts; it would be the first time since that autumn retreat in the Palisades that all of the interns would have an evening free together.
“What’s your karaoke jam?” he asked. “I’m going with Cher and/or Naughty by Nature, depending on time constraints.” I raised an eyebrow. He dipped his hips and wagged an index finger at me. “I’m naughty by nature not ’cause I hate ya.”
Mark was clearly not experiencing the same twinge of regret I was. In that moment, I wished that I knew more about him. More about all of my colleagues, really. I’d had substantive conversations with so few of them. Had Mark broken down in tears? Had he stuck himself with a patient’s bloodied needle? Did he ever think about leaving medicine? I had no idea.
“I might fire up Journey,” I said as we stepped out of the elevator. “Or maybe the Outfield.” He shrugged; the band’s name clearly didn’t register. Perhaps it was a poor choice for karaoke. “You know, the one that goes, ‘I don’t wanna lose your love tonight.’ ” It was the tune playing in my head as Banderas had counseled me after my needle stick and it was the song Heather and I would one day walk out to at our wedding.
“Huh.”
“I could also do the Goo Goo Dolls.”
“Oh please, no!”
“I might have to,” I said. “I’ll blame it on the sake.”
“Don’t blame it on the sunshine,” Mark sang in falsetto, “don’t blame it on the moonlight…just blame it on the sake.”
“Nice.”
“Michael Jackson, nineteen seventy-eight.”
“Very nice.” I couldn’t remember the last time I’d been in the presence of such unabashed intern joy. Maybe the year had been harder on him than I’d realized. Or maybe he was just a fun-loving goofball.
“Maybe your pod could do reverse Black Eyed Peas,” he said. “I could see you as Fergie. Corset and fishnets.” I wondered how much sake it would take to convince Lalitha to be will.i.am. “For the big finish I’m doing Celine,” he said, putting his left hand on my forearm. “If I touch you like this…” He grabbed my left hand and put it on his chest. “And if you kiss me like that…” I pulled my hand away as a nurse glanced at us.
“You are a nut.”
“I am, Matisyahu. I am! See you tonight, pal.”
We quickly ate our food and parted ways. I was finishing the year on the general cardiology service, and Benny, battling a case of pneumonia, was one of my patients. I headed over to his room to check on him, but he wasn’t there. Unlike Dre, however, I knew he couldn’t have gone far.
I headed down a long hallway and found him in a communal area, holding court. Seated in a horseshoe around him were five middle-aged men and women, nodding and taking notes as he spoke. Benny looked like a doctor conducting rounds, and those surrounding him appeared to be patients, or family members of patients, presumably dealing with similar medical conditions. Some were probably on the transplant waiting list.
“The thing is,” Benny said, “this isn’t easy. And it’s not something that is going to be cured like that.” He snapped his fingers and a woman raised her hand.
“How do you know if you’re retaining fluid? They told me to take an extra dose of Lasix if I have a salty meal, but sometimes I just can’t tell.”
“Great question,” Benny said. “I weigh myself every day. If I’m up a few pounds, I take an extra dose of…” He looked at me and trailed off.
“I’ll come back,” I whispered. “Thirty minutes?”
“Cool,” he said, smiling as he returned to the group. “Where was I?”
We reconvened in his drab, straw-colored room a short while later, and I took a seat on the edge of Benny’s bed. The relative calm of the general cardiology floor was a far cry from the bells and whistles we had grown accustomed to in the cardiac care unit. “Should I call you Professor?” I asked. “Or Doctor?” I smiled and patted him on the back.
“Just trying to pay it forward.”
“I think it’s great.”
“So, this is it,” he said. “Last day, right? You made it through.”
“I did. It was some crazy shit. And some pretty amazing shit.”
“Proud of you, Matt.”
I thought about delivering some vaguely prepared remarks. A few words I had been mulling over in my head for months that would sum up what Benny’s presence in the hospital had meant to me and to others. I wanted to tell him about his reputation as the embodiment of courage and patience—a kind man who had been given a raw deal and rarely complained.
I wanted to say something we’d both remember. But I didn’t. Instead I repeated that phrase that I had said so often to him—the words I tossed off to countless patients, colleagues, and, most frequently, to myself: “You’re gonna get through this.” But it meant something different here, something far more personal. I wasn’t saying this just to say it; I was saying it because I needed to believe it. And I wanted him to believe it. I had accused others of having gilded personas, but in this case I was the one possibly putting a false gloss on something, trying to adorn a difficult situation with unwarranted optimism. But I needed to say it.
I recalled the day I’d bumped into Baio at the vending machine, in the aftermath of my needle stick, when he said, “You’ll get through it.” The words had meant something to me then, even after he’d conceded that he said that to everyone. I grinned at Benny and picked up one of his Babyface CDs. “A bunch of us are going to karaoke tonight. Maybe I should try this out. A little slow jam.”
Benny shook his head. “I would pay to see that.”
He turned on the television and methodically flipped through the channels, and I sighed. “Oh please, please not Judge Judy.” I felt my pager buzz. “Listen,” I said, “I gotta get to rounds. Last one as an intern. Gonna try not to go out with a bang.”
“I’m sure I’ll see you around,” he said, extending a fist.
“No doubt.”
Walking out of the room, I glanced at a ripe banana peel in his trash can and smiled. “Benny,” I said as I closed the door, “you really are going to get through this.”