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.]