Left for Dead (13 page)

I never have had a strong self-image, certainly not in my adult life. In high school, I considered myself pretty much a wimp. Bright dweeb says it pretty well.

Nor was I ever all that happy. I existed in what you might call a steady state; I could do my work and function day to day, but I was never at peace or happy or really ever felt good. Certainly from my college days forward, I always was off in the future somewhere, trying to get someplace so I could get out of whatever place I was. I was never able to be of the moment.

This was my mood, more or less, when my first depression descended in my freshman year at Midwestern. Anxiety and low self-esteem may have been my chronic companions, but the depression was acute. I didn’t mention anything about it to anybody. I just crawled into bed and stayed there. If I admitted I was depressed, then I’d be admitting a weakness, which I wouldn’t do. I also knew someone would want me to get help.
I’d have to talk to somebody about it, share the fact that I felt miserable. Then I’d be forced to deal with it, and I didn’t want to do that.

But I did think about suicide. The pain and the feelings of hopelessness were that intense. After three or four months of this, I just sort of wandered out of it and began feeling a lot better—or at least not as bad. What didn’t go away was a new certainty within me: Barring the unforeseen (a fatal accident or mortal disease), the black dog someday would return and overwhelm me, and I would die by my own hand.

Beck and I have discussed his depression, and mine. I think Beck’s emotional tone is not much different from mine. I see us very much as soulmates.

I struggle with lethargy, and therefore seek activities to energize me: working in the emergency room, exercising, flying airplanes. I do things to bump up my adrenaline.

I’m not sure which side of the family we get it from, but I think it’s our mother’s. Pappy drank, and I have a tendency toward alcoholism—medicating the bad feelings. I’m sure that’s not too different from what my grandfather was doing.

He and Beck were a lot alike, too. There wasn’t a subject Pappy couldn’t talk about, and Beck’s the same way. The only thing I’ve ever discussed with Beck that he was clueless about was emotions. He still doesn’t get it, doesn’t fully understand. This may be a survival issue with him, but he became so hyper-intellectual that it got him away from feelings. Beck has a huge wall, although it’s a little lower now.

The depression did not interfere with my education. Once that summer-school English class taught me how ignorant I was, I settled down to work at Midwestern. Despite a six-week bout with mononucleosis my first semester—which also kept me in bed a good deal—I earned one
B
, in band, and the rest
A
’s. I dropped band after that, even though I enjoyed it, which tells you something about my nature. I wasn’t going to take any subject unless I excelled in it.

I lived at home to save money, but I joined the Kappa Alphas to force myself into some sort of social life. I wasn’t the reticent sort, but I knew that I wouldn’t attend any college functions on my own. I certainly did not have the kind of personality to go barhopping in search of girls.

In return for the social boost, I upped the fraternity chapter’s grade average a full point.

When one of my KA brothers remarked on the obvious and suggested I add some muscle through weight lifting, I took his suggestion and found that I really enjoyed the exertion. That seems to be a key word for me:
exertion
.

For the first time since Little League I had some sort of athletic achievement of which to be proud. Plus it bulked me up to about 165 pounds. It felt good to be one of the stronger guys in the fraternity.

Nevertheless, I remained preoccupied with tomorrow instead of today, which inevitably raised the issue of what I wanted that tomorrow to be. I prefer to be judged on what I can do, what
skills I bring to the table, rather than who I am or may seem to be. Therefore I like subjects such as mathematics (no surprise), where at the end of an exercise there is an answer. Not so in English class. I hated the subjectivity of most liberal arts courses. With science, you know exactly where you’re headed.

The law interested me for that reason; not courtroom oratory, but the noble sense that law codifies our humanity. It is structure. Some of the greatest intellectual struggles in history turned on issues of legal rights. That had enormous appeal to me. Still does.

I think I’d make a good contract lawyer, because I understand the nuances of how people try to lever each other. That’s simply a grasp of tactics and strategy. I’d be a disaster at counseling people to understand their motivations. I know I’d project my concrete view of the world on them.

Medicine beckoned, too, and for a while I considered pursuing degrees in both disciplines. I’m most comfortable in a situation where the application of intelligence and hard work will yield a desired result in a fairly predictable way. Mountain climbing appealed to me, in part, for that reason. It also rewards the gradual accretion of skills and experience. You can lay out a plan to climb mountains the same way you can lay out a course of study in medical school.

Too bad one’s personal life is not so easily managed.

In the end, I decided it would be a waste of time and effort to train as both a physician and a lawyer. I declared myself a premed student, principally because that preserved the most academic options for the longest time, and I pursued a double major in mathematics and chemistry, which required 160 semester
hours of course credit to complete. A full scholarship for my final three years at Midwestern did wondrous things for my personal exchequer, but I still needed to work full-time one summer to cover my costs.

The job was long-haul trucking around Texas for Mayflower, the moving company (I was too young to drive interstate). The compensation was a pitiable $1.25 an hour, plus $4 a day for motels and a dollar for food. I’d hire high school kids and winos to pack a truckload for me in the afternoon, then drive all night—typically three or four hundred miles—to reach my destination by first thing the next morning. In this way, I logged about ninety hours a week, and shaved costs by sleeping in the truck and packing my own sandwiches.

Usually I’d push the big rigs until I was so tired I saw double, my clue that it was time to pull over and sleep. I recall that on one trip to Houston, I was asleep in the back of the truck on some furniture pads when I was awakened in the middle of the night by this tremendous noise. It was a locomotive, and it seemed to be coming straight for me. I couldn’t remember where I was for a moment, then it dawned on me: Okay, I’m in the truck.
Where
did I put the truck? I knew I’d pulled off the road.

I thought to myself, You could not have parked this thing on a railroad track, could you?

By now the sound was right on top of me. The truck was starting to shake. I held my breath, and the train blew by, barely missing me, the truck and some poor guy’s divans and end tables.

I need to be a little more careful, I thought, but did not connect
the episode with any sort of death wish or my earlier depression.

It was not an enjoyable summer hauling furniture around in the Texas heat, but it certainly was instructive, an object lesson in the value of learning to use your mind instead of your back. By September I was more than happy to be hitting the books instead of the road, and for the next two summers I went to summer school.

I followed Beck from Burkburnett to Midwestern. Our father retired and took a job with the FAA in Memphis. Mother, who had gotten her master’s degree at Midwestern, was contracted to teach biology there for a year. I took her class, in fact. She and Beck and I lived together that year. The next year, Beck’s last at Midwestern, he and I shared an apartment together. When he graduated, I transferred to the University of Texas at Austin, where I decided to study medicine, as well. Until that moment it had been a toss-up whether I would become a doctor, or a pilot like my father.

As I finished college, I, like many of my generation, developed a burning interest in further education. The Vietnam War focused many of us on the benefits of graduate school, if it entailed a military deferment.

My medical schools of choice were Duke, Tennessee and the University of Texas Southwestern Medical School in Dallas.
Southwestern both accepted me and offered me an academic scholarship. Next stop: Dallas.

That first summer before starting medical school I worked at the university as a computer programmer, assigned chores like transposing census tract data from one format to another. It was mind-bogglingly dull work, about as stimulating as schlepping furniture.

I found a suitable duplex apartment near campus and lived there alone my first year. My landlady was a sweet old soul, in her mid-to late-eighties, I guessed, still tough enough at that age to mow her own lawn, in the summer, with an old push mower. She occasionally cooked suppers for me, signal events in a life otherwise spent buried in the labors of first-year med school.

There was a huge amount of memorization, which I sort of plodded through, making grades from the ordinary to the very good. A student’s success that first year hinges on whether he can develop an interest in what his professors are trying to hammer into him. The information itself often turns out to be a random series of facts with no discernible unifying themes.

In microbiology, for example, you might get a guy who talks for ten days on cholera, a disease I have yet to encounter in twenty-plus years of practice. I remember another professor wanted to spend a couple of days on osmosis across the toad bladder, because that was what he understood. Needless to say, I found a good deal of this right up there with transposing census tracts.

That summer I got a job as a scrub nurse at Parkland Hospital, Southwestern’s teaching facility. A scrub nurse is a sort of operating room technician. Gowned and gloved like the surgeons,
the scrub nurse manages all their materials and instruments for them, keeping track of sutures and sponges, slapping scalpels and probes into the doctors’ hands, just like on television.

Parkland’s most famous emergency surgical patient had been President Kennedy. When I arrived six years later, I discovered that the hospital emergency room had a very active knife and gun club; individuals, couples and families on Friday and Saturday nights would bring their blankets and picnic baskets to a hill in front of the ER entrance, where they’d settle down to watch the evening’s casualties hauled in.

It was quite a show.

Inside, I pulled a lot of double shifts that summer, and got to see some amazing stuff myself. ER surgery is medicine on the fly. It was not at all uncommon to be sitting around throwing cards in a hat when,
blam!
the double doors would fly open. “We’ve got somebody
now!”
an EMT would shout, pushing a bloody mass our way.

The surgeon—in the Parkland ER they were all second-year surgery residents—would just start opening up the patient. You’d build the room from there, adding more personnel and equipment if the guy didn’t die right away. Most of the time, he didn’t last more than a couple of minutes.

Once, they brought in a half-drunk gunshot victim. He basically was bleeding to death, but he wouldn’t give permission to operate. As long as a patient was of sound mind, more or less, you could not open him up against his wishes.

So the surgeon did what anyone would do in such a situation: He ordered a pizza. He said, “When the pizza’s delivered, turn
off this guy’s IVs.” So the pizza came and they flipped off the IVs. It took about twenty minutes for the guy to become sufficiently shocky that he no longer was of sound mind, and we could proceed to do whatever we thought was necessary.

In my second year at Southwestern I was fortunate enough to discover a specialty, pathology, that ideally suited my strengths and interests—and a professor who made the subject fascinating for me: Dr. Bruce Fallis.

The pathologist deals directly with diseased tissue, usually under a microscope, but not necessarily. Most other physicians do not. They see reflections of the disease in symptoms or maybe X rays or perhaps changes in body chemistry. But in pathology you see the disease itself. You hold it in your hands. You look directly at it through a microscope. That appealed to me; I liked the exactness.