Left for Dead Read online

  I was able to push the Ghia to the edge, but not out, of the hole. So I walked out to the nearby highway and hitched a ride from a trucker, who drove me down the road to a friend’s house. He knew a farmer with a tractor who pulled the car out of the mud for me. Then a morning’s worth of scrubbing and cleaning and voilà! The evidence was washed away, and my parents never found out. Until now.

  For refreshments, we’d drive an hour north into Oklahoma and to a certain remote roadside establishment whose owner stayed in business, I believe, principally on the strength of his alcohol sales to minors. This was the sort of place where if you could say, “Scotch and wa-wa,” they’d serve it to you.

  We’d buy a couple cases of Jax, a barely potable regional brand, since defunct, which my buddies and I drank as we rumbled around, shooting rabbits. Any beer we didn’t finish off we’d bury and then disinter for consumption on our next hunting trip, unbothered by the ugly things that can happen inside a bottle of beer when it sits in a shallow grave in 115-degree weather for a week or two.

  Eventually, we tired of the two-hour-round-trip drive to Oklahoma to purchase just a six-pack or three of 3–2 beer—that is, beer with a 3.2 percent alcohol content, about the equivalent of old apple juice. So on one excursion I bought several cases and secreted them away in the family camper, which we rarely used. This, of course, was my father’s signal to offer the camper for sale. When he took a potential buyer out one day to demonstrate its many features, Dad and his buyer found beer in drawers, closets and the fridge, everywhere I’d stuffed it.

  Dad was angry with me. On the other hand, he didn’t have to buy any beer for the next couple of months.

  These halcyon days finally skidded to a close with my graduation from Burkburnett High in June of 1964. Hubristically, I sent applications to first-tier universities such as Duke and Rice, not understanding at the time how thoroughly undereducated I really was. They, of course, rejected me, probably to a chorus of hoots and guffaws as they did.

  So I chose Midwestern State as Kit had, and began my college education in a summer-school English class. I recall the course was taught by a good professor. He stunned me with a D on my first graded assignment. My life passed before my eyes.

  TWELVE

  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.

  Dan:

  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 hou
r, 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.

  Dan:

  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.

  Being a pathologist also means you don’t see trivial stuff. No colds or sniffles or well-baby physicals, only diseases of consequence. And you see all the diseases in all different parts of the body. You see everything that is common, and you see everything that is rare. And you never learn it all.

  The stereotype of the pathologist is the weird duck. Some people go into pathology because they cannot handle human contact. They retreat into pathology, as opposed to choosing it. A lot of them are nerdy. However, the ones I trained with were fairly normal.

  Our guiding light was Dr. Fallis, a tremendous teacher whom we all held in the greatest awe, me more than most. Fallis was a no-nonsense guy. He looked like a marine corps drill sergeant, and browbeat his students in the finest boot-camp tradition.

  Each of us was held to uncompromising standards. His only acceptable level of performance was perfect. You could not not know everything about a case. I had never before encountered an instructor such as him.

  After my second year I did a summer rotation on the autopsy service at Parkland. My classmate Charlie Cramer, now my partner in practice, shared the job with me. We were given some instruction in how to conduct an autopsy and get all your body parts in different piles. After completing an autopsy one morning, you had until seven the next morning, when you presented the case to your professor. That meant that once you thought you’d figured out what had happened to the deceased, you went to the medical library and worked nearly nonstop for almost twenty-four hours trying to learn as much as you could about what you thought had gone on. We all knew that Fallis would grill us to the point of humiliation if we weren’t prepared.

  My very first case was a young man
who’d died while cleaning a petroleum tank. The vessel had not been properly ventilated, and he’d been overwhelmed. He died in the ICU on oxygen therapy.

  Now, I had practically memorized Dr. Fallis’s textbook; I had read it four or five times. But damn my luck, the disease I had seen in the autopsy room was not described there. So now I had to present a full medical history, which I’d never seen done, about a disease I couldn’t identify.

  Next morning at seven, my knees knocking, I suggested bilobar pneumococcal pneumonia.

  “In twenty years of medicine,” Fallis sardonically observed when I finished, “I’ve never heard a more inept, ill-prepared presentation.

  I’m extremely disappointed. Maybe we can go through this and clarify it.”

  That was the high point of the morning. Over the next three and a half hours, I would be asked every question a human can ask. When Fallis was done, and I sat whimpering in the corner, he explained that my cadaver had died of oxygen toxicity pneumonitis, which means the level of pure oxygen needed to keep him alive in the ICU had killed him. Since I’d never heard of such a condition, it was tough to read up on it.

  THIRTEEN

  Peach:

  The women in my family are well accustomed to domestic catastrophes.

  Both my grandmothers lost their husbands to sudden deaths. My father died of radiation sickness.

  My mother, Edna Howard of Griffin, Georgia, met Lawrence Olson in the late 1930s at a state experimental farm not far from Griffin (the postmark was, and is, Experiment, Georgia). Edna was a library assistant; Lawrence was an agronomist down from Illinois. During this period, he did research in several labs, including the government’s atomic energy facility at Oak Ridge, Tennessee.