PseudoPod 751: As Well as the Infirm

PseudoPod

• Author : Scott Beggs
• Narrator : Premee Mohamed
• Host : Alasdair Stuart
• Audio Producer : Marty Perrett
• Discuss on Forums

“As Well as the Infirm” was originally published in Dark Moon Digest, April 2020

From the author: “The title comes from a section in the Hippocratic Oath: ‘I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.'”

As Well As The Infirm

by Scott Beggs

---

$243,378

You get two shots at becoming a doctor after med school. If you match with a hospital straight off, bully for you, great job, give mom and dad a hug. If you don’t, you need to wait a year holding your breath while chopping off pig hooves for science even though you’re vegan. Then you pray you match the second time around. If you don’t, that’s it. You spent a quarter of a million dollars to disappoint your parents.

That’s how I ended up taking a business card with only a phone number printed on it from a slick Wall Street-looking asshole with a bad cough while rounding my third shot of tequila. That’s also how I ended up covered in someone else’s blood in a knock-off Sesame Street bouncy castle, crushed by a murderer’s guilt and wondering if I’d survive to sunrise.

All I ever wanted was to help people.

---

My mother named me Jayanti, although people seem to relax when I tell them they can call me Jay. I’m as tall as my father was, and I’ve wanted to be a doctor since before my first training bra.

The night before my dream died, Shondra, Mackie, and I got drunk playing Fuzzy Operation. You know the kids’ game. Tiny plastic maladies. Light up the patient’s nose, get buzzed, do a shot. I swirled my Lone Stars to make tiny cyclones in the bottles. I pulled the labels off in single, pristine pieces and thought solely of whether I would match to a hospital this time around. Second time lucky.

Mackie kept zapping the funny bone, his long, dark fingers slipping at just the wrong moment. Shondra kept laughing like mad and pouring his Cuervo Gold. We got drunk and pretended the future wasn’t coming for us in the morning. We all avoided bringing up my fragile position until, following a sloppy group hug at the door, Mackie flashed his hundred-tooth smile and said, “Jay, if you don’t match, the system’s broken.”

Well I didn’t match, the system’s broken, and I was fucked to the merry tune of $243,378.

We would get together a few more times after that night, but never again without the cloying sensation that my friends were being plucked from me – drawn away to hospitals all over the country. Mackie was staying in Austin at Clemsy-Sebold, but we both knew the summer camp nature of residency meant he’d fade from my life while living five minutes away.

Mackie. Squat and plump like a bodybuilder who only recently discovered pizza. Always shyly standing a few inches too close to me. Even he’d be pulled away.

I was left alone, surrounded by the Styrofoam-laced smell of a take-out food world tour and a dozen books on internal medicine it made no sense to own. For weeks I held out hope that I’d get a call any moment to clear up a regrettable clerical error and head for the residency program I’d ground myself to dust to earn. That call never came, so I ordered more fried rice and spent an episode of The Great British Bake-Off screaming into a decorative pillow.

I called my mom and cried. I sat alone on my living room rug and cried. Mackie came over with a sympathy fruit basket, and I cried.

The system’s broken. The system’s broken. The system’s broken.

My father lost his job as a civil engineer when I was a freshman in college. He avoided talking about it using conversational Tai Chi, deflecting to how the Cowboys were doing and whether I was keeping my grades up. But once, just once, he admitted it was like losing a loved one.

But how was I supposed to mourn for a job I’d never had a chance to do?

I felt dissected. On nights that I slept, I dreamt I was donating blood, but the nurse had disappeared so gallon after gallon drained from me until laughably small vials overflowed, and the floor slicked with shiny purple-red vitality. I fell to my knees in it, frantically sweeping it against my body as it flooded away from me with the force of inevitability. The caustic metal scent overwhelmed me. Even after I lost the last ounce my heart wouldn’t stop beating dry in my chest.

When I made it through my first day without crying, I considered what I would trade to get a residency spot and realized that I had nothing left to give. I thought about shaving my head but chickened out. I crawled on my belly through a handful of the five stages of grief, and, thank God, never made it to Acceptance.

On the morning of Shondra and Mackie’s graduation – a ritual I’d seethed through in a cap and gown a year before – I fixated on my six-figure student loan debt and had to find a bar, stat.

That’s where Darden found me.

Nimble and petite with a persistent cough and the scaly signs of seborrheic dermatitis at the corners of his mouth, he handed me a shot when I was already floating. His suit advertised the size of his bank account, and his floral cologne mixed poorly with the stale yeast smell of the bar, but his confidence was infectious. As if he had enough to let you borrow.

“Your bartender friend there tells me you’re a med school student,” he said, sliding next to me uninvited.

“Close. I already graduated. Who are you?”

“You can call me Darden.” He motioned to the three upturned shot glasses. “I hope you don’t have rounds anytime soon.”

“Ha! No. I will not have rounds, anytime soon, ever.”

“You didn’t match?”

“I’m an old pro at not matching. But I’m thinking the third time will be my lucky break. You a doctor?”

That’s when he pulled out his business card. Plain white. Black ink. No name. Just a phone number.

“Definitely not. Never had a sense of sacrifice bordering on self-hatred.”

“Exactly!” I said with embarrassing enthusiasm. I took the card without thinking. “Sacrifice. Yes. Doctors smoke the most, sleep the least, memorize entire libraries. Man, I’ve read so many fucking books. Just destroy our bodies, you know. Destroy our bodies so that, what, everyone else can live just a little bit longer?”

“And the debt. You must be swimming in it.”

“Indentured servitude was my fall back, so it’s really not all bad.”

He only grinned at that, which sunk me to a sober reality that made my stomach churn. I would die still owing on my student loan.

“I’m a kind of middle man,” Darden said, coughing into his hand before retrieving his card and writing an address on it. “I’ve got an opportunity for you that could be very, very lucrative.”

“I’m not flying to Dubai in my bikini, pal.”

“That’s funny, but no. The job is more specific to your talents.”

“Tell me.”

I was suddenly aware of how quiet the rest of the bar was.

“Do you know how many people die every day waiting for organ transplants, Jay?”

---

Gutierrez Brothers Funeral Home was on the east side of the highway near an Iglesia Bautista, a neon-bathed corner shop, and rows of modest brick homes overlooking potholed streets, but everything was calm at midnight. I stood in front of the door in black scrubs feeling like a party clown at the wrong kid’s birthday. Could I go through with it?

The heavy latch clicked, and Solomon Gutierrez beckoned me inside. He was an unfussy old man with a cataract squint and bad hips that forced him to waddle. His face was broadly wrinkled, wide with an easy smile, and his skin was dark and thin like he’d been baking in an oven on low heat his entire life.

At the time, I thought that I crossed the threshold into the funeral home solely because of my debt, but I recognize now that I said yes because nothing else in my life was asking me to say anything at all.

None of the furniture in the front room of the funeral home was made after the Korean War. It gave the impression of quaint comfort and probably reminded Solomon’s key demographic of toddling around Nana’s living room, but there was something off about it. It took me three sips of complementary herbal tea before realizing that there was too much light in the space. Clouds of fine particles swirled rampant through the air. I could feel the plush fabric of the settee fading, the fine oak of the coffee table drying out, and the pages of shelved books no one would ever read yellowing. I cringed at the exposure. A place like this needed a little darkness.

Where there should have been a faint smell of mildew and sweat, there was only the sharp cut of fake vanilla that gave the parlor its showroom airs, threatening to expose the lie at the heart of it. Never mind the sofa enveloping you or the tinny clink of tea cups resurrecting a sweet memory, this was not your living room. It wasn’t anyone’s living room. It was where you paid a stranger to bury the person you knew best.

“You must be proud of what you’ve built here,” I said, carefully placing my cup down on its gold-rimmed saucer.

“Oh, yes. Very, very proud indeed,” Solomon replied, his voice sugar cane sweet.

Before we could speak more, Darden burst in from a back room demanding joyously that we get the show on the road, jangling my nerves even further, and yanking me up from the sofa.

The basement did not smell like vanilla.

The fat old woman’s body lay on a gurney with a loose sheet draped over it. She was blue from whatever they were using to keep her cold, and her hair clung to her scalp as if someone had glued it on in a hurry. Beside her was a row of red coolers like you might take tailgating, filled with medical grade ice packs.

I wanted to be horrified.

Instead, I buzzed with how eager I was to hold a scalpel again. The sight of her brought a keen glaze of familiarity – the resuming repetition of my medical school cadaver studies – that steadied my nerves and, in that moment, gave me an activating purpose.

Vintage Tejano music played on a crummy radio, and I cut into her belly.

You won’t be able to imagine it. What they don’t show you on TV dramas is the physical strenuousness of surgery. All that sweat. It’s a marathon on your feet that requires complete, constant focus and an acrobat’s muscle control. Doctors lose pounds of body weight during procedures. Just like NASCAR.

The kidneys, the heart, the liver, the lungs, the pancreas, the intestines, the thymus. The corneas were trashed, but everything else was in working order, and I felt the cool slimy heft of each part of her that I carved out imbuing me with a stirring sense of importance that I craved.

But when it was done, when I shed that adrenalized cloak of purpose, I became aware of the scent of chemical-soaked skin, the forever stare of her eyes, the grays and blues and pinks and blacks of her insides. I started to wonder who she was, what she was like, who loved her. Why she had ended up here.

It came in one strong wave. The metal of the gurney felt too slick, and my feet couldn’t quite find the floor. I doubled over, shoving the gurney with a linoleum screech just far enough to make the fat old woman’s hollow body flop a few inches toward the edge. Darden clamored back. I heaved into my mask, but nothing came up.

“Okay, okay. You’ve worked your magic. Deep breaths. Deep. Breaths,” Darden said, holding out his hand to bring me to my feet. “Solomon can handle the scraps. Let’s get you some air.”

---

Darden wouldn’t stop jackhammering his left knee as we sat in the booth at Magnolia Café. Small as he was, his nervous energy still tingled my Spidey sense.

“It’s important to unwind after these things, so I come here for a tofu scramble and a slice of pie” he said between hacking coughs.

I’d sat before with happy exhaustion at this café cramming for exams until sunrise, but after hearing that, I looked at each surrounding face – the skeletal hippie couple, the lonely scowl trapped under fat headphones, the hungry eyes and mouths of cackling frat-holes – wondering what horror they’d also been elbow-deep in tonight.

A young woman with an open economics textbook sat with half a grilled cheese congealing on the plate, and I thought of how far I’d drifted away from that version of myself in just the last few hours. I felt the raw meat coolness of the dead woman’s kidney in my hand again and tried to avoid the pictures on the menu.

Darden ripped the tops off four creamers and reached for the honey. “This was a big step tonight. I get that. I’ve been there.”

Food sounded disgusting. Or maybe I wanted one of everything?

“You’re jacked right now, endorphins surging, that’s all normal,” he said. “But I want to put your mind at ease.”

It took all my energy to focus on his voice.

“One, that stock is going to good homes that can’t wither on the waitlist any longer. You’re fucking Robin Hood, Jay. A half-dozen GoFundMe drives scored their reward tonight.” He stirred the creamers and a generous stream of honey into his cup. The chattering around us seemed to grow louder, and I leaned forward, mouth dry, trying to resurface.

“What about desecration?” I asked, surprised to hear my own voice.

He clicked his tongue against the side of his mouth. “Look, that’s between you and your god, but when everything we take is headed to the incinerator, I take the pragmatic view. It’s not like anyone knows how big an ash pile grandma makes, you know?”

I slowly nodded, trying to picture the great parabola of one life saving a dozen lives and spiraling out until everyone was restored. I needed to believe him, so I did. My appetite was returning.

$227,003

After a summer of pulling cash out of dead people’s chest cavities twice a week, I settled into a happy rhythm. I bought more scrubs, surgical bandanas, and a pair of Crocs. I studied everything I could about surgery in heavy books and videos on YouTube. I documented absolutely everything for post-game assessment. When I successfully removed my first corneas, I bought myself a pricey set of kitchen knives you never have to sharpen. Every other spare dollar went to my loan.

During the weekdays I worked at Johnston Holbrook Labs, slicing chunks of pig fat into research-ready slabs we called Bibles. Bubbling with caffeine to push against my black market all-nighters, I found every moment of my day job a waste of time I could have spent playing doctor. Its sterility made me long for the dank linoleum of the basement, its clinical silence for staticky Tejano, its infinite supply of pink pig flesh for the assembly line of people whose lives were in transit between completion and celebrated remembrance.

I played dominos with Solomon and grew accustomed to Darden’s wiry intensity. I started yoga classes and learned to brew my own kombucha.

But the thinness of my joy crept up on me, and, after the novelty wore off, I recognized that my side hustle would never satisfy me the same way residency at a hospital would. It was hard to care that I was saving lives if I never got to see that resurrection myself. I desperately needed the curtain call. The sloppy, sobbing embrace and thankyouthankyouthankyou of someone who loves the person I just saved. I could not pretend my way to happiness.

As thrill turned to drudgery, I found both comfort and frustration in still wanting to be a doctor.

I spent August falling asleep for half an hour only to be awake the rest of the night. I paced and shivered and shook around my apartment and only called my mom once a week.

One morning I hunched inside a hot shower and found my fingertips were still freezing. The warmth had evaporated from me. As if reaching into each body to harvest their offal pulled me deeper down into gray flesh – up to my knuckles, to my wrists, threatening to spread across every inch of bone and flesh. I saw myself crawling inside that first, fat woman’s chest cavity, pulling her skin flaps shut behind me, and making it my tomb.

My call to Mackie went to voicemail. When I yelled at the bubbly, acne-scarred PA at the Urgent Care for saying maybe it was a circulation problem, there was no one else left in my life to call except Darden.

He took a short puff off his vape pen and blew raspberry smoke into the night air as we walked the placid shoreline at Lady Bird Park. “I thought at first this would be a legitimate liminal substitute, but lately it just feels like I’m play-acting at being a doctor,” I said, pulling my hands inside the sleeve of my black sweater. “It’s not enough.”

“A few others reached this point.” Being this close to him made my lips feel chapped. “You’re paying bills, but you can read a calendar. How many years of yanking out kidneys from Great Auntie Mirabelle before you’re square?”

“At this rate, 18 years.”

“Have you considered becoming a radiology tech?”

“Oh, fuck you.”

“Then it’s time for a raise,” he puffed again. “If you really think you’re ready for it.”

“Ready for what exactly?”

$104,888

Anthony Jenkins ran track but wasn’t good enough for a college scholarship, so he dropped out to get a job stocking at H-E-B to help at home. His mother Gladys did janitorial work for two companies and cleaned houses whenever she could. Her chemo still wasn’t paid for, and she considered stopping it, but Anthony wouldn’t let her even though he had no clue where to get that kind of money.

That’s where Lloyd came in. Lloyd had money, and Lloyd needed a lung.

In the legitimate system, if one of your organs blows out on you, you get added to a waitlist with far more people than parts. The system doesn’t care how much money you have or if you’re cute or play the piano better than everyone else at your school. Your only hope is that enough people die before you do. That’s the subtext for every prayer you send to God. Please, please, please let them all die before me.

The system is broken. The system breaks you.

Outside the legitimate system, Darden cares very, very much how much money you have.

I shadowed another doctor for that first live transfer, watching from over her shoulder as she artfully removed a kidney from a lithe young man whose mouth hung open in unconscious reverie. I shadowed a few more times, got a crack at a live kidney for myself, and spent the winter reveling in keeping the organ bucket on the table alive alongside a small, rotating crew of anesthesiologists.

All of it took place inside a strip mall space between an auto repair store and a discount market with pyramids of disintegrating grapefruits and blood oranges stacked inside the window.

Our windows were newspapered over, and large poster board jack o’ lanterns adorned the walls from its past life as a seasonal costume shop. There were four gurneys separated by surgical curtains, and the place stank with antiseptic cleaners and building insulation. There were beeping monitors and blood pressure cuffs and when I closed my eyes, I could almost hear my name paged over the intercom. It was exquisite.

Darden had crafted a sad little front area with a cheap couch, a couple of leather chairs, and a smudged glass coffee table where we helped the donor and donee agree on how much the organ was worth. Outfitted in scrubs, surgical mask slung under my chin, explaining the procedure and its risks to the patient was the closest I had ever felt to the real thing, and the high I earned off it lasted long after the last suture was in.

I’d operated on dozens of live subjects before, but my first real dose of being a doctor came with Anthony.

The first thing that went wrong that night was the anesthesiologist that showed up. It was Mackie.

When he walked into the lobby I almost bolted for the back door, but when Darden shook his hand, it was worse. A piece of my life as a decent person had infiltrated this other version. We were theatrically casual about seeing each other again, but the mutual shame and judgement we felt was impossible to avoid broadcasting when our eyes met. Nerves forced that hundred-tooth smile across his face, but it immediately receded into eclipse. I was thrown for a loop.

Then he threw me for a loop again.

“Funny how we ended up with the same boss after all,” he said, prepping a series of sticky nodes to place all over Anthony’s body.

“Darden?”

“Oh, Christ. That dude’s a grease trap.” He placed another node. “I meant Dr. Hagel.”

“Wait. The Chief of Medicine at Clemsy-Sebold?”

“Of course. She’s the one who set me up with him.”

Confusion. Yes. But also rage that someone so respected lorded over our dark market. Embarrassment that I was only adjacent to that respectability. Relief that there was a backbone of legitimacy behind everything we’d been doing. Horror to see beyond my dank, operational cell.

I don’t know if I cleared these emotions from my mind before we began. I don’t know if what happened would have happened to anyone. I don’t know if I had any business in that room. All I remember is Anthony’s eyes taped shut, the microscopic slip of my hand, the nick in his renal artery, and the blood rising against the sides of stomach and small intestine. I sponged and tamped down sterile bandages, but the blood kept pooling. I applied pressure until Mackie shoved me out of the way and did something I couldn’t quite see. The room turned violet and I stumbled back, useless and hyperventilating.

The monitor sounded a piercing alarm which turned into the single, steady tone. Mackie kept working, and I regained my senses enough to assist him in digging, digging, digging through the red muck to clamp the artery at various points. When Mackie got them in place, I started CPR, but it wasn’t enough. By that point, it almost never is.

Darden calmly rose, walking to the monitor and pressing a button to power it down.

“Alright, everyone. Let’s take ten cleansing breaths and try to gather ourselves,” he said.

The room shook with silence.

“Okay, then,” he continued. “This is obviously a tough situation, but it happens from time to time, and now that we’ve relaxed a bit, let’s get our game faces back on and finish up the job.”

“You still want me to remove his kidney?” I asked, my throat clenching, my eyes raw.

“At this point, I’d like you to remove everything.”

I couldn’t believe what he was saying.

“Fucking do it yourself.”

“Jay—”

“No. No more bullshit. This kid – this kid! – has a family.”

“And he and his mother both understood the risks, and, hey, listen to me. Listen to me. It is in our best interests to make sure that she’s taken care of monetarily to the extent that she remains silent about all of this. Being pragmatic about the assets in front of us will go a long way to helping us ensure that. Unless maybe you’d like to foot that bill?”

“That’s grotesque.”

“Oh, please, Jay. You’ve always acted like you’re somehow detached from what we’re doing here when you’re the star of the goddamned show. Time to pick up your big girl panties and do what needs to be done.”

I moved for the door, but Darden charged me, throwing me against the wall with his hand around my throat. Mackie turned his face away.

“There. Is. A process for this, Jay,” Darden sneered. I froze at the ferocity of his voice and the sharp angles of his body against mine.

Then I slammed my palm into his cheek, shocking him back and earning me enough time to scramble through the back door into the alleyway.

I ran, covered in blood, into the darkness.

Lost and panicked, I spun left out of the alleyway onto a two-lane road that plunged on either side into drainage ditches. Shouting voices echoed down the block. I ran until headlights bloomed behind me, and I was forced to stumble down the thin embankment and up to the fence line.

Weary and sore where Darden had grabbed me, I gritted my teeth, lifting myself over the fence, landing next to a dozen bouncy houses, some inflated, most not. I hurried to the back door of the party store, peering inside to see a cluster of piñatas and rentable helium tanks. Locked.

Exhausted, I crawled inside a bouncy house with a too-scrawny version of Elmo jutting out from the top with its bug-eyed gaze and static smile. I crouched down in the corner, listened, and hyperventilated as quietly as I could.

---

I slept on the plane to my mom’s house in California. I hadn’t bothered going back to my apartment. After a frightened woman found me asleep inside the bouncy castle, I stole some clothes from a laundromat and caught a cab to the airport.

My mom, short and sturdy with wide open arms and a sandalwood white bindi on her forehead, had not changed since I’d seen her last. She didn’t ask me why I’d suddenly landed on her doorstep; just chided me for not visiting enough and remarked that my job must be so, so stressful.

The house hadn’t changed either. The carpet was soft with daily care, and the mist of spices constantly flying around the kitchen permeated every room with thick smells of cinnamon and spicy lal mirchi. She embraced me, and I relaxed. She cooked for me, and I collapsed.

I read the first page of an old paperback twenty times. I slept. We got pedicures, and mom told me what she planned to plant in the fall. We chopped mangoes and ate them with yogurt. We walked to the park by the house and back.

That night – for the first time since a friend’s surgeon father showed up for fifth grade career day and told me I could be a doctor too if I rigorously dedicated my life to it – I considered what other job I might do. I struggled to come up with much, but I caught a sliver of a life beyond a dead childhood dream.

But at the end of the week, mom brought in the mail. There – tucked in among the Shopper Saver and a credit union statement – was a tidy little envelope addressed to me.

The return address was the same one Darden had scribbled on the back of his business card. Inside was a Mother’s Day card.

$85,332

My nights became slogs that mirrored the day. Worn thin, nearly broken, but stuck, I shaped pig fat into Bibles between lectures on how I looked tired and carved out all the useful bits from useless bodies in Solomon’s basement. I never worked on a live patient again.

“I haven’t been completely honest with you, and that’s my fault,” Darden said when he picked me up from the airport. “Finding you at that bar wasn’t by chance. Dr. Hagel keeps her eye on promising students who fizzle out, and here you are. You’ve upset the natural order, but if keep your head down, everything else is forgiven.” He grinned with the promise of future violence.

So, my head was down. All the joy I felt removing organs from dead bodies was gone. Darden had robbed me of it. When I closed my eyes at night, I saw an assembly line of decaying flesh stretching well beyond the horizon.

I told myself I had no choice. I pictured my mom, frozen and graying in Solomon’s basement with Darden’s greedy hands shoved inside. I wilted against the threat.

The drudgery lasted until September, about the same time my mom was planting her Celosia, when the police discovered Anthony’s body, his chest and stomach cavities stuffed with newspaper. I heaved and, this time, something came up. The disregard of the act awoke the last shred of who I once was, and a lot of things happened very quickly.

I gathered up every note and picture I’d ever taken of our operations and called Clemsy-Sebold to let them know I was coming.

---

Dr. Elizabeth Hagel’s office was modern and unremarkable except for the abundance of small, copper bird statues littered on bookshelves and side tables. Several floor-to-ceiling windows lined the wall behind her desk, framing her in sunlight. There was no complementary herbal tea.

I’d seen Dr. Hagel speak at a colloquium on campus my sophomore year and was struck then by how unbothered she seemed for someone who’d spent twenty years in a profession known for long hours, drug abuse, and personal neglect. Her health problems, if she had any, were not immediately obvious to me, and that drove me crazy.

They say that the guilty sleep well once they’ve been caught, but that’s not how I felt. What I decided to do meant reckoning with my own doom, and I found a certain measure of acceptance there, but I still cringed at whether I should be bartering at all.

“What exactly are you requesting of me?” Dr. Hagel asked, her eyes studying her laptop screen.

“I take everything I have to the police or you get me late admittance to a residency program far, far away from here.”

“Kind of a small price considering I won’t be the one paying it,” she said, meeting my eyes. “And your threat is to turn yourself in?”

“After seeing Anthony’s body on the news, yes. Along with all of you.”

“I see.”

“I don’t understand why Darden didn’t have him cremated.”

“Solomon declined to get his hands dirty, and I’m smart enough to recognize leverage, which is why I’m also disinclined to accept your offer. Go to the police if you wish, but don’t expect me to visit you in prison.”

Whether I was brave enough not to beg or simply saw no use in it, I can’t be sure, but I took a moment to resign myself to her refusal.

“This – thing – that we do,” she said. “There is no road map for it save the one we create.”

“So, was I helping people in desperate need or was I exploiting people just as financially fucked as I am?”

She let a melancholy smile slip and told me, “Yes,” before motioning for me to leave.

---

The system was broken, and so was I.

I killed my car’s engine and sat in the police station parking lot for as long as I needed. I remember laughing because I genuinely had no idea what kind of jail sentence they give people for grave robbing.

I tried to absorb as much of the sun as I could as I walked across the parking lot, as much of the birds flittering and singing. I kept one eye out for Darden or the fat old woman, mucky and disintegrating and slick with fluids, flying across the pavement to drag me away.

I got to the door, grabbed the handle, and my phone rang.

$70,532

You get three shots at becoming a doctor after med school. Match with a hospital straight off, pad your resume by prepping pig parts for lab tests and score on your second try, or extort a prominent Chief of Medicine who’s running an illegal organ racket.

Dr. Hagel’s timing could have been better for my blood pressure, but I’d called her bluff, and I think she was happier to see me shipped away to St. Someone’s Hospital in Nowhere, Idaho, than to leave me as another loose end that could float to the surface of a drainage ditch.

So, that’s how I became a doctor. Third time lucky.

The move was hard. And expensive. I found it difficult to relate to my colleagues during the few months of my residency, but I’m settling in more now. I taught them how to play Fuzzy Operation. I lead a pre-natal yoga class.

I disimpact bowels and deliver babies. I shove tubes into throats and urinary tracts. I’m up to my elbows in almost every warm liquid the human body creates. It’s everything I’ve ever wanted, and I’ve got to tell you, it lives up to my every expectation. My exhausting dream.

I still have the nightmares, too. In my personal favorite, I’m standing barefoot in the fat old woman’s open gut, squishing intestines warm as congealed cheese between each toe. My mother lies on our weathered kitchen table in front me, telling me my job must be so, so stressful as I cut neatly into her, pulling away cubes of her meat, and eating them with slippery globs of yogurt.

Otherwise, I have never been so happy. I’ve never felt so free to pay the minimum monthly amount on my student loan.

This morning I assisted with my first legal surgery. A hernia with no tailgating equipment in sight. The lead surgeon was tall and thin and sharp with jaundice-kissed eyes. He was warm and funny and complimented my work although I mostly stood off to the side.

As we scrubbed out, rubbing our forearms almost raw with soap, he lamented how tough it was for residents. He said if I ever need some extra cash, ever got desperate, he could hook me up with a very, very lucrative side gig.

Off my silence, he grinned and asked if I wanted to tell the patient’s family that everything had gone smooth.

Walking from the OR to the waiting room, I struggled to peel the shock from my face and felt double the shame that I couldn’t shake it. Couldn’t compartmentalize.

The patient’s wife and young daughter were a matching set of straw-blonde hair. I introduced myself as a doctor, savoring a sweetness from it I hope I never get tired of. Our talk was business-like and kind. Clinical and comforting. Direct and softened with head nods. I swear I nailed it.

The daughter – with wet eyes and a skull full of teeth that would soon need braces – told me, “Thanks for helping my daddy. Someday I wanna be a doctor just like you.”

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