Dr. Galen's Little Black Bag: Stories. R.A. Comunale M.D. M.D.
again we cocooned ourselves in our rooms, hid out in library carrels, or found secret, unused niches in the education building to study like monks. Not even our friends could help us through this.
We had been warned that part one was written by Ph.D. types, so we had better know all our basic sciences. It has always been a running battle between the Ph.D.s in science and the M.D.s as to what really matters in a medical education. As students, we were caught in the middle of the academic fracas.
It took two days, and when it ended our fates were sealed. Those who passed would advance to year three. Those who did not either had to retake it or a state-sponsored, equivalent-competency test. Neither was a piece of cake. The prime advantage of passing the National Boards lay in one word: reciprocity. Those who successfully completed all three parts—the first now, the second at the end of year three, and the third during first-year post-graduate—would be granted a license to practice medicine in all but three states: Florida, California, and Hawaii.
The reason? Those three sunshine states did not want to be inundated by geezer physicians when they retired.
“Hey, City Boy, got your whites yet?”
Dave stood in the doorway of our apartment on Church Hill, looking like a thin line of whipped cream. He grinned at me. In one month we would be hitting the wards.
Soon our little black bags would be put to daily use.
I quickly changed into my outfit, and we laughed hysterically at our reflections in the full-length door mirror: tall and short, slim and stocky, Mutt and Jeff.
We changed back into civvies and ran down the stairs to Dave’s car. We were headed to his family’s farm near Lynchburg again for some well-earned rest and relaxation.
We would need it.
Year three would use live ammunition.
Lock and Load
Berto, do you really want to be like me?
I lay in the four-poster, twin-size bed, the overstuffed mattress probably not much younger than the handmade chestnut wood frame passed down through six generations in Dave’s family. The rustic sounds and scents easily penetrated the thin bedroom walls: crickets chirping, small nocturnal creatures rustling through piles of decaying leaves; the ch-hoot of the wood owl and the groaning yips of raccoons competing for food scraps tossed atop a nearby compost pile.
Even the early summer couldn’t ward off the natural night chill permeating the little farmhouse in the middle of nowhere. I settled the patchwork down quilt around my neck, turned on my side, and closed my eyes. It was so easy to fall asleep.
I dreamed that night.
I was once more a young boy named Berto. I strode through the alleys of my memory, seeing once more the friends who had shared my life: Angie, Tomas, Salvatore, and others. I ran through the tenement streets, legs pumping, short gasps of breath in anticipation of what I would see, what I would learn next at the storefront clinic run by my mentor, Dr. Corrado Agnelli.
Doors seemed to melt away. I entered the examining room. A man lay on a table. He was gaunt, wasted, the sheet covering his body missing the outline of one leg. I saw my friend, the one who had opened the door to my life’s work, lying there.
“Corrado, it’s me, Berto. What’s wrong?” I heard myself cry out.
The face staring up at me smiled wanly, and then tears flowed from the man I sought to emulate.
“I’m dying, Berto. I will die alone.”
He paused to catch a breath then stared into my soul.
“Berto, do you really want to be like me?”
I awoke screaming with Dave standing over me and shaking me.
Those three weeks between the end of sophomore year and the beginning of our clinical rotations as third-year students were painfully short.
Dave’s parents had accepted me as a second son, a brother to their only child.
They instructed me in the ways of farming and how plants and animals really lived.
Dave and his father, Big Dave, laughed at my awkward attempts to cut and split firewood. I nearly amputated my left foot and smashed my toe from clumsy swings of axe and hammer. His mother, Mary, showed me what fresh vegetables looked like and how to prepare them. To my amazement they were actually edible, not the gray mucilage I was accustomed to from my mother’s ethnic, iron-cauldron-cooked “everything soup.”
Dave and I walked and walked over rutted dirt roads, gazing at gentle-sloping hills dotted with tobacco patches and pastures of grazing cows. My skin easily burned in the full Virginia summer sun.
“Why do you want to leave here, Dave?”
We sat on mounds of hay grass, with large, dried tobacco leaves our only fans and protection against the midday gnats and blue-tail flies that populated the cow pastures.
A nearby black snake sunned itself, as Dave turned to me.
“Sometimes even paradise can be boring, City Boy.”
He looked down for a second then faced me once more.
“’Sides, I got Connie waitin’ fer me, and I betcha you ain’t stopped thinkin’ ’bout June.”
We walked past the now-abandoned tin shack where Aunt Hattie, the local conjer lady, had lived and died, and I felt once more the chill of my first and last encounter with the burnished ebony woman, when she had warned me about the Bone Man. We walked through cow-patty-filled fields and over rock-strewn woods. Dave easily stepped over the moss-hidden stones, while I tried my best to avoid tripping and breaking my neck.
I laugh now, as I remember how unsuccessful I was at avoiding cow pies.
Suddenly we came upon a clearing in the midst of Jackson oaks, persimmon trees, and scrub vegetation. The ground rose and fell in short mounds and depressions unlike anything I had seen before.
Dave stood there, head bowed, eyes closed, and I suddenly understood: It was a cemetery, his family’s final resting place. Six generations of pioneer farmers, each striving to earn a better life, had lived and died on that property. Someday Big Dave and Mary would lie there, too. Dave was the first in his family to achieve his level of education. He was also the last of his line—unless Connie would change that.
We walked and walked, and we shared each other’s demons. And then it was time to go.
Strange, as we left the little farmhouse to return to Richmond, Dave’s parents hugged me as they did their natural son. They were proud of us both.
The first morning back we dressed in our starched white pants and shirts. They felt stiff and rough, not like the synthetic-blend fabrics used today. We had received our list of clinical rotations in the campus mail. For the most part Dave and I shared the same, six-to-eight-week turns in the various medical and surgical services. Connie, Peggy, June, and Bill had also been matched with us.
It was only a short walk across the Marshall Street Viaduct from our apartment on Church Hill. It was 6:30 a.m., but the heat was already scorching by the time we neared the hospital. Cars honked at us and drivers waved. The locals knew we were the new medical kids, little black bags clutched in our hands, striding into our first day of ward duty.
“Galen, Nash, you’re with me.”
Our first boss was Joe Tremayne. As a first-year, post-graduate—we called them interns then—he was directly in charge of us newbies. It was not considered a fun job. Not only did he have to do his own work, he also had to diaper and change us during our first, critical rotation. Of course the resident over him felt the same way about interns. Tremayne himself was fresh out of school, full of book knowledge and undergraduate ward experience. But this was also his first day as a real doctor. And so it went up the pecking order, from first- to second- to third- and fourth-year students all the way to chief resident and attending physician.