The men’s footsteps echoed through the empty hallway as they walked along the dull linoleum floor, one behind the other, toward the patient’s room. The hospital attendant was in the lead and dressed in white from his shoes to his stiff ironed shirt. He was strong and tall, with big arms and long legs, the stride of which he modified for the sake of his companion. The other man was tall, as well, but older and much slower. Not long ago he had undergone another procedure to treat his rectal cancer, and he felt it in each step he took. His hair, what was left of it, had turned gray, along with his Van Dyke, and a fistful of skin drooped off his neck. His outfit was casual, clean pants and a shortsleeved shirt.
“We’re almost there, Dr. Freeman,” the younger man said.
It had been about ten years since Walter Freeman’s last visit. Looking over his records the night before, he found that he had performed thirteen transorbital lobotomies that day. Of the patients he treated, just one remained under the hospital’s care. One was in prison, two had died. The others returned home to their families. Freeman smiled.
The attendant stopped at a heavy door with a picture frame-sized window at eye level. “Here we are,” he said.
Freeman peered in, his breath fogging the thick glass. Inside he saw the hulking outline of a man who sat in a chair that faced a tall barred window overlooking the hospital grounds. Freeman took a black pen from his breast pocket and clicked it before he made a series of notations on the yellow notepad he carried.
“This is the man,” Freeman said. It was not a question. His voice was sharp and commanding, like that of a military officer, and the attendant was caught off-guard by its strength.
“Yeah. You don’t hafta worry about him, he’s pretty calm. I’ll be right here in case anything happens, though.
Freeman nodded, his eyes trained on his subject.
“Dr. Brewster told me he was sorry he couldn’t make it today.”
“That’s perfectly all right,” Freeman said. “It’s not him I came to see.” He took a step away from the door. “You may enter first.”
The attendant gave the door a gentle knock, then lifted the handle until it clicked. Pushing the door open, he knocked again. “William?” he said as if he were addressing an easily-frightened child. “William?”
The patient turned in his chair to look at the visitors. His heavy eyelids made a few sluggish blinks, showing no signs of recognition.
“How you doin’ today, William?” the attendant asked.
The patient watched them, silent and disinterested. His big green eyes lolled about, hazy and unfocused. His dirty blond hair was sheared close to his scalp, with uneven bits sticking out here and there like tufts of stiff dead grass. He had the fat cheeks of a baby, with downy patches of white fuzz sprouting by his ears.
“Can he not speak?” Freeman asked.
“Nah, not really. He makes noises sometimes, but I don’t think he says any real words.”
Freeman jotted something down. Then, pen in hand, he took a step closer and spoke with careful enunciation. “William,” he said a bit too loud. “William, can you tell me how you are feeling?”
He received no answer.
“Can you tell me how you are feeling, William? Can you tell me where you are?”
The patient continued to stare. His mouth hanging open, he sniffed and coughed, and a gob of bubbling saliva dribbled onto his pudgy chin.
Freeman turned back to the attendant, who was removing a clean handkerchief from his front trouser pocket. “You — forgive me, what is your name again?” He swung his pen like a baton as he spoke.
“Joe,” the attendant said and sidled past the doctor.
“How long have you worked at this facility?”
“Fifteen years,” Joe said as he put the handkerchief to William’s mouth, and dried it with brusque strokes. William did not respond to his touch.
“Were you here the day of my visit?”
“Yeah. Yes, sir.”
“Had you regular interactions with this patient?”
“William,” Joe said. He straightened his back and gave the handkerchief a shake before returning it to his pocket.
“William. Did you interact with him on a frequent basis?”
“Yes, sir.”
“How would you compare his current behavior to that he displayed prior to the surgery?”
Joe shrugged. “Can’t really. He don’t do too much now, you can see that. Just sits there and stares out the window. If he’s not there he’s sittin’ starin’ at something else. Like I said, he don’t do too much.”
“And before?” Freeman asked, raising his eyebrows.
“I guess he was kinda wild.”
“Kind of wild? You guess?”
“He was wild,” Joe said, shrugging again.
Freeman held his pen above the notepad, as if poised to write. “Please continue.”
“He shouted a lot. He hit people. I remember one time he got hold of someone’s hair. He wouldn’t let go, and he ended up yankin’ out a good chunk of their skin.”
A flurry of pen scratches continued long after Joe had finished speaking.
“And this was another patient, you say?”
“Sir?”
“Whose hair our friend yanked out by the roots. It was another patient?”
“Yes. Yes, sir.”
“I see,” Freeman said and went back to his writing. “Apropos of nothing, I suppose.”
“I don’t know what that means.”
Freeman looked at him and smiled. “This person did nothing to initiate the attack.”
“Oh. No, sir, they didn’t.”
The doctor removed his glasses, brought out a cloth and polished them. All the while he watched the man in the chair, as if by waiting long enough he could will him to acknowledge his presence.
“Do you suppose,” Freeman said, replacing his glasses, “that if we came back in, say, twenty minutes his behavior would be any different?”
“I don’t know why it would,” Joe said. “You never can tell, I guess.”
Moments later the men sat across from each other at the long wooden table in the employee lounge, drinking coffee from white paper cups. The refrigerator droned nearby with a high-pitched rattle. Freeman took more notes and thought back to his previous visit. It was during one of his cross-country voyages, on which he would travel state by state, performing transorbital lobotomies as he went. Along with the electroconvulsive shockbox, surgical instruments and patient records, he liked to load his station wagon with camping equipment and rough it the night before he arrived at the hospital. By the tie summer was over he could easily end up driving eleven thousand miles.
He had arrived at this hospital just after daybreak to take a survey of the patients he might be able to treat, had lunch and then began to operate before a crowd of resident specialists. One of them fainted watching him work. That happened often. Some people just were not strong enough, Freeman thought with a smile.
But those days were over, thanks to the woman last year. It was her third procedure. She had undergone her first in 1946, her second ten years later. Then, during their final encounter, she suffered a brain hemorrhage and died. It was his last operation.
Sipping his unsweetened coffee, Freeman pondered the irony of the situation. Not once had he sought her out as a subject for surgery. She always found him, always asked for his assistance, always seemed so grateful. It truly was unfair. He remembered his visit to Cherokee, Iowa, in 1951. Twenty-five patients and three of them died. Nobody complained then.
Freeman opened his case and fetched another notepad. As he took it a bright blue envelope tumbled to the floor. He did not notice.
Joe stood and walked around the table, and stooped to retrieve the fallen item. “Here,” he said, offering it to the doctor. “You dropped this.”
Freeman glanced at him. “Open it.”
“No, that’s okay. Here.”
“I told you to open it. I want you to read it.”
Joe turned the envelope in his hands. He slid his finger beneath the flap and pulled it loose. Inside was a card depicting a honey-drenched sunset over a calm beach, with the words “Thank you” embossed at the top in red script. Joe opened the card and found a message written in smooth black ink: “Thank you so much for helping our boy. He is much better now.” Joe did not read the rest of the note. He put the card back in the envelope and set it on the table.
“How many of your doctors here receive cards like these?” Freeman asked. “I have hundreds. People write me all the time to thank me for what I’ve done for them. For their mothers, or their fathers, or their children. How often are your doctors met with such gratitude?”
“I don’t know,” Joe said.
Freeman clicked his pen. “I’ve been speaking to as many of them as I can these past few months. I’ve been traveling all over the country in my van, interviewing my patients and their families. I’ve seen some of them multiple times and they never fail to thank me. Many of them weep during our meetings. They cry real tears when they thank me.”
Joe nodded. He said nothing. The doctor watched him, his head tilted to the side in a permanent, almost arrogant show of defiance. Joe wished he would stop talking.
“I plan to see some more of them today,” Freeman said. “Some of the others who live nearby. I plan on interviewing them and adding the data to my case files.”
Joe returned to his seat and drank some coffee. Freeman set his pen on the table and folded his hands.
“Have you something you wish to say?”
“No, sir.”
“Don’t be shy. I encourage questions.”
Joe held his cup. “All those people you saw,” he began, staring at a place where the finish had been worn off the table. “Did they all turn out like William?”
“They did not. Results of the procedure varied on a case-by-case basis, the vast majority of which were positive, I feel.” Freeman picked up his pen and clicked it once more. “I have some inquiries of my own for you. May I?”
“All right,” Joe said. He put down his cup and crossed his arms as if he felt a chill.
“Relax, this is strictly informal.” Freeman adjusted his glasses and stared across the table. “You’ve established your employment here on the occasion of my previous visit. Were you here on the day in question?”
“I helped bring them in and take them back to their rooms.”
“Ah, very good. Very good. What did you think?”
“I couldn’t really say. I don’t really know much about this kinda stuff.”
“Which is precisely why I want your perspective — your insights are of much value to me. What did you think? You didn’t faint.”
“No.”
Freeman waited.
“I just don’t know. I wouldn’t wanna say anything. I really don’t know anything about it.”
“What about the procedures themselves? What were your impressions?”
Joe lifted his cup and held it near his mouth. “Seemed kinda strange, I guess, but you know. I don’t really…”
“Strange? How so? Please continue.”
“Well, I mean, shoving that thing into their eyeball—”
“The orbitoclast.”
Joe looked up. “The what?”
“The orbitoclast. The surgical instrument.”
“Oh.”
“It replaced the leucotome. It was much stronger, you see. The leucotomes kept breaking off midway through the procedure.”
Joe set down his cup. “But the orbit?”
“The orbitoclast.”
“Yeah.”
“What would you like to know about it?”
“Just seemed sorta strange to me. It looked kinda like an ice pick or something.”
With a smile, Freeman leaned back in his chair. “It’s funny you should say that. The first transorbital procedures I ever undertook were performed with an ice pick I borrowed from my own kitchen.”
Joe rubbed the flat paper handle of his cup with his thumb.
“And, to clarify,” Freeman added, “I never once shoved anything into a patient’s eye. I inserted the orbitoclast between the eye and the eyelid, not into the eye itself.”
“With a hammer.”
“Again you are incorrect. It was a mallet. Its use was necessary, too, in that it enabled me to push the orbitoclast through the roof of the orbital cavity. Otherwise I would never have been able to get it into the prefrontal lobe.”
Freeman’s tone was never anything less than cordial.
Joe sipped his coffee. “It just seemed kind of… I don’t know. Strange. But you know, I’m not a doctor.”
“No,” Freeman said. “You’re not.”
William had not moved since the men left his room. Although he was seated facing the door, he did not react when they returned. The only sound he made was that of his calm, steady breathing. Joe put a metal folding chair three feet before him and waved. “We’re back, William,” he said in a quiet voice.
Freeman sat in the empty chair and Joe moved aside to give him an unobstructed view of the patient.
“William,” the doctor said. “William, can you understand me?”
William did not even move his head at the sound.
“Can you hear the words I am speaking to you, William? Can you say anything yourself?”
Silence. Freeman made a notation.
Joe shifted in the doorway, sniffing as he spoke. “Like I told you, he don’t really say anything now. Course, he didn’t say much before, either, to tell you the truth. I’m sorry you came all this way for nothin’.”
“No matter,” Freeman said and continued to write. “He has family nearby, and I’ve an appointment with them later on today. I’ll be speaking with some other patients, too, before I move on.” He clicked his pen and returned it to his pocket before he twisted in the chair to face the other man. “So, the trip is hardly wasted, is it?”
Joe shook his head. “No, sir. I’m sorry.”
Freeman rose without speaking and set his case on the chair. Opening it, he slipped the notepad into a sleeve on the lid, which he then closed and snapped tight.
“Would you mind accompanying me back to my van?”
IN the hallway Freeman limped as if he had a jagged stone in his shoe.
“Are you all right?” Joe asked.
“I’m just a bit stiff.”
“You need me to carry your bag?”
“Certainly not.”
Soon they came to a water fountain. Freeman stopped, set his case beside it, and took a long drink. Beads of moisture dripped from his lips when he righted himself and he wiped his mouth with the palm of his hand, which he then rubbed dry on his khaki pants. He clicked his wedding ring against the whitepainted metal side of the fountain and pointed toward his case. “Hand that to me, please.”
“I can carry it if you need me to,” Joe said as he picked it up.
“That’s not necessary.”
Taking the case, Freeman led the way down the hall, slower than before. After a moment, he asked, “What did your father do for a living?”
“I don’t know, sir, I never met him.”
“My father was a physician,” Freeman said as if he had received no answer. “He specialized in otolaryngology. My maternal grandfather was a physician, as well. He once served as president of the American Medical Association. He even performed surgery on Grover Cleveland.”
Joe gave a polite nod.
“To think I used to be more famous than he ever was.” He chuckled before adding, “Now I’m just a fossil.” He laughed a bit more before going quiet. “Have you any children?”
“No, sir, I don’t. You?”
“My wife and I had six.”
“That’s good.”
“They buried my youngest son today,” Freeman said.
Joe looked at the doctor, who stared straight ahead as they walked. “Sir?”
“My youngest son,” Freeman said. “Randy. They buried him today. He developed a metastatic brain tumor. He had melanoma.”
“You didn’t go to the funeral?”
Freeman shook his head. “My work is important. If I don’t do this now I may not get another chance. And anyway, I was too far from home when I heard the news. I would never have made it in time.”
Joe stayed quiet. The hallway seemed endless.
“My children often would accompany me on my travels,” Freeman said after a bit. “Instead of staying the night in some overpriced hotel we took backpacking trips between my hospital visits. I still do, in fact. I camped out last night. I remember one particular trip, to Yosemite. I had with me my sons Keen and Randy, and two of my nephews. We were on the Merced River, near Vernal Falls. Keen went to the water’s edge to refill his canteen. Somehow he lost his footing and fell in. I saw it happen, yet I couldn’t move. It was as if I were paralyzed. There was a young sailor near us who dove in after him, but it did no good. The current was just too strong. I remember lying awake nights for years, when all I could see was the expression on Keen’s face as they went over the edge of the falls.”
Freeman spoke as if he were describing the weather, and it made Joe uncomfortable. The doctor glanced at him for the first time since he began his story.
“I’ve been taking Nembutal every night now for the past thirty years. Oh, I’m not addicted to it. I’ve rarely had to take more than three at a time.” Freeman continued to speak as they reached the front entrance of the hospital, where he stopped and watched Joe. “It took two days of dredging the river before the bodies were found,” he said. “They died very quickly.”
Joe moved in front of the doctor and pushed open the door for him.
“I remember there was a clean hole in the posterior region of Keen’s skull,” the old man said as he passed.
With a shudder Joe stepped outside and let the door close behind him.
In the parking lot Freeman slowly climbed into his Cortez van. He groaned as he lifted himself into the driver’s seat, and again when he shut the heavy door. “I’ll just be a moment,” he said to Joe and leaned toward the passenger side. Soon he thrust his skinny arm out the window. In his hand was a Kodak Instamatic, its thin black neck strap coiled around his wrist. “Here,” he said. “I was wondering if you might take my picture.”
Joe accepted the camera and looked through the viewfinder while Freeman leaned out the window. With a smile he extended his arm and waved. Joe clicked the shutter.
“Thank you for your assistance,” the doctor said.
Freeman began to think as he drove away. He wondered if the patient’s family would supply him with any pertinent information. Perhaps not. He doubted they paid their son many visits. It was too bad. But, at least he was no longer a danger to himself, or to others. Yes. He had done the right thing.
— Travis Gulbrandson, 2009