Why Fat People Make the Best Editors (With Apologies to Erin Morgenstern)

~first posted 3 Mar 13

Now before you start, I’m not talking about nonfiction editors, okay? And not copy editors, either. So don’t send all those nasty emails. (Who am I kidding, right? You and I are the only ones who read this blog. And you never write. Why don’t you write?) When it comes to copy editors, especially, go ahead and hire the skinniest, bony nosed bespectacled one-eyed fella you can find; he’ll do a great job moving those commas inside the quotations, every time. Not like he’s going out clubbing this coming Saturday night, anyway. No, I’m talking about the kind of person that you entrust with your story. When it comes to your real, live story editor, go obese or take that manuscript home. Avoid asceticism; err on the side of jovial gluttony. Ascetics are mean. You want the editor that hands back your manuscript with “Cherry Garcia” stains all over it, saying “That was great, I just made a few suggestions…”Minolta DSC

We all know the drill. Any author who desires “acceptance” must submit to professional editorial oversight. You must! Even if you’re self-published (which we all lovingly refer to now as “indie”). Especially if you’re self-published indie. If you can at least say, with a straight face, “I spent my hard earned money, which I will never in a thousand years recoup from the sale of this dog, to hire a professional editor and I incorporated all her suggestions in this fine, final product. It is the minimal price of admission, though it still just gets you staring at the door, being held back by the big bouncer of anonymity, but you’re so much closer to really getting in (sticking with the clubbing metaphor here). And if you’re lucky enough to actually be under contract, you will submit to editorial oversight/improvement/mercantile optimization/product placement; whatever is asked of you. It’s in the contract, brother. Right there, and there, and again here on page nine hundred twenty-two. So if you have to submit, let it be to a comfortably endowed, built for comfort/not speed, kind of editor. I, for one, quake at sharp tongued criticism of every adjective or descriptive nuance as “not moving the plot forward.” I like the fat, I love the fat. Even when said fat drags the plot a little backwards like a reluctant rump. I write like I cook–with lard, not dried out and burnt to a crisp. I don’t “kill my darlings,” I love my occasional authorial shining nuggets. Everyone says to get rid of the little parts you really love; but I won’t do it. It’s what makes the writing fun. I love the slight poetic excess, the unique turn of phrase, the ironic juxtaposition–even when something much pithier will do. I hate pithy. Except Hemingway. I’m not Hemingway, and, now that I mention it, either is anyone else. And Hemingway was a very sad man.

Of course, this attitude is one of the many reasons that you haven’t bought my book. A true story: I almost had a real live, professional agent, almost. Maybe. She is one of the best in the business, and I was in earnest discussion with her about my new book. She was interested. She was impressed that a good friend in the business that she respected had read my manuscript and strongly recommended that she consider taking me on. We enjoyed repartee, verbal and electronic. This until the fateful day when, in the course of discussing the work, I mentioned that it was 185,000 words. Anguished wailing ensued. The budding courtship was pinched off–unless and until I got a professional editor to excise at least 60k of dead stuff. But, I insisted, there is no dead stuff, it’s all great, all vital tissue. It is a great read, don’t you think? I ask her. She really can’t say, since she admits at this point that she hasn’t had the opportunity to read the thing, or even have her unpaid intern read the thing, and now that she realizes how long it is, she’s sending it back, because it’s soooo long. Wait, I protest, how can you say it’s too long if you haven’t even read it? Because, she says, I can’t sell it at that length.

And that, dear reader, is how it works. Almost-agent of mine wasn’t being mean, or unartistic, or unappreciative of my hard work–she was stating a fact of life in the literary industrial complex. Why should she take this on if I’m not willing to do the work to make it into something that she can actually sell for me/us? Answer: She shouldn’t. And she didn’t. I decided that I would prefer the book I love to sell in the dozens (how prophetic of me, eh?) than to retire on the fat movie royalties guaranteed if I’d only just play the game. But wait, you say,  professional editors make books better. Yes and no. Any professional editor with sense would improve my book, but anyone getting paid to cut 30% off is mangling my masterpiece. I won’t have it, not to my child, no way. I love my ‘non plot-driving scenes,’ my lacy descriptive prose, my ‘realistic-to-the-point-of excess-verbosity’ dialogue. I will not have it sliced off down to the sinew, even if done by a master surgeon. No doubt, I would be forced to give up the little literary techniques that I think I invented, that I love to employ. Like, when I use the exact same line of dialogue twice, spoken by different characters but with a completely different meaning, to draw a meaningful connection between remote areas of the book. Who else does that, I ask you? And other, equally cool stuff. It’s why I write stories, not technical manuals about how to tear down and rebuild your Ducati.

A completely speculative example may be illustrative. I loved the book The Night Circus, by Erin Morgenstern. It was, in so many ways, fantastic. I must admit, however, that I read the final act with an aching heart. The depth of feeling in the writing seemed to grow shallower as I fought the crashing waves of the last third to the climatic shore of conclusion. Only my opinion, now, and please keep in mind that I truly love the book as a whole; it is one of my favorite books and I’ve been reading a good deal longer than Morgenstern has been alive, an amazing statistic. But I got the sense, and still have it on rereading, that somebody at Doubleday Publishing, Inc. lured her unsuspecting manuscript into one of their basement ‘repair’ chambers and, with Erin protesting loudly against her contractual restraints, the smoothly running but rather luxurious manuscript was put up on the rack and had a significant amount of ‘excessive oil’ and ‘overstuffed upholstery’ editorially removed. By professionals, of course, who hardly left a mark. But the result in the third and final act was a thinning of the magic that Morgenstern had deeply ladled into the previous two acts. (Note that I am employing ‘magic’ here to represent the magic of Erin’s writing, not her writing about magic, and that ‘thinning’ is here used in an alternate meaning that contrasts to the overweight metaphor that began this blog. Just riffing here, reader.)

I could well be wrong. I have never met Erin Morgenstern, heard her speak, or exchanged even the most cursory of missives. I’m sure she loves her editors and sends them quirky gifts at unexpected moments. It’s entirely possible that she may not have even had the most minute manicure of her glorious opus at their hands. This is complete speculative bullshit on my part, based upon what I think, having read her book and a bit of her other fine writing. She is an undeniable talent and, no doubt, will forever be a literary force to be reckoned with. I think, though, that she might have been editorially sandbagged on her first outing. No doubt, the movie rights will lead to a fantastically rich adaptation that will have painfully little in common with the best parts of her book, but hopefully will net her a huge amount on the back end for life. Congratulations and well deserved. For this next one, though Erin, get yourself a comfortably plump editor. You deserve it.

Inflammable Man

During the first year of my surgical residency, we were required to rotate through the Burn Unit.  The Burn Unit was an isolated six bed ICU with a twenty bed stepdown ward.  The unit had living quarters, and the burn resident was required to basically live in-hospital for the entire two month rotation.  Depending upon how early in the year you drew the rotation, the resident knew something between nothing and very little.  Nonetheless, the burn resident was the sole physician in charge of caring for the sickest patients in the hospital.  Thankfully, there was an expert crew of Filipino nurses who really ran the show.  It was a good thing, because the only attending supervision consisted of one of the staff plastic surgeons, Eli G*, weekly sticking his head into the airlock doors and calling out, “Everything going okay?”  The resident, overwhelmed with critically ill, septic, and dying patients would run to the door, yelling that “No, no everything was not okay, we need some help here, need to discuss operating on a couple of patients, Dr. G* “–to which G* would invariably turn a deaf ear and call over his shoulder as he strode purposefully away about the resident doing a great job and that he should feel free to call him if he was having any problems or needed any help with surgery.Dog Doctor253

I did the Burn Unit early in my first year, before doing any significant critical care rotations where I could have been taught something by a supervising Chief resident.  So I was basically completely incompetent to run the Burn ICU.   We had some great critical care nurses, but I had the misfortune of having a continuously full unit, with a bunch of big time, sick-as-shit “crispies.”   The patients would constantly die, but were immediately replaced by someone even toastier and sicker.  Most were alcoholics or addicts, homeless individuals who had managed to set themselves on fire in various ways.  It was late autumn, when every homeless Detroiter fired up their makeshift Sterno furnace, which usually promptly blew up or lit their Muscatel soaked clothing on fire.

A couple of weeks into the rotation, I was taking care of a fellow who had suffered thirty percent body surface area (BSA) burns when he fell asleep smoking and lit his mattress on fire.  Now this guy was relatively young, in his early thirties and, though an alcoholic, relatively healthy.  So I was kind of hoping I could get this guy out of my unit alive.  I was batting about .150 at the time.  Most of the patients, the ones with eighty percent BSA  burns or older than seventy years old with any significant burn at all, we were just kind of going through the motions because we knew they weren’t going to survive.  This guy, though, he came in with a survivable burn and talking, initially doing pretty well.  As usual, though, after a few days he started to go into DT’s (delirium tremens).  He became delirious, then septic, and finally ended up intubated on a ventilator.  We had had to sedate him due to the DT’s, and as he started to improve I stopped his sedation, but he didn’t wake up.  I waited a couple of days and finally called in neurology for a consultation.  I was still new and hadn’t had rule number four of the surgical residency program beaten into me–never, ever call a consult. So neurology, of course, orders an EEG to see if he’s still in there or if my expert care has already made the guy a vegetable.  About nine in the morning, after my initial ICU rounds, the tech comes in to  give the guy his EEG.  I’m around the corner in the stepdown unit when Filipino head nurse yells she needs “Geller Doctor STAT!”  I come flying back into the ICU to see the guy’s nurse doing chest compressions and yelling “V-tack,V-tack!” over and over again.  The EEG tech, who had just finished gluing about fifty electrodes to this guy’s head, decides he’s going to go on break now, maybe come back later.  You know, if the guy’s still alive and all.

Rule number three of the surgical residency was never, ever call a code.  The reason  for rule number three was the same as the reason for rule number four–the result would be a lot of crazy, dumb as a rock, medical residents gathering around your patient and ordering a lot of useless tests and medications that would inevitably kill off your patient.  Unfortunately, I was equally ignorant of rule number three.  So, upon seeing the nurse doing compressions and confirming that, yes, indeed, that was a pretty funky looking rhythm on the monitor, I picked up the phone and called a code.  “Bad, bad move, Geller doctor,” commented the head nurse when I hung up.  And she was right. Head Filipino nurse always right.

As I mentioned, the entire Burn Unit was an isolation ward.  It was entered solely through a double airlock door with all personnel being required to don isolation gowns, masks, booties, and hats prior to entering.  As the twenty man code team started to arrive, the head nurse stood just inside the airlock and insisted that everyone dress before entering.  This slowed things down considerably, and generally pissed off the medical residents anxious to save a life.  Meanwhile, I was in the process of trying to code my patient.  This one was supposed to live.  Now, even I knew the treatment of sudden ventricular tachycardia.  It’s  the application of a 700 joule jolt of electricity to the man’s chest.  So while the nurse continued CPR, I charged up the defibrillator to full power.  It may be worth noting that I had never done this before.  Actually, I had pretended to do it once on a mannequin.  So I was ready.  The first members of the code team, dressed in disposable paper bunny suits, started to arrive at the bedside as I applied the defibrillator paddles.  To her credit, the nurse momentarily paused in her chest compressions and indicated that this might not be a great idea.  I remember being somewhat annoyed by her lack of enthusiasm.  I was very excited to be defibrillating my first patient.

At this point, I must digress a bit to explain that, in order to perform an EEG, numerous electrodes are applied to the patient’s head.  By applied, I mean that they are glued to the scalp with a highly flammable compound called collodion.  While I was not familiar with the exact nature of collodion, I did like its smell.  Somewhat alcoholic in nature.  It’s rare that its flammability is much of an issue.

It is not difficult to properly apply a defibrillator.  It simply involves applying a special conducting paste to the paddles and then firmly pressing the paddles onto the patient’s chest.  The location for applying the paddles is conveniently pictured on the device itself.  It is traditional to loudly call out “Clear” just before pushing the little red button to deliver the jolt.  This gives the nurse the opportunity to move away from the patient so she does not also experience the 700 joule shock.  While I’m sure it was not a conscious decision, I elected not to bother with the conducting paste.  Like I said, first time was a manequin, no problem.

I yelled “Clear” as the the nurse yelled something about paste.  There was a flash, immediately followed by a strong burning smell.  The smell originated from two sources.  Initially, it was from the electrical burn I had caused my patient by not applying the paste.  This did not trouble me greatly, as I was a specialist in treating burns.  In addition, I was very pleased to note on the patient’s monitor that my jolt had been effective in converting his heart rhythm back to normal.  However, the nurse at this point indicated that I should perhaps take note of the patient’s head, which was now engulfed in flames.  It seems that the improperly applied paddles had arced, causing the collodion to catch fire.  I believe that Jeri-Curl, an alcohol based hair product popular amongst my patients at the time, may also have contributed.  In any event, as additional members of the code team joined the bedside, we all watched incredulously as the fire rapidly spread to the patient’s pillow and bedsheets.  It then spread to the tubing carrying pure oxygen to the patient’s ventilator.  This melted and began to shoot fire, flamethrower fashion, about the room.

The senior medical resident, a usually reserved Indian gentleman in his thirties, was the first to give voice to our general concern.  “Everybody out,” he screamed in accented English, “It is going to blow!”  Now, at this moment about half of the code team had made it past the head nurse and the double automatic airlock doors, dressed in highly flammable paper bunny suits, paper booties, paper hats, and paper masks.   These individuals, sensing the significant possibility of becoming one of my patients, turned and ran.  The remaining half, however, still oblivious to events unfolding within, continued enthusiastically to join our lifesaving efforts at the bedside.  The problem with automatic double airlock doors is that they only swing one way and rather slowly, at that.  Panic rapidly ensued.

It was at this point that a nurse kindly pointed out that perhaps I should do something, doctor-fashion, to address the rapidly progressing cataclysm.  I agreed enthusiastically, but was sadly at a loss.  As usual, the head nurse had already sprung into action.   Though somewhat trampled by the stampeding physicians still recreating a Keystone Kops routine at the airlock, she rapidly moved to the oxygen cutoff valve on the wall, disarming the torchlike ventilator.  Prior to that moment, I was quite unaware that such a valve existed.  It was, in retrospect, spectacularly convenient to have such a device.  Having extinguished the oxygen hose, she proceeded to soak a blanket in the bedside sink and throw it over the patient and myself, extinguishing the flames.  The patient woke up, ripped the tube from his airway, and began screaming and cursing out everyone in the room.

The patient survived.  He was discharged from Our Medical Center six weeks later.  His discharge diagnosis was “Second and Third Degree Burns, 48% BSA”  Hardly anyone noticed that his admitting diagnosis was “Second and Third Degree Burns, 30% BSA”.

Setting

~first posted 17 Nov 12

Most of the time I’m not entirely sure where I am. I mean, who really is, most of the time? It’s hard enough just to keep track of what I’m doing and why. Usually, even the why is pretty murky. But the where is just kind of taken for granted. I can’t tell you how many times I’ll pull into my driveway and look up in shock at my house, wondering how in hell I got here. And wondering if I stopped at any of the traffic lights between where I was and where I am now.

Is this a problem? Not really. How often does what I’m doing depend on where I’m doing it? Not very often. Oh, occasionally I’ll find myself at the top of a windswept mountain or completely lost in the woods, but not very often. Usually, my surroundings are pretty pedestrian. The house is unremarkable, unless I step barefoot in a puddle of dog vomit. Suddenly, my setting becomes important. My environment has just started to drive my action. Before I stepped in the dog vomit, I was planning on sitting down in front of Meet the Press with a cup of black coffee and a copy of the NY Times. Now, events are dictated differently. Shouldn’t have given Bob Barker all that left over pizza. Remorse. Concern. The pressure-packed search for a roll of paper towels.

Sorry, Dad.  Bad anchovy.

Sorry, Dad. Bad anchovy.

Usually, though, you don’t want to know much about where I’m sitting. You want to know what I’m doing. Perhaps, you’re interested in how I’m feeling, or why I’m doing what I’m doing or why I”m feeling the way I’m feeling. Do you care about the color of the sunset outside my window? Does the hue of my Hawaiian shirt affect your understanding of my mood? I think not. And all the time I spend in deeply nuanced description of setting, ambiance, or weather; whether poetic or pedestrian, is time spent sifting through detritus in an effort to get back to what’s important.

Let me paint the walls if I wish. Most of the time, I’m not even sure there are walls. Roof stays up anyway.

Structure

~first posted 25 Nov 12

I just finished reading Cloud Atlas a couple of months ago. I’ve recently published my own first novel, and–no surprise–I think it’s great. Actually, for a little while there, I suspected that I may have written the best novel, ever. (I have subsequently learned that every single new writer feels exactly the same way. This was disappointing. We can’t all beIMG_0063 right.) I decided to read Cloud Atlas because I heard it was a truly great novel. It was certified great by winning the Man Booker Prize. I’m impressed by this, but only because I think that the name of the prize is so much more impressive than the relatively mundane sounding National Book Award. (Note to anyone thinking of nominating my book for the NBA–I would not be adverse just because I think they can come up with a sexier name for the award.) Also, I began to see trailers for the film adaptation starring Tom Hanks. This also fits my definition of greatness for a book–the honor of being adapted (at great personal profit to the author, no doubt) into a film starring Tom Hanks. So, I was impressed that Cloud Atlas was a truly great novel. I wanted to see if my book was in the same league.

I think Cloud Atlas is a great book. I enjoyed it. It is not the best book ever, in my opinion. In case you haven’t read it (it is my impression that a lot of people haven’t read it), the book has a unique structure. Every review, and there have been quite a few, focuses on the structure of the book. Basically, the book is divided into six separate journals spanning a period from the nineteenth century to the post apocalyptic future. The journals are split in half, however. Each journal ends abruptly in mid-story. The next journal takes up with new characters in a subsequent time period, with a few fairly thin hooks implying that the subsequent journal is meaningfully connected to the one you just left. (I’m sorry, but having two characters in different time periods sporting similar birth marks doesn’t impress me as a deeply meaningful insight into the timeless nature of the universe.) After the middle journal, the book takes up the second half of each journal in sequence. You can’t argue that this isn’t a unique structure for a novel. Very unique.

Unfortunately, I found that this very unique structure actually detracted from what otherwise was an exceptional book. Mitchell masterfully employs various dialects in each of the stories, going so far as to invent a future pidgen English that is fascinating in its own right. But the fragmented nature of the narrative compromises every other aspect of the novel. It negatively impacts character development, narrative arc, and especially the tension that creates interest for the reader. Worst of all, the structure is so artificial that it becomes a distraction, a too-obvious and opaque window through which the reader is forced to observe the story. The reader is required to recall details from earlier journals, easily confusing aspects of each journal. It bothered me.

I have had similar experiences with the occasional book that can’t settle on a point of view. The book starts in first person, but suddenly shifts to the third person. Then we’re back in the head of the protagonist. I get it, first person is tough to write in. I’ve tried it, and failed. The author is severely limited. So if that structure is not going to serve your narrative needs, don’t go there. Personally, I find the switching point of view wrenching and distracting.

As a reader, I want the structure of the book to serve my needs, to disappear as I get involved in the story. I don’t want to see the author’s devices, even if they are unique and masterful. Let me get lost in the story, which I can’t do if I’m constantly being reminded of how hard the writer is working. Structure needs to serve story, not the other way around. Unless you’re trying to win a really cool award.

“Overcourteous Assholes” Like Me

~first posted 12 Feb 13

You may have heard that we had a bit of snow recently here on the Eastern seaboard. IMG_0324Where I live, on the north shore of Long Island, our little New England hamlet got thirty inches of the stuff, with fifty mile per hour winds raising drifts over six feet. If snow can be biblical, this was getting close, at least for those of us who don’t live in North Dakota. We were literally “snowed in” by drifts halfway up the doors and windows. So you can surmise how happy and thrilled we all were to finally be plowed out at the wee hours of this morning. Free at last! None too soon, either, as I’ve had to remove all the knives from the kitchen and throw them out a second story window–the wife and I were getting a little “stir crazy.”

Today is a beautiful, blue sky day in the mid-forties, with bright sunshine sparkling off the still pristine whiteness blanketing everything. You’d think that everyone would be kind, and happy, and pleasant, just thrilled to be alive. You’d be wrong.

So, just now I was driving merrily along our recently plowed streets, doing one of the many things I couldn’t do because I was “snowed in.” The roads are still very narrow, with huge banks of snow on each side. We’re all driving around at about thirty miles per hour, even on the main streets. So there I was, approaching an intersection with a red light, several cars already stopped to wait for the signal. I notice a car inching out of a side street just ahead, trying to see around the huge drift. Being the guy I am (we’ll get to that), I stop and wave him in. As he waves back and moves in, the guy in the car behind me leans on his horn. Really. Not a toot. A real extended blare. Twice.

Now, I know that this has happened to you. It has happened to me lots of times, not to mention all those times the jerk in the Mustang behind you honks if you don’t jackrabbit off the line within 3 milliseconds of the light turning green. When I was (much) younger, and in a time when not everyone was packing a pistol in their glove compartment, I remember responding once by sticking the car into park and walking back to the asshole. When I knocked on the window and he rolled it down, I asked if I knew him. No, he stammered, and started swearing. Well, I said, I’m sorry, but when he honked I looked in the mirror and he looked kinda familiar and I figured he honked because he was Billy who I hadn’t seen in, oh, must be almost six years now, but you’re right, you’re not Billy, really don’t look much like him at all now that I can see you up close, so I’ll just be going then. I got back in my car and timed it just right so the light was yellow again, allowing me to give the guy one of those “ain’t life funny” shrugs that I like to give guys like that as we sit through another cycle of life/traffic light together. Try that now and the dude will shoot you in the eye.

On this occasion, we’re sitting in a line of stopped cars waiting for a red light. On what basis does one deserve a honk for that? But I’m in luck, as the light cycles but Mr. Honker and I don’t make it through, ending up side by side. I couldn’t resist (again, don’t try this if you live in Arizona), so I rolled down my window. I was genuinely curious to learn why the guy had honked at me. He was pretty old, very late sixties or early seventies, and looked to be a reasonably pleasant person on the surface. Maybe he was rushing because his great-great grand daughter was in labor and he was afraid that I would make him miss the delivery. I didn’t know. Never going to know, either.

Elderly Mr. Honknose rolls down his passenger window and turns beet-red, yelling that “It’s over-courteous assholes like you (meaning me) that are going to get me (meaning him) killed.” He embellishes this with the standard set of NY resident traffic epithets that one must memorize to pass the driver’s license exam in this state. Then the light changes and he spews snow/ice/salt/phlegm onto nearby pedestrians by flooring it and roaring through the intersection. Never got a word in.

I was offended. I think that I’m a good driver. I know that this is subjective, and others describe my driving differently. My wife, for instance. She describes my driving style as “old womanly.” Please note that my wife is devoutly opposed to any use of the brake for any reason and at any time. I describe her style of driving as “bat out of Hell.” Today, however, marks the first occasion when I have been called an “overcourteous asshole.” I have marked the calendar. I wish to formally announce that I am licensing for my own use the phrase “overcourteous asshole” and even the word “overcourteous,” now and forever. I will be releasing a line of hats, shirts, and bumper stickers featuring such catchy phrases as “Warning: Overcourteous Asshole at the Wheel” and “I Brake for Overcourteous Assholes!” As for the old geezer who actually came up with the phrase, he can suck wind. He’s not overcourteous.

Wiser

Quote

“Girl, you are wiser than your years.”

“Actually, Randall, I’m just older than I look.”

                                                       God Bless the Dead

                                                         Evan Geller

Character

Bulldog~first posted 15 Nov 12

I’m pretty old, and as a consequence I’ve met a fair number of people over the years. This is not to say that I’m sociable–absolutely not. I’m the guy at the party that appears to be reading the label on the bottle of wine he just polished off for an inexplicably long time. On the rare occasion some interesting party-goer would approach me to engage in wine related party conversation, I’d immediately panic and admit that I know nothing about wine. And then excuse myself to find the bathroom. That kind of sociable. But I’m married, with many children. Inevitably, one finds oneself socially interacting with one’s spouse, one’s spouse’s friends, the parents of one’s children’s friends, teachers of one’s children, and occasionally one’s children. Can’t be helped. In addition, I work as a surgeon. This employment involves a great deal of socializing. I’m constantly encountering patients, fellow health care professionals, the occasional malpractice attorney. Not all of them are under general anesthesia, a fact that is horribly depressing in the case of the lawyers.

As a consequence, I’ve met some people. Some are “real characters,” if you know what I mean. Just this morning, in fact. It was 4 am, and I was seeing a young woman in consult in the ER. I didn’t want to, I was writing at the time and experiencing a pretty good flow but, unfortunately, on occasion a person will die if I don’t actually answer my page and go into the hospital, so I’ve pretty much decided that the surgery thing takes precedence. So I hauled myself in to see this thirty-something nice lady suffering from a gallbladder attack (teaching moment: we in medicine call this “acute cholecystitis”–feel free to use this as a conversation starter at your next cocktail party, just not with me). She was with her mother and younger (twenty-something) sister. At 4 am, this is either a sign of an intensely loving nuclear family or evidence that they are homeless (so soon after hurricane Sandy, homeless is not out of the question). After explaining that the woman will need surgery, I ask if they have any questions. The patient does not. Mom looks at me with great intensity and asks, “Are you gonna take care of my girl?” “Yes, I am,” I assure her. “You gonna take GOOD care of her?” “I sure am,” I say, smiling reassuringly. “Cause if you don’t,” the woman continues, “I’m going to come and find you.” She wagged her finger at me. “Oh,” I said.

Now, I’ve been threatened on numerous occasions. On two occasions, the threatening was being done by an individual with a knife. Not my wife, though. I’ve been threatened by patients before, plenty of times. One was a NY Supreme Court Justice, who said to me just as he was being rolled into the OR, “You fuck this up and it will be the last thing you fuck up for the rest of your life.” I wasn’t sure what he meant by this, and I pointed out that, actually, if I fuck this up, it will be the last thing I fuck up for the rest of your life. Unfortunately, Supreme Court justices seem to have no sense of humor. One patient was an organized crime boss (I practice on Long Island), and his threat was much more convincing, believe me. Usually, when faced by this sort of talk, I just ignore it or nod appreciatively. But it was 4 am and, like I said, I’m old now and I handle sleeplessness poorly. So without really thinking, I said to the mother, “Little bit of advice. Never a good idea to threaten your child’s surgeon. Just saying.” And then I left to do my charting. From outside the room, I hear the twenty-something sister say in Long Island/Jersey Shore falsetto, “OMG, I am SOOOO embarrassed! Did you just you hear what he said? You threatened him! He is, like, going to so hate you!”

No, I don’t hate her. I love characters. Maybe I’ll just put her in my next book.