Sunday, January 22, 2012


Lining the ocean between Fort Lauderdale and Miami is a strip of land, about 15 miles long and perhaps half a mile wide, from which rise thousands (or so it seems) of hotels, motels and condominiums:  white, gold-on-white, white-and-blue structures, angling for space and view against the glass-blue sky. The facades of these structures are smooth and flat; beside them, palms and mangroves sustain a pruned and precarious existence.  The fusion of land and Atlantic is the magnet that draws to it the smooth, clean, sun­-seared bodies that swim in blue-bottomed, hotel-side pools and bask on nearby patios.  The beach itself is rarely seen except from windows of expensive ocean-front rooms. Only the most unconventional souls deliberately gain access to it.

On the narrow and nearly lifeless shoreline fronting the Dominic Hotel one early April morning, the only person in view is Carleton Hagen, there to attend the annual meeting of The Anatomical Society. His gaze, directed downward toward the speckled sand, detects a few shells but mostly man-made debris – cigarette filters, rubbers, other plastic objects, and black globules of uncertain origin and purpose. He picks up one of the black objects shaped like a shark's tooth and it deforms in his hand, leaving a viscous brown smudge. He recognizes it and others like it as sludge from some passing tanker.

Carleton Hagen regularly attends meetings of The Society, but he usually sits by himself, arms folded across his chest, legs crossed, a strangely solitary man at these meetings where compulsive camaraderie, reunion with old friends and colleagues, and the exchange of ideas and gossip are the rule. If you saw his name tag, you would notice that he teaches at Union Medical College, a predominantly black school. You might wonder how it came about that this tall, fair-haired, distinguished-looking white man in his fifties happens to be teaching at Union. If you looked up his name in the Society's directory, you would realize that he graduated from medical school at the University of C... in 1960.  Perhaps you might guess that he was a shy, industrious student who did well in his coursework but didn't interact much with his fellow students. Or that, in Gross Anatomy, he didn't participate in the obscene jokes and horseplay that helped other students cope with their unavoidable violation of the human body consigned to them.  Or suppose that his life has taken a very different course than he imagined when he first began his professional career.

He leaves the beach and walks up narrow steps and through a gate toward the hotel. The cement patio surrounding the pool is covered with row upon row of closely-packed, white, sunning chairs, still empty at this early hour.  He imagines them filled with bodies, immobile, absorbing the sun, tanned like the pharaohs. It conjures up the image of a giant morgue or an enormous dissecting room, full of cadavers as still as sunbathers.

*    *    *
More than twenty years ago, as a freshman medical student, Carleton Hagen first walked into the huge, gray-walled dissecting room on the top floor of the Medical Sciences building at the University of Cincinnati.  The tall windows ringing the massive room and the large skylights overhead were gray and grime-covered, but they admitted a soft, diffuse light that permeated the room despite its size. The odor of phenol and formaldehyde stiffened the air. Square cement columns about two feet in thickness interrupted the otherwise open space, determining the placing and orientation of dissecting tables upon which lay elongated objects, each covered with a gray tarpaulin.

As he walked among them, Carleton knew what those objects were, but did not dare imagine the lifeless human bodies underneath the tarps, each corpse the embalmed cast of a lifetime: cryptic, no longer decipherable, but still real, and not quite finished. He felt awe and a touch of carefully suppressed terror as he walked into the room and weaved around the dissecting tables with the formless forms atop them to a table near the wall beneath a window through which light poured steadily. He waited until his lab partner, Henry, arrived at the table before daring to lift the tarp off the form beneath.
It was the cadaver of a young black man, the skull opened and the eyes removed.  Carleton replaced the tarp and suggested they take a different cadaver. He withdrew the cover from the form lying on an adjacent table and beheld a puffy, elderly white man with a gray stubble of a beard and hanging, ashen flesh. On this body, too, the skull had been cut open and the eyes removed.

"Let's take the first one." Henry said. "It's probably in better shape, anyway."

Henry's guess proved to be correct and they, with the two other students who later joined them at the dissecting table, had one of the best preserved specimens in the laboratory that year. Except for a chest wound and a few superficial scars on the extremities, their cadaver was in excellent condition. The professors often came to their table to demonstrate structures that couldn't be found in the more obese or diseased specimens.

During the first few days of Gross Anatomy, whenever Carleton entered the lab, the original nausea, fear, and awe gripped him, but with each succeeding day, he found it easier to throw them off. By the second week, he was practically able to ignore the other cadavers and walk directly to his own table with only slight hesitation.

Henry had nicknamed the cadaver "George." It was usually "good old George," or "poor George," or "Georgie-boy." One of the other students at the dissecting table, a rather thin and darting fellow from North Carolina named Chris, sometimes called him "our nigger." The fourth student, a quiet fellow named Bart (short for Bartholomew), didn't have much stomach for dissection and usually sat off to the side reading the lab manual and informing the others about structures they should be finding during the dissection.

*   *   *

Carleton passes through the glass patio door into the vast lobby of the elegant Dominic Hotel. The lobby is three stories high, and from the ceiling hangs a large, gold-toned sun-burst. Beyond the spiral staircase is a sunken sitting room, and above its center hangs an elaborate, glittering glass and bronze chandelier. Carleton sits down on one of the plush sunken sofas, crosses his legs, folds his arms across his chest and gazes absently at the people milling about the reception desk.
This meeting of the Anatomical Society is well attended. The reputation of the resort hotel and the promise of a warm and sunny respite from the winter's bitter cold have enticed many from the North. Carleton recognizes most of the older faces from meetings past; a few of them were colleagues at a time when he was more actively engaged in research.  He does not make an effort to greet former colleagues; if someone approaches him, he exchanges greetings and pleasantries with a subdued and distant air. It's easy to be anonymous at the meetings these days; there are so many in attendance – so many young people, even women – and most of them he doesn't know.

*   *   *

At the time, many years back, when Carleton was newly inducted into the Society, fewer people attended the meetings and a new member soon came to know almost everyone. Older scientists were pointed out with awe, almost reverence. He was much younger then and pleased, almost enthusiastic, about his decision to go into an academic career rather than into the practice of medicine. The two clinical years had been unpleasant for him, filled with indigent clinic patients who were ignorant, impatient, oozing blood or pus from various orifices, smelling of sweat or urine or alcohol, and unable to communicate. The medicine he had seen practiced upon these unfortunates, many of whom were black, was too often simply palliative, aimed at symptoms rather than the disease: inadequate, unthinking and worst of all, uncaring. Carleton had found himself drifting back to the basic science professors and their laboratories. Toward the end of his first year of clinics, he began to work on a small research project in comparative embryology that had been suggested by Dr. Gerard Moseley, an embryologist of some renown, whose textbook had recently come into wide usage.

By his last year of medical school, Carleton was spending several hours a week in the laboratory and was doing some model dissections for the Gross Anatomy teaching staff. When he graduated from medical school, he did not take an internship but rather, at the urging of Professor Moseley, spent the next year as an Anatomy Assistant, thinking he could take the internship later, and he would then be equipped with a much better understanding of the human body.  During that year, he married a nursing student he met in the clinics.  The internship never came to pass, and he spent two years as an assistant in the Anatomy Department.

During the following year, he helped as a laboratory instructor in addition to his research and dissections for the faculty.  And that year, he attended his first national meeting of the Society, where he presented the initial results of his research project with Dr. Moseley. He had found that the course of development in the yolk sac of chickens was subject to mutation, casting doubt on the dogma that "ontogeny recapitulates phylogeny" in the system he was studying.  He had found solid evidence that individual development does not necessarily follow the course of species evolutionary development.

His results created something of a stir at the time, and he was introduced to (and received favorable comments from) several leading embryol­ogists of the day. At those early meetings, although he was naturally shy and socially awkward, he was automatically accepted into the company of Professor Moseley's former students and current colleagues, most of whom had good positions in medical schools and universities throughout the country. 

At the second national meeting he attended, he presented a follow-up study of his initial work. During lunch one day that week, he found himself in conversation with a graduate of Harvard Medical School, a young black man named Janus Jenkins, who was finishing a residency in Pathology at New York University. Jenkins talked passionately about the need for adequate training of doctors for the black community, of “Negro doctors for the Negro community." Carleton remembered his clinic years and the indifference of most of the clinic physicians to the poor patients, who were often black.

"Physicians need to be trained specifically to treat Negro patients," Jenkins said, "physicians who speak the same language, who come out of the same background, who identify with their patients, which means Negro physicians."

"You may be right," Carleton affirmed, hesitantly.

"But it's not enough simply to train them, you understand.  They need to be trained well, to have the best possible background so they can practice the best possible medicine."

"Of course," Carlton assented.

"And the only way to train them well is to get well trained people to teach them.  People out of the best schools.  People like you and me."

Carleton nodded.

"And where are most of the future Negro physicians being trained at this moment?"

Jenkins paused. Carleton didn't answer.

"At Negro medical colleges. At places like Howard and Meharry and Union," said Jenkins, emphatically.  "Although they probably don't get excellent training there," he added, lowering his voice, "because they don't have the best teachers."

"That may be true," admitted Carleton, feeling vaguely embarrassed, perhaps even guilty.

"But you know," continued Jenkins, "I'm seriously considering taking a job at Union Medical College myself, though I'm just a bit worried about going back South."

"Oh, are you originally from the South?" asked Carleton, surprised.

"No," said Jenkins with a smile. ''I grew up in New York. A figure of speech, you know."

About six months after the meeting, Carleton received a letter from Janus Jenkins, by now at Union, which went into detail about the satisfactions and challenges of teaching there. In the letter, Jenkins mentioned  a faculty position available in the Anatomy Department for an embryologist and gross anatomist at the rank of Instructor or possibly even Assistant Professor. He asked Carleton if he might be interested in considering such a position and offered to propose his name to the department chairman as a prospective candidate.

Something about the tone of the letter--its openness and apparently genuine interest in him--moved Carleton.  He remembered Jenkins' intense concern with obtaining first-rate faculty at Negro medical schools.  Although he realized that taking such a job might entail a certain professional risk, something in him was stirred by the idea. He thought about it for a couple of days before saying something to his wife, Sharon.  She was hesitant at first, but she had recently become pregnant and was concerned about how they would support a baby on a laboratory assistant's salary.  Eventually, she gave him a guarded: "Okay, if it's what you would like to do."

It was another week or so before he spoke to Dr. Moseley, bringing up the subject in as casual and off-hand a manner as he could feign.

"I got a letter a few days ago from Janus Jenkins."

"Oh really? Good man, Jenkins. Did some nice work with McIverson on smooth muscle regeneration in atherosclerosis. What did he have to say?"

"He's teaching in the Pathology Department at Union Medical College."

"Too bad, that. Could have been predicted though, I guess."

"He considers it a real challenge. He wanted to know if I might be interested in looking at a position there"

"Well, you wouldn't want to go there, would you?"

"It would be a real faculty position, at a much higher salary than I'm getting now.  Sharon's pregnant and we'll be needing the money soon."

"I didn't know that. Congratulations, my boy. Say, if it's more money you want, I could probably squeeze out another five hundred or so, though we haven't got much extra in the budget. We won't have another faculty position open ‘til Moore retires, which'll be at least three years from now. I wish I could offer you more."

"It's not just the money I'm after, or even really the faculty position."

"What is it then?"
"Maybe a sense of professional autonomy.  Or the idea that I might be doing something worthwhile."

"You're doing something quite worthwhile right where you are.  Don't even consider a job at Union."

"Why not?"

"It would be professional suicide. Besides, you'd probably stagnate."

"I wouldn't have to. Not if I kept up with research and publishing. Not if I went to meetings and stayed in touch with what was going on."

"Don't do it, my boy. You'll regret it."

That interchange left Carleton thoughtful and insecure. He did not understand why taking a job at a Negro medical school meant he had to drop out of the professional scene.  In fact, he sensed some previously unsuspected bigotry in this admired mentor, this seeker after truth, that annoyed and even angered him.

He wrote back to Jenkins telling him that he might be interested in the position if he could be assured of facilities for continuing his research and if he could be guaranteed travel funds for attending the yearly meetings of the Society. Within a month, he received a letter from Dr. Sebastian Grant, Chairman of Anatomy, inviting him for an interview at Union Medical College.

*   *   *
Carleton Hagen glances absently toward the hotel reception desk and notices a moderately dark black man in his early fifties whom he recognizes with some surprise as Janus Jenkins. He has become a bit flabby but not fat, except for a protruding abdomen that pulls his shirt tight beneath his unbuttoned suit coat. Carleton wonders what Jenkins is doing at the meetings again; wonders whether or not to go up and speak to him or to wait until Jenkins sees him (if he sees him); and wonders what to say if they do meet.

After leaving Union several years ago to take a better job in Ohio, Jenkins had stopped coming to the meetings. Carlton has heard (but isn't sure it's true) that Jenkins is working in a private Pathology laboratory in Atlanta, is no longer doing research, and has developed a "drinking problem."

Jenkins wanders down the steps into the sunken lounge, looking from side to side, and spies Carleton. A smile of recognition sweeps across his face, then he hesitates and the smile quickly disappears. Composing himself, straightening his shoulders and reforming his smile, he walks with a slight swagger over to Carleton, who rises, tilts his head sideways, and holds out his hand. Jenkins takes Carlton's right hand firmly and slaps his shoulder with the left hand.

"How are you, Carleton? Looking good! How are things at Union?"
With that, Jenkins drops his hands, his shoulders droop perceptibly, the smile weakens, and his face takes on a discernibly defensive look.

"Things are going along as usual.  Bailey took over the chair last year, but nothing has really changed."

"You didn't expect it to, did you?" asks Jenkins.
"I suppose not.  I guess I did expect at least a symbolic gesture toward broadening the faculty base."

"How's Histology?"

"It's all right. Clive's still in charge and Harper's teaching it with him."

"That's not very many people teaching seventy-five students."

 "The administration seems to think that's all we need.  And Bailey hasn't challenged them."

"Do they still do Pathology correlations?"  Jenkins tilts his head to one side.

"No, not since you left. They've asked me to come in and do a little embryology of tissue organization, but mostly it's the two of them handling the whole course."

"Are they looking for someone else to help out in the course?"  Jenkins asks, looking intently at Carleton, as if trying to decipher the droop-lidded, phlegmatic expression that has become the habitual mask of the professor. 

Carleton looks down toward the plush carpet and up again, over Janus' shoulders, across the lobby and out the large windows facing onto the patio toward the variegated forms beginning to assemble there.  "I don't know how things are at the moment, Janus. They should hire at least one, maybe two more people in Anatomy, but so far, Bailey hasn't said he’s looking for anybody.  I don't know whether the administration will give him more money, anyway." Carleton shifts his weight from one leg to the other. "That's the trouble with promoting an inside man to chairman.  The administration thinks they have a bargain and they aren't willing to do anything for the department, so we're stuck in the same rut as before."  Carleton glances obliquely at Jenkins' mouth which rolls and shifts as if he were trying to remove a stubborn bit of fiber from between his teeth. "I don't know how things are in Pathology. Angeletti's still got another seven or eight years before he retires."

Closing his mouth and sucking in on his pursed lips, Jenkins recomposes himself and responds off-handedly:  "Well, if you hear of anything, let me know, will you?  I'm with Pathology Associates in Atlanta." He draws a card out of his inner suit-coat pocket and hands it to Carleton. "The money's good, but I don't get much chance for research doing full-time service, you know."

"Yes, I'm sure that's true. . . I'll let you know if anything comes open in the department." Carleton pockets the card.

"Well, I best be getting on," Janus says, extending his hand.

Carleton gives his hand a brief but firm shake and says, "It's good to see you again, Janus."
"Same here, Carleton. See you around the hotel, most likely."

Carleton watches him walk away, down a corridor that leads to the information desk and message board set up for the meetings. Carleton turns back to the lobby where he selects a soft chair looking toward the patio. From this vantage, he does not see the sunning bodies outside, only two palm trees and the far-off, draperied windows in another wing of the hotel. As he settles himself into the chair and crosses his legs, his mind wanders back to the circumstances surrounding Jenkins' departure from Union.

*   *   *

A few months prior to Jenkins’ leaving Union, Carleton had a lunch conversation with him in which Janus criticized the scientific credentials and even the integrity of the new chairman of Pathology, Dr. Dante Angeletti. In fact, Jenkins had suggested that the analysis of morbidity in sickle cell crisis, Angeletti's major scientific contribution, was more show than substance.

"He's oversimplified everything," complained Jenkins. "The disease is far more complicated than he makes it out to be.  For example, shock is sometimes an important component of the critical phase and needs to be treated as such.  Furthermore, the organ where sickled cells are primarily trapped varies from individual to individual. I know. I've seen lots of autopsy material. It's important to be able to recognize this individual variability in order to treat the crisis effectively. Believe me, he hasn't done anybody a favor by presenting the phenomenon as simple, or by proclaiming his three key rules for treating sickle cell crisis. Those famous three rules have probably killed more patients than they've saved!" Jenkins added with a hint of exasperation mingled with contempt.

Carleton looked at Jenkins incredulously, then commented, "You don't dare say that straight to Angeletti, though, do you?"
"I don't suppose so,” Janus said, raising his eyebrows, closing both eyes and grinning briefly.
"On the other hand," Carleton went on, "the students really ought to be aware of the way things are, because they'll be dealing with sickle cell crises throughout their practice."

"Angeletti gives the lectures on sickle cell anemia, so he's pretty much in control of what they hear.  The only time I get them alone is in the autopsy service, particularly if they stay on for their residency."

"Maybe Angeletti would be willing to pay some attention to your observations and evidence," Carleton suggested.
"Not likely. I tried talking with him about it once and he as much as told me I didn't know shit about sickle cell," responded Jenkins angrily. "Hell, I've got a niece who died of it. He told me to stick to atherosclerosis. He's got his career and reputation invested in being right in his oversimplified nonsense about sickle cell anemia."

"Well, you're in a tough position," commented Carleton, turning back to his unfinished rice and stew.

It was, in fact, not long after that conversation that Jenkins told Carleton Hagen he was going to the University of Cincinatti to interview for a position in the Pathology Department there. They were looking for someone with a background and reputation in atherosclerosis.

"Besides," confided Jenkins, "they need a black man. The government's after them to get blacks on the faculty. I'd be an obvious asset," he added with a grin that was almost a sneer. "And I need to get out of this little swamp."
After Jenkins left Union, Carleton began seriously to consider taking a job elsewhere. He had been at Union for seven years but had few colleagues there with whom he could discuss research or socialize.

He contacted a number of colleagues at other institutions throughout the country, both by letter and at the annual meetings of the Society, inquiring about the possibility of positions available elsewhere. He had by that time become an Associate Professor at Union.  Those who bothered to respond gave that as the reason they couldn't consider him for a position. Any jobs available were going to younger men who could come in at the Instructor or Assistant Professor level, at a lower salary.

For the most part, however, his inquiries went unanswered. And Carleton began to realize, reluctantly, that despite his broad base of contacts among Dr. Moseley's students and associates, despite his steady productivity in research and his frequent publications, despite regular attendance and presentations at meetings, he was being intentionally ignored as a potential member of any other department. He suspected that neither he nor his work were taken seriously anymore, that his colleagues were perfectly happy for him to teach at Union, that they were willing to exchange pleasantries at meetings and to tell him it was commendable of him to teach at a "minority" institution, but that they didn't want to have to admit him again to the circle of those with prestige and influence.  He had been prepared for hostility, even contempt, on the part of some in the Society who might view his job at Union as a threat to their segregated world view.  What he had encountered instead was a studied, uncomfortable politeness on the surface and underneath, a profound and deliberate indifference.  He had been prepared for anything but to be dismissed out of hand, as if he scarcely existed.

He stayed at Union and was eventually promoted to the rank of Full Professor.  He was placed in charge of the combined course in Gross Anatomy and Embryology and continued to perform in a competent fashion, though he was not (nor had he ever been) a charismatic teacher.  He sometimes, although not often, wondered whether it did make a difference in their later practice of medicine that his students received a good, solid course in Anatomy. At Union, he was neither fully accepted nor shunned by his predominantly black colleagues. His old chairman, Sebastian Grant, had been good­ natured and almost paternalistic toward him; his new chairman, Melvin Bailey, treated him with distant respect. When he was placed in charge of the Gross Anatomy course, his research became increasingly neglected; he had not obtained grant money for several years. Supplies and equipment were so expensive that it was almost impossible to keep a laboratory operating on the modest research budget that had been a part of his original contract.
Even though he no longer presented papers at the annual meetings, he still attended regularly. That, too, had been a stipulation of the original contract. On his return from the meetings, he always gave a report to the department on the keynote talks and symposium papers, since others in the department rarely attended the national meetings.

*   *   *
Carleton sits in the comfortable chair in the sunken lobby for a while longer, his arms held loosely across his chest, watching people aggregate around the reception desk: older men, younger men, occasional women. They smile, exchange greetings, gesticulate, huddle together, then separate and walk off again in smaller groups. He wonders if they, too, are aware of the transience of what they are doing here, at this scientific gathering with its pretensions of consequence reflected in the glittering decor of a grand hotel?

He glances at his watch and realizes that the Embryology papers are about to begin. He always attends the Embryology sessions, partly from habit, partly out of a sense of duty. He rarely hears reference to his own work, as he used to. He rises from his chair, walks across the lounge next to the patio window and glances out at the gleaming, sun-baked, mulatto-brown bodies filling the lounge chairs, jig-sawed into every bit of square area around the pool. He walks on, down a long corridor and through a door into an already darkened room. He sits at the back of the room, crosses his legs, folds his arms across his chest and leans back to listen to the first speaker of the session.

[This was written in 1979, one of the first in a set of short stories entitled "Laboratory Notebook.]