Beat the Reaper: A Novel by Josh Bazell

Gone so fast you can’t believe you still have to pay for it.

9
    I’m on my way to catheterize a couple of people when my med students find me. “Survival five years status post gastrectomy is ten percent,” * one of them says. “But only fifty percent survive the operation.”
    “Huh,” I say.
    The upside of this information is that if Squillante does live through his surgery, his odds of surviving another five years are actually more like twenty percent than ten, because the ten percent figure presumably includes people who die during the operation. The downside is that Squillante has fifty-fifty odds of dying today, on the table. And calling David Locano down on me if he does.
    The elevator doors open in front of us: Assman, getting returned to the floor in his stretcher-bed. Mostly to make it look like I’m doing something, I fall in beside him.
    “How are you feeling?” I say.
    He’s still lying on his side. “I’m fuckin dying, you fuckin asshole,” he says. Or something like that. His teeth are chattering too hard to be sure.
    It gets my attention. He certainly looks like he’s dying. “Allergic to any medications?” I ask him.
    “No.”
    “Good. Hang in there.”
    “Fuck you.”
    I follow him back to his unit and quickly write orders for a whole collage of antibiotics and antivirals, putting “STAT” on every one of them. Thinking: Should I go threaten Squillante some more? With what, and to what end? Then I go pull Assman’s CT scan up on a computer screen.
    It’s calming, in a way. If you know what you’re doing, trackballing through a CT is beautiful. Probably even if you don’t. You rise or fall through the hundreds of horizontal cross sections, and the various ovals—chest, lungs, heart chambers, aorta— expand and contract like roiling weather patterns, passing through each other and tapering at different levels. But even then you always know where you are, because the inside of a human being has practically no two cubic inches that are identical. This is true even on a left-right basis. Your heart and spleen are on the left while your liver and gallbladder are on the right. Your left lung has two lobes while your right has three. Your left and right colon are different widths and follow differently shaped paths. The vein of your right gonad drains directly toward your heart, while the vein of the left joins the vein of your left kidney. If you’re male, your left gonad even hangs lower than your right, to accommodate the scissor motion of your legs.
    So the two golf ball–sized abscesses on Assman’s CT are immediately noticeable, one behind his right collarbone and the other in his right buttock. On closer inspection they might have some sort of fuzz around the edges—a fungus or something. They look like what alcoholics get when they pass out and inhale their own vomit, then grow colonies from it in their lungs. I’m pretty sure I’ve never seen anything like it in muscle before.
    I send my med students off to page Pathology. It tends to be difficult to pry those people out of their nasty little lairs, which are lined with bottles of human organs like the homes of the serial killers they chase on TV, but Assman is going to need a biopsy. I tell them to page Infectious Disease while they’re at it, since odds are neither service will answer us.
    And once they’re out of sight I close out the CT screen on the computer and Google Squillante’s surgeon, John Friendly, MD, just to take one more depth reading on the shit I’m in.
    But surprise: the word is positive. My man Friendly has either banded or reduced the stomach of every obese celebrity I’ve ever heard of. In fact, New York magazine—which should know, since its primary function is to transfer pathogens between the hands of people in waiting rooms—names him as one of the five best GI surgeons in the city. Friendly even has a book that’s doing not too sucky on Amazon: Eye of the Needle: Cooking for the