Excerpt from Beat the Reaper by Josh Bazell, plus links to reviews, author biography & more

The other thing that sometimes happens when you round early on patients is that none of them complain at all.

Which is never a good sign.

The fifth or sixth room I enter is that of Duke Mosby, easily the patient I currently hate least. He's a ninety-year-old black male in for diabetes complications that now include gangrene of both feet. He was one of ten black Americans who served in Special Forces in World War II, and in 1944 he escaped from Colditz. Two weeks ago he escaped from this very room at Manhattan Catholic Hospital. In his underpants. In January. Hence the gangrene. Diabetes fucks your circulation even if you wear, say, shoes. Thankfully, Akfal was on shift at the time.

"What's going on, Doc?" he says to me.

"Not much, sir," I tell him.

"Don't call me sir. I work for a living," he says. He always says this. It's some kind of army joke, about how he wasn't a commissioned officer or something. "Just give me some news, Doc."

He doesn't mean about his health, which rarely seems to interest him, so I make up some shit about the government. He'll never find out differently.

As I start bandaging his reeking feet, I say, "Also, I saw a rat fighting a pigeon on my way to work this morning."

"Yeah? Who won?"

"The rat," I tell him. "It wasn't even close."

"Guess it figures a rat could take a pigeon."

I say, "The weird thing was that the pigeon kept trying, though. It had its feathers all puffed out and it was covered with blood. Every time it attacked, the rat would just bite it once and throw it onto its back. Go mammals, I guess, but it was pretty disgusting." I put my stethoscope on his chest.

Mosby's voice booms in through the earpieces. "That rat must have done something pretty bad to that pigeon to make it keep on like that."

"Doubtless," I say. I push his abdomen around, trying to elicit pain. Mosby doesn't seem to notice. "Seen any of the nurses this morning?" I ask him.

"Sure. They been in and out all the time."

"Any of the ones in the little white skirts, with the hats?"

"Many times."

Uh huh. You see a woman dressed like that, it's not a nurse, it's a strip-o-gram. I feel the glands around Mosby's neck.

"I got a joke for you, Doc," Mosby says.

"Yeah? What's that?"

"Doctor says to a guy, 'I got two pieces of bad news for you. First one is, you got cancer.' Man says, 'Lordy! What's the second one?' Doctor says, 'You got Alzheimer's.' Man says, 'Well, at least I don't have cancer!' "

I laugh.

Like I always do when he tells me that joke.

In the bed by the door of Mosby's room - the bed Mosby had until the ward clerk decided he'd be less likely to escape if he was five feet farther from the door - there's a fat white guy I don't know with a short blond beard and a mullet. Forty-five years old. Lying on his side with the light on, awake. When I checked the computer earlier, his "Chief Complaint" - the line that quotes the patient directly, thereby making him look like an idiot - just said "Ass pain."

"You got ass pain?" I say to him.

"Yeah." He's gritting his teeth. "And now I got shoulder pain too."

"Let's start with the ass. When did that start?"

"I've already been through this. It's in the chart."

It probably is. In the paper chart, anyway. But since the paper chart is the one the patient can request, and that a judge can subpoena, there's not much incentive to make it legible. Assman's looks like a child's drawing of some waves.

As for his computer chart - which is off the record, and would contain any information anyone actually felt like giving me - the only thing written besides "CC: Ass pain" is "Nuts? Sciatica?" I don't even know if "nuts" means "testicles" or "crazy."

"I know," I say. "But sometimes it helps if you tell it again."

Copyright © 2009 by Josh Bazell. All rights reserved. No part of this book maybe reproduced without written permission from the publisher.