The Yale Journal for Humanities in Medicine

House Calls

Douglas Krohn
dougkrohn@optonline.net

     In a meager studio, four enervating flights of stairs above a side street near the East River, a young internist named Blinderman lived among the medical books stacked along its walls and the futon that collected dust on the floor.  His apartment mate was a refrigerator, empty but for several jars of condiments, and when he was lonely he punched a heavy bag that hung from his ceiling.  Blinderman considered himself a throwback to more genuine times, so much that when he completed his residency with no job prospects, he decided to take an advertisement in the Spirit and set about the business of a solo medical practice that made only house calls.  His schoolteacher-father, also one for nostalgia, convinced him of the dignity of getting paid in cash and tomatoes.

     The summer passed and, with the exception of some troubling calls from men who thought him a professional escort, the phone never rang.  Blinderman’s hands hurt him, so frequently were they pounding the heavy bag.  He stared at the black leather medical bag in the corner, a graduation gift from his father.  It was stiff and unworn, its architecture like that of a country barn with two hard black handles at its top, secured at its mouth by a golden metal clasp.  Inside the bag his father had put a new Littmann stethoscope and the detritus of a bygone internist’s trade: a sphygmomanometer, a tuning fork and a reflex hammer.  Blinderman opened the bag and emptied its contents.  He hit the tuning fork against the palm of his left hand, and its soothing hum nearly obscured the sound of his ringing telephone.

     Blinderman answered the phone with guarded optimism.  The voice on the other end of the line was familiar, like it belonged to an estranged uncle.

     “Yes, hello.  I’m looking for Doctor Blinderman.”

     “This is he.”

     “Oh, thank goodness you’re in, Doctor!  You have no idea what I’ve been through.”

     Blinderman felt his heart race.

     “How can I help you?”

     “God bless you, Doctor, you’ve already helped me.  It helps just to know that there’s somebody out there listening.”

     The voice at the end of the line was sturdy, and, with its tinge of good-natured aggression, comforting: Blinderman wanted his maiden house visit to be uneventful, and a hearty voice reassured him.  But there was something unsettling, too, in the man’s forward address, as well as the sounds behind his voice.  Blinderman thought he heard resonant pings, sliding doors, and the echo of names ringing from a loudspeaker.

     “Where are you calling from?” asked Blinderman.

     “The emergency room at Lenox Hill.  And let me tell you something, Doctor: They need more help here than I do!”

     Blinderman felt his heart sink, as it had with so many of the calls that had come before.

     “I’m sorry, sir, but I can’t visit you in an emergency room.  It’s staffed with its own doctors.”

     “’Sir?’  My father they call ‘sir.’  Me they call Manny.  Last name Shapiro.”

     “I’m sorry, Mr. Shapiro, but I’m not welcome in someone else’s emergency room.  I don’t even have hospital privileges at Lenox Hill.”

     “So who says you have to see me in an emergency room?  I been stuck in this one three hours and the doctors who work here won’t even see me.  Can you maybe meet me at my apartment in a few minutes?"

     “Mr. Shapiro, you haven’t even told me what’s wrong.  I don’t want you walking out of a hospital if you’re not well.”

     “What’s wrong is I could die in this waiting room right now and no one would notice for three hours, that’s what’s wrong.  So how’s about it, Doctor?  Will you make me a house visit, or you going to let God-knows-what happen to me?”

     Blinderman sighed under the weight of his own sense of obligation.  It was curious, he thought, that he was motivated by guilt even more than money.  In any event, he needed to get his practice off the ground, and he hurriedly scribbled Shapiro’s address onto his notepad.  Blinderman was so excited he hung up the phone before he realized he had forgotten to discuss his fee.

     When Blinderman arrived at the lobby of Shapiro’s apartment building, he was soothed by the marble floors and muted sconces.  A few more clients like this, he thought, and I’m on my way.  The concierge at the front desk greeted Blinderman kindly, offering the respect accorded a young man who arrives with an important black bag.  Blinderman announced, “I’m here for Mr. Shapiro in 8-F,” and the concierge’s smile disappeared.  Blinderman felt the man’s eyes survey him, full of suspicion, and he was directed to the elevator with a cool shrug.

     The door to the apartment opened so soon after he pressed the door buzzer that Blinderman wondered if Shapiro had been crouching behind it, peering through the keyhole in anticipation of his arrival.  Blinderman still felt the breeze of the swinging door when the short man who opened it announced, “Doctor, how are you!”  Shapiro’s dark eyes, nervous and darting, set in a head of salt and pepper, peered up at Blinderman.  The pleasure with which he greeted Blinderman lay in contrast with the concern in his brow and soft pout in his lips.

     “Come in, Doctor, please, come in.”

     Blinderman seated himself on a couch in the living room, taking note of how well his patient appeared.  Shapiro’s shirt was ironed smoothly.  There were potted African violets by the window sill.  Shapiro seated himself on the couch next to Blinderman, smiling faintly, hanging on the words he waited Blinderman to initiate.  After a few moments of silence and gawking, Blinderman broke down.

     “So, Mr. Shapiro – what can I do for you?”

     “I don’t know if there’s anything you could do for me.  I think I might be short of breath.  I feel like there might be something in my chest – like a beating or something.”

     Blinderman suppressed his smile.  He had heard all he needed to hear, seen all he needed to see.  But he wanted to give Shapiro his money’s worth, and so he continued on with his questioning.  He asked his patient how long he had been suffering these symptoms.

     “How long?” asked the older man.  “That’s a good question, how long.  How about a hundred years?  I’ve felt this way a hundred years.”

     “I see,” said Blinderman.  “So you’ve had this for just a little longer than you were waiting in that emergency room.”

     Shapiro laughed like he was clearing his throat.  “That’s a good one, Doctor.  It’s true what they say – laughter is the best medicine.”  Shapiro gazed at his young doctor as if he were seeing in him the joy of his own youth.  He was pleased by Blinderman’s nose, blunt and flattened at its end, and his unwrinkled skin, belied by the gray that flecked his temples.  Shapiro sighed and felt the process of healing take hold.

     Blinderman, meanwhile, fumbled through his black bag.  Searching blindly for his stethoscope and blood pressure cuff, he removed his reflex hammer – a red rubber mallet on a bi-concave blade – and his tuning fork, a silver Y of humming metal.  Shapiro’s brow unfurrowed in anticipation of all this attention.

     “Ooh, Doctor, you got some big doings in that there bag of yours.  You think I’m going to be okay?”

     Applying his stethoscope to Shapiro’s chest, Blinderman put a finger to his lips, and his patient cheerily agreed to keep quiet.  There was, indeed, a beating in Shapiro’s chest – a happy, healthy heart pounding with excitement.  His lungs were like blue skies, his every pulse a wellspring.

     “Well, Mr. Shapiro, I can’t find anything wrong, except perhaps a little case of nerves.”

     Shapiro rose suddenly to his feet and clasped his hands before his chest, a muffled clap expressing his gratitude.  “This is a cause for celebration, Doctor.  I made a chicken soup this morning.  I’ll heat you up a bowl right now."

     “I already ate,” Blinderman lied.

     “I put in a kreplach for you.  Don’t you worry, you just look at it you’ll find your appetite.”

     “Thank you, Mr. Shapiro, but I really have to get going.”

     Shapiro furrowed his brow, pouted his lips.  “I understand, Doctor.  You a busy man I’m sure, running around half the city all day taking care of meshugges like me.”

     Blinderman looked at himself in a mirror on the wall.

     “I regret doing this at late notice, Mr. Shapiro, but there’s one thing I failed to discuss with you.”

     “What’s that, boychik?”

     Blinderman was startled by this address, one his own grandfather had used with affection.  Shapiro had grown too familiar for Blinderman’s taste.  He rose from the sofa and gave his black bag an authoritative clasp.

     Shapiro quickly realized his misstep.  “I’m sorry – Doctor.  You have to forgive me, but you’re such a nice young man, it’s almost like you’re family to me.”

     Blinderman steered clear of this avenue.  “The fee for my service is one hundred dollars.”

     “Ooh, now I know why you work so hard to be a doctor.  I’m sorry, Doctor, but I don’t have that kind of money.”

     Blinderman eyed the Baccarat vase on the coffee table.

     “A gift from my mother,” Shapiro said.  “An heirloom.”

     Blinderman was not prepared to play collector.  “Then what can you afford?”

     “Right now I’m strapped for cash.  Hardly a penny to my name.  But you send me a bill and I pay you back, I promise.”  Shapiro motioned Blinderman not to go anywhere and disappeared into his kitchen.  He re-emerged with a big plastic keg of beer pretzels.  “In the meantime, Doctor, you take this as temporary payment.  You go home and enjoy them with your family.”

     Disappointed in his first house call, but nevertheless happy to leave Shapiro’s apartment intact, Blinderman accepted the container of pretzels in near disbelief and went home to sit in the company of his refrigerator.  He opened the refrigerator door hopefully, but no new produce had magically appeared.  He took out a jar of deli mustard and spread it on the pretzels, which he ate as his dinner.

     The weeks passed into autumn and the telephone almost never rang.  Once Blinderman was called to remove a pebble from a child’s nose, but his forceps could not grasp the rock and he had to send the child to the emergency room.  All of his appetites went unsatisfied: his refrigerator was empty, his daily schedule unfilled, and the only woman he saw was a framed picture of his mother atop a night stand.  One night these hungers grew to a terrible intensity inside of him, and Blinderman pounded his heavy bag until not even his thoughts could keep him awake, and he fell into a deep sleep.

     The telephone, however, disturbed Blinderman from his rest at two o’clock in the morning.  Blinderman put the telephone speaker to his ear and, unable to hear anything, turned clumsily the handle so that he pressed his head against the receiver and mumbled something into the phone.

     “Doctor, I hope I didn’t wake you.  This is Manny speaking.”

     Blinderman tried to think, but couldn’t.  He squinted his eyes and concentrated deeply, but all he saw was streaks of light and formless shapes.

     “I’m sorry – I don’t know anyone named Manny.”

     “Sure you do, Doctor – Manny Shapiro.  You practically saved my life when I had that beating in my chest.”

     Blinderman concentrated again, and then remembered the container of pretzels which, empty, he had just thrown out that week.

     “Yes, Mr. Shapiro, I remember.  Is there a problem?”

     “When isn’t there a problem?  This time the beating is back, but now it’s worse.  Like a palpitation.”

     “Then I think you should go directly to an emergency room, Mr. Shapiro.”

     “And do what?  Die like a dog in a waiting room?  I need you, Doctor Blinderman.  Don’t you do house calls no more?”

     “Can’t this wait until the morning, Mr. Shapiro?”

     “How should I know?  You’re the doctor.”

     Obligation hung over Blinderman like a dark cloud.  Also guilt, and, for good measure, uncertainty.  Blinderman exhaled slowly.

     “Okay, Mr. Shapiro.  I’ll be right over.”

     “Oh, bless you, Doctor!  You can never know the good you do.”

     Blinderman’s joints were still stiff when he descended the four flights of stairs from his apartment.  He shivered when he stepped into early morning autumn, black bag in hand.  With uncharacteristic indulgence, he hailed a taxi to Shapiro’s apartment.

     When he arrived, the same concierge from the last visit stood behind the front desk.  This time he paid no respect to the black bag or the man carrying it, and, because of the unusual hour, gave his watch a dubious glance.  Severely, the concierge told Blinderman, “You can go on up to 8-F.”  This time Shapiro was waiting in his open doorway, neatly dressed in pajamas and a crisp robe, slippers on his feet.

     “Doctor, thank God you made it.  You’re a lifesaver.”

     “How are you feeling?” Blinderman asked as he brushed past his patient and made his way directly to the sofa.  Shapiro followed him excitedly.

     “A little better.  But still, I’m glad you stopped by, just to be safe.”

     These last words gave Blinderman pause.  He unclasped the black bag and went about his routine.  He put his fingers to Shapiro’s wrist and found his pulse calm, predictable.  His skin was warm, not cool or clammy.  In his chest he heard only necessary beats and the soft exchange of air.

     “What did you have before you went to bed?” Blinderman asked.

     “A glass of tea maybe.  Why?”

     “Don’t have tea before you go to bed anymore.  The caffeine makes your heart race, and it’ll keep you awake besides.”

     “That’s exactly my problem, Doctor – my heart is racing and I’m awake when I should be sleeping.  Who knew a glass of tea could do all this?  Coffee, certainly.  But tea?  Never.”

     “Well now you know.”

     “And I feel better just knowing, Doctor.  How can I ever repay you?  You maybe want to stay for breakfast?”

     “I’m sorry, but I’d really like to get back home.  My fee, Mr. Shapiro, would be payment enough.”

     Shapiro knitted his brow, and concern suffused his chest.

     “We got a problem then, Doctor.  I don’t have any cash on me now, and no checks neither.”

     Blinderman was cranky from a half-night’s sleep.  “Enough is enough, Shapiro.  You still haven’t paid me for the last visit.”

     “You tell me, Doctor: where am I to get money at this time of night?”

     “A bank machine.”

     “And what, get mugged on the street in the dead of night?”

     “Listen, Shapiro, maybe you should have thought about this before you pulled me out of bed with your bogus complaints.”

     “You’re mad at me, Doctor, and I understand.  But let me make it up to you.”  Shapiro rushed off into his bedroom and soon came out with a video cassette in his hand.  “Send me a bill for both visits and I’ll pay you back, I promise.  In the meantime, please accept this gift from me, for your pleasure.”

     Blinderman had to remind himself that he was a doctor, and that he could not strike another man.  Seeing red, he swiped the video from Shapiro’s hand. On the slow walk home from Shapiro’s apartment, Blinderman pondered intensely his own character, and he was very critical.  He was a man of lofty ideals and old-school chivalry, he concluded, but there was no courage in his convictions.  Not once but twice, now, he had left his patient’s home empty-handed but for a second-hand gift and a share of disbelief.

     He was tired when he got home, too tired to hit the heavy bag, but the rising sun kept him from falling asleep.  Unable to read, he put Shapiro’s video into the player and watched the movie.  Unlike his own life, the movie was full of women – more than he knew what to do with, in fact, and performing feats he longed for but could only dream about.  It was a pleasant departure from the Civil War documentary that he usually viewed.  Blushing, Blinderman turned the picture of his mother on the night stand face down and watched the movie (volume mute, so he wouldn’t disturb the neighbors) until, at last, he fell asleep.

     When the trees at last went bare and the sky, bitter cold, turned gray, Blinderman thought about abandoning his pipe dream and joining a more traditional practice.  He had not made a house call in weeks, with the exception of an office Christmas party he was called to when a festive drunk hit his head; sadly, it was the only party invitation he received all season.  He would have enjoyed this Sunday morning eating bagels and appetizing, his hands smudged with the newsprint of the sports section, but instead he read through the Times classifieds.  His belly rumbled, and nearly obscured the ringing of his telephone.

     A weak voice spoke on the other end of the line, thready and swept away by its own breath.  It inhaled deeply and with great effort, as if speaking the next sentence required the effort to push a boulder up a hill.  Blinderman had to cover his other ear to hear the voice through the receiver.

     “Hello, Doctor?” asked the voice.

     The voice was the skeleton of something familiar to Blinderman, but he struggled in identifying it.

     “Shapiro, is that you?”

     “I feel like I’m a boy who cried wolf.  You going to believe me this time, Doctor?”

     Blinderman had never heard the voice so frail, and he began to button his coat.

     “Of course I’m going to believe you, Mr. Shapiro.  Please tell me what’s wrong.”

     “I’m not doing so good, Doctor.  I’m very weak, and I think I maybe might have passed out.”

     “You stay put, Mr. Shapiro,” the Doctor ordered.  “I’ll be right over.”

     The cold air stung Blinderman’s chest as he ran to Shapiro’s apartment.  He arrived nearly breathless, but did not bother to stop at the concierge’s desk and subject himself to his disapproving glances.  He blew through the lobby, directly to the stairwell, and bounded his way to the eighth floor.  He came upon the door to apartment 8-F, cracked open slightly, and gave it a hesitant rap.  Shapiro’s voice, slightly stronger than it had been on the phone, told Blinderman to enter.

     Blinderman did, and he was surprised to find Shapiro standing behind a long buffet, clean-shaven in a cardigan and tie.  The table was like a Jewish bounty: a basket filled with bagels, already sliced.  Tubs of cream cheese.  Bowls of whitefish salad.  Plates of peppered bluefish.  Sliced Nova.  Blinderman was stunned.

     “Shapiro, what is all this?”

     “I made us a lunch.  I’m feeling better, thank God.”

     Again, Blinderman had to remind himself he was a doctor.

     “You just called me up, Shapiro, sounding like death warmed over, and told me you weren’t doing so good!”

     “And I wasn’t.  What can I tell you – I hear your voice and I start to feel better.  You should be proud.”

     “I’m not proud, Shapiro.  I feel like a fool – a stupid fool who is constantly falling for your twisted perversions.”

     Shapiro was insulted: “You watch what you say, you.”

     “You have some nerve, Shapiro, telling me to watch what I say.  This is the end of the line!  So please, I’d like to collect my fee for this unnecessary visit and then be on my way!”

     “But I don’t – “

     “And don’t tell me that you don’t have the money, Shapiro – not with your crystal vase and your doorman building and your marble lobby.”

     “Fine,” said Shapiro.  His knobby finger warned Blinderman to keep his distance, and his other hand reached deep into the front pocket of his pants.  Shapiro pulled out of his pocket a money clip, a thick sterling silver clip, monogrammed and polished.  The clip was stretched to the point of the metal’s fatigue by a thick wad of bills, and Blinderman could see that they were each a hundred dollars.  Shapiro pulled out three bills and crumpled them, throwing each at Blinderman’s feet.  “Here you go, Doctor – one for each visit.  And now you’re a whore just like the rest of them!”

     Blinderman trembled – with fear? With self-loathing?  He wasn’t sure.  He kneeled down on the floor to collect his fees and Shapiro yelled over him, “And I hope you enjoyed the dirty movie, you filthy bastard!”  Blinderman wanted nothing more than to leave the home of this lunatic, and he rushed out the door, Shapiro’s invective filling his ears.  “This is the thanks I get for inviting you into my home.  For trying to introduce a human element to our relation.  And you, all you want is to rush out the door the minute you get my money.  Like you’ve got somewhere else you have to be.”

     These last words stung Blinderman as he made his way to the elevator bank.  Riding down to the lobby, observing his own descent, he thought about empathy and compassion and all the other high ideals that had led him to medicine.  But none of these ideals were good enough for him anymore – nothing was good enough for him anymore – because at his core he knew himself to be completely alone.  And with every passing floor, Blinderman realized that it was not empathy and compassion that led him to medicine, but the other way around – he sought medicine so that he might teach himself the empathy and compassion he so sorely lacked.  When he walked out into the building’s lobby, Blinderman saw a man and his young son, the boy on a small bicycle with training wheels, walk together into the blustery day.  Seeing the little boy laugh as the wind blew him off his bike, and his father tenderly brush off the dirt from his knees, Blinderman turned around and took the elevator back to the eighth floor.

Published: October 11, 2004