this is dr. bock.  yes, mrs. christie, what is it? it's all right, i'd be getting up in a few minutes anyway.  i'm sorry i missed that. would you say it again? yes, i know him, schaefer, the stud with the glasses, who fancies the nurses.  i'm afraid i don't understand that, what do you mean? was he sick? i mean, was he.  uh, what was the cause of death? was he being treated? i don't understand. what was he doing in the bed? you did say he.  look, mrs. christie, did you call the office? good, well, i'll.  no, no, it's all right. i'll be getting my wake-up call any minute anyway.
one of my interns dropped dead this morning.
yes.
it's been that bad for twenty-four years. are you going to be solicitous?
oh, god.
i'm going to do rounds today.
no.
for god's sake, john, i'm fifty-three years old with all the attendant fears. i just left my wife after twenty-four years. standard case of menopausal melancholy.
i don't want to see a psychiatrist. stop worrying about me. all i have to do is get my ass back to work, and i'll be fine. i'm sorry i've caused you concern.
what happened?
what happened?
what do you mean, a nurse plugged an i.v. into him?
and he talked a nurse into zapping him on that bed.
my god, it's a roman farce.
as i understand it, one of the nurses inadvertently administered an i.v. to schaefer here. how the hell could that happen?
i still don't know what happened.
i get the drift, mrs. christie. in other words, nurse perez went in and sedated dr. schaefer thinking it was the patient guernsey. my god! what i don't understand.
so she plugged an i.v. into him.
how much?
a five percent glucose solution won't kill anybody. did he have any other ancillary conditions? he wasn't dehydrated, was he? didn't anybody bother to go in to check him during the night, even under the impression he was merely a patient? was he hyperasthmolic? did he have a bad heart? he must have had some kind of thrombosis. i want the post done here, mr. hitchcock. and you and i better have a little chat, mrs. christie, about your excessive use of float nurses.
and every time one of them has her period, she disappears for three days. my doctors complain regularly they can't find the same nurse on the same floor two days in a row. what the hell am i supposed to tell that boy schaefer's parents? that a substitute nurse assassinated him, because she couldn't tell the doctors from the patients on the floor? my god, the incompetence here is absolutely radiant! i mean, two separate nurses walk into a room, stick needles into a man -- and one of those was a number eighteen jelco! -- tourniquet the poor sonofabitch, anchor the poor sonofabitch's arm with adhesive tape, and it's the wrong poor sonofabitch! i mean, my god! where do you train your nurses, mrs. christie? dachau!? all right, wrap him up and get him down to pathology. i'm especially interested in his blood sugar. a liter of glucose never killed anybody. your ladies must've done something else to him.
no.
find out if dr. einhorn is in his office yet.
psychiatry. never mind. i'll look in myself.
is he in?
can you give me a few minutes, joe?
i've been having periods of acute depression recently. apparently, it's becoming noticeable. a number of people have remarked on it. anyway, john sundstrom thought it might be a good idea if i spoke to you about it.
no. i'm not good at confessional. well, what can i tell you? the last year, two, three.  it goes way back, i suppose. i can remember entertaining suicidal thoughts as a college student. at any rate, i've always found life demanding. i'm an only child of lower-middle-class people. i was the glory of my parents. my son the doctor. well, you know. i was always top of my class. scholarship to harvard. the boy genius, the brilliant eccentric. terrified of women, clumsy at sports. god, joe, how the hell do i go about this?
i left her a dozen times. she left me a dozen times. we stayed together through a process of attrition. obviously sado-masochistic dependency. my home is hell. we've got a twenty- three-year-old boy i threw out of the house last year. a shaggy-haired maoist. i don't know where he is, presumably building bombs in basements as an expression of his universal brotherhood. i've got a seventeen- year-old daughter who's had two abortions in two years and got arrested last week at a rock festival for pushing drugs. they let her off. the typical affluent american family. i don't mean to be facile about this.
i blame myself for those two useless young people. i never exercised parental authority. i'm no good at that. oh, god, i'm no good at this either. joe, let's just forget the whole thing. i'm sorry i bothered you.
i amuse myself with different ways of killing myself that don't look like suicide. i wouldn't want to do my family out of the insurance.
a good toxologist would find traces. potassium's much better. sixty milli equivalent. instantaneous. of course, then you're stuck with how to get rid of the hypodermic. forty milli equivalent. gives you plenty of time to dispose of the evidence.
you ought to know a man who talks about it all the time never does it.
intermittently.
it means i haven't tried in so long, i don't know. let's just drop the whole thing, joe. i feel humiliated and stupid. all i have to do is pull myself together and get back into my work. i'm sorry i troubled you. take care of yourself. i'll see you.
all set?
who's that exotic group?
dr. perry said he picked the tuberculosis and the liver nodes for today, right?
good. because that's the one i studied up. a hell of a case.
all right, who's presenting?
five, a full abdomen contrasted to wasting elsewhere; six, ascites with a protein content above four grams; unexplained anemia, leukopenia, unexplained elevation of the serum gamma globulin level, especially abnormal flocculation tests, and of course, a positive p.p.d. all these findings assume special significance among negroes. this has been a very commendable workup, as commendable a workup of an f.u.o. as i can remember. the staff of this floor is to be applauded. it's a reportable case, brubaker. write it up. well, let's go have a look at the girl.
i wonder if there might not be some correlation between hepatic tuberculosis and drug addiction. presumably, there was an early consideration of s.b.e.
you, ambler. is that right, ambler?
what else do you look for in bacterial endocarditis?
good.
still a little icteric. who's got an opthalmoscope?
did anyone note roth spots?
well, don't worry about it. there aren't any. ambler, you're our big man on s.b.e. what was the latex- fixation?
don't you think that's an important test to differentiate s.b.e. from miliary t.b.?
not you, biegelman. ambler.
you have been reading up. if the diagnosis were s.b.e., would a positive latex indicate anything in the therapy?
if?
are you applying for your internship here?
come and see me. would you sit up for a minute?
all right, wait a minute. let me have all that again.
never mind the professional ethics, what happened?
what sonofabitch in farkis pavilion?
are you trying to tell me some post- grad fellow came up here and did a biopsy on the patient?
protein in the urine?
and he biopsied the man?
welbeck?! that barber!
without actually testing.
and the patient went into shock.
in short, a man came into this hospital in perfectly good health, and, in the space of one week, we chopped out one kidney, damaged the other, reduced him to coma and damn near killed him.
you know, brubaker, last night i sat in my hotel room, reviewing the shambles of my life and contemplating suicide. then i said "no, bock, don't do it. you're a doctor, a healer. you're the chief of medicine at one of the great hospitals of the world. you're a necessary person. your life is meaningful." then i came in this morning and find out one of my doctors was killed by a couple of nurses who mistook him for a patient because he screwed a technician from the nephrology lab.
and now you come to me with this gothic horror story in which the entire machinery of modern medicine has apparently conspired to destroy one lousy patient. how am i to sustain my feeling of meaningfulness in the face of this? you know, brubaker, if there was an oven around, i'd stick my head in it. what was the name of that sonofabitch from farkis pavilion again?
i'm going to ream his ass. and i'm going to break that barber welbeck's back. i'm going to defrock those two cannibals. they won't practice in my hospital, i'll tell you that!
let him go. before we kill him.
get me dr. gilley. put him on page if you have to. i want to talk to him right now. i don't care if he's operating. and you get me some monkey named ives. ives. i-v-e-s, first name elroy. he's in the farkis pavilion.
i want to talk to you, joe. would you mind coming into my office?
have you got some punk named ives rotating in your department?
i also want to know what the hell kind of a dialysis room you're running. i just came from.
yeah.  gilley? put him on. bock. didn't you tell me a couple of months ago you were going to cut off all privileges for that assassin, welbeck? yeah. wellbeck. he just butchered another one of my patients.  oh, come on, harry! the man's a buccaneer! i want him brought before the medical executive committee.  he's in your department, harry, not mine. he's putatively a surgeon!.  i'll be here! listen, joe, i think you should know that you've got a research guy in your department named ives who's been doing some very dubious biopsies. we're having enough trouble squeezing grants out of the nixon administration.
what do you mean, ives is dead?
he had a heart attack in the emergency room?
what the hell is this? some kind of plague? where is he now?
you don't find anything grotesque about all this?
i mean, at half past eight this morning, we meet over a doctor who's been killed intravenously, and here we are again, four hours later, with another doctor who had a heart attack in the emergency room.
how long are they going to be on schaefer's post?
i don't suppose you'd like to call next of kin?
oh god, i need a drink.
you don't seriously believe all that mumbo-jumbo will cure him?
okay. go ahead.
miss drummond, are you still taking your father out?
use my office.
you believe in witchcraft, miss drummond?
like a drink?
what the hell am i supposed to say to that, miss drummond?
i'm sitting here boozing and, all of a sudden, you start telling me some demented story about your father's religious conversion.
now what was that all about, miss drummond?
i admire your candor.
you're wasting your time. i've been impotent for years.
what the hell's wrong with being impotent? my god, you kids are more hung up on sex than the victorians! i've got a son, twenty-three. i threw him out of the house last year. pietistic little humbug. he preached universal love and despised everyone. he had a blanket contempt for the middle class, even its decencies. he detested my mother because she had petit bourgeois pride in her son the doctor. i cannot tell you how brutishly he ignored that rather good old lady. when she died, he didn't even come to the funeral. he thought the chapel service an hypocrisy. his generation didn't live with lies, he told me. "everybody lives with lies," i said. i grabbed him by his poncho, dragged him the full length of our seven-room despicably affluent middle-class apartment and flung him out. i haven't seen him since. but do you know what he said to me as he stood there on that landing on the verge of tears. he shrieked at me: "you old fink! you can't even get it up anymore!" that was it, you see. that was his real revolution. it wasn't racism and the oppressed poor and the war in vietnam. the ultimate american societal sickness was a limp dingus. hah! my god, if there is a despised and misunderstood minority in this country, it's us poor impotent bastards. well, i'm impotent and proud of it! impotence is beautiful, baby! power to the impotent! right on, baby!
when i say impotent, i don't mean merely limp. disagreeable as it may be for a woman, a man may sometimes lust for other things, something less transient than an erection, some sense of permanent worth. that's what medicine was for me, my reason for being. when i was thirty-four, miss drummond, i presented a paper before the annual convention of the society of clinical investigation that pioneered the whole goddam field of immunology. a breakthrough! i'm in all the textbooks. i happen to be an eminent man, miss drummond. and you want to know something, miss drummond? i don't give a goddam. when i say i'm impotent, i mean i've lost even my desire for work, which is a hell of a lot more primal a passion than sex. i've lost my raison d'etre, my purpose, the only thing i ever truly loved. it's all rubbish anyway. transplants, antibodies, we manufacture genes, we can produce birth ectogenetically, we can practically clone people like carrots, and half the kids in this ghetto haven't even been inoculated for polio! we have assembled the most enormous medical establishment ever conceived, and people are sicker than ever! we cure nothing! we heal nothing! the whole goddam wretched world is strangulating in front of our eyes! that's what i mean when i say impotent! you don't know what the hell i'm talking about, do you?
i'm tired, i'm terribly tired, miss drummond. and i hurt, and i've got nothing going for me anymore. can you understand that?
then can you understand that the only admissable matter left is death?
oh christ.
oh, bugger off. that's all i need now, clinical insights. some cockamamie twenty-five-year-old.
acidhead's going to reassure me about menopause now. look, i'd like to be alone, so why don't you beat it? close the door and turn off the lights on your way out.
swell. just close the door and turn off the lights.
leave me alone.
who the hell asked you!
who the hell asked you!
leave me alone! why the hell don't you leave me alone!
why didn't you let me do it? who the hell asked you!
you wouldn't be awake.
i swiped this for you out of the nurses' locker room. i'll make good on your dress. i'm afraid it's torn beyond repair. buy yourself a new one or, if you like, give me your size and i'll send it on to you. but i want to talk to you about that.
about your father. you really shouldn't move him in his condition. i just had a look at his chart. there's no reason to presume brain damage. you know as well as i you can't predict anything in these instances. he could pull out of that coma at any time. i think you should let him stay here. i'll personally look after him.
well, that would be nice, too.
what do you say, miss drummond?
three times?
let's give your father a week, barbara, what do you say?
you're a real fruitcake, you know?
swell. now, look, do you have a hotel, some sort of accommodations where you can stay for a week or so?
i'm afraid mexico sounds a little too remote for me.
what do you mean, if i love you? i raped you in a suicidal rage. how did we get to love and children all of a sudden?
i think those were more expressions of gratitude than love.
well, my god, for resurrecting feelings of life in me i thought dead.
okay, i love you, and you love me. i'm not about to argue with so relentless a romantic. well, then, since we have this great passion going for us, i don't see why you won't stay on here in new york for a week or ten days.
as long as it takes for your father's condition to improve.
you're certifiable! my god, half the time you're a perfectly intelligent young woman, and then suddenly you turn into a goddam cabalist who believes in dreams, witchcraft and bear power! and i don't like the way you dismiss my whole life as unnecessary. i do a lot of healing right here in manhattan. i don't have to go to mexico for it. i also teach. i send out eighty doctors a year into the world, sometimes inspirited, at least competent. i've built up one of the best damned departments of medicine in the world. we've got a hell of a heart unit here and a hell of a kidney group. a lot of people come into this hospital in big trouble, miss drummond, and go out better for the experience. so don't tell me how unnecessary i am.
yeah.
where are you going now?
well, you're coming back, of course.
what decisions?
all right. i love you! my god!
now, i don't want to get into an institutional hassle with you, mrs. christie. the malpractice here is monumental. as you see, dr. schaefer's blood sugar was twenty-three. no glucose solution is going to do that. the only thing that will do that is at least fifty units of insulin, probably more. the only presumption is that one of those nurses on the eighth floor shot fifty units of insulin into schaefer's blood stream, either by injection or through the i.v., although how in god's name.
yes.
thank you.
look, you're not going. i love you, and i'm not going to let you go.
come on, let's start putting your father's things back. he's staying here. i'll find an apartment somewhere. i'm staying in a filthy little hotel room. we can't use that.
for god's sake, barbara, you can't seriously see me living in a grass shack hunting jackrabbits for dinner? be sensible for god's sake.
you make it sound almost plausible.
no, that's all over. i suppose if i'm married to anything, it's this hospital. it's been my whole life. i just can't walk out on it as if it never mattered. i'm middle-class. among us middle-class, love doesn't triumph over all. responsibility does.
i'll come with you.
what dialysis nurse?
what do you mean, she died on the operating table in o.r. three?
you mean she was the one?
what the hell's going on around here? every time i try to find somebody in this hospital, they either died of a heart attack in emergency or of anesthesia shock in an operating room.
i had a schaefer. he died yesterday of an overdose of insulin. what do they want schaefer for?
there's no senior staff named schaefer in this hospital.
as a matter of fact, he said, "i am the fool for christ and the paraclete of caborca." and you'd better close the door, because if he's going to tell everyone who walks in here he's the fool for christ and the paraclete of caborca, they'll put us all away. he's already killed two doctors and one nurse.
i mean, he's killed two doctors and a nurse! and he just tried to kill me! he has something against doctors. somehow he got hold of a thousand units of insulin and put it in dr. schaefer's intravenous solution. and somehow he got dr. ives to die of a heart attack in the middle of the emergency room. and somehow he got a dialysis nurse named campanella to die of anesthesia shock on an operating table! he's been running around the hospital wearing dr. schaefer's uniform. right now, they're looking all over the place for this mysterious dr. schaefer. i know this all sounds as grotesque to you as it does to me, but you can see for yourself your father is not the helpless comatose patient we thought he was. don't look at me like i'm the one who's crazy. ask your crazy father!
and you put schaefer's insulin into the i.v. jar.
why x-ray?
of course.
you rang for your nurse?
oh yes.
are you kidding? we'll both take him. i'm going with you! get him dressed. we're getting out of here before the police put us all in rockland state.
look, that ambulance must be here by now. you go down and get them. i'll give him a shot of something to knock him out. we'll take him to the airport in the ambulance.
no.
i'm busy, welbeck.
you turned up half-stoned for a simple nephrectomy eight days ago, botched it, put the patient into failure and damn near killed him. then, pausing only to send in your bill, you flew off on the wings of man to an island of sun in montego bay. this is the third time in two years we've had to patch up your patients; the other two died. you're greedy, unfeeling, inept, indifferent, self-inflating and unconscionably profitable. aside from that, i have nothing against you. i'm sure you play a hell of a game of golf. what else do you want to know?
yeah, but your father isn't. he's disappeared. he put on schaefer's uniform and has gone out to do god's work, presumably the murder of dr. welbeck. except, that fellow on the phone over there is dr. welbeck.
and, on top of everything else, the other patient in your father's room overheard his whole confession and just told the chief administrator of the hospital. they're sending for the cops.
are you all right, welbeck?
all right, take it easy, mr. mead.
cardiac arrest, holly eight.
breathe him.
total cardiac arrest.
about a minute. no pulse, no heartbeat, no respiration.
endotrachial tube.
yes, his name's drummond. that's his chart.
they can't get him out of fib. i don't think he'll make it.
dr. welbeck is dead. they thought he was you.
i'm not going. the hospital's coming apart. i can't walk out on it when it's coming apart. somebody has to be responsible, barbara. everybody's hitting the road, running to the hills, running away. somebody's got to be responsible. kennedy airport. you've got a two- thirty flight to make.
you going back in?
right.