First, Do No Harm Read online

  All of a sudden, Dad looked like a man just told the governor had declined to issue a last-minute stay. “I’m going to tell you a story, Martin.” Voice like a ghost’s. “Should’ve long ago, maybe, but I thought…hoped… June, 1943, I was sixteen. Finishing my junior year of high school. Summer before, I worked as a soda jerk, Ransome’s Confectionery, a few blocks from our house. But Mr. Ransome enlisted in the Navy that spring, closed the store, sold the property.”

  Dad, a teenaged soda jerk? I must’ve smiled, because he stopped talking, stared at me. “Hell’s so funny, Martin?”

  “Sorry, Dad. I just can’t picture you behind a soda counter with a little white cap on your head.”

  Lines around his mouth softened. He seemed to be looking at something far away. “Neither could Samuel.”

  “Samuel?”

  “My father.”

  “You called your father by his first name?”

  “My mother too. Part of your grandfather’s way of teaching me self-reliance. As far back as I can remember, it was ‘Count on yourself. Trust yourself.’”

  Dad’s eyes, black ice. His story hardly begun, already enlightening. “Didn’t people think that was strange?” I asked. “Especially in those days?”

  “If it were anyone else…but your grandfather was Samuel Firestone, and Samuel Firestone’s son calling his parents by their first names was the least…” Again, that massive fist, bang, on the table top. Silverware clattered. “Martin, God damn it. Would you kindly shut up for a minute and listen to me?”

  The waiter set down our drinks, glanced at Dad, left in a hurry.

  “Sorry, Dad. I’m all ears.” I gave him the go-ahead.

  He glared just a bit too long, almost smiled, managed not to. He coughed, knocked down half his Manhattan in a swallow, then turned back to me.

  All right, then. One evening at dinner, a week before school was out, Samuel asked whether I’d found a summer job. I told him no, but I had a couple of leads.

  He jumped in, both feet. “You can use this summer to see what being a doctor is really about. I’ll make you my extern. Take you to the office, to the hospital on rounds, into surgery. House calls, emergencies. Where I go, you’ll go.”

  I couldn’t answer. Sixty years ago, doctors were revered, trusted without reservation. People cracked jokes about lawyers, bankers, politicians, even ministers, but never about doctors. But even more than that, there was something about my father…when he walked into a room, people stopped talking, stopped whatever they were doing, turned to him. He defined center stage. Where he’d go, I’d go? I might still be sitting there wordless at the dinner table if my mother hadn’t said, “Samuel, do you think that kind of work would be good for him—staying up all hours, going to some of the places you go? He’s only sixteen, still a growing boy. And with all the men who’ve been drafted, he shouldn’t have any trouble finding a job.”

  Samuel laughed, pointed at me. “He’s six-four, a hundred-eighty. If he grows any more… All right, Ramona, I won’t overwork the lad, promise. If I keep him out at night, he can sleep late the next day. But it’s time for him to stop being a soda jerk. Next year, he’ll be going to college, and the sooner a college student declares for premed, the better his chances of getting into a medical school. Or, if Leo’s drafted, he could choose the medical corps.”

  “If that’s what he wants.” Ramona tried to keep her voice even, didn’t come close. The thought of her son, her only child, being drafted and going off to Asia or Europe to be shot at, was her special nightmare. “Do you want to be a doctor, Leo?”

  “I don’t know,” I said. “Maybe, if I’m good enough. But I also like to paint.”

  Samuel leaned toward me across the edge of the table, then started to smile. When your grandfather smiled, the room lit. Tanned face, perfect white teeth, black wavy hair, neatly trimmed. The most alert blue eyes imaginable. I could never read The Great Gatsby without seeing my father. Now he turned that smile on me full blast. “You can still paint, Leo. Painting’s a great hobby, good relaxation, but you need to live your life in the world. I say you’re plenty good enough to be a doctor, and this summer you can learn firsthand what being a doctor is all about. What do you say? Think you can handle it?”

  He was some piece of work, my father. Not “Do you want to?” or “Would you like to try it?” “Yes, I can handle it,” I said to Samuel, with all the offended dignity a sixteen-year-old could muster.

  Samuel stuck out his hand. “Shake, Extern.”

  Ramona, pale, silent, watched me shake.

  “You start first day after school’s out,” Samuel said. “Hospital rounds, eight o’clock.” That was it. All employment formalities taken care of. In 1943, a doctor didn’t need anyone’s permission to give a student a summer externship. Especially if the extern was his son. Especially if the doctor was Samuel Firestone. He was a legend in Hobart.

  Hobart, New Jersey, where Dad grew up. One of those metropolitan Jersey cities still struggling to recover from the disasters of the Sixties, but in Dad’s youth, Hobart was a textile town with a busy central business district surrounded by vibrant ethnic neighborhoods, families going back three, four generations under the same roof.

  So that summer I carried my father’s big black bag. It took me no time to see he was a great doctor, an outstanding diagnostician, but there was something else. The minute your grandfather walked into a room and caught the patient’s eye, that patient knew he was going to get better. You could read it all over his face. I watched Samuel treat sore throats, heart disease, diabetes, learned how to set broken bones. I assisted at gall bladder surgery, went along on post-op visits. Then one night, after I’d been on the job for almost a month, Samuel shook me awake just a little after twelve. “Come on, Leo, up, move it. Sick kid Down-river.”

  I threw on clothes, charged after Samuel, outside. He had the ’thirty-nine Plymouth started before I was onto the passenger seat. We backed out of the driveway, Samuel’s face glowing in streetlamp light. Gasoline rationing stickers on the rear windows flashed into view, a black-and-white A, good for three gallons a week, for ordinary persons to make do. But Samuel Firestone was not an ordinary person, and he never just made do. Next to the A was his C sticker, doctor’s guarantee of fill-up on demand. The day I watched him put on that sticker he winked at me and said, “Every job’s got bennies.”

  Not much traffic at twelve-thirty in the morning. We shot down Roosevelt Avenue at fifty-five, never mind the wartime thirty-five-mile-an-hour speed limit. No cop in town would’ve stopped Samuel Firestone’s car, not even for an air-raid drill, not for any reason. Windows wide open, mid-July, a real Jersey summer night, temperature about eighty, humidity in the nineties. Samuel wheeled a sharp right off Roosevelt onto Straight Street, then across to Fulton, finally a right onto River Street. A couple of blocks up, he pulled to the curb, killed the motor, set the brake.

  I grabbed the emergency bag off the back seat where Samuel always kept it, jumped out, paused long enough to lock the doors. Not many people in Hobart locked cars in 1943, but in that neighborhood you did. Down-river was Hobart’s equal-opportunity neighborhood, big fat zero for everyone. Mazes of crooked little streets squished between the shopping district and the Passaic River, tumble-down coldwater shacks only real estate agents would call houses and no one would call homes. Bars, brothels, dollar-a-night hotels. Down-river was jagged bottle-edges, knives, guns. You tried not to let the sun set on you Down-river.

  Not easy to keep pace with Samuel. We ran past Marvin’s Bar, music blasting into the street over drunken shouting and laughter. Artie Shaw, “Perfidia.” Samuel danced along, double-time. He motioned me past a couple of sorry little houses into a narrow open doorway, then up a flight of stairs to a small landing. Air like a blanket soaked in piss, sweat, and months-old cabbage stew. Wall plaster yellowed, chipped. Samuel motioned toward an iron handrail, lower end hanging loose. “Careful, Leo.” Then he took off up t
he steps, three at a pace. By the time I hit the second-story landing, he was knocking at the door. “Lou, Lena,” he called. “Samuel Firestone.”

  The door flew open. Samuel strode in, me on his heels, trying to look a hell of a lot surer than I felt. Just one room, curtain pulled across the back to make a bedroom, tiny kitchen off to the left. From behind the curtain came loud sobs, now and then a whimper. Couple of windows up, but not a stir of a breeze off the river. I could taste the stench of rancid cooking fat, shit, human secretions. A short chunky man in an undershirt and boxer shorts stood near the curtain, bloodshot eyes glaring at me. The man swiped the back of his hand across his nostrils. Samuel smiled. “Lou Westcott, my son Leo. He’s learning to be a doctor.”

  Lou raked stringy black hair back off his forehead, then nodded at me, almost a bow. “Welcome.” One word, couched in respect. No argument if Dr. Samuel Firestone wanted to bring his son along to learn the trade.

  Samuel flipped his Panama onto the post of a ratty stuffed green chair, then turned to a stocky, coarse-featured redhead in a nightgown that barely covered her breasts above and her crotch below. “Lena, you’re looking good. Little guy’s in back?”

  Lena pointed toward the curtain. “He’s got pain, Doc, don’t know what’s the matter.” I heard generations of hardscrabble Appalachian farmers in Lena’s twang. “Just rolls around, pullin’ at his shoulder. I wanted to do a mustard plaster before I called you, but he wouldn’t let me put it on.”

  Samuel glanced toward the curtain, where the sobs were slowly developing into howls. “How long’s he been hurting, Lena?”

  She glanced at Lou, who let out a low growl like a threatened animal. “Just about an hour, Doc. Not even.”

  Samuel looked at his watch. “Little before midnight, then. Was he asleep? Woke up with pain?”

  Again Lena looked at Lou, but before she could say anything, Samuel moved toward the curtain. “Let’s have a look.” He pulled the curtain aside, and there on a filthy uncovered mattress sat a two-year-old version of Lou, pasty face mottled from crying, making frantic grabs at his right shoulder. I could’ve painted him onto velvet, straight from life. “Hey, Bub,” Samuel said. “Shoulder bothering you, is it? We’ll take care of that.”

  He walked to the low bed, sat on the edge, talking all the while, eye to eye. He had that little boy mesmerized, only an occasional snuffle. But when he reached for the injured shoulder, Bub pulled away.

  Lena said, “Bub, now you let Doc Firestone look at your shoulder,” but Samuel didn’t seem to hear her. He took the doctor’s bag from me, snapped it open, fumbled around inside, came out with a New Year’s noisemaker, one of those little blat-horns where you blow paper out, then it rolls back. He blew. Bub jumped six inches. Samuel blew again. The kid started to laugh, reached for the noisemaker, then screamed and clutched at his shoulder. Samuel nodded, put the mouthpiece between Bub’s lips. “Blow,” he said. The boy just stared at him. “Blow!” The kid blew a short blast, laughed again, then blew harder. Lena let out a sloppy giggle.

  “Keep blowing, Bub, that’s right,” said Samuel, all the while fiddling gently with the boy’s shoulder and upper arm. “Dislocation,” he mumbled in my direction. “Subcoracoid, most common kind. Elbow’s displaced out from his side, see? And that bump in his armpit—head of the humerus. No crepitus, so probably no fracture.” Samuel stood up, took us all in with a look. “I’ll need your help,” he said. “The three of you.”

  “What’s wrong?” Lena, anxious.

  “Shoulder’s dislocated. Must’ve happened when he fell out of bed.”

  Lena went white. I thought Lou might hit the deck. Samuel didn’t seem to notice, just kept talking. “We’ve got to get the bones back into place, then keep them there. Only take a few seconds but it’ll be painful. We’ll put him on the floor, on his back. Leo, you kneel across him, right below his stomach, rest your hands on his chest. Lena, sit above his head, hold it down. Lou, keep his left shoulder on the ground. None of you let him move, not a muscle. That’s important. Understand?”

  One yes and two yeahs. Samuel smiled. “Boy’ll be fine, don’t worry.” He shrugged out of his jacket, slung it onto the chair, sat on the edge of the bed, winked at Bub. Then he unlaced his right shoe, slipped it off, dropped it. Bub started whimpering again.

  “Come on, Lena,” Samuel said, very gently, then stood up. “Sooner we get started, easier it’s going to be on everyone.”

  As Lena bent, I could see all the way to China down the front of her nightgown. She picked up the boy as if he were made of eggshell, lowered him to the floor.

  “Now,” Samuel said. “Everyone in place, fast.”

  Lena cradled the boy’s head between her hands. Lou fell onto the boy’s left shoulder. I flopped across his belly. The kid started to howl, legs kicked wildly under me. Samuel scampered to the floor at my left, shot his stockinged right foot into the boy’s armpit. “Look at the shoulders,” Samuel whispered to me. “See the difference?”

  “Right one’s sunken on top,” I said.

  “Sure is.” Samuel grabbed the boy’s flailing hand. Slowly, firmly, he pulled downward, then pressed the arm against the boy’s body. “Watch the shoulders,” Samuel whispered again.

  The kid let out a screech that could’ve shattered glass, as the lump in his right armpit slid up and out of sight. The shoulders looked symmetrical.

  “Okay, done.” Carefully, Samuel laid the boy’s arm across his chest. “Leo, go get some gauze strips out of my bag. Lena, Lou, relax, just a little. Let him sit up.”

  By the time I got back with my hands full of rolled gauze, the war zone had pretty well cleared. Bub was snuffling but calm. “Start unrolling,” Samuel said, not letting go of the boy’s hand. “Still hurt, Bub?” The boy shook his head. The way Lena looked at my father made my cheeks flame.

  Calmly, slowly, Samuel wrapped gauze around Bub’s arm and shoulder. When the boy started to cry again, Samuel picked up the noisemaker, stuck it into his mouth and blew. He kept blowing, loud, then soft, long and short, as he worked gauze round and round, splinting the boy’s arm against his chest. “Dislocation means you’ve torn a ligament,” he muttered to me between noisemaker blasts. “Move the arm before the ligament heals, it dislocates again.”

  Finally Samuel stood up, stretched. “Sit in a chair with him, Lena. Hold his arm just like we’ve got it. He’ll need a little medicine.” Samuel grabbed his jacket, slapped the Panama into place on his head. “Back in a few minutes.”

  I could hardly contain myself. Soon as we got into the car I asked Samuel how he knew the boy had hurt himself by falling out of bed. Samuel smiled, this time not pleasantly. “Most common cause of shoulder dislocation is a fall on the outstretched hand or elbow. Did you look around that place? Where does the little boy sleep?”

  “I didn’t see any—”

  “Other bed? No, there isn’t one. The kid sleeps with his parents. Did you smell the booze on them?”

  “I smelled something. But there were so many smells in there—”

  “All right. Here’s what happened. Lou and Lena left the kid in the bed asleep, went down to the bar, had a few shots, came back ready for some business people usually like to conduct in private. But they’ve got no privacy. Probably they woke the kid, he got in the way, and one of them gave him a shove or just out and pitched him off the bed.”

  “Are you going to call the police?”

  “The police?” Samuel sounded weary. “Leo, think. Those poor red-earth southerners came up here looking for jobs in the silk mills, didn’t know silk’s been on its uppers for the last ten years. If they can squeeze out a couple bucks a week they’re doing well. Look where they live, for Christ’s sake, look how they live. Children are the last thing they want or need, but their creator gave them an irresistible urge, and their priest tells them contraception’s a mortal sin.” Samuel was shouting now, any momentary fatigue blown away. “They have a few drinks to take t
he edge off their pain, then go home to do just about the only thing two people in their situation can do to forget it all, if only for a while. Kid wakes up, starts crying. A little impatience, little thoughtlessness, and there’s your dislocated shoulder. Next week they’ll go to confession, be forgiven, and drop money they can’t spare onto a plate so the Pope can buy another gold cup for a cathedral. You want me to call the cops, Leo? Who for?”

  Samuel wheeled onto East Sixteenth, pulled to the curb near the corner of Seventh Avenue, snapped off the ignition as if he were angry at the car. “Suppose I call the cops,” he said. “Suppose they lock Lou and Lena up. You think that kid’d be better off at the county orphanage?”

  He threw the car door open, jumped out, slammed it shut. I did the same, then followed him to the door of a pharmacy. Dark inside. Samuel rang the buzzer, once, twice. A man’s head poked out the second story window. “We’re closed,” the man bellowed. He jabbed a finger at his watch. “It’s nearly two in the goddamn morning… Samuel?”

  “Get your fat ass down here, Jack,” Samuel shouted back. “Emergency.”

  A couple of minutes later, a light went on inside the drugstore, then the door opened. A big man wearing only green and white striped pajama bottoms stood in the entryway, peppering Samuel with silent anger. He ran fingers through a meager crop of greasy reddish hair, as if that might stimulate it to grow. “You and your fucking emergencies,” he growled at Samuel. “What is it this time? Some nigger got watermelon withdrawal?”