There is a gleam in his eye and just the hint of a lilt in his step as
Giacomo Giacomo M.D., PHD., LTD., PC, FACS, Etc. practically prances into
the doctors' dining room a few minutes before noon. Dr. Giacomo feels a
little tingle of anticipation stir in the folds of his impressive belly as
he thinks of the two harvested hearts, plump, succulent, and bursting with
blood, resting languidly in their twin igloo coolers, a plethora of
undreamed of riches.
Suddenly, a thin little moue of distaste moves across his features, crisp
and polished as a Chippendale chair. A little dark lizard of gloom crawls
slowly from his lips to the corners of his eyes.
"Bollocks!" he says lightly under his breath, "two hearts at once and
only one pair of hands!"
The shelf life of the human heart being so maddeningly limited, unlike
that of freeze-dried mushrooms or California prunes, he knows he will not be
able to retain both hearts. He will be forced to share. But, Dr. Giacomo, an
only child, is not accustomed to share. Just for a moment, a little black
thought, heavy as a rain-sodden cloud, skids across his consciousness. If I
can't have it, no one will, he thinks, as his own heart, safely set in his
chest like a diamond on its prong, begins to beat like a tightly-stretched
No, he decides, brushing temptation from his mind like so much lint, I
shall have to pass the damn thing along to Rindfleisch. But, the thought of
his rival running off with his heart brings to mind immediate images of a
pack of savages, members swollen, bearing down on a retinue of nuns. Such
musings momentarily take the edge off his appetite. Then a rich, visceral
aroma, smooth as panne velvet, caresses his nostrils, causing them to quiver
like the strings of an Irish harp.
"Ah," he sighs, "sweetbreads, with just a suspicion of port."
He catches himself quickly and retracts his tongue which is hanging over
his chin in anticipation like that of Pavlov's dog. Dr. Giacomo moves
swiftly to his accustomed table where his fellow surgeons are already busily
at work, forks and elbows flying.
"What's the plat du jour?" he asks hopefully.
"Kidneys in red wine, cow's lungs en croute", says Rabinowitz, looking up
from his plate of liver and onions.
"Sounds good," says Dr. Giacomo, 'but I have my heart set on the
"I recommend the tripe," says Semmelweiss, "a bit salty, but prepared to
Dr. Giacomo sinks heavily into his chair like water suffusing a sponge.
"Hard day?" asks Rabinowitz spearing a blob of liver.
"No," says Giacomo, "as a matter of fact, things couldn't be better. I
have two hearts," he says, trying not to sound smug.
He hears the forks clatter and the conversation cease as if sucked up
deep into a vacuum cleaner hose.
"Two hearts!" squeaks Rindfleisch like an old lock.
"It's obscene," Rabinowitz says, looking up from his liver and onions.
"Rabinowitz," Giacomo says, viewing his colleague's plate with barely
concealed distaste, "how can a man who transplants livers have liver and
onions every day for lunch?"
"Why not?" Rabinowitz counters. "None of them belong to my patients. It's
only calf’s liver."
"Be that as it may," Giacomo continues, feeling compelled to lecture,
"your choice of entree does suggest a certain coarseness of spirit, don't
you think, a slight slackening of sensibility'?"
"Man cannot live by bread and beans alone, Giacomo," Rabinowitz answers
with a hint of pique, "I need organ meat for energy. Transplanting livers is
no picnic. I have to keep up my strength."
"He's right", pipes in Semmelweiss, spearing a bit of tripe, "couldn't
you eat swordfish or a nice breast of chicken? It does seem a bit more
"I find all this talk of sensitivity a bit quaint," Rabinowitz says,
eyeing Giacomo the way a mongoose sizes up a cobra, "coming from a man who
regularly slits his patients stem to sternum, grabs a heart out of a beer
cooler, slaps it into the chest like a halibut filet, and then sews it all
up with the flourish of Bela Ligousi. I only trifle with livers. There is
something positively ghoulish about mucking about with hearts. If you had
any sensitivity, you would have selected a less emotionally charged organ to
"Hearts are trumps," says Rindfleisch, diving into his lamb's brains.
"I just think," Giacomo continues stubbornly, "that it would be more
professional if a man who transplants livers didn't eat them regularly for
Schadenfreude, with a quick reptilian flick of the tongue, deftly removes
a blob of gravy from his chin.
"By the same token," he says, "Wickham, as a neurosurgeon should never
indulge in lamb's brains or sweetbreads, at least not in public."
"Well," Giacomo says, "has anyone ever seen me eating hearts!"
He preens like a pouter pigeon as he plunges into his sweetbreads with
the vigour of a high-diving horse.
"Have you ever noticed," Rabinowitz says spitefully as he plops a large
slice of liver into his mouth, "that Giacomo always seems to have a fistful
of organs at the ready while the rest of us are shackled to lists?"
Giacomo drops his fork as if bitten by its prongs.
"Are you suggesting," he hisses, "that there is anything unorthodox in my
organ retrieval system!"
"Of course not," Rabinowitz says smoothly, "but there are some of us who
wonder why you are always hanging around the intensive care unit and giving
out boxes of Belgian chocolates to the nurses."
Giacomo opens his mouth and expels two sweetbreads but, before he can
reply, he is interrupted by Steinmetz.
"Now that we are discussing the ICU, that brain-dead girl you have on the
respirator, Schadenfreude, I noticed that her colour's not too good. How
about slipping me her lungs?"
"What's in it for me?" Schadenfreude asks, less than graciously. "I have
two kidneys I might be able to get my hands on," Steinmetz says.
"OK," says Schadenfreude.
"I don't wish to appear piggish," Steinmetz says, pushing his luck, "but
perhaps you could throw in the liver and corneas as well. Then I could trade
with Bongiorno, Augenblick, or Rabinowitz for-….
"Just a minute!" Semmelweiss scolds, putting down his fork, "is this what
we've come to, trading body parts like baseball cards! No wonder the rest of
the staff refers to our table as the Auto Body Shop. Gentlemen, I beseech
you, a little decorum, please."
"Oh," says Giacomo, with a voice hard as a silver spoon, "they call us
the Auto Body Shop do they? Who does, all the paediatricians who wipe snotty
noses all day for peanuts? It's all envy. Sour grapes. We surgeons are like
fighter pilots, the elite of our profession. It's only natural that we would
get some sniping from the ranks. Our hands move with an inborn grace, like
Pavlova dancing the Dying Swan. Remember gentlemen, surgeons, like
Rembrandts, are born not made-"
"Hear! Hear!" His colleague's voices rise around him softly like a chorus
of smoke signals.
"Have you tried the steak and kidney pie?" Semmelweiss asks timidly
hoping to direct the conversation to a less emotionally charged topic, "I,
myself, of course, being a transplanter of kidneys, would never touch them."
He waits expectantly for their compliments on his sensitivity. None are
"Did you hear the story about the South American dictator who cooked his
prisoner's son and served him to him in a chafing dish?" Bongiomo offers,
hoping to turn the conversation to a more pleasant topic.
"Pass the hearts of palm, please," says Semmelweiss. "How's the harvest?"
Giacomo asks, just to make conversation. "Heavy on hearts, low on lungs,
kidneys dipping, skin and corneas holding." Rindfleisch says.
"I have a heart and two lungs hanging by a cat gut," Rabinowitz offers,
"liver's gone though. Drats! Anybody need a trade?"
"Pass the bread and butter, please," says Bongiorno.
"Pass the slaw," says Steinmetz.
"I'll trade you a heart and a kidney for a lung. Any takers? he asks,
plopping a sliver of cow's lung deftly into his gullet.
"Steinmetz!" Giacomo asks disapprovingly, "are you eating lungs?"
"What if I am!"
"I had hoped we had all agreed not to eat what we transplant."
"Ditto," says Rabinowitz.
Giacomo rises from his seat, a tiny speck of sweetbread swinging from his
chin like a little flag. "Please, Steinmetz," he says, "no gutter language
"Sorry, the pressure is getting to me," Steinmetz mutters, lunging for
another bit of lung. I need a week in Acapulco."
"Might I try a bit of kidney?" Giacomo asks, moving his fork toward
Bongiorno's plate, "I do hearts."
"Certainly, as I do corneas, I have little conflict at table." "Corneas
are best. Very uncomplicated," says Augenblick, from across the table.
Steinmetz appears to be losing control. "Listen," he says, rising from
his chair, "I'll trade you one of my own kidneys for a lung, half a lung."
"No can do," Schadenfreude says.
"Gentlemen," Augenblick says, spearing a carrot "don't we have lists? All
this plotting and trading smacks of blackmarketeering."
"Well, Augenblick, as you only dabble in corneas, you can afford to be
holier than the Pope. The rest of us deal in vital organs," Rabinowitz says,
with the hint of a sneer
"Now, see here," Steinmetz shouts, grabbing Schadenfreude by the neck,
"are you holding out again! Everyone knows you're always skulking around the
ICU pulling out plugs. Every time you do your rounds, the next sound we hear
is the crash cart!"
"What nerve!" Schadenfreude says, deftly removing Steinmetz' hands from
his throat, "this is slander!" He attracts the attention of several
podiatrists at a nearby table.
"See here, I have never deliberately pulled a plug on a patient in my
life," he continues, "occasionally, I trip and pull one out accidentally. I
have ambylopia and lack depth perception. It's an act of God. If God had
wanted the patient to live, He would have made sure that I saw the cord!"
"It seems to me that you've been very clumsy lately," Rabinowitz says
sourly, "every time you need a kidney, you take a pratfall in intensive
"Pass the crudites, please," says Bongiorno, desperately trying to make
"I can't take all this pressure!" Steinmetz says again, his voice taking
on a sharp edge of hysteria, "I'm off to Palm Beach next week for a few
rounds of golf and I don't want any of you mucking about with my sources
while I'm gone, no plug-pulling - and eyeing Schadenfreude - no tripping, or
"Or else what?" Rabinowitz asks, laying down his fork as quietly as a
"Or else our Thursday golf game is off indefinitely," Steinmetz says
"Gotcha," says Rabinowitz and returns to his liver and onions.
"I don't want any lungs changing hands while I’m gone," Steinmetz says,
"it's getting so you can't even take a vacation anymore."
"Listen," he says, beginning to become agitated, "let's come to an
agreement - that girl in the coma - when she goes - how about I take the
lungs, Rindfleisch or Giacomo takes the heart, Schadenfreude or Semmelweiss
gets the kidneys, Bongiorno or Augenblick takes the corneas, Rabinowitz gets
the liver. Well now, what's for dessert?"
"Blood pudding!" Schadenfreude says sarcastically.
"You know," Steinmetz says, looking at Schadenfreude like a robin taking
the dimensions of a particularly succulent worm," you know you haven't been
looking too good lately. Color's bad. Better let me take your pulse."
"I don't like the way you're looking at me," Schadenfreude says, "don't
look at me like I've got potential. You're a ghoul, Steinmetz. One sneeze
and he's already mentally snipping out your lungs!"
"You're right, Schadenfreude, "I'm losing it, but I'm desperate for lungs
and you're the only one at the table who's under forty. No one else's organs
are viable. Forgive me. I forgot myself. But I'm like a bricklayer with no
bricks! The pressure's building up. I can't take it. Last night, my wife got
a headache and for one awful moment I found myself hoping it was a fatal
'The trouble is that we've all become too competitive," Rindfleisch says,
"too goal-oriented, too driven. Medicine has become too much of a business,
not enough of an art."
"Right," Semelweiss echoes, " there's no real humanism left in medicine,
no real concern for the person qua person."
"Hear! Hear!" A chorus of nods.
Steinmetz rises from his chair as if to go to the men's room and neglects
to put down his steak knife. He trips over the rungs of Giacomo's chair and
falls onto Schadenfreude, plunging the knife three inches into his chest.
The blood sprouts out like a bouquet of Helen Traubel roses, red as plum
tomatoes, splattering the remnants of Giacomo's sweetbreads, dusting the
last of Rabinowitz' liver and onions, spotting Bongiorno's kidneys with
flecks of red.
The table rises as one to staunch the flow of blood.
"Not so quickly, gentlemen," says Rabinowitz, "a colleague is a
colleague, but, after all, a liver is still a liver and a lung is still a