PETRAS ESSAYS IN ENGLISH

17 de diciembre del 2001

A CONSCIENTIOUS DOCTOR

James Petras

Horacio Biderman was seventy-five years old and he continued to practice medicine for one of the private health clinics in the city of Rosario. Biderman lived with his mother until she died, a few years past, at the age of ninety-three, which didn't lessen his grief. He graduated from medical school late in life, at he age of fifty after working for many years as a technician and nurse.

Every morning he would rise at six o'clock, take his dog for a walk, feed the cat and return to breakfast: hot cereal, toast and coffee. He would take the bus to the hospital and arrive a few minutes before the seven-thirty shift. He was never late; when the public transport workers went on strike he would ride his bicycle to work, starting a few minutes earlier.

Well, it is not true that he was never late to work. Once a passenger on the bus had a seizure and Horacio attended him, until the ambulance arrived. He in fact thought that his work started a half-hour earlier that day, even though technically he punched the time clock late.

Each day the corridors leading to his office were full of patients: coughs, cries and silent faces. Biderman always greeted his patients cordially, though not effusively. He always began by asking his patient's about their ailments and listened carefully to their complaints. It was a habit: he was very methodical, modest and prudent. For years when he was a nurse, especially at night, he always punctually checked the patients and responded quickly to any question, request or problem.

In other times he would have been a neighborhood "house doctor." But now he was an employee of a private clinic. He did not rush patients in and out to finish and go off to a second or third job: this was his only job and he wanted to be sure, he got it right with his patients. Some of his colleagues whispered that he took so long because he was slow in diagnosing illnesses or had to consult medical books, that he was a mediocrity. But these were almost always doctors drawing two or three pay-checks, and were slightly annoyed that he stayed on while they jumped into their BMW's and zipped off to another clinic. Others, thought he was a rather calm and competent "old fashion doctor," who was simply very conscientious.

Biderman,being single, was never invited to dinner by his colleagues. At the annual New Year's party, he only drank ginger ale and ate quickly with his former colleagues among the older nurses. Some of the nurses who knew him for a long time, thought he might be a homosexual, because he never flirted, never dated (at least not among the numerous and attractive hospital workers) and was mostly concerned to return home to take care of his mother. Unbeknownst to the staff, he discreetly did visit an acquaintance in a respectable small apartment once a month.

On Sunday morning he would ride his bicycle to the Plaza Central where the stamp and numismatic dealers and collectors gathered. His hobby was collecting 19th century argentine pesos by year, by grade ("very fine") and by mint. Each week he would circulate from table to table, bend over, pick up a coin, examine it with his magnifying glass and then, if he approved, make an offer. Usually the dealer accepted it, since they knew each other for many years and both understood the value of the coin. Biderman was not totally adverse to negotiating, but he preferred to bid and buy. Each coin was placed in a chemically treated holder to avoid tarnishing. Each week he allocated a certain amount of time to reading numismatic journals, his only extravagance.

Before his mother became bed-ridden, he would take her out for a drive to the river every Sunday and then to a restaurant. In the summer he would rent an apartment facing the sea near Montevideo, and every evening after supper they would stroll along the shore, while his mother recounted her days in Odessa.

In 1989 when the hyperinflation reached 200% per month and salaries plummeted, Biderman, who never spoke at a union assembly, joined a strike. He always paid his union dues on time, joined the strikes but disliked spending time at the meetings. He almost always brought his lunch from home, but he usually ate in the cafeteria with his colleagues, mostly listening to their banter. In the office however he never hesitated to consult specialists or order tests and read the pathologist diagnosis carefully. He was always very courteous to the secretaries when he handed them his reports to file and never raised his voice, even when the orderlies failed to empty his disposal container.

In the year after the presidential elections, the new regime announced "structural adjustments" and the "modernization of health service delivery." Biderman could not but listen to the heated discussions among the doctors nor could he avoid hearing the fearful murmurs among the staff - "cuts are coming." But it was the presence of a new director of medical services that brought this discussion home to Biderman. He was called into the director's office for what he was told would be an "introductory" meeting. All the doctors were called and they were told in turn about the new modern efficiency standards. It turned out the meetings were a monologue: the director setting a quota of patients for each doctor: one patient every eight minutes. Biderman was flustered by the new director's brusque approach. Gone was the cordiality and understanding of the old director - who was himself a doctor. Biderman could not contain himself. "But, some patients have complex illnesses that need time to diagnose, it takes time to explain the regimen of recovery?"

The director eyed him and forcefully interrupted. "Send them a letter on your time, we have a limited budget." He scribbled something in his notebook and told Biderman to attend his patients.

That was how it began; every week the director would pass by Biderman's office and point out how many more patients were waiting outside his office than the other doctors, how his "output per hour" was below "normal." One day he came in and sat down and watched Biderman treat a patient, glancing down at his watch. When the patient left, the director stood up and in an unfriendly voice told him to "cut out all the family talk. You're not a relative."

Biderman's face reddened. "She's a terminal cancer patient. Cancer of the breast."

The director turned around and walked out slamming the door.

In the last days before his mother died, she whispered in his ear, "The director is a snake, a member of the Black Hundred. Be careful. Defend yourself."

Biderman tried to calm her but he was troubled. He always took to heart his mothers advice.

He smiled and patted her forehead.

"Don't worry. Everything will turn out all right. This is not Odessa, this is Rosario." After his mother's death, Biderman felt no great desire to rush home. He would go into a bar near the hospital and have a ginger ale and watch the crowd of medical employees noisily pushing their way in to have a drink and chatter.

The atmosphere at the hospital changed. Everyone raced around doing the same work as before only with more repetitions. No one confided or consulted with anyone. Denunciations replaced solidarity on the floor. The surgeons wore dirty scrub suits. The doctors emptied their own waste containers and were told to wash their latex gloves and nurses doubled as orderlies cleaning out bed pans. The director was working within the President's budget.

One of Biderman's oldest colleague told him he was getting out, taking his retirement early.

"And you Biderman, why don't you call it quits? The Director is giving you the evil eye."

"And what am I going to do, stay home or go to the cafe and play dominos all day? Anyway I can't abandon my patients." Biderman spoke slowly and carefully without any passion. "Anyway when I go it will be after the director and I will go when I am ready." His colleague looked surprised, hearing that from Biderman.

He shrugged his shoulders, his bottom lip puckered. "It's your life or his."

Biderman became thoughtful. "Yes, I think your are right."

The week after his colleague retired, the director called Biderman into his office. The director ordered him to sit down and pulled out a dossier. "Your output is far below the rest of the doctors. Maybe it's your age, or the old fashion methods you still use. You have deliberately resisted the modernization of your practice. Why are you so rebellious, are you on some kind of vendetta against the President's plan to take us into the First World?"

Biderman sat quietly and refused to be provoked.

"No." He answered. The director tightened his lips and then spit out his words in a quiet rage. "Biderman, that's not an Argentine name is it?"

Biderman looked at him calmly and answered: "That's what it says on my identity card." "They made a mistake," the Director missed.

Biderman leaned slightly forward.

"I was born in Argentina, I work in Argentina and I will die in Argentina?what else?" Then, after a pause, Biderman added in a very clear methodical voice, "But at times I am a Jew."

The Director sneered. "How's that 'at times'? You're either a Jew or an Argentine," he ejaculated.

"I am an Argentine but faced with an anti-Semite I am a Jew." Biderman spoke in an even voice, looking into Director's eyes.

Silence. The Director bit his lip and gestured toward the door.

Biderman left and went back to his office.

The following day upon entering the clinic, the personnel director handed him a memorandum of dismissal. The charges poor treatment of patients, inattentive to hospital norms, unsanitary office and hostility to administrative personnel. As he walked out, his head sunk to his chest, a patient walking in the corridor greeted him.

He looked up. "Hello doctor. I brought my baby she has a chest cold. When can we see you?"

He smiled and walked on.

He went home on the mid morning bus. It was quite empty at that hour. The sun poured into the windows on the vegetables in the shopping bags of the older housewives coming back from the market.

He got off the bus and went into the house. His dog raised his head and wagged his tail. Biderman went into his bedroom looked at an older picture with his mother, opened the drawer of his bureau,and picked up a gun. He took the bus back to the clinic. He walked into the Director's outer office where the secretaries and clerks were scurrying back and forth. He walked straight through, opened the Director's office and walked up to the desk. The Director glanced up in time to catch the bullet in the forehead.

Before the stupor of the office workers, as he was leaving, Biderman said, "Now you don't have a Director." He went to the bar and ordered a ginger ale and waited for the police to arrest him.

The newspapers described the director as a man of 42 years old with two kids, who was known by his colleagues as a very likeable but highly professional administrator.

Biderman's colleagues spoke highly of him as a cordial, quiet and competent doctor. His patients said he was a very attentive and caring doctor. The waiter at the bar where he took his drink said that he didn't appear to be ? One newspaper mentioned that he received his medical degree late in life and had worked for years as a paramedic.