Back to On Being a Doctor - Teaching Modules
Playing God - Essay
Why she called me first I never figured out. Maybe she had more brains than I gave her credit for. All she had said was,
My husband has passed away, Doctor. Can you come over?
That was it: flat monotone, no emotion, just matter-of-fact. Now I'm one of
those old-fashioned doctors who still makes house
calls on certain occasions, and this was definitely
one of those occasions.
I could feel it in the pit of my stomach. I grabbed
my clothes, got dressed in the bathroom so as not to wake my wife,
brushed the snow from the car, and headed over to
their farm. A storm had passed through unannounced, leaving snow
It was the kind of night where, once you get out
into it, you're glad you're there - everything blanketed in rolling
not a rift in the
cover-so cold and clear the stars hang down out of
the sky just above the snow. On a night like that, you had trouble
there could be
any evil in the world.
From the bend in the road I could see the light
from their kitchen far off, sparkling down the crystals of snow.
I pulled the car in at the barest suggestion of a
driveway, turned off the motor, and pushed through the drifts up to the
I let myself in. The house was quiet as a tomb. The
kitchen clock gave off a quiet hum.
On the face of the refrigerator were plastered the
kids' school papers: spelling tests and arithmetic, maps colored in
and the minimal artwork of the early grades. There
was a "Mom-Dad-and-Me" family portrait - "Mom" about a quarter the size
who occupied center stage, and "Me" off to the
side, a stick figure without arms - no mouth drawn in.
I stepped through the kitchen and found Kitty
sitting in the darkened living room in a straight-backed chair, staring
in shock maybe. What appeared to be small marbles
lay scattered on the carpet. I picked one up. It was a pearl.
"Where's Earl?" I asked her.
"In the bedroom?" said Kitty. She always said everything as though it were a question. She motioned with her head.
"Where are the kids?"
"At my sister's?" she answered.
"You all right?" I asked.
I took a deep breath and headed into the bedroom,
expecting the worst. I wasn't disappointed. Earl lay flat on the bed, a
bullet hole above his right ear. The left half of
his cranium and its contents were splattered next to him on the bedroom
wall. I began to run a cold sweat. Even after all
the years of small-town practice, being called in for mangled bodies
auto wrecks, botched amateur abortions, deceased
elderly pensioners not found for days, and - worst of all - the abused
- that, worst of all - despite all of that
up, a scene like this still could weaken you at the
knees. I swallowed against the sweat, looked away, looked back again,
and had to look away. It was hard to stay clinical.
Doctors have trouble with violent death. Disease we learn to accept.
I surveyed the scene. Earl's .30-.30 Winchester lay on the floor just inside the door. A half-empty bottle of Schenley's stood
next to the bed, within easy reach.
Earl lay on the bed fully dressed, shoes on, with that eternal gaze that can make your skin crawl.
The rest of the room was precise and neat.
The top of the bureau was uncluttered: a brush, a
comb, a mirror, all arranged just so, and an ash tray full of change.
A wedding picture of Kitty and Earl stood off to
the side. The bedside table held a small reading lamp, the shade a
the dark streaks of Earl's blood on the wall. There
was a Bible and an old cloth-bound book, its title faded, and a pair of
glasses folded on top. There were no clothes lying
about. The closet doors were closed. The window drapes hung just so. All
framing the mess of Earl's body.
I went back out to the living room to Kitty. She hadn't moved a muscle, except that her eyes had the look of a cornered mouse.
"What happened?" I asked her.
"He shot himself?" Kitty answered.
"Shot himself," I said.
"Kitty ..." my voice trailed off. I sat down in a chair opposite her and looked at her for a long minute.
"Kitty, we go way back don't we?"
She nodded again.
Some thirty years ago I had brought her into this
world, supported her through her mother's premature death, and twenty
delivered babies of her own. I had seen her boy
through a bad case of spinal meningitis, and harped at her father's
smoking, in the end burying him because of it.
But, through the most of it there had been Kitty.
She held the record for most abused woman in Taylor County. There had
the time I had hospitalized her for a hairline
fracture of the mandibular ramus, a both-bones fracture of the left
and God knows how many internal injuries, for the
better part of a week. We had Earl all wrapped up and ready to send down
to the state prison. And then Kitty wouldn't sign
the papers. The night I hospitalized her from that episode I stopped by
her father's house just to check on things. Al was
in a murderous rage. I could hardly blame him.
"I'm going to kill the son of a bitch. I'm going to kill the son of a bitch," was all he kept muttering. He'd look at me with
his reddened, burning eyes, and I knew he meant it.
"Al," I said, "you do that and you'll wind up in prison yourself."
"I don't give a damn," he said.
"And Earl will get off."
"Earl will be dead," he answered.
"And your grandchildren will hate you for the rest of their lives," I said, "for killing their father."
At that, the hardness left him and he gave it up.
"I'm going to tell you something else, Al," I said. "In two weeks Kitty will be right back with him and there isn't a damn
thing you can do about it."
Soon Kitty did go back with Earl. You had trouble
saying whose sickness was worse. But there was no question about Kitty's
suffering. Or her father's. It was the same
scenario for some ten years, Kitty coming into the emergency room, badly
meekly asking to see me, Al flying into a rage,
and, in the early years, loading up his gun, resolving to put Earl away,
resigning himself to this terrible disease that
both Earl and Kitty were torturing him with. Two other times Kitty had
so severely beaten that she required
hospitalization. Each time we got the town police involved, had Earl
arrested, had the
complaint papers all filled out. All sealed, and
delivered, except that Kitty would never sign the papers. And she always
went back to him.
"You know, Doc," said the Chief of Police one day, "some day one of these two is going to wind up dead."
Kitty shifted in her chair and brought me back to the darkened living room. I turned to look at her. I was her doctor, her
family's doctor. She'd level with me.
"What really happened?" I asked her.
"I heard the gun go off?" she said. "I went in. And he was dead."
"I didn't see a suicide note, Kitty," I said,
pressing her. "Did he leave a note? People usually leave a note in these
"No," she said. "There wasn't any note." Her voice fell. As tentative as she was, Kitty wouldn't budge. I thought later, looking
back on it, that this was probably the first time in her life she had made up her mind and stuck to it.
"Kitty. ..." I didn't know what else to say to her. She shifted nervously in the chair and I saw her wince. She held her left
arm close to her body.
There she was, Al's little girl - everybody's
little girl. I could remember Kitty skipping into my office at five full
happiness and life, for her preschool shots, and
coming in again at twelve, the apple of her daddy's eye, for her camp
We were there, Al and I, on that crisp November day
when Kitty bagged her first deer. And I sat at the head table, at her
wedding reception - she and Earl the handsome
couple - Kitty proudly wearing her mother's string of pearls that Al had
her with on that day. And after that all those
hospital admissions . . . Kitty . . . most abused woman in the whole
But there was a lot more that went into this case.
There had been Leon Tilley's murder two years before. He had been found
dead in his hay field, two bullet holes at the base
of his skull, relieved of a large amount of cash. For a year nothing
Tilley had been one popular old man, the kind of
Norman Rockwell farmer everybody stops to talk to, wisdom written all
over his face. The town was pretty unhappy with
what they saw as police inaction. Then four teenagers and a drug dealer
apprehended and the papers were filled with yellow
journalism for six months: stories of bad cops, barflies, drugs, and
who lied. The kind of stuff that's not supposed to
happen in the country. The whole county salivated. After all the
the big-city lawyers, and backroom deals, the D.A.
managed only one conviction. Now everybody was still screaming for the
police chiefs head and small-time entrepreneurs
were getting rich selling T-shirts that read:
Come to Herkimer and get away with murder.
I looked at Kitty, and then into the bedroom, then back at Kitty again. I nodded to myself. Yes indeed, I thought, the Chief
would dearly love to get his hands on this one. He needed this one.
One time back along, I had a bad baby on my hands, a
newborn with hydrocephalus and a big cyst at the base of the neck - the
crippled-for-life kind of baby you see once in a
lifetime. I watched that baby struggle and watched and didn't do a damn
to save it and apologized to the family afterwards,
explaining it was a stillborn, lying to them. That was the one time I
played God and it aggravated me, I can tell you. I
went home that night and yelled at my wife, kicked the dog, and drank
much - brooded for weeks and never talked about it.
It can eat at you. There had never been a second time until Kitty.
I grabbed one of the kitchen chairs and a dish
towel and went back into the bedroom. In a few minutes I was on the
had the dispatcher get hold of the Chief. Shortly
he was at the other end of the line, sleepy, gruff, trying to be
"Chief," I said, "I'm at Earl Staples' house. He's
finally done himself in. He got drunk and shot himself with his deer
. . . yeah, I'm at the house now . . . well, it
looks to me like he rested the gun on a chair next to the bed, and then
himself down and shot himself in the temple. Clear
suicide in my book. I'll be signing it out that way. . . . Yeah, she's
here with me. I'll drive her over to her sister's.
I'd sure appreciate it if you'd send one of your men over here to clean
things up. . . . Thanks Chief."
I put the phone down and turned back to Kitty. She was staring at the floor. She hadn't moved. I sighed, slapped my thighs,
and got up to go.
"Where's your coat, Kitty? I'll drive you over to Kate's, and in the morning," I said, nodding to her left arm, "you come
over to the office so I can set that fracture for you one last time."