The entirety of Walter Robinson's piece "White Coat, Black Habit" appears in Issue 60: At Sea.
I am defeated by the smell of blood
In the last hour of the day in a coal mine ten miles out of town, a top-mounted conveyor caught a man between the belt and the roof of the mineshaft, scraping his body along the jagged seam. Only his helmet kept the machine from crushing his skull. Someone shut off the diesel engine and pulled him from the mechanism and someone else got him to the surface, his moans echoing though the shaft.
The EMTs rolled him into the ER on a narrow stretcher and placed him on a trauma bed set like an altar in the middle of the treatment room. The nurse put EKG leads on his chest and an IV catheter in his left arm, checked his pulse and pupils. Only once she was sure he was stable did she begin to peel off the dressings around his chest. A wave of blood crested onto his plaid shirt; she clamped a thick white bandage over the wound and called for the doctor, “Hey, back here, now.”
I was a twenty-three-year-old volunteer in the ER, one year before starting medical school. I stood uselessly outside the door of the treatment room. The stench of so much blood, the stained clothes, and the low moans of the miner collided against me. I felt as if my head were lifting off my neck and floating over me; the hallway seemed to jerk sideways and spin forward. The ceiling lights narrowed into a spiky cone surrounded by inky dark. I could feel my feet inside my socks.
I sat down heavily on a low metal stool, my head in my hands.
I thought: Do not fall over. Do not pass out.
I thought: Do not make a fool of yourself.
I thought: You will never survive as a doctor.
I see the molecules of God
When I was seven, I could see round circles of shining gold filling the bars of the cross behind the altar at our church, forty-eight perfect circles aligned in hollow rows. I thought they were the building blocks of holiness. God was made of golden molecules, divinely symmetric, glowing above my head. I could not get the cross and the circles in focus all at once. The cross floated in front of the wall behind the altar and I thought the molecules of God’s holiness held the cross in place. I had no choice but to gaze at God’s solid, inexplicable presence, the buoyant proof of living divinity.
I didn’t take Jesus very seriously. He was a pale man in a pastel bathrobe on a filmstrip and we only saw him in Sunday School. Jesus smelled too much like paste to be a serious part of the divine world. He was full of advice, but all the men in my childhood were full of advice, none of which I could follow: Keep your eyes on the ball, keep your sights set on target, don’t think too hard, don’t be so sensitive. Golden molecules of God made more sense than any of that. Jesus said Drink ye all of this, and I thought he meant that you had to drink the whole cup of wine at once, which no one seemed to do, and anyway this command sounded like Jesus telling us to clean our plates.
What I loved when I was a boy was the language of the service, the Thee and Thou and the rhythm of the words, but especially the sameness of the words every week. Morning Prayer was the first play I ever learned by heart. As I got older, like everyone who has seen a play over and over, I became a connoisseur and critic of the performance. I could tell when the minister said the words with hesitation or added some new inflection. I cringed when he didn’t have the right solemnity in his voice. I thought of the service as poetry. The only poet I knew was A.A. Milne, and I was a great reader aloud of his poetry. I won a prize for poetry recitation every year from first grade until fifth, except in sixth grade when I wanted to recite a poem by Robert Service about how Adam did not have a bellybutton, but was not allowed because it might confuse the children in the lower grades. If I hadn’t read the poems just so, I wouldn’t have won the prizes, would I?
These words were written down centuries before I was born, and if the words were said out of turn or in the wrong tone of voice then the holiness might not descend. If we didn't get it just right, the golden circles might just be metal, and the church might be just a big room, and Sunday morning might be nothing special.
I practiced not needing the prayer book, because I thought God would want me to know his words by heart. I criticized those adults who still used the book, including my father and mother, and hoped that God would have patience with them for not studying enough. I wanted to have the words of the prayers flow out of me, come forth as if commanded, so that I could feel their meaning, even if I did not understand them all. The words were a script for talking to God, and I wanted to get my lines right.
I cut open my first patient
In the dissection room, a week into my first year of medical school, I surprised myself by being unmoved by the proximity of twelve dead human beings. After that first evening in the ER I was never truly squeamish again. Dissection didn’t bother me at all. Gloved-up and holding a new scalpel in my right hand, I made a line straight down the sternum and then laterally across the top of the chest near the collarbones—I had not yet learned to call them clavicles. I peeled back the cool gray skin to reveal the thin flap of muscle called the platysma, a word that even now sounds perfect in my mouth, the second syllable emphasized in the same manner as epiphany.
True, the smell was bad, and it seemed to cling to me. The perfume of formaldehyde lived inside my nostrils and sometimes I thought I smelled preservative every time I blinked. But the senses exhaust themselves, and a few breaths on entering the room each day were all it took to no longer to notice the reek while I worked on the body.
Our cadaver was a large bald man with a body shaped like mine is today, flabby and round. He was hairless except for his groin. I am anything but hairless, so I will be the polar bear to his walrus, if they still do human dissections by the time I am a candidate. There will be one other difference: our cadaver’s eyes were empty sockets, cotton balls with white flame-like wisps licking the air through his eyelids, his corneas harvested to give sight to someone still living. My incipient cataracts will ensure that medical students will be able to look right into the windows of my soul, should they feel the need.
To cut open a stranger’s dead body you have turn off your imagination. You have to refuse to ponder the indignity of death. You have to focus on the usefulness of the human husk. What once was a person is now a lesson plan. You hope to benefit people you have not met. Your cadaver is your first patient, and you are not yet a doctor. I spent a lot of time picking globs of fat away from something I thought was the vagus nerve, only to discover that I had been carefully uncovering a strand of connective tissue so irrelevant as to be nameless in the textbooks.
Near the end of the months of dissection the body looks very much worse for wear, usually cut in half through the spinal cord so that the different student teams can work on the upper and lower body at once. You discard all the organs and tissues already examined, so that the body shrinks each week, and what is left falls apart in your hands, shredded as it is by all the poking and prying of your tools.
I was solid now, fearful of failing but not of fainting. I had come to understand how to distance myself from my imagination. I began to reconfigure frailty into curable sickness. I was learning to see people as bodies.
I consider the black habit
I became a doctor, and twenty years later, I wanted to become a monk as well. I wanted to put on the black habit and white rope belt of The Society of St. John the Evangelist, an Episcopalian order. About fifteen monks lived in the monastery. For one year, every day before going to work at the hospital, I went to the Morning Prayer service at the monastery. Outsiders like me could come to the monks’ services and sit to the side of the central aisle. We spoke and sang the service together, although I mumbled in exhaustion some mornings.
I wanted to join the monks because in their presence I thought I could speak to something like God. I wanted to leave the relentlessly contemporary language of medicine for half an hour and rest inside the solemn vocabulary of my childhood. It was a relief to return to the Book of Common Prayer.
The yearly cycle of the Psalms turned upon a wheel forged by certainty about human nature. During one week, the monks and I begged a vengeful God to smite our heathen enemies in ways too terrible to say aloud: leave them yowling in pits of oily despair, rend their limbs, break their ungodly teeth, cover them with running sores and pinching pains. Through the Psalms I might delight in the suffering of the ungodly and join my voice to others in the expectation that He might hound them trembling from their strongholds and cast them like dirt into the streets.
In the following week the monks and I might leave off calling down plagues and instead chant our frustration at our human smallness, at the drudgery of being in a life “waxen old with heaviness.” The next month we would sing about how hard it is, and how glorious, to see the mystery of the heavens from our pitiful vantage in this ordinary world. Later we would wonder at the heavy burden of faith, how poorly we are equipped to shoulder it, and how often we stumble under the weight. A few months later we would speak all week only of waiting in fervent patience for the solace of a God who might provide something so rare and wonderful that it required its own compound word: “loving-kindness.”
I heard these verses with new ears, spoke them with a voice grown tired, and wrapped up my soul in the new opportunity to understand myself. I thought I had found the words to show me the golden molecules again. I returned to the monastery each morning like an addict. (continued in Issue 60: At Sea)
Walter M. Robinson is a writer and physician in Massachusetts. He is an editor for EastOver Press and the literary journal Cutleaf. His collection of essays, What Cannot Be Undone, won the River Teeth Book Prize for 2020 and will be published by University of New Mexico Press in Spring 2022.
Comments will be approved before showing up. We don't allow comments that are disrespectful or personally attack our blog writers.