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

"Just tell them to do it," I say, leaving.

I feel better already.

But even after that I have to take a slight break. The Moxfane I chewed up half an hour ago, along with some Dexedrine I found in an envelope in my lab coat and ate in case the Moxfane took too long to kick in, is making it hard for me to concentrate. I'm peaking a little too sharply.

I love Dexedrine. It's shield-shaped, with a vertical line down the middle so it looks like some vulvae.^[6] But even on its own, Dexedrine can sometimes make things too slippy to focus on, or even look at. On top of a Moxfane it can make things start to blur.

[6] In fact, the medical word for pubic hair, "escutcheon," means "shield," although in free-range humans only women's pubic hair is shield-shaped. Men's is naturally diamond-shaped, pointing up toward the navel as well as down toward the groin. Which is why women who shave their pubic hair into a diamond shape subconsciously skeeze you out.

So I go to the medicine residents' call room to chill out, and maybe take some benzodiazapines I've got hidden in the bed frame.

The second I open the door, though, I know there's someone in there in the darkness. The room stinks like bad breath and body odor.

"Akfal?" I say, though I know it can't be Akfal. Akfal's aroma I will take to my grave. This is worse. It's worse than Duke Mosby's feet.

"No, man," comes a weak voice from the corner with the bunk bed.

"Then who the fuck are you?" I snarl.

"Surgery ghost," ^[7] the voice says.

[7] This is an actual job, though it's not interesting enough to go into.

"Why are you in the Medicine call room?"

"I. .. I needed a place to sleep, man."

He means, "Where no one would look for me."

Great. Not only is the guy stenching up the call room, he's using the only available bunk, since the upper one is covered by a complete run of Oui magazine from 1978 to 1986, which I know from experience is too much of a pain in the ass to move.

I consider just letting him stay. The room smells unusable for the foreseeable future anyway. But I've got that Moxfane Edge, and there's always deterrence to think about.

"I'll give you five minutes to get the fuck out," I tell him. "After that I'm dumping a bottle of urine on your head."

I turn the lights on as I go.

I'm feeling slightly more focused now, but still not focused enough to talk to patients, so I go and check labs on the computer. Akfal has already copied most of them into the charts. But there's a pathology report on a patient of Dr. Nordenskirk's who actually has insurance, so Akfal hasn't touched it. Dr. Nordenskirk doesn't let anyone who's not white or Asian interact with patients with insurance.

So I scan the report on-screen. It's a bunch of bad news for a man named Nicholas LoBrutto. The Italian name alarm in my head goes off, but I'm pretty sure I've never heard of this guy. And anyway mobsters - like most people with options - don't come to Manhattan Catholic. It's why I'm allowed to work here.

The key phrase in the pathology report is "positive for signet cells." A signet cell is a cell that looks like a ring with a diamond (or a signet, if you're still sealing your letters with wax) on it, because its nucleus, which is supposed to be in the center, has been pushed to the wall by all the proteins the cell can't stop making because it's cancer. Specifically, either stomach cancer or cancer that was stomach cancer and has now metastasized, like to your brain, or your lungs.

All stomach cancers suck, but signet cell is the worst. Where most stomach cancers just drill a hole through your stomach wall, so you can have half your stomach cut out and conceivably live, just not be able to shit solid, signet cell cancer infiltrates the stomach along the surface, producing a condition known as "leather bottle stomach." The whole organ has to go. And even then, by the time you're diagnosed it's usually too late.

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