… who wrote How We Die, has died. The book is full of great prose passages, including this one at the beginning, which recounts his comic/horrific initiation into doctoring:
I had just begun my third year of medical school, and it was my unsettling lot to encounter death and my very first patient at the same hour.
Only in his twenties, he was “eager to the point of zealousness” for patient contact, and when the busy intern on duty asked Nuland “to do the admission workup on this new coronary that’s just going into 507,” he was thrilled.
After a small heart attack, the patient – a hard-charging construction executive in his fifties who loved “smoking, red meat, and great slabs of bacon [and] butter” – seemed to have stabilized.
McCarty greeted me with a thin, forced smile, but he couldn’t have found my presence reassuring. I have often wondered over the years what must have gone through the mind of that high-pressure boss of large, tough men when he saw my boyish (I was then twenty-two) face and heard me say that I had come to take his history and examine him. Whatever it was, he didn’t get much chance to mull it over. As I sat down at his bedside he suddenly threw his head back and bellowed out a wordless roar that seemed to rise up out of his throat from somewhere deep within his stricken heart. He hit his balled fists with startling force up against the front of his chest in a single synchronous thump, just as his face and neck, in the flash of an instant, turned swollen and purple. His eyes seemed to have pushed themselves forward in one bulging thrust, as though they were trying to leap out of his head. He took one immensely long, gurgling breath, and died.
Yes, this is conventional straightforward first-person past-tense narration. No emotional fireworks. But precisely because of the fireworks he’s describing, because of the astounding sudden break in the fabric of life he’s about to witness, the correct prose medium is indeed cool. The dry, wry, after-the-fact feel of the piece (the best line in the paragraph is Whatever it was, he didn’t get much chance to mull it over.), combined with unsparing clinical detail in his description (synchronous is good) gives us all at once the complex scenic elements we want: James McCarty’s instantaneous unfathomable transformation from a man to a bellowing dying beast; the rarin’ to go young doctor’s almost farcical, equally instantaneous, plunge into futility; the seasoned, self-amused, self-pitying narrator. The narrator who exhibits the peculiar brief sharp empathic curiosity about other human beings (what must have gone through the mind) doctors must so often feel…