Another beach day for mosquito. His mother is having the time of her life like all young upperclass women do so she dumps him at the Bu to be with subculture criminals. The best surfer who ever entered the waters at the Bu is a counterculture decrepit who has a side job as crooner for the rest. They had his father develop spy planes for the government during his lifespan like the SR-71 blackbird. He has long hair and wonderful personage and mosquito is hoping he tells Kelly Slater how he did it before he passes. They call this little grom in a silk hawian shirt mosquito because he hovers around the beautiful children and begs for food. Occasionally Moon dog buys him a hotdog. Elephants never forget. The bikini originated here and the girls let him hang around in their briefness because he is a child and not in puberty yet.
He watches one girl, she has olive skin like a European and a fine luscious body with breasts not to big to clunk around. Mosquito notices she is not like the other girls and her hair is cut very short so the boys cant spy her at a distance and chase her. Her eyes are light grey and mosquito wonders how she ever happened. She chooses bikinis that exactly match her light olive complexion and of a fabric that really clings and she looks like she is walking around naked. Mosquito wonders and he comes close to see and she bares her teeth at him, like a mother wolf protecting her litter. She makes bikinis for the cosmic children. In the thatched hut which is a meeting point for the gang she measure a womans fourchette and derriere, writes the measurements on paper and makes the most incredible mind boggling swim suits under the gaze of God. She lets Mosquito hold the measuring tape while she measures because he is not in puberty yet. the models then put their cut off jeans back on and look at Mosquito and he smiles and the thatched hut is no more at the Bu. Women are amazing when they are young, and innocent , and pretty and wild.. The cat is out surfing now with the Malibu Masochist. Together they beat up anyone at the Bu who doesn’t have respect. The masochist flies off his board in a side thrust kick and breaks people in half. They whisper he is a black belt. The only one he cannot beat up is the cat, and he tries repeatedly to no avail. This is why his nickname is the masochist. Maybe it is because the cat is six foot three inches and an expert in tZu Jan Men that he learned somewhere in the military.
The sun is shining, the waves are up and mosquito sits next to the wall watching their surfboards so no one steals them and the girls walk around in the land of freedom and liberty and all is well, and the clouds move in and the west wind comes up, and there is a glass off phase between two and three PM when everyone is gone and the jobless pros are here and go out. Mosquito has a little Timex watch his mother gave him so he can be at the pickup zone on pacific coast highway at about three thirty and his mother bat turns the blue Chevrolet station wagon in the turnaround
zone and waves. She has on dark Rayban sunglasses and a chiffon scarf around her thick, thick hair cut short so she can wear a wig. Mosquitos mom has been a blond, a brunette, and a redhead on a mission just like Tokyo rose. Mom uses mosquito as insurance and he is happy he has a bed to sleep in. He wonders who lives in the underground logging, dug in and camouflaged on the beach. Word is it is the beach house of the Joe Bfstky, and he sleeps there when one of his five wives cannot take him to a luncheon. He has a bigger house at the base of Sunset boulevard, but his relatives make him lock himself in the bedroom. When the waves get fifteen feet, once in every couple years, the Bu is the place to be and people live in Malibu their whole lives just to ride it and experience it once. The day ends and Mom smiles and hands mosquito a popsicle for the ride home. Fonz is not here. He is her favorite and is elsewhere and the peak at third point does not break anymore. The Movie industry diverted the runoff and it doesn’t exist anymore and time goes on. Don’t bother to go anymore.

“bonk, bonk bonk,” goes the knuckle against the glass window in Wrack’s room[R1] [R2] . “Who is outside my window at three in the morning,” asks Wracks?  “Bonk, Bonk, Bonk, meet me outside,” says BG.  “bonk, bonk, and bonk, its me BG.” Says BG.  “Where is my dog,” asks Wracks. “I gave Punkin a milk bone and put him to sleep,” says BG.  “How did you get in my house,” asks Wracks who now is wide awake. “I reached through the dog door and opened it up,” explains BG. “I did not want to wake your parents so I put Punkin to bed and came around to your window.  Meet me in back.”   “I have to put on some pants,” says Wracks, “give me a minute.”  Wracks exits his room, walks down the hall, closes the hall door and looks at the cushion where Punkin the house dog sleeps.  Punkin dozes upside down with a smile on his face and stirs when Wracks walks by.   He opens his eyes, makes a whining noise and goes back to sleep.  Wracks let BG in the back door. Bg wears a cardigan sweater and a large woodsman hat because it is winter even here in the best climate in North America on the west coast in December.  “The con is on,” says BG.  “It should be about eight to ten feet at the point and bigger at indicator.”  “A new swell is hitting today and then it will drop tomorrow. The con is on and we should go now and be out in the water at sunup. The tide is low at two PM so the swell should peak in the morning and then drop with the tide. Let’s have breakfast.  What do you have? “   “We have eggs and toast,” says Wracks.  “I’ll have two eggs sunny side up and two pieces of toast with butter,” states BG. Wracks takes out a pan from underneath the stove, adds butter to the bottom of the pan and turns on the electric range and then drops four eggs into the melting and then sizzling butter.  Five minutes later the two sit at the kitchen table and have breakfast with two cups of Yuban fresh brewed coffee.  “It will not be as big as last time we went but it should be real good and have excellent shape. “  BG takes a draw on his coffee and finishes his eggs. “Bring some gas money and a pack of Pall mall Gold.   We will need the nicotine.”  Says BG.  He rises from his chair, takes his dish and sets it in the sink like he would at home.  “Ill gets my stuff, “says wracks. The dog spins around right side up and yawns.  “Ill see you out front, “says BG as he exits the back door in the dark in December as the mist from the ocean puts a shade and shadow on everything.   The dog goes back to sleep.  Wracks gets his jacket, his coke and bread, his paraffin bar, a pack of cigarettes, two dollars in change, and an O’Neill super suit, and goes out the back door into the garage.  A red diamond tail Nat Pro gun sits in the rafters and Wracks pulls it down with a hook and brings his gear outside the gate to underneath the big pine tree on Bacon way as the street lights illuminate the misty air about the night. The green General motors durabuilt engine econocar hatch sits open and Cool is loading his surfboard into the car between the seats.  “I invited him along, “says BG. “The more the merrier.”  Cool turns his head in a Mexican pullover with hood and says,  “Hey brau,”  He then takes a draw on his cigarette and finishes a Heineken bear in a dark green bottle then heaves the empty into the neighbors yard.   “tonight you are going coffin,” says BG.  “Wait till I get my motorcycle helmet,” says Wracks.  Wracks dashes back into the back, into the garage and extracts a black bell motocross helmet and puts it on.   The three surfboards sit in the middle of the car separating the two driver seats and the back folds down into a large cargo area.  The gear of the three surfers sits on the right behind the “passenger side,   On the left will go Wracks coffin style. “Get in,” says BG, we have to get going.”  Wracks climbs into the cargo section, sits down facing back and lays into the car like count Dracula going to sleep.  BG closes the Hatchback over him, enters the car, ignites the ignition, puts the car into gear and the three set off into history. Down Bacon, past Mellow man’s, onto Quiz lane and then sunrise avenue and Wracks look up at the stars with his helmet on, chin strap on and starts to fall asleep and the car accelerates like mad up highway number one.  “We are going to take the freeway today,” stipulates BG.  Up Pang oh road the hatchback flies and the tires screech around the hairpin curves until the plateau and the freeway 101 appears as a green sign in the headlights at night perpendicular to the direction they were going.   Onto the onramp the car flies and BG accelerates until the car is in forth gear and floored at night with the high beams on traveling on the 101 north.  Wracks awakens from sleep to see the stars and the car fills with smoke and the windows are half way down and the wind whips around Wracks helmet, the icy coolness bringing him back to life.   Within a short time the three arrive at the junction, the junction of California street and highway one, and the ocean makes sounds and the moon sets largely on the ocean, illuminating the way to the little corner.   The little corner is the most consistent surf break in SB and gets a northwest, a hard north and a straight west swell.  BG says today the swell sweeps in straight west and Wracks dozes coffin style in the hatchback.   Kool comes to life and says, “let’s stop at the little clam for provisions.”  BG acknowledges and the car comes to a stop a half hour later at a little market, in a shack, set against s a hill with a gas station a half block away and the ocean rumbles and roars.  BG buys a hot dog and a pastrami sandwich heated in the store microwave.  Kool gets a sandwich and a bag of candy.   Wracks stays inside the car.   The two eat in silence.   Then BG says, “Lets get going and be out in the water at sunrise.”  Kool acknowledges with a hand gesture.  BG ignites the car and heads out on the highway. Within ten minutes the three are at the little corner and pull into the big parking lot made especially for wave riders surrounding  them with cyclone fencing and concrete blockades.   The night closes and the scene begins to lighten into a dark grey and morning arrives.  Eight cars situate inside the parking area.  Die hard wave riders who scoff a normal life sit in their cabs or hang out of the cargo doors of their vans waiting for first light.  Sharks cruise in the darkness and light sends them back out to deep water until the sun starts to set again.  Vans of ladies arrive to watch the wave rider’s surf the long thin tubular swells of the little corner.  The little corner breaks mostly on a west or northwest swell.  On these disturbances, the wave’s line up perpendicular to the point and break with ruler straightness in cylindrical almond shaped tubes.  From the outer first point three separate tube sections exist and a wave rider can situate his or her self strategically at each section to ride deep inside the wave.  The little corner holds a west swell up to fifteen feet, and then it starts to break erratically and close out.  On a rare hard north swell that refracts off the Channel Islands onto the west facing beach, thirty foot waves will break for a morning and then disappear in the afternoon.  For these waves people dedicate their lives and wait and watch for the perfect big day to arrive.  Once initiated, the little corner draws addicts from all over the coastal region of southern California.  Cool is the first out of the car. BG uncorks wracks who arises life a vampire from his tomb, the shucks the helmet and saunters with the other two down the little trail unto the base of the beach to catch a glimpse of what morning brings.   Today, the three are lucky, a solid ten to twelve foot swell sends lines three to five at a time to break down the point into the bay.  The morning starts, the light arrives and a cool offshore breeze holds up the waves unto perfect spinning vortexes larger than ten feet and growling.  Cool screams out an unexplained word and runs back to the green hatchback along with BG.  The hatch open, three wetsuits hang on the car and wracks shares the bar of paraffin with the other tow and white streaks appear on the surface of the three long surfboards. With boards in hand, the three run down the trail, through the flotsam and jetsam of wood and seaweed up to the point.  Timing the sets, they launch during a lull and are outside.   The sun comes up over the mountain interior to the little corner point and the day begins.  About twenty people ride the waves that morning and enough waves arrive to give each his or her own to enjoy.  When the sun raises to directly overhead, the offshore wind stops and the ocean becomes completely smooth and glassy like a window pane.  Three wave sets pour through endlessly.  Within an hour the wind reverses into a westward flow and the ocean surface starts to roughen up and chop.  BG turns to Wracks and says, “Were going in.” Wracks starts to paddle to shore without waiting for a wave to ride and then arrives on the beach by going along with the white water.    Cool waits up at the car. BG opens the car, cool grabs a bag of candy and starts eating.  Wracks strips off his wetsuit and enters his druid robe.  Cool takes off his wetsuit then noticing some young ladies down the parking lot, starts dancing stark naked and singing.  He is a rock star.  The girls laugh and blush and Wracks stows his gear in the hatchback and modestly puts on his corduroy jeans and tee shirt and then his jacket.  BG smokes a Pall mall gold and drinks a coke.   The waves still pour in and the parking lot shows full.   Surfers run down to the beach with their boards and the wind is a light five knots on shore.   BG tosses his cigarette butt and says, “Lets go.  Wracks get in the coffin.”  Wracks dons the black bell helmet and descends into the hatch.  Cool drinks a beer and tosses the can as close to a trash receptacle as he can.  The green Chevrolet launches southward at light speed. “I told you so, I told you so,” chides BG….  Ten to twelve feet slides and churning green tubes.  What more can you ask for.”

“I have to go work for my father,” says Cool “mellow.”    Wracks as customary fades into oblivion as the car enters the 101 at California street.    The three arrive back at Bacon way at three thirty pm.  “Service with a smile,” says BG.  “Wracks, get out, I have to go to work.”  Wracks grabs his gear in a brown grocery bag and plucks his red NatPro gun from the car.   “Thank you very much BG that was a session I will always remember.  BG and cool accelerate in a close circle and rocket up Mellow man’s land to Charmed street where Cool lives.  Wracks stows his board in the rafters and washes his super suit with cold hose water.   The little dog sits on the kitchen step, growls and wags his tail.   Wracks enters the house.  “What for dinner” asks Wracks. “Grab a frozen bag of chicken and microwave it, “says mom.   “Where were you?” “I was surfing big wave up in SB with BG,” explains Wracks.  “go shower off and do your homework,” says Mom.   Wracks walks to his bedroom, the falls into his bed and is asleep.  The day closes, and night arrives again and the darkness brooding in the silence becomes a reality.  Wracks wake up when it is dark, makes his meal, boils water for a cup of coffee and reads by his little desk lamp.  The dog saunters in through the doggy door and falls asleep on his little cushion and wracks turns on the evening lights and locks up the house.  A light shines from under the door in Grandma’s room and Grandma is watching tony Orlando on television.  “Do you need dinner,” asks Wracks.  “No she says and smiles and holds a speaker up to her ear.  “I already ate.”  The day ends, the night begins and another page turns over in the book of Wracks life.  Today he rode long thin tubular waves for a quarter mile ride while the world turns.  No one noticed except Wracks and maybe his little dog and tomorrow he will wake up and read the Sunday paper and maybe go to church.  Then a new week begins again and wracks grows a little older.

---

 [R1]

 [R2]

Why not get on a plan with free vision, dental, exercise and spa membership, all that is necessary is a co payment and an administrator sitting at a desk and playing video games, and shuffling papers for a 5 figure salary. Don’t mind the decadent luxury, the government pays for it all if you make it to 65 and debit for schedule B coverage. Thirty percent of the gross national product pays for medical care for the working class, the upper class can pay for what they want out of pocket. The administrators of corporations and small business huff and puff when they inform their loyal workers that health care coverage is matched by their employer, and they are lucky indeed. Unfortunately, the health care the working class receive is not worth a single cent and like the diehard professionals adamantly state that “it is better than nothing.’ this author tends to disagree.
Working people go to medical doctors with maladies mostly due to workplace noscomial pathogens or environmental factors, and the professionals take their blood pressure and fasting sugar glucose and inform them that they have either high blood pressure or diabetes, and all people eventually acquire high blood pressure or diabetes. The medications sanctioned by the AMA are cooked in a pot by organic chemists at big pharmaceutical companies and eventually induce blood cancer or cancer of the pancreas. A patient makes an appointment with a physician and does not get a cure, only carcinogen and a promise, and the professionals check with the pharmacists to make sure their patients are taking their medication. Employers pay for one half this charlatan behavior and they think that their monetary output is helping their staff that they depend on for performance and reliability. When a patient has an infection, these salt of the earth people are told to drive to another city to see a specialist. These dedicated humanitarian professionals do not want to live in the same town as their patients, they might be seen by them.
Unlike what people are led to believe, human existence is free from disease unless it is given to them. In a lifespan time line, a spike in incidence arises in youth and early adulthood when people are most sociable. In essence do not leave your children with others unattended. As humans age, the incidence of disease slowly increases until government retirement age when it spike up to termination.. These maladies are usually chronic and due to environmental or career choices, and there is no cure for them, only palliation with snake oil remedies that exert no effect. Medical administration states that it is a persons long lifetime and that this is normal and they need some kind of organ transplant to extend a normal life span. A transplant of any kind costs the government one million dollars in medicare costs and lasts at most five years. It would be prudent at this point to ascertain the environmental or work factors that induce disease and to reduce or eliminate them. Emergency rooms do not test for chemical toxins, Current diagnosis and treatment only list them in a glossary, in the back of the book and alas , the panacea is symptomatic support only.
In mid life, around the age of forty everyone should be wormed! That bulging beer belly or horrible increase in a woman’s waistline is probably due to intestinal worms of many types depending on the diet. Everyone who eats meet, especially rare meat acquires intestinal tapeworms and in our McDonald hamburger culture this usually means Taenia saginatta which is the tapeworm seen mostly in beef. Taenia solium is the similar tapeworm in pork. When your belly is growing fast or your wife cannot fit in her old clothes he or she has a tapeworm of some sort and needs to be wormed. Allopathic doctors regard an increase in girth as obesity and put all their patients on diets and order a colonoscopy. Diet is only temporary and colonoscopy often leads to perforation and an exploratory laparotomy. Health care administrators do not fund a veterinarian to worm human beings. In a animal clinic most animals are either wormed, spade or euthanized. Health insurance does not pay for a worming. Do animals, receive better care than human beings?
If a worker makes it to retirement, and their employers have doled out half of their medical costs for twenty years, they need to be chelated. All commercial foods contain some type of metal to preserve it from spoilage and bacterial contamination. Returning food to the store and crediting it to loss is an expensive undertaking and corporate does anything they can to prevent this loss in their commercial product. The English were the first to use metal salts to preserve food and they work great but metal, of any kind builds up in a human body, causing aging and senility. All humans at sixty need to be chelated but this is an expensive undertaking. The duration of Chelation therapy can last ten years of admission to outpatient surgical units for IV therapy. The government can not afford this, only the upper class pay for this out of pocket, so the working class get a colonoscopy and post surgical morbidity.
Hurrah, Hurrah. An hourly worker lives on boiled rice and an egg their whole existence with some fruit for soluble vitamins. They survive the opposition that most assume in our hamburger society. The aged now, have either hypertension and diabetes and they get prescribed carcinogen to escort their goodness to the undertaker. If a devoted scholar reads pathology books, he or she notices that the percentage of occurrence of cancer has increased exponentially in relation to industrial development in Technology. In other words, Cancer existed as a rare disease in the Nineteen hundreds, and our educated professionals ascribe this tremendous increase in cancer mortality due to extended life spans. Our doctors are humanitarian and highly intelligent and this must be the case. THE ONLY REASON MANKIND LIVES LONGER TODAY IS BECAUSE WE NOW HAVE ANTIBIOTICS THAT COMBAT INFECTIONS. Before 1940 and the advent of penicillin, everyone in the snow belt died of pneumonia in old age, and everyone in the deep south eventually died of dysentery due to shigella, salmonella or otherwise.
If everyone wants to live on bread, rice and fruit, be a vegetarian, and work on a farm, he or she might live a long time. Except for we the people and not everyone else, this is not the case and we get tired of medical doctors living in mansions and refusing treatment if the patient does not want a colonoscopy. Something has to give.
On to standard time.

Life in the United States depends on three factors. The first is genetic factors, beautiful people tend to be more successful, socioeconomic factors, the 20 percent usually get their way. Religious factors, the most apparent religion holds sway for ethical values unless they give it all away. This is life in the continental forty eight, and the rule has nearly been the same since the beginning of history. Without causing a national uproar in a democratic, capitalistic country where the good old dollar holds sway, whoever has it. The true people , the fifty percent of us that work for a living and pray every day that their children can attend college and land a good job, don’t get a good shake of the culture that is happening.
The rulers of the financial fiefdom, want their children to be rulers too, and this is nepotism
The clergy of the predominant religion want their children to be successful and this is nepotism too. The professionals, who attend expensive graduate schools field a closed shop, and for the most part, to be a professional, a person has to be the child of a professional, or marry the child of a professional. This seems to be Americanism or at least a democratic semblance of the reality that was and is to be. The reality of life on planet earth happens really not as communism or socialism but peoples, and political names are a coverup of past injustices and misuse.
The reality of existence lies in the fact that the people who work an hourly wage for a living, and want the most for their children, and their people, derive the least profit from their toil during their lives. The people that work an hourly wage for their existence: keep the water flowing, keep the electricity charging, build the bridges, highways and structures that define our society, and consume the products that the financiers acquiesce and continue the Malthusian economic cycle that requires constant input of natural resources to keep the pump primed and pumping.
In upper class diatribe this means, that the working people, clean up the motel rooms after the professionals cheat away. The working people fuel the airplanes and stock the galleys of fancy aircraft that take them on exotic vacations. The working class stand on girders and dangle from pulleys to build tall skyscrapers that no one wants to work in and are incredibly expensive to tear down. The working class become valets and busboys so the twenty percent can have a gas while they are governing. Most of all, and in the name of God, the working class die in wars for the right of burning foreign petroleum and their daughters are sold as slaves so obscure foreigners can have a good time on Friday night. Can this be reality in a nation under God, indivisible, for liberty and justice for all?
Martin Luther said, “believe in the truth because the truth will set you free.” and he was shot several times with a hunting rifle. So as not to be a political pariah and martyr, let the author state empirically, and with regret, and with knowledge of what might be: politicians and administrators, and investment bankers are superfluous commodities that should be dispensed with in a timely fashion. The working class does not have to accept the medicine that the ruling bodies provide which is worthless and expensive. All professionals are millionaires and soak up a third of the nations budget. Only the dedicated surgeon, a rare and important breed, is necessary because when you are shot or blasted, nothing else anywhere anytime will do in a farthing. Remember, God made the devil so to test mankind so that they might be saved. Surgeons are a necessary evil, and the rest to be dispensed with. Democracy is best because it gives everyone a chance to rise above the masses. No other system does.
It is the working class alone that is important to maintain the infrastructure of the civilization. Almost anything else is unnecessary. The government in all it administrative excellence should coddle and enhance these people which are the lifeblood of to the exclusion of everything else. Fifty percent of the population are decadent and unnecessary. The educated middle class has the onerous duty to maintain the civilization and keep it running while the twenty percent take drugs and have porno parties.
The working people of the United States of America make our civilization beautiful and this essay is for them. They are this nation and no one else. Maybe someone can stand up for right and justice and wear a bulletproof vest and ballistic helmet if the 20 percent feel they are too testy. We the people of the United States are real. United we stand divided we fall.

Wracks, I want you to come in at night at the ER because that is when the action happens.  Be sure to be here Friday or Saturday night on the Graveyard.  Every week we have a gunshot or a bludgeoning event.  We need the extra hands to tie sutures,” said Dr. Saber. “I will be here,” said Wracks

“We have a stat on a fight victim coming in” said the dispatcher.  “Wracks, bring him in and work him up. Then call me.” Said Dr. Saber.  The Paramedics brought the patient into the double doors of the ER.  The ER had double electric doors in case a murderer wanted to finalize an act not perfected.  We could lock them out.  The patient was of average height and average build Caucasian male.  He wore sweats and had no obvious odors diagnostic of metabolic conditions.  Upon neurological exam, The Wracks find the pupils fixed and dilated. The breathing is intermittent but not agonal.  There is no obvious bleeding from the nose, eyes or ear canals upon fundoscopic observation.  The patient is unconscious and does not respond to pain from needle prick or skin pull.  “Dr. Saber, I think we have a subarachnoid hemorrhage with antecedents of trauma to the face. “  Dr. Saber runs to console, grabs the phone and calls upstairs.  “Wait with him!” Dr. Saber commands.

     “Dr. Saber said you have good hands,” said the brain surgeon.  He is a middle size man of obvious English ancestry with short brownish red wavy hair. He stands at middle build on the lean side like people who are always on the run from an adversary. His clothing is impeccable like he arrived from a ball at the palace of Versailles. His shoes look brand new like he never walked in them because he doesn’t have to.  An aquiline gaze reveals steel grey eyes almost like the prince of Wales.  He must be related.   “I want you to assist me in neurosurgery tonight.”  “I will teach you how.”   The patient was already upstairs. He gestures to Wracks and says, “Take the elevator all the way up.  They will let you in.”   The elevator to the top surgical unit is slow and steady and quiet.  The light blink by slowly as it rises to the place where God alone rules and man tries to cheat him of his due.  Someone said to Wracks that the Obelisk was owned by a very rich man.  the Wracks did not believe them because he was forever hungry and looking for food.  Tonight, at eleven o’clock the Wracks will assist a brain surgeon and bring a dead man back to life. This is a third-year externship at Christmas when all his friends are surfing Pipe or the Con and he wasn’t.  He was already scrubbed when the Wracks arrives as if he flew up to the surgical suite.  There was Wracks, the brain surgeon and an older anesthesiologist who looked like he needed sleep too.

“I will teach you brain surgery,” said the brain surgeon.  “First, the conditions.”   “Cool your patient to 90 degrees Fahrenheit with a water blanket.  This will slow the heart and make the neurons less irritable.”  “ Then infuse urea to establish hyper osmotic equilibrium to prevent brain swelling.  This is faster.  Switch to mannitol post operative.  Now infuse solumedrol to prevent inflammation. This takes 24 hours to begin to take effect.  When the patient is readied by the anesthesiologist then we will begin.  Anesthesiology must be light or the patient will stop breathing.  The patient will be conscious.  No matter what the patient says keep going. Learn to focus and block out everything but the job at hand.”

   The patients head was shaved and the brain surgeon looked at the x-rays.  Visualize in your mind where the lesion is from the x-rays.  Take your own x-rays before surgery.   Do not rely on anyone.  Do not let anyone but licensed surgeons into the room.”  “Now we will unearth the calvarium.” Said the brain surgeon. 

     The bone saw whirs at a high frightening screech.  The saw is a small stainless steel orb that glints under the klieg lights and comes from a sterilized package.   “Hold open the operating theatre for me,” he said.  “Do not let go.”  “The patient might move!”  The saw whirred with a horrible whine and the frequency dulled as the blade cut the bone.  Smoke arose from the cut and I started to vomit.  “Dr. Saber said you were good.”   “Are you good?”  “I am good.” Says the Wracks and his senses came back to him.  He pulled of the top of the patient’s skull and snipped the tentorial ligaments with a small scissors.  “This is the durra mater and underneath the subarachnoid membrane. “  Under the durra mater, a skin like membrane stretched over the top of the brain was a mass of congealed blood.  The patient started to speak in a childish voice a language the Wracks could not discern. “Do not listen,” he said.  The brain then started to swell like a loaf of bread rising in an oven.  It pushed out two inches high.   “This is a bad one,” said the brain surgeon.  “We will have to do a total lobectomy.”     “I Want you to hold the suck and turn the fulgerator when I tell you to.”  The Wracks held the suck stable.  The surgeon literally sucked brain matter through a stylet into a huge plastic receptacle.  The osterized brain matter was bright pink like Jell-O.   The neurons are a light grey and the supporting structure of glial cells and myelin is alabaster white.  The brain surgeon hit a capillary and the blood spurt two feet high like a small geyser.  He clipped it with the forceps and said “burn it.” Wracks pressed the trigger of the fulgurator.  The smell of burnt brain permeated the whole operating area.  The wracks started to black out.  “I am going Doctor,” said the Wracks.  The brain surgeon commanded, “Hold the suck.”   “I am going Dr,” the Wracks.   The brain surgeon commanded “Hold the suck.”   The Wracks slowly started to come back. Slowly, surely, he came back to consciousness.  “Now we can continue.” He said.  Small hemorrhages would occur as he aspirated brain tissue.  The Wracks held the suck and triggered the burner as he commanded.  “Our father who art in heaven.”  And we continued.  “Hallowed be thy name.”  And we continued.  “Thy kingdom come. Thy will be done.”   “There” said the brain surgeon.   “The bleeding and swelling have stopped and the patient still breathes.”  He put the top of the skull back on the patient and secured it with staples.  Then he sutured the scalp back into place.   The clock says two A.M and I am spent.  “You can go now.” Said the brain surgeon.  “I am done here.”

      The elevator from the top slowly descended to moral reality and the Wracks walked back into the ER.   “Did he make it?” said Dr. Saber “He made it.” Says the Wracks.  “Good “said Dr. Saber.  “We have a gunshot wound to the abdomen in room 3 and I want you to wait there until the police arrive.”   “o.K.,” says the wracks.

      They said the patient was alive on a respirator until he was transferred to another hospital.  The Wracks lost track of him.  Some say he died some say he slipped away.  Some say the event never happened.   The Wracks never saw the brain surgeon again. He is a very busy man who lives on an airplane and flies all around the world cutting into people’s brain., They say he is the best in the world.   Instead, the Wracks does neuro- surgery with an African American who hates to do colostomies.   There was always action in the south, in the city, downtown, late at night during the summer externships at the hospital when the Wracks was a medical student.

“Where were you,” said Dr. Saber.   We need suturing for a head wound in room two.  the wracks went back to work for nothing to learn the craft in the days before the darkness in youth when achieving was so important and nothing else mattered.  They still do not know how to prevent the brain from swelling during trauma.  It is the increased intracranial pressure that stops the respiratory center from working., Pray to Yahweh and beg him to whisper the secret to a sincere dedicated surgeon.  Mankind is depending on you.   La Ilya alha Allah, Muhamed resund Allah.  

At eleven o’clock A.M. He is preparing to go to the cafeteria to eat.  The charge nurse for the surgical unit runs directly at W  and says “There is a large aneurysm to be resected in the main surgical theatre. Dr. P and Dr. Are want you there now.” Tell them to find someone else to assist them,” says W.   “They want you now,” says the charge nurse. “Go and scrub in, Now!”  “I have to check a bandage and then eat,” W says.   The Charge nurse points at the door and says “NOW!”    W then then slouches to the hallway ramparts, turns right and key in the code at the surgical unit door and enter.  “Grab a cup of coffee and some donuts,” says Dr. Are.  “We may be in there all afternoon.”   Get a new green and then scrub in.  “Where did you learn to wash your hands like that,” says Dr. are.  “In Mexico,” W says “And I got a “C” in surgery operating on dogs.”  “You will do,” he adds.

      The patient is a huge obese lady who is out cold under anesthesia.  The staff ropes her to the table.  Dr. P is there with a knife.  “Watch me rip her open,” he says.    He takes the stainless steel knife that glints from autoclave clean, starts at the belly and jerks it up to her rib cage.  Blood spurts everywhere.  “I will clamp the bleeders, you tie them off,” says Dr. Are.   We learned to tie knots fast at the Guad.   He clamps, W ties, he takes off the clamps and W ties the next. “We will be in next,” says Dr. P.  He takes all the used hemostat clamps and throws them in the corner eight feet away.”   “We have to count them all before we close,” says Dr. Are.   Dr. Are. takes a scalpel and cuts the peritoneal membrane and the viscera bulge out of the wound.  They are a beautiful pink on white.  He then sticks his hands into her abdomen and pulls out all of her guts and sets them on her chest on top of a cotton gauze towel.   He puts another towel on top of her bowels and says to me. “You have to hold them on her chest.  If you let them go, she dies.”  W holds.  He starts sweating and W holds and look inside her body cavity.  Dr. P is clamping off her aorta top and bottoms one large underneath her kidney and two other on the other two femoral arteries.  The aneurysm loots like a huge asymmetrical sac, reddish purple from coagulated blood about eight centimeters in diameter.   “It is ready to burst,” says Dr. P and he goes and gets the polyester pants that will replace the artery.  He holds them up and plays with them like a little rag doll.  Dr. Are says, “Is everyone ready?”  By now the whole surgical staff and medical student were watching from afar.  Some of them began to faint and were pulled outside by their friends.  The big fat woman who was dead because her heart had to stop to resect the aneurysm rolled on the table like a huge beached whale.  Dr. P said “Now.”  Dr. Are maneuvered to the other side of the table next to me.  Dr. P took a scalpel and in one motion delivered the aorta with aneurysm to a waiting steel bedpan held by Dr. W.  A charge nurse stepped in and took the bedpan.  W holds her guts on top of her chest.  Dr. P put the polyester pants in place and started to sew.  Dr. Are. took the top end and started to sew.  When they were done the polyester pants were in place with three clamps remaining.  “Second guess me Dr. Are.” said Dr. P.  “It looks good,” says Dr. Are.  “Let’s let her rip”.  Dr. P was the chief surgical resident in his fifth year.  He won the by over Dr. Are by subjective advantage.  They were both equally good.  Dr. P slowly, slowly. Slowly took the clamps off the aorta and threw them as far away from the table as he could.  W holds her viscera on her chest.   “Start her heart,” Dr. Are said to the anesthesiologist.  He injects epinephrine in her subclavian port and shocked her.  He shocked her again and the monitor came alive.  Sine wave and red blinking dot online. She is alive.  The graft inflated like a balloon and it held.  “Lets wait,” said Dr. W.  “I want to see.” The graft held and pulsed slowly. “Let go of her guts,” said Dr. Are.  W’s muscles were frozen into tetanic spasm and as she came back into consciousness, W let them go and stepped away from the table.  Dr. P stuffed the intestines back into her body cavity and closed the peritoneum with polylysine blue strand. Dr. are tied and cut the knots.  Dr. P said “thank you everyone.” And left.  Dr. W. said “Here is the stapler, “you staple her up.”  “I have to do an amputation.” So, W staples with a large stainless-steel stapler.  A second-year resident hold the skin together for W. as W staples.  W asked, “Why staples?”  The resident said, “In case we need to rip her open again, we can pop them quickly.”  W staples.  The anesthesiologist and the internist wheel her into recovery. They said, “You can go eat dinner now.”   We had to eat dinner because tonight was a call night every third day.  W will have to be up late.  Cigarettes lose their taste.  Coffee gives everyone who drinks a lot of it an ulcer.  What keeps someone going is sheer will, perseverance and faith.  After dinner W will sleep an hour and then walk rounds through the hospital till they tell W they do not need him until tomorrow.  By then it will be tomorrow anyway and the cycle begins anew and W wonders if he is really cut out to be a surgeon.  W needs too much sleep.  Every man must know his limitations and without knowing these a man is vulnerable to life and in life is birth, death and a new beginning.  W goes to the locker and scrub out.  Someone has stolen the earpieces from his stethoscope. W wraps tape around the pipe. Stick them in his pocket and walk towards the cafeteria.  The moon is full outside.  Spring is in the air.  The snow has melted and the air is delicious, but he is inside doing what needs to be done because it has to be done and he really wonder why.  He thinks about how he is going to sabotage the pager because they always bust him at dinner to do a blood gas.  They say he have good hands.  he would rather have a good heart.  The African American cook looks at me with a smile in the cafeteria. “The same,” he says  Chicken fricassee with broccoli and a scoop of mashed potatoes.  W does not know why she smiles at him. At this point W does not care.  He is on call tonight in the ICU.

“Well Dr. Wrak, you have completed twenty weeks of surgery and Dr. Ony has passed you,” says Dr. Q.  Dr. Q is the chief of internal medicine at Amityville hospital and oversees the fifth pathway program offered by New Amsterdam College.   Dr. Q stands slightly taller than average, has a slight build, olive colored skin, thin hair, but bright eyes.  His teeth show that braces were too expensive for his family in his youth and now as a rich medical doctor, he still has not corrected the poor bite which stands out when he smiles.  “I think that it is time for a vacation for you.  What elective rotation would you like for six weeks?” inquires Dr. Q.   “I would like radiology because there is no call in Radiology,” says Dr. Wrak.  “Don’t you like call,” explores Dr. Q.  “Not when it is every third day and I have to do surgery in the middle of the night,” says Dr. Wrak. “You will like the Radiology vacation,” says Dr. Q. “Dr. Pine will be instructing you.” “He is an extremely busy man.  Do not speak as you sit in the reading room and Dr. Pine will instruct you.”  “Not a word!”  insists Dr. Q.  “Not a word!”  “I promise,” says Dr. Wrak, “When do I begin?” “As soon as you leave this room.” Says Dr. Q.  “Dr. Pine is a pioneer in balloon angioplasty and will let you assist him if he likes you.”  “They read at ten AM and Four PM.” “Be there.’  “Thank you Dr. Q.” says Dr. Wrak.  As Dr. Wrak walks out of the room he hears again in the hall “Not a word Dr. Wrak.”   “Yes sir,” says Dr. Wrak as he enters the stairway and walks down from the second story at Amityville hospital into the stairwell.  Radiology lives on the first floor next to admissions.   The sign says, “Radiology, Patients enter here.”  Down the hall a smaller sign says, “Doctors only.”  Wrak chooses to enter there.  The cryptographer at the desk next to the door says, “Dr. Wrak you are late.  They are reading now.  Enter the room and take a chair in the back if one is available.  If not stand in back until they finish reading.”  “Thank you,” says Dr. Wrak.  The reading room lies to the right behind a sturdy oak door.  Inside the lights shroud a huge wall of white fluorescent reading screens with cloth pins at the top of each screen to hold the transparent X-ray films.  Comfortable padded chairs sit behind the screen plush with padding. Dr. Pine sits with three residents looking at films.  The room is dark and a red light provides enough illumination to enable a person to walk safely.  Dr. Wrak decides to stand in back.  “Good morning Dr. Wrak,” says Dr. Pine and he resumes reading films.   “This one is an intusception. Notice the fluid level above the obstruction. Phone third floor now.”   He flicks the film off the wall and places it back into a manila envelope.  A resident grabs the envelope, stands up and leaves without speaking a word.  Dr. Wrak takes his seat.  “This film is reactivation tuberculosis.  Notice the cavitation in the right lung apex on an anterior posterior.”  He puts the film back in an envelope, hands it to a resident and the resident leaves like the first one.  “Dr. Wrak, remember tuberculosis prefers the right lung because the main stem bronchus juts at a right angle.  The left stem bronchus exits at forty five degrees.  Above all be systematic in your analysis.” Says Dr. Pine.  Dr. Wrak nods his head once.   Dr. pine shoots through ten more films, looking at a film, writing an interpretation, and throwing the film back into a manila envelope.  He does this quickly and the clothes pins holding the transparencies on the wall make a snapping noise with the speed and ferocity of the actions.  “I am done.” Exclaims Dr. Pine.  “Do you want to assist in a procedure, he inquires.”  Dr. Wrak nods his head once.  “Get a radiology badge from the front office and meet me in surgery in thirty minutes.” Says Dr. Pine.  Dr. Wrak nods his head once.   The cryptographer in the front office opens a large manila folder as Dr. Wrak enters the office.  Inside the folder are bunch of radiology badges like prizes in a cracker jack box.   She wears her hair short, has glasses and a professional looking blouse buttoned up.  “Here is your badge. Do not lose it.”  She writes the number of the badge on a ledger and asks Dr. Wrak to sign it.”  “Thank you very much,” says Dr. Wrak.  “Take the badge home with you too,” She insists.

     “This patient has a stenosis in the left femoral artery at the level of the inferior olecranon process proximal to the popliteal space.” Says Dr. Pine.  “You are going to hold her leg still as I advance the cannula from her femoral triangle down to the obstruction.”  We will take films periodically as the balloon stylus descends.  The films will reveal progress.  Hold her leg still with both hands because if I pierce the arterial intima, an aneurysm will develop and the procedure will fail.  Dr. Wrak holds the patients leg and Dr. Pine inserts the cannula in the arterial stent created by a general surgeon moments before.  The X-ray gun hums.  A picture appears on the screen.  “Pixels,” says Dr. Pine.  “It is the new technology.”  He advances the cannula further.  The x-ray machine hums.  He advances the cannula as Dr. Wrak holds the patients leg.  The x-ray machine hums with a buzz and another picture appears on the screen above the table.  “We are almost there,” says Dr. Pine.  “When we get to the obstruction, hold the leg extremely still and I will inflate the balloon. At this point we will take films at the rate of one per five seconds to monitor the progress of the balloon inflating.”  The x-ray machine buzzes and a picture appears on the screen.  Dr. Pine squeezes a bulb furiously.  The x-ray machine buzzes and another picture appears on the screen.  The closed artery is being expanded.  The x-ray machine buzzes three more times and then Dr. Pine exclaims, “the dilation is successful.”  He deflates the balloon and slowly withdraws the catheter from the artery like an angler pulling in a fish.  The catheter appears to be three or more feet long. “Bring the patient back to recovery.” Says Dr. Pine The anesthesiologist leaves with the patient, dragging her IV pole beside him.  “Thank you Dr. Wrak.”  Says Dr. Pine. “See you at four.”  Dr. Wrak nods his head once.  As Dr. Pine walks out the surgical suite door he says casually as he exits, “The procedure only lasts for six months then the artery re-occludes.  I do them anyway.” “I am told what to do by the administration upstairs and if I don’t, they find someone who will.”

   “Dr. zel wants you to assist him in a lower GI barium swallow,” says the cryptographer. “Enter the room down the hall. You do not have to scrub.  The procedure will take about an hour.  You will rejoin the radiologists at four PM after lunch.  “What a morning,” thinks Dr. Wrak.  “Another surgical procedure.  I thought Radiology would be my vacation!”   Dr. Zel stands at medium height with large owl like spectacles and wavy dark brown hair.  He wears a pressed shirt and tie underneath the hospital smock.  “Take off your hospital smock and put on this lead suit says Dr. Zel.  Dr. Wrak complies. He puts his smock on the desk outside the radiology suite.  Dr. Wrak looks like the alien invader from Earth versus flying saucers. Dr. Wrak feels ill at ease.  The patient wheels in and the radiology orderly runs out.  Dr. Wrak helps Dr. Zel position the patient on a movable table and fastens the patient down.  “When I invert the patient hold them so they do not fall off the table. Assist the patient whenever possible, “teaches Dr. Zel.  Dr. Wrak helps Dr. Zel by moving the table into various positions as Dr. Zel takes pictures with an x-ray gun. About a half hour into the procedure something strange happens.  On the wall behind the screen a metal plate falls off the collimator at the top of the device, and a blue glowing flame appears in a steel box like a reactor core melting down.  The flame is intensely blue and Dr. Wrak cannot bear to look at it.  The room starts to smell like a lightning flash during a thunderstorm.  Dr. Wrak moves behind the lead glass screen and gesticulates to Dr. Zel about the huge blue flame in the metal box on the wall.  Dr. Zel smiles and says, “I have to finish the procedure,”  “You can go.” Dr. Wrak pounds on the glass and jumps up and down.  “It’s Ok” says Dr. Zel “the procedure is nearly over, you can go.”  Dr. Wrak nods his head in prayer and implores Dr. Zel to leave.  “It’s OK,” says Dr. Zel.  Dr. Wrak exits the room from behind the leaded glass and throws off the radiation suit.  He grabs his smock and proceeds to the cafeteria.  “Finally time to sit around and eat,” thinks Dr. Wrak.  “Where are you,” inquires a resident. “I am in Radiology now,” says Dr. Wrak.  “If you want to help in surgery, just stop by says a fourth year surgical resident. “I most certainly will,” says Dr. Wrak with a wan smile and he begins to eat the chicken fricassee with broccoli, mashed potatoes and gravy, chocolate milk and a cup of coffee with free refills to residents only.  This is the standard fare he can afford.

   “Good morning Ms. Kleb,” says Dr. Wrak.  “Dr. Wrak, you radiation badge is red and you must see the head of Radiology immediately.”  Dr. Wrak examines the radiation badge clipped to his left breast pocket and by Jove, the badge turned from ivory white to a bloody crimson red.  The chief of radiology is an older man with white hair and looks like either the God Thor or Loki the evil elf.  Dr. Wrak hands him his badge.  “Where have you been?” inquires the chief.  “Just a few procedures,” says Dr. Wrak.  ” I left my badge outside a procedure yesterday because I was wearing a lead radiation suit head to toe.  Somehow the badge got exposed to radiation.  The Chief says, “When a badge turns red , the event signifies a lethal dose of radiation.  You do not look sick.  If I report this badge, you cannot continue your residency until you complete medical treatment. I am going to throw it away and issue you a new badge as if this event did not ever happen.  I will alter the books.  Here is your new badge.  You can go back to the wards. If you feel sick in any way, come back and see me.”  “I will,” says Dr. Wrak.  “Good luck,” says the chief. 

     This is how radiology is. Even amongst educated elite, the world is a tooth and nail fight for wealth and supremacy.  All rivals and competitors face instant elimination on a daily basis and interact with  the forces of evil constantly.  Dr. Wrak hopes he was not exposed to high energy ionizing radiation.  Lots of radiation destroys the immune system.  Today is a new day and more films are to be read and more procedures done with x-ray guns pointed nearby.  Dr. Wrak finished the book on Clinical Radiology in one night and now knows what to expect and what to do in the hospital.  The future of Medicine lies in imagery because viewing things in situ, de facto, in surgery portends morbidity, mortality and worse for the patient and the staff.  Dr. Wrak runs with the new technology of Radiology and feels proud to be part of the new wave.  With the new wave comes great danger and in danger heroes are made. Some things must be done and not talked about.  Reading x-ray films expertly requires high intelligence, a background of medicine and the ability to visualize anatomic detail in the  mind as a doctor  correlates the information with the imagery presented on the film. Hope springs eternal even for the damned.

     “Dr. Wrak, are you finished with Radiology yet,” inquires Dr. Q from across the hall.  “We need you back on the ward.”  “I am still on vacation Dr. Q,  Still on vacation. Nice to see you. Two weeks to go.” 

Medicine is a fun and helping profession and W is glad to be part of it. 

In this clandestine life he has the opportunity to meet people, mostly at work. They come in all sizes and shapes and races and nationalities. Some are good, some are bad, some are pretty. Others not. They exist in different classes: some in suits, some in work-clothes, others in pajamas, others in bathing suits. If you decide to enter the health sciences, there are others.
Nurses in white, doctors in a smock, technicians in green. No blue, red or purple. Then there are the suits. Wearing a suit designates a human entity as administrative. Does the maker wear a suit? Late at night in a hospital, an ethical human being can find him there. Why is it always a him? He doesn’t talk, he doesn’t have to. Actions speak louder than words and when you are close, so very close, speaking does not make any sense.
He is tall, like most Celtic or Germanic men are. He is not muscular or overly emaciated, just thin like a long distance runner. He wears an expensive thin wool tweed suit in black or dark grey with something. Attornment of the very best. He sports a black tie, a small one neatly inserted into a white linen shirt. We never did get a chance to look at his shoes, he was entirely occupied. This man sports official credentials in a plastic placard hanging from a lanyard on his chest. This person seems to have contacts of the highest echelon and favor and has no friends. At least it doesn’t seem he has friends, the staff don’t seem to see him.
If a person dares to get close, and few people have, he contains light brown hair, a fair complexion, a normal nose with a slight crook to it and lips within the standard stanine. He might have freckles on his cheeks, only the lord knows. His eyes seem aquiline of the grey spectrum and he does not speak. We in the youth identified him once in a hospital at the witching hour of two AM. The occult seem to be fixed on this number for reasons unknown to the faithful. Of all things to have, he has a small book, all in black with white pages, and he outstretches his hand and shows it to you as if you know what it is, but you don’t. Then you leave, and don’t look back.
Upon the squalls of impending death this author saw him again, some fifty years later, looking at him with the hospital staff and they did not seem to see him, and he showed us the book, again, as if we know what it means, but we don’t. The author lives to write this and has not seen this man again and he hopes he never does. This man does not evidence, hate, envy, lust, greed or otherwise, he just is and when he shows up it is important. He might be an Englishman or worse a Teutonic but at times they are all the same.
If you see this man, turn around and walk away if you can.

justice is a beautiful lady

she holds a scale

on the right in white is ethos

on the left is black and pathos

she speaks the law

sometimes in between

you want to approach

and touch her

but you know you should not

At eleven P.M the nursing night shift arrives.  The charge nurse enters through the main door and the four nurses sit in the nursing stations and discuss the seven patients in the ICU.  The charge nurse leaves and within the next fifteen minutes the night shift evaporates to a small kitchen at the front of the unit near the main door.  They lock the door and draw the shades.  The fluorescent tubes glow within and the smell of coffee permeates the ICU. Dr. W is alone, and on call as a surgical resident at the Amityville general hospital.  The clock shows 12 A.M. and the orders from Q are to cover the surgical floor, the obstetrics gynecology surgical unit and the pediatric oncology unit here.  No one is in the ICU except Dr. W.  The heart monitors display their green lines and a red light pulses with each heartbeat for each patient on the verge of life or death. The respirators puff at inspiration and gasp at the expiration as a filmy foggy mist exits the respirator regulators.  Q’s orders are to survey the patients and report any neurological disturbances that might herald death such as decerebrate posturing and agonal respiration through the thoracic muscles.  Normal breathing is diaphragmatic and using the accessory muscles of respiration signals anoxia and a consequent cardiac arrest.  Decerebrate posturing happens when the brain does not receive blood any more. Then the patient curls into themselves and dies. Alongside the most critical patients is a crash cart. The crash cart is a metal box full of syringes, needles of varying sizes and a myriad of heart drugs, mostly epinephrine. The lights are low and one fixture pulsates with a dying light Dr. W note this and will tell physical plant at first light.  Dr. W never really felt at home at the ICU because everything, all parameters are taken away and placed in God’s hands. During the day Dr. W would have to rush in and take an arterial blood gas of a respirator patient and bring it to the cigarette smoking technician locked within a little room down the hall with three machines and a coffee urn. He would take the blood, blow smoke at Dr. W, say thanks and then close the door.  The rest was in God’s hands.  Tonight, he is alone, as he is always alone and left with a thankless job.  Every man must know his limitations and the limitations are that this body requires much sleep that he has not gotten in six months. Dr. W is on call every third night and call begins at 11 P.M.  He must visit all units at least once during my shift and catch what sleep he can.  Dr. W never really sleeps because fate wakes him up before he enters REM sleep and he is never satisfied.  Most surgical patients require a sleeper medication and those pre-operation meds induce respiratory arrest as a side effect.   The anesthesiologists caution Dr. W before to be prejudicial and withhold medication. The patients moan and look at Dr. W with wide scared eyes and beg to be put to sleep.  Oxacepam does not work as the books state.  Dalmane is the only thing that works and 5 mg may not be enough and the patient begs for more; He signs a requisition and give five more.  The nurse administers it in his presence.  Dr. W leaves and tries to get more sleep. Dr. W is tired of smoking cigarettes and drinking coffee, especially at night because he becomes irritable and short tempered.  he exits to a call room, close the door, and barricade it with furniture so no one can enter silently.  Sleep is always short and a nurse bangs on the hardwood door until Dr. W emerges. Now is the second run through the hospital and he enters the ICU.  It must be two AM, and the lights are dim, and the respirators puff, the monitors skew and the red lights blink.  Sometimes he imagines a dying patient turns and smiles out of the corner of his eye.  He turns around and they are asleep once again.  The nurses lock themselves in the kitchen. Another patient seems to open their eyes and beckon to Dr. W, but when he turns around, they are asleep.  Once a human being is at deaths door, they ask everyone around them not to bring them back, and when there is an arrest, a surgeon moonlighting in the Emergency room appears and starts the procedures.  They inject epinephrine, calcium and more and use the shockers to start the heart beating again.  When the patient dies, they all seem to have a wan smile on their face because they know their will be no more, pain; anguish, despair, or disappointment and Dr. W says a prayer and wish them God speed. Nothing is going on in the ICU tonight.  Dr. W has not met God and he do es not want to.  The eerie glows and the shadows and the weird feeling He get at night here are an effect of hopelessness and finality.  Dr. W exits the unit through the front door and wait in the hall for someone else to come out or enter.  No one does.  He is told to use the stairway at night.   Entering the pediatric Oncology section Dr. W lingers as to make sure the poor children condemned to suffering are comfortable and not vomiting.  If they are, He is to contact the oncologist attending by hall phone and wait until they arrive. The kids are at rest and a single nurse sits in the station reading a book. She smiles at Dr. W; He waves and walk by.  Back to the surgical ward on floor three He looks for a bag of tea and put a traveler boiler probe in the cup with it.  A tall man with a small black book enters the unit. He is greater then six feet and wears an expensive suit.  He looks at the book, then at the room number and enters a suite. Dr. W follows him in.  He is sitting next to a surgical patient.  Dr. W Walk over and examine his badge that he wears on his left lapel.  Everything seems to be in order.  He is a bonafide licensed member of the hospital. He looks at Dr. W and gestures as he looks at my badge too.  I do not know what he does but the credentials are in order.  Rocking the boat will get Dr. W trashed. He leaves.  W enters his call room and barricade the door with furniture.  His watch says 3:30 A.M. He takes his pager and pulls the batteries out of it and set it on the bureau.   He hangs his smock on the door and crawl into a small bunk bed.  W pulls the covers over his head and says a prayer.  Now I lay me down to sleep……  Surgical rounds begin at seven A.M and W will be in surgery from eight A.M. to at least 2 P.M. non-stop.  He wonders if this is the life he really wants. Sleep overtakes him again.  As W drift off he imagines he hear a hand trying to open the handle on the door. Then W is asleep.  The ICU can wait for another day.