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

I sigh. I don't have a brother. But I know what he's getting at.

I put my knee into the guy's fucked-up elbow and pull the bones as far apart as the tendons feel likely to bear, then let them come slowly back together into their positions of least resistance. It makes the fuckhead groan in pain in his sleep, but whatever: they'd just do the same to him in the ER, only by then he'd be awake.

I frisk him for a cellphone. No such luck, of course, and I'm not about to use my own. If I did have a brother, would he want me getting hassled by the cops?

So instead I pick the fuckhead up and fold him over my shoulder. He's light and stinky, like a urine-logged towel.

And, before I stand, I pick up his handgun.

The gun is a real piece of shit. Two pieces of pressed sheet-metal - no grips, even - and a slightly off-center cylinder. It looks like something that began life as a starter pistol at a track meet. For a second it makes me feel better about there being 350 million handguns in the United States. Then I see the bright brass ends of the bullets and am reminded how little it takes to kill someone.

I should throw it out. Bend the barrel and drop it down a storm drain.

Instead, I slip it into the back pocket of my scrub pants.

Old habits die harder than that.

In the elevator up to Medicine there's a small blond drug rep in a black party dress, with a roller bag. She's got a flat chest, and the arch of her back boosts her ass, so she's shaped like a sexy, slender kidney bean. She's twenty-six after a bit too much sun exposure,^[2] and her nose is the kind that looks like a nose job but isn't. Freckles, I shit you not. Her teeth are the cleanest things in the hospital.

[2]* Doctors always know how old you are. We use it to tell whether you're lying to us. There are various formulas for it - compare the creases of the neck to the veins on the backs of the hands and so on - but they're not really necessary. If you met thirty people a day and asked them how old they were, you'd get good at it too.

"Hi," she says like she's from Oklahoma. "Do I know you?"

"Not yet, no," I say. Thinking: Because you're new on this job, or you wouldn't have such shitty hours.

"Are you an orderly?" she asks.

"I'm an intern in Internal Medicine."

An intern is a first-year resident, one year out of medical school, so typically about six years younger than I am. I don't know what an orderly is. It sounds like someone who works in an insane asylum, if there are still insane asylums.

"Wow," the drug rep says. "You're cute for a doctor."

If by "cute" she means brutal and stupid-looking, which in my experience most women do, she's right. My scrub shirt is so tight you can see the tattoos on my shoulders.

Snake staff on the left, Star of David on the right.^[3]

[3] The tattoo on my left shoulder - winged staff, two snakes - turns out to actually be the symbol of Hermes, and therefore of commerce. The symbol of Asclepius, and therefore of medicine, is a nonwinged staff with one snake. Who knew?

"You're from Oklahoma?" I ask her.

"Well yes I am."

"You're twenty-two?"

"I wish. Twenty-four."

"You took a couple of years off."

"Yes, but oh my God that is a boring story."

"It's okay so far. What's your name?"

"Staaaaacey," she says, stepping closer with her arms behind her back.

I should say here that being chronically sleep-deprived is so demonstrably similar to being drunk that hospitals often feel like giant, ceaseless office Christmas parties. Except that at a Christmas party the schmuck standing next to you isn't about to fillet your pancreas with something called a "hot knife."

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