The Axeman's Jazz

follow the family path, hadn’t flunked out, as it appeared Sonny was about to do.
    He’d started getting squeamish in the neonatal intensive-care unit, doing heel sticks on those unbelievably tiny babies—all night stabbing babies, night after night. He hadn’t been ready for that, but he’d steeled himself, prayed about it. He got through it. Got through it easily—it was just one of the things you had to do if you were a doctor. He even heard other people talk about it. This was normal, that baby-stabbing would get to you. The other thing wasn’t.
    It had started with the woman who came in with nausea and vomiting about six months ago—not the first person he’d seen die, not by a long shot. But he’d felt the mass in her stomach and gotten the resident to order the CAT scan. She loved him—all the old ladies loved him—black or white, he treated them all the same, spoke quietly, calmly, didn’t try to kid around and call them beautiful. She asked to see him every day he was there—he couldn’t run away from it—and in a week she was dead.
    Here in this rotation, in the emergency room, they lost about three a week. Usually, he was fine. It was as the folklore had it—adrenaline kicked in and the patient became only a medical problem. Nothing else. But frequently they had the medical students do the chest compressions. At first he could dissociate when he was doing that, could do it so well he could even see himself as the charge resident, orchestrating the thing. Now he was beginning to lose it a little. It was starting to get to him.
    The distressing thing about the whole situation was that it shouldn’t be that big a deal—a cosmetic surgeon who lost patients wouldn’t be in practice for long. In other words, if he could just get through medical school, he was never going to have a problem with this. But pretty soon one of two things was going to happen. Someone would notice him turning pale, shaking—and it would all go up in smoke. Or worse, he would get worse.
    “Room Four now!”
    Sonny’s stomach did a quick flip, but stabilized. He felt okay, excited, the way you were supposed to feel. Anything could happen—they could save this one. What was he thinking of? They usually did. It was a Tuesday morning, so it probably wasn’t a gunshot wound—maybe an accident.
    Gloves and goggles were going on.
    The team was standing around the table, IV’s already hanging, each ready to take what he needed from the crash cart, to do his or her part, simple as ABC:
    A. Airway—make sure he’s able to breathe.
    B. Breathing and blood—if he’s not breathing, put a tube in and breathe for him; if he is, look for blood; get blood tests, dipstick his urine for blood.
    C. Circulation—hook heart to monitor; shock chest if in fibrillation.
    D. Disability—is he awake or comatose? Can he move his arms and legs?
    They had it down not to a science, more like a recipe.
    The paramedics wheeled the victim in. Sonny stood in the hall, watched with med students and others. A Room Four was a show.
    It was an accident—he’d guessed right. A hit-and-run victim, a pedestrian, the paramedics said. She must have weighed three hundred pounds.
    The team performed like the Moscow Ballet—stabilized her, patched her up, put her back together, working like a bunch of robots invented for the purpose. It made you proud to be a doctor.
    The charge resident took off his goggles, stepped into the hall.
    “Okay, Sonny, let’s take her up to seven.” For a CAT scan.
    She was breathing okay, but still unconscious, just lying there sleeping like a baby.
    Seven was the most cheerful floor in the hospital—tiled in midnight blue, all recently redone. It was cold here—had to be for the equipment—and very quiet. No one was around except for the C-T tech.
    “Uh-oh,” she said. “Got one for me?”
    “A big one.”
    “Damn! I’ve got to go to the little girls’ room.”
    “Go ahead,” said the resident. “Plenty of time.” He began to inject the dye for the CAT scan.
    The patient’s chest heaved. She wheezed.
    “Jesus! She’s allergic.”
    Red blotches were popping out on her arms. Her mouth worked as she fought for breath, the terrible sounds of “strider” caught in her throat.
    “Sonny! Get the epinephrine!”
    “Where do they keep it?”
    “Just find it, goddammit! And get us some help.”
    Sonny started rummaging. There had to be a kit somewhere.
    “Where the hell is that tech?”
    The resident