We're pleased to have two new articles by Sharon Farber in our final issue. This first one dates back to her medical school days in St. Louis and demonstrates that the embodiment of FIAWOL is not limited just to science fiction fandom. As its definition implies, when used as an escape mechanism it can also help get one through difficult times in life.
'Tales of Adventure and Medical Life #16: Adventures of 
  the On-Call Knight' by Sharon Farber; title illo by Teddy Harvia
Recent studies have shown that doctors tend to be obsessive-compulsive. Well duh -- only an obsessive could get an 'A' in Organic Chemistry. And its not like other professions don't recruit from those with diagnosable psychiatric disorders -- cops, firemen and paratroopers are often sociopaths, hysterics (I have been told) make good actresses, and of course reporters in the grand old days were all alcoholics. (I had a delirious patient in the ICU once. "How much does he drink?" asked my attending. "One a day." The attending shook his head in dismay at my student naivete. "Sharon," he said. "He's a journalist.")

Unfortunately, obsessives are prone to the comorbidities of anxiety, depression, insecurity and anguish at their imperfections. Perhaps as an undergrad you can know everything and you can smoke an exam -- bemoaning your score of 99 rather than 100 -- but in a school full of other high-performing obsessives and a fund of knowledge that exceeds human capacity... Well, get ready to be severely bummed out.

Sixty percent of my classmates sought help. Two killed themselves.

The question that has been asked is this: Does a science fiction writer cope differently with the stress of med school?

# # # #

After a year in the dorm I moved into an apartment a mile down the road, in a neighborhood once fashionable, then slum, starting to be rehabbed. One of my attendings owned the mansion in which William S. Burroughs grew up. They filmed a documentary there; she said he was her only houseguest to bring his own methadone.

There was one street of new shops, an oasis in the decay. Many of the street people had been my patients at Malcolm Bliss. I would either nod and hurry by, or avert my eyes. Someone was shot outside my apartment one night. Another night watched cops wrestle down a suspect. A conventioneer had his wallet stolen, and he pursued the suspect until he developed angina, then slumped over my Dodge Colt. I checked his pulse with the ludicrous phrase "It'll be all right, I'm a medical student."

Medical students are the bottom of the social hierarchy in the hospital, with only the nursing students exceeding us in cluelessness. Even the janitors have our number. And the contempt spills out into the nearby community. So I was astonished when the man was not only reassured but announced in awe to his arriving friends, "She's a med student!"

They had been at the Chase Park Plaza, a once grand hotel now famous primarily because its auditorium was used every Sunday morning for the TV show Wrestling at the Chase -- a name implying volumes of social disconnect. The wrestling groupies would gather in the parking lot across the street from my own and wait to meet their heroes.

Our apartment building had been the dernier cri in stylish modernity seventy years earlier, and had not been remodeled or painted since. Even the cockroachs seemed courteously old fashioned. (We kept them under control with a typically obsessive scheme -- a scorecard. Kill 5, you were an Ace. 86, a Red Baron. While waiting for the coffee to boil grab the swatter and hunt roaches.)

There were mice, too. We found the hole they came in from and closed it up. Then lent our traps to the apartment below us, inhabited by students in the 6-year combined program. Presumably smarter than the rest of us mortals.

One day one of them came upstairs. "The traps aren't working," he complained.

"Well, what are you using for bait?"


Their apartment was a humid mess due to a continuously dripping shower. A friend of mine, going through a divorce, lived there briefly. He came up one day, sat on the couch, and just shook his head. Finally he said, "All you have to do is turn the handle firmly."

# # # #

We were busy and didn't really get to know the non-medical student tenants who were scattered in the various apartments like raisins in a pudding. Okay, not a good metaphor. I remember once some guys across the hall having a bachelor party. The stripper brought her child, an auburn-haired little girl who sat in the empty stairwell engrossed in her coloring book.

Fourth year we had a kegger and (as one always should do when planning a loud party) invited any neighbors close enough to complain. The apartment above ours was currently occupied by some undergrads.

They arrived duly, got paper cups of beer, and began to hit on the women. Their line -- and it's a sad sad world to think that it might under some circumstances work -- was the proud statement, "We're accounting majors."

"That's nice," said my roommate. "Those guys are PhDs in biochemistry and the rest of us are just medical doctors."

The accountants refilled their cups and stole away into the night.

# # # #

We were an odd assortment -- a top student, from a family of important doctors; the sexiest guy in the class, so drop-dead handsome that women would turn and follow him down the hall; the president of the Christian Medical Society; and me, the class bohemian. (A demented elderly patient once snarled at me, "Are you a gypsy?" "No, ma'am, I'm a bohemian," I replied, and my attending started laughing so hard I thought I'd have to Heimlich him.)

Later the cute guy took his mushroom collection and left, and we acquired a depressed grad student and a succession of others. The tiptop student in class lived there a while (the sister of the other top student). Her talents, unfortunately, did not include cleaning. Once a week or so we'd venture into her cesspit, stepping carefully between books and boxes and discarded clothing, to retrieve coffee cups. When we were burglarized, the cops looked into her room. "It's been ransacked!" they gasped in horror. Her embarrassed sister hastened to agree.

One day I took down the hanging plants, watered them, and left them on the radiator. That day -- not particularly cold, and a month earlier than usual -- was the day the landlord chose to turn on the heat. The twins' mother -- herself an important physician -- called to ask for one of her daughters.

"She's in the kitchen, performing fluid resuscitation on a plant I just killed," I replied.

There was a long pause. Finally she said, "And to think we're turning you loose on people."

# # # #

Once during second year, before a particularly important test, we were all nervous. I told the particularly jumpy studious roomie: "If you eat your dinner, do your homework and go to bed. I'll tell you a bedtime story." This was it:

A research biochemist married a beautiful woman, and set her up in a lovely house of many windows. But she was lonely, and complained he was always in the lab. So he cloned himself, and the two of them got so much work done that he could spend more time with his wife.

But his clone grew fond of a research post-doc, and when he thought the scientist and his wife were both away, took his girlfriend to their house. The wife came home early, saw them, presumed it was her husband, sued for divorce, and won the house and half the patents.

Which just proves that people who live in glass houses should not grow clones.

# # # #

Okay, not that good, but it was the first bedtime story. They became more frequent, and developed recurring characters. There was the Ivory Tower, dedicated to training pages to become knights. Then they had to pass the Boards -- a plank bridge fraught with hazards -- in order to enter the Magic Forest and become squires. In other words, they became third year medical students on clinical rotations.

I told most of the stories, of course, and the epic began to parallel my own journey through the clinics. For instance, while I was studying surgery Our Heroine was captive of the adventuresome but dimwitted Green Knights. At the end of my rotation Our Heroine offered to go for pizza and ran like hell. But I had put off three weeks of surgery until fourth year, and when I had that rotation Our Heroine, on her way elsewhere, blundered into a clearing still full of Green Knights awaiting pizza. Thinking quickly, she said, "Okay, was that 43 pepperoni and 17 sausage, or 17 pepperoni and 43 sausage?" And escaped again. It was the only time I've ever pulled off a joke with a sixteen month buildup.

illo by Teddy Harvia Because City Hospital, where I did neurology, was next door to Malcolm Bliss Mental Hospital, and because neuro and psychiatry deal with different aspects of human consciousness, I invented a castle called the City of Distress (shades of Dante) wherein dwelt the bold Knights of the Hammer, always accompanied by their saber-tooth Catscans. But at night it transmogrified into the horrific Tower of the Blissful. Once the Green Knights decided to invade the Tower, and were held off by the last remaining Knight of Sigmund, who analyzed them into stupefaction.

Another time the Dashing Rogue -- the gentleman thief character chosen by the guy who was head of the Christian Medical Association and about as undashing and unroguelike as you can get -- was in the Tower to steal the Grandiose Grail. As he climbed out the window, dawn broke and he was hanging in mid air...

Our roomie the very top student appeared only once. As Our Heroine is in the tilting-at-windmills class and complaining that no one can do that, she does. Oh well.

Gradually a plot of sorts occurred. Our Heroine, thanks to her many screw-ups and consistent distractability (especially whenever she sees the Wonderful Knight) is charged with finding the Pen of Flexner and healing the ills in the Magic Forest. (Abraham Flexner wrote the 1911 book which reformed American medical education.)

Our Heroine stumbled from adventure to adventure, eventually gaining some knowledge and talents. She was aided by The On-Call Knight, an idealized amalgam of helpful interns I had met. Finally there was a big battle, the Pen was recovered, the evil wizards defeated, everyone with amnesia remembered his identity, the king was rethroned, etcetera etcetera. And Our Heroine was rewarded yet punished by becoming the new On-Call Knight.

Well, you had to be there. But transforming my travails into a metaphoric silly Arthurian quest helped get me through it.

# # # #

This is the year of my twentieth reunion (which I don't intend to attend). Life is still weird, work hard, people bizarre. Just a few days ago I was royally yelled at by a patient whom I refused to give a motorized wheelchair because she didn't meet Medicare criteria. Because she walks fine. I was called callous and heartless and well, I've heard it before.

I'll leave with a gross-out story. A couple months ago I saw a hospital patient and noticed that his toes were, as we put it, a little dusky. He indeed had poor blood flow to his legs but refused intervention.

A month later saw him in the ICU -- back because a friend had scored some cool drugs and he'd tried a few too many. Which he freely admitted. I was called to see him because of the brief self-induced coma.

I pulled back the sheets to test his reflexes and paused. His distal right foot was now black. Not dark or gray, but frank black, like my polished leather shoes, with a line of demarcation. He had gangrene. Two toes were missing, having sloughed off. (They can do that in dry gangrene. Of course, anything bigger than a digit won't, and unless dealt with will prove fatal. And as for wet gangrene -- well, let's not discuss the odor.)

I well knew the answer, but I was rather shocked and said "Gee. What happened to your toes?"

He looked down with casual unconcern. "Ahh," he said, "they came off in my socks."

Well, again, I guess you had to be there.

All illustrations by Teddy Harvia

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