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.

The train to Pookipsie is a slow easy ride beginning in Grand Central station.  Underneath the huge coliseum of trains, the engine snakes and skittles across classic upstate countryside. Brownstones come into view and vanish and there is some green in-between the snowdrifts slowly melting in the end of a late winter and beginning of a beautiful spring blossom.  Somewhere near the classic town of Pookipsie, lies the biggest Psychiatric facility in the United States of America.  At least it was.   Now the Wracks hear the huge veterans’ facility near Pookipsie is closed down, shut up and the subterranean tunnels filled with snarling rodents and slithering serpents.  The classic tunnels were devised to connect the buildings for communication and transportation even during the heaviest winter storms. Now Dr. Wracks is here and the Head of Psychiatry at the Veterans administration welcomes us for a ten-week tour of duty at a Psychiatric facility lockup. The chief of the facility is a tall handsome man with silver hair.  His looks are marred by Popsicle sticks protruding from his nose splinting it securely.  Unfortunately, the chief had a mental lapse and got too close to a florid patient.  The patient was a black belt in Okinawa Karate and smashed his nose to pieces with a powerful back fist strike. He would make a good president.   The Popsicle sticks did not impair his diction as he welcomes us.   He says he will be in and out of his office during the week and that our liaison and mentor during our intern rotation will be Dr. Lecter M.D. 

     We meet Dr. Lecter at his office.  He sits in a space with a huge desk, a couch and a library of a thousand books.  The books are like a bullet proof barricade shielding him from the outside and reality.  He turns to us and passes out lecture notes.  He says these notes will help us identify neuroses and Psychoses before the behavior can affect us.  We are to memorize the notes because the knowledge might save our lives.   The Veterans facility is a Psychiatric lockup.   At the end of each hall is a huge oak door with a large deadbolt   the interns are to enter a corridor and close the deadbolt before proceeding further.  During the week huge wrestlers acting as Psychiatric aids will let us in and out of each level as we identify ourselves at the small window in the middle of the door.  It is our responsibility to make sure the door is locked behind us as we progress and transgress the environment that will soon be ours. Any failure to maintain security overtly will result in instant termination as some of the patients are violent with criminal records. The majority of patients are Veterans of foreign wars.  The minority are horrible curiosities too dangerous or too strange to be allowed to live in the community. Dr. Lecter is a man of average height like Dr. W.  He has long straight jet-black hair, like Dr. W.  He moves like he is levitated across the room.  He assures us that what we learn and see here will remain with us for the rest of our lives.  We are to eat with the patients because they have to see us to trust us.  Other wise there exists no reason why they shouldn’t attack us.   In the main cafeteria, we eat in the Doctors area, immediately next to the patient area.  We are to wear our white smocks everywhere as they identify us as professionals.  We are to shave or trim our beards neatly and keep our hair short.  There can not exist any interaction with the patients in public.  All communication must be in a public area or consult where the cameras can watch and alarm security if a patient becomes homicidal. Dr. Lecter assures the group he will be near should some excitement ensue. He introduces Dr. Beck.  Dr. Beck has black hair but is tall and lean.  He must be the protégé of Dr. Lecter.  Dr. Beck looks too serious to fool around with.  I note this instantly and file the anagram in the dominant temporal lobe.  Dr. Beck states that if we have any problems to come and see him during weekday hours. Now we will meet the staff.  Two huge psychiatric technicians patrol the unit.  The nurses sit in a guarded station with bulletproof glass and a ticket terminal to distribute psychiatric drugs to inmates.  Both aides are wrestlers but work only nine to five during the week.  On weekends the staff is skeletal and the interns must patrol the unit to insure all patients are present and that no one is hurt or killed by another patient.  During the day in the winter most patients sit in the recreation room and play ping pong, deal cards or watch TV.  Most of these people are normal looking except for a cross dresser who sits inordinately still and a huge African American football player who plays on a national championship team as a defensive lineman. Most of the patients turn to the interns and wave in validation.  They are used to being surveyed, assayed and evaluated for their behavior that really is not their fault. These people are casualties of society and their behavior is too violent or exaggerated for them to continue to lead functional lives in the community.  Some are Viet Nam veterans who have a disorder called traumatic stress syndrome.  The affected patients have flashbacks to situations the soldiers encountered in the jungles of Viet Nam.  Psychologically the reason for the traumatic syndrome is the psychoses induced by being forced to witness the killing and torturing of hundreds or thousands of civilians close at hand.  Some of these soldiers were forced to kill thousands of innocent people because they harbored the Viet Cong.  Some soldiers who served our country in Viet Nam could never readjust to civilian life because of what they witnessed or were forced to do.  The soldiers with traumatic stress syndrome come and go in this Veterans facility and it is their second home and the Nation pays for the burden of the horrible destruction of a thankless war.  The interns move on.  Soon lunch arrives and we head to the cafeteria.  The long hours of internship are broken by a meal. Army style the interns get in line with the patients and we are given a ration of provisions that will maintain our health.  A sandwich, potato chips, and some raw vegetables are it but we can get refills of orangeade or lemonade from the coolers.  Dr. W asks the distributor of food why we are given so little.  “So you do not get fat.” She speaks.  Dr. W grabs a sandwich and walks by.  We eat together, the eight of us and then move to our quarters to move in.  We each have a little nook with a bunk bed like the quarters on the “MASH” show on television.  Dr. W is expecting Hawkeye to appear out of nowhere and make him look ridiculous.  This never happens and Dr. W resigns himself to books, cigarettes, and packets of instant coffee to be used sparingly.  The facility sells cigarettes at the canteen for Armed services prices.  The quarter master says he will sell me several cartons at this price because he likes Dr. W.  He looks like Napolean Bonaparte on the “MASH” television show.

Dr. W does not react and accept the gift with humility and rancor.  Back in a pigeon hole, Dr. W lights up a Marlboro and begin to memorize the notes.

 He is up late and the niche fills with smoke and   he put out a butt and falls asleep by himself, waiting for reverie at 6 hundred hours military time tomorrow.