Marcus Welby, where are you?

Mrs. R sat less than five feet away from me, a low, densely compacted woman, her stomach rested on her lap like a pudding. Her face was wide and expectant as she waited for me to answer the question that had driven her into my office half an hour before.

Why was it that every time she squeezed her left breast, she wanted to know, did it cause her to let loose a window shattering, bone fracturing belch.

Early, very early, I'd learned that medicine was not glamorous. That is, unless you think that long hours, weird odors and body fluids are glamorous. Most of the time, as wending my way through the day, I feel less like Marcus Welby, M.D. and more like the ringmaster at Barnum and Bailey's Circus.

In medical school I spent long hours with my arms wrist deep in the formaldehyde soaked chest cavity of a cadaver, learning the mysteries of the human body, but it was not until I started my clinicals, seeing patients, that I got my first glimpse of what the real life of a doctor would be.

There was the man dying from lung cancer that insisted on smoking through the hole in his throat. There was the woman who showed up in the emergency room once a month for stomach pains who was so huge that someone always found coins buried in the folds of her body. And then there was the guy who was convinced that he could kill roaches with his eyes.

Hunkered down in a corner of his room, dread locks standing away from his head as if electrically charged, he'd fix me with a stare so wildly demented it made my skin crawl and, scary as it sounds, I actually started to believe him about the roaches.

I lived in a roach infested studio apartment not far from the hospital. So bad was the problem, that I had to spread a thick circle of boric acid around my bed. Like an incantation of magic, it was my last nocturnal defense, a little perimeter of death to the beasts.

Hopefully.

Unfortunately, I had proof that this was less than completely successful. At least one of the buggers made it past my defenses. Every morning at six, when the alarm clock rang, there he was, clinging resolutely to a zero, taunting me, trapped inside my alarm clock.

I began to devise a plan to secret Roach Guy out of the hospital. Before he was cured. He was only dangerous to roaches and I was desperate.

I thought about dressing him up as an intern and sneaking him out at the end of the day, but Roach Guy had an unnerving habit of walking hunched over his knees and staring at the floor, dashing off unpredictably to root through garbage cans. To look for bugs, I presume. Not exactly inconspicuous. Regrettably, before I could devise another plan to spring him, he was given a shot of Haldol and released, having apparently lost his pesticide powers.

By the time I became a resident, I had learned to mask, if not completely lose my incredulity. I listened, seemingly impassively, as a young man explained that he'd gotten the huge gash over his eye after deciding to wrestle with a pig at 2 a.m. ( I trained in Nebraska) and while preparing a middle-aged man for surgery to have his finger reattached after he reached into a moving fan to grab at a piece of paper.

I did treat pneumonia, heart failure and strokes. I counseled people about their diabetes. I drilled holes in skulls to relieve the pressure on traumatized brains. I reversed dehydration and struggled to prevent bedsores. But in the real world, in my own office, where I was a real doctor and people listened to me (well, no they didn't, but that's another story), my days were filled with grinding monotony (rashes, colds, headaches) interspersed with insanity. (Mr. Jones, how exactly did you get the zipper of your pants stuck to your eyebrow?) Though I did kind of sympathize with the woman who mistook Crazy Glue for contact lens solution and. . . well, use your imagination.



And the roach problem followed me to private practice in Chicago. One of my first patients was a frantic young woman with an excruciating earache. She writhed in the exam room, clutching her hair, screaming, "There's something in there! It's killing me!"

While a nurse held her down, I leaned in with a scope and looked in her ear. I found myself staring at the beady eyes (do roaches have eyes?) and waving antennae of a living, breathing roach.

I had learned about AIDS, encephalitis, meningitis. I'd removed erasers from three year old nostrils and treated a woman who's eyelashes had been inexplicably singed off in the fireplace, but I'd never had the singular experience of removing a live insect from a living ear. My exposure with them was limited, the roach in the alarm clock and Roach Guy notwithstanding.

We sedated the girl. I would have wanted sedation in her place and almost everything goes better with sedation. I tried suctioning it out but the roach seemed to have developed a special attachment to its new surroundings and would not be moved. I tried pulling it out with tweezers but managed only to rip its head off.

By now, cooking school began to seem very attractive. Finally, I tried flushing it out, reasoning that getting a roach, by this time a roach corpse, out of an ear, was not different mechanically than getting out a huge wad of wax.

And it worked. After nearly an hour, five gallons of water and pounding on the opposite side of the patient's head, I had success. All those years of medical school and residency paid off. The roach was out. The woman was grateful and I was a nervous wreck.

Since then, I've learned to be surprised by almost nothing that walks into my office, though I admit to being a bit taken aback my Mrs. R's complaint. With all I had not learned in medical school, I was almost one hundred percent positive that breasts and belching were mutually exclusive. I did give a fleeting thought as to how Mrs. R. might have stumbled upon her ailment but I was unenthusiastic about pursuing that line of questioning.

I decided that no matter how bonkers I might think the lady was, reassurance was the best treatment. As I stood to leave, Mrs. R. asked me if I wanted her to demonstrate. Sure, why not, I told her. I smiled indulgently as she freed her left breast from her blouse and looked up at me.

She squeezed her left breast.

For a moment I was confused. A sound, not unlike that of an outboard motor, seemed to be emanating from the walls. I stared at Mrs. R. Though not a small woman, it still seemed impossible that a human body could generate that sound. As it grew in intensity, I wondered why my staff had not yet burst into the room to investigate. Mrs. R. and her breast were breaking at least two noise pollution ordinances that I knew of. Maybe the decibels had rendered everyone else unconscious.

It seemed to go on forever, though in truth it was probably less than eight or nine seconds. When it was over, Mrs. R calmly put her breast away and looked up at me expectantly.

I blinked and tried to think of some profound morsel of medical wisdom. What I came up with was. . .

"Oh . . . my . . . God!"

Surprisingly, this seemed to satisfy her. She smiled as she stood, reaching to shake my hand.

"The body. It is a mystery, no?" she said.

I nodded in agreement, keeping a wary eye on her breast. Later, long after Mrs. R. had gone home and I had collected my wits, I wondered.

Would the military be interested in a woman with a belch that could bring down small aircraft?