SPECIALTY ADVANTAGES DISADVANTAGES

RAYS Money (100K/annum) Gomers.

Dark offices, narcolepsy.

Damaged gonads; 8?fingered progeny.

Barium enemas and bowel runs.

GAS Money (100K/annum) Gomers.

Boredom punctured by panic.

Astronomical malpractice premiums.

Noxious gases, producing bizarre personalities.

Contempt, daily, of surgeons.

PATH No live bodies. Gomers (rare).

Low malpractice Dead bodies.

premiums Smell of dead bodies and formalin

Basement office.

Contempt, daily, of all but other pathologists.

Depression.

DERM Money (100K/ annum) Gomers.

Travel to sunny conventions Contagion.

Naked skin attraction Naked skin repulsion

OPHTHAL? Astronomical money Gomers

MOLOGY (millions/annum) Astronomical maplpractice premiums

Opportunity, daily, to Surgical internship required

torment GAS. Occasional patient care

PSYCHI? NO GOMERS! Hourly wage.

ATRY Never touch bodies Hard on lumbar spine.

except in sex-surrogate Multiple accusations from rightwingers,

Voyeurism, perversion, cf. 'communist,' 'queer,' 'pervert.'.

eroticism, autoeroticism,

polyeroticism.

Easy on feet.

Long lunch hours.

Cure?alleged-many others

By the end of the Fat Man's colloquium, the remarkable had happened: on paper, Psychiatry was the clear winner.

On the canoe trip, Psychiatry loomed even larger. Chuck had organized this final intern outing, and one bright, sweet?breezed summer day we signed out to the House residents, loaded the beer, and headed for the shore, into the foothills of the marshland to the tidal river, winding through the grasses to the sea. As we paddled lazily downriver, Berry and I found ourselves in a race with the two policemen for last. Gilheeny, a great red?feathered mallard in the bow, continued to curse his rudderman, Quick, as their listing canoe smacked first one bank and then the other. And yet what could have been better than drifting along, drinking cool beer, listening behind us for the deep carmine baritone of the redhead and the insistent tenor of his mate crooning "a lament from the Emerald Isle"?

We stopped on an island for a picnic. In a pine grove dappled with shadow, we found ourselves drawn to Berry. She listened to our discontent; she agreed that the year had been a horror:

"It's been inhuman," she said. "No wonder doctors are so distant in the face of the most poignant human dramas. The tragedy isn't the crassness, but the lack of depth. Most people have some human reaction to their daily work, but doctors don't. It's an incredible paradox that being a doctor is so degrading and yet is so valued by society. In any community, the most respected group are doctors."

"You mean the whole thing's a deception?" asked the Runt.

"An unconscious one, a terrific repression that makes doctors really believe that they are omnipotent healers. If you hear yourselves saying, 'Well, this year wasn't really that bad,' you're repressing, to put the next group through it."

"Well, then, my clever woman," said Gilheeny, "why is it that these fine young men do this at all?"

"Because it's so hard to say no. If you're programmed from age six to be a doctor, invest years in it, develop your repressive skills so that you can't even recall how miserable you were during internship, you can't stop. Can a star take himself out of a ballgame? No way:"

She was right. What could we say. We sat, still, absorbed, hushed, as the afternoon shadows inched on. Berry answered some questions about psychiatry, and as we awoke to what she was saying, she turned our picnic into a sort of group session. The theme was loss.

"What all loss do you mean?" asked Chuck.

"What each of you has lost this year. I know it first hand only from Roy but I've heard about the MORs and RORs and . . . and Eddies break and . . " She paused, and then, her voice trembling, said, " And Potts. You lost Potts. If you felt that loss, you'd still be crying. You're crippled by your guilt, the guilt of killing off the cherished parts of yourselves:'

In the darkening grove, silence hung somber as a shroud. I felt choked up. What had I killed off? Days like this one, my creativity, my ability to love. Gloom. Stasis. Doom. Finally, with the sun curdling down its the reddening hills, Gilheeny asked softly, "These men are wounded. Can anything still be done?"

"Guilt's a hot potato?whoever holds onto it burned. You're all doing a slow burn. Give it up. Get mad. Give it back to the ones who infantalized you. Is there a House shrink to talk to?"

There was: Dr. Frank, the psychiatrist at the B-M Deli lunch on our first day in the House. He'd mentioned suicide, and the Fish had canned him. He'd stayed canned the whole year. Why? Returning to the canoes, we floated toward the sounds of oceans, each wondering what had been lost, how this Dr. Frank might help find it, and finally, as the lightning bugs began their dance, wondering how to take this rage and stick it to the ones who'd ripped off parts of each of us, these House Robber Barons, the House Bosses of Loss.

I was on call that night, and arrived from the canoe trip with blistered hands, my drunkenness beginning to hang, preoccupied with what Berry had said, and mad about being back inside the House. It was hot and humid, and my sweatiness brought back memories of the terrifying summer I'd spent as a new tern a year before. Everything had happened. An admission was awaiting me in the E.W. It was to turn out to be extraordinary in that it was to be redeeming. I was greeted in the E.W. by the Pearl, who wanted to warn me about this particular patient, but I wasn't in the mood and I picked up the clipboard and read: "Nathan Zock, 63; bloody diarrhea? benign polyp." No wonder the Pearl had wanted a word with me. Zock, of the MICU Zocks and of the Wing of Zock, which had shut out summer from my on?call room.

Irritated, I entered the room, the Pearl rolling in at my heels. I had never seen so much flesh. Six bovine Zocks, overinflated flesh balloons, hovered around the stretcher, chomping, sucking, nibbling, snacking, smacking in a tribute to Freud's oral stage of development. Gems glittering, the Pearl introduced me to Nate Zock's fat kids, in an effort to herd them away from the stretcher on which Nate Zock allegedly lay. As they edged back, they dislodged a nasty?eyed chalkvoiced macaw of a woman with artificially black hair, who, hearing my name, said, "Well, young Dr. Kildare, it's about time?"

"Trixie," came an authoritative voice from the stretcher, "shut up!"

She did. There lay Nate, a rubbery?faced sixty, a bit booze?riddled, but with wealth in his manner and decisiveness in his mien. Even hassled by the herd, he was calm. The Pearl introduced me and left. Immediately I was besieged by the non?Nate Zocks. Everyone wanted feeding, about the diagnosis, prognosis, and the portending emergency: that Nate might not procure the best room in the House. To work on the latter problem, Trixie kept hinting in my ear the name Zock and "do you know who Nate is, have you heard of the Wing of Zock, eh?" After being sucked on for about three minutes, I'd had it and said loudly, "OK, everyone but Nate, get out of this room now!" Shock. No one moved. To talk like that to Zocks?

"You wait a minute, young Dr. Kil?"

"Trixie, shut up and get out!" said Nate, and when Nate Zock talked, even other Zocks listened. The room cleared fast. As I began my exam, Nate went on.

Thay're too fat. We tried, but nothing worked. You know, Dr. Pearlstein told me about you, Basch, he warned me, he said you're a, tough guy, that I shouldn't try to cross you. Said you're very good, but straightforward. I like that. Docs should be tough. When you're rich as I am, people don't treat you tough enough."