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The First Circle of Hell

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 The first time it happens, Greg assumes that he's having a bad trip. Still, the feeling of déjà vu is disconcertingly intensive and the experience lacks the dream-like frenzy of previous drug-induced hallucinations. It's not a roller coaster ride straight to hell; it's more like a long, wearisome trek up a slope with a mild gradient, at the top of which you realize that you are still as far removed from your goal as when you set out, separated from it by countless rolling hills and gently dipping vales.

The ordeal that descends upon him is so well camouflaged that he fails to recognize the harbingers: his alarm clock playing ‘Satisfaction’ just like it did a week ago, the steady patter of rain on the window pane even though yesterday's weather forecast predicted unmitigated sunshine, the clatter of Mark puttering around in the kitchen before noon, the mouth-watering smell of a cooked breakfast. The latter is . . . unusual, because Mark restricts cooked breakfasts to times of tribulation, such as exam periods.

Like last week.

Greg waits until Mick Jagger has finished moaning about not getting laid (Get a life, Mick, you aren’t the only one!) before turning off the alarm. He squints at the red numerals. Fucking nine a.m.? What bug bit him last night that he set his alarm to nine? He doesn’t have anything planned for the day — unless one counts ‘packing up one’s stuff’ and ‘looking for a new life’, neither of which he's desperate to do.

All things considered, he is sure that he didn't set the alarm. He doesn’t set it by rote, and last night he'd gotten so plastered that finding his way home and into his own bed had been a challenge. He didn’t contemplate getting up at all the next day. Nine o’clock is his waking hour when he's on the verge of a major life crisis, not when the crisis has already rolled over him, leaving him broken and retching on the shattered planks of his former aspirations.

He idly picks up the alarm clock and examines it. It has passed its heyday; it’s time for their ways to part, especially if it insists on rousing him at an unearthly hour of its own accord. He'll gift it to Mark when he leaves for . . . wherever. The thought reminds him that he has to tell Mark to find a new housemate. He shuffles into the kitchen, wondering why he isn't nauseated by the smell of eggs, bacon, and pancakes. He can’t remember much of last night, except for alcohol in such quantities that he should be nursing a hangover from hell — which he isn’t.

Regardless, he is massively irritated by Mark's cheerful rendition of ‘Girls Just Wanna Have Fun’. It hasn't improved one jot since the last time he heard Mark sing it, maybe a week ago.

A week ago, like the Stones song on the radio?

He shoves the thought aside as he grunts at Mark to shut it or sing something decent instead. Mark, instead of ceasing his caterwauling, sways and weaves through the kitchen, nodding towards a chair while he piles a plate with food for Greg. It’s all queasily like last week, right down to the egg with the runny yolk.

"What's the occasion?" Greg asks, poking a slice of bacon with his fork instead of impaling and eating it. His appetite has vanished, displaced by a vague premonition.

"Exams?" Mark half asks, half states. "Need plenty of calories and proteins and saturated fats if I'm to survive till Friday. You too. You may have only one exam this exam period, but you not only need to survive, you need to pass your damn endocro ... endorco-ology exam, if you don't want to get expelled."

Mark is referring to the letter that Greg received from the Dean’s office a few weeks ago. Mark often refers to that letter; Greg equally often regrets having shown it to him in a vulnerable moment. The letter is long, because it contains a detailed record of Greg’s various failings and misdemeanors, and it is full of phrases such as ‘a deplorable academic record’, ‘lack of motivation’, ‘irregular attendance’, ‘recurring rudeness toward various members of the teaching staff’, and ‘repeated incidents of fraudulence pertaining to class assignments and project work’. It concludes with the threat of expulsion should Greg put as much as a toenail out of line, get caught cheating (once again), fail to hand in coursework on time, or fail another examination.

Mark said the same words last week (to no effect). Ignoring his repetitiveness, Greg focuses instead on correcting his misapprehension.

"Too late," he mumbles. "Endocrinology was last week. And I fucked it up."

That stops Mark dead in his tracks. "Wait, what? You took what's-it-called last week? How come I never . . . ?" He peers at the planner on the wall. "You put it down for this Friday. Was it re-scheduled?"

Greg swivels around to scrutinize the planner. "What day is it?" he asks.

"Tuesday," Mark says.

"Yeah, I got that. Which Tuesday?"

"The fifteenth."

"Oh." Greg digests this, scrubbing his face with the palms of his hands. Finally he says, "I . . . had a nightmare where I got caught cheating during the exam. Got expelled. A very realistic nightmare. Too realistic."

If the exam hasn’t taken place yet, then he must have dreamed it all: taking the exam, being called to the Dean’s office, being expelled.

"Crap," Mark says sympathetically. "Coffee?"

Greg nods, his heartbeat erratic, his brain in turmoil. On waking this morning he'd been convinced that his medical career had capsized and sunk to the bottom of the Mariana Trench, but now? He's both relieved and apprehensive. His memories of the past week appear to be a figment of his overloaded brain, but there's no guarantee that he’ll fare any better in the week ahead than in his vivid nightmare. Considering that he knows next to nothing about endocrinology, it's a fair bet that his subconscious predicted the outcome of the exam and the subsequent interview in the Dean's office with accuracy.

"So, what's your plan?" Mark asks once Greg is duly caffeinated. Mark tends to hover and worry, which irritates Greg no end, but it's impossible to get Mark to put a lid on it and get on with his own life. Does Greg ask him how he intends to pass Advanced Statistics? No, he doesn't.

He’s too rattled to evade Mark, so he says, "I, uh, sit next to a hard-working chick and copy off her paper."

There isn't much else he can do. The exam is in three days, and even if he had attended classes regularly (which he hadn’t) or had the slightest clue of the subject matter (which he hasn’t), he doesn’t have enough time to revise successfully. He has no notes and he isn’t strong on revising anyway.

"I suppose that might work," Mark says doubtfully.

"It will," Greg says. "There's always some gal with a soft spot for bad boys."

"And if you get caught?"

"I won't."

In his dream he'd gotten caught, but didn’t that always happen in nightmares? He's much too devious to get caught in real life. Besides, in his nightmare he'd cheated off the guy seated next to him — a naïve strategy. Guys are much too competitive to help their fellow sufferers. Heck, he'd never help anyone who was stupid enough to maneuver himself into a tight spot.

"You know," Mark says, "I really don't get why you chose medicine. You couldn't care less about it and you're not . . ." He breaks off, flushing with embarrassment.

Greg obligingly completes his sentence. ". . . not smart enough. Yeah, I know." He pushes his half-eaten breakfast aside.

"You could be if you tried," Mark says, trying to salvage the conversation.

"News flash, Mark! Not everyone gets to be an astronaut and fly to the moon."

He’d chosen medicine because it was guaranteed to please his mother while pissing his father off big time. His dad hates doctors. There's no logical explanation for his animosity; he has no history of disease nor is he the victim of medical malpractice, so Greg figures that one of his mother's lovers must've been a doctor. Maybe it was his biological father — although Greg rather suspects his dad’s best friend, a military chaplain, of having that dubious honor. Still, he isn't about to tell Mark that he fucked up his life big time just to spite his dad, so he mumbles something about underestimating the brain-melting stupidity of medical school.

"You could at least try!" Mark almost yells.

Actually, he did — in the beginning, before it became obvious that he was way out of his depth. No amount of cockiness can disguise that he's much too slow a learner to keep up with the mad pace at med school.

Still, the shock of the morning sits too deep for him to hang around the apartment boozing and smoking dope like he'd done in the dream, so he takes off for the library with the noble intention of drowning himself in information. Unfortunately he doesn't really know where to start. The gaps in his knowledge are veritable abysses; browsing through a few textbooks won't bridge them. He scans the reading room in search of a clue on how to tackle the problem.

He spots a few vaguely familiar students at a neighboring table. Yes, he's sure that two of them were in his endocrinology class: a vivacious brunette whom he mentally dubbed 'Miss Overachiever' because she took notes frantically and frequently asked the lecturer to expand on obscure points, and next to her the brash blond frat boy who puts Greg's teeth on edge simply by existing. He can't place the second girl, a mousey type. Greg picks a random book off the shelf and walks past the group, pretending to be heading toward an empty seat at a far table.

"Symptoms of thyroid storm?" he hears Brash Boy ask. Miss Overachiever answers something that makes no sense whatsoever to Greg, but earns her nods of approval from both her companions.

A study group, Greg surmises. Miss Overachiever is exactly the person he needs to put his plan of cheating into practice; he flashes her a smile as he passes the table, so she'll remember him when he seats himself next to her during the exam. He'll have to keep an eye on her so he can follow her to the cafeteria later and get her a cup of coffee.

Sitting down at a table with a clear view of his victim, he opens the book he brought as a screen. Opposite him a guy with glasses and frizzy hair glances up before returning to his studies. Greg fidgets around until Frizzy Head gives an impatient huff.

"Could you be bored somewhere else, please?"

Greg is about to say something about the library being there for everyone — the lazy, the bored, and the dumb — when he's struck by an idea. "Say, you know the symptoms of thyroid storm?"

Frizzy Head pushes his glasses up his nose. "One, I'm not studying for exams; I’ve been done with that for years, thank God! Two, a fucking pre-med could answer your question. Three, if you don't have anything useful to contribute to the problem of what presents as scurvy, but isn't scurvy, I suggest you jiggle your legs and tap the table somewhere else."

"Looks like scurvy, but isn't scurvy," Greg repeats. "Is that a riddle?"

"The kind where, if no one finds the answer, someone dies. In this case, my patient. So shut up or scram!"

He follows the latter recommendation, loitering in the library cafeteria in the hope that the brunette student will appear. She doesn't, which means that he has wasted most of the day with nothing to show for it. He should have approached her in the library saying something like, ‘Hey, don't I know you from Rounceville's class?’ and gotten into a casual conversation from there — but he doesn't do casual.

The next two days pass in a similar manner. He hangs out in the library, smiles at the brunette whenever he sees her there (and at the Grey Mouse too, as a backup plan), but hesitates to approach either of them. They seem so . . . self-contained, so little in need of contact with him of all people, that accosting them seems presumptuous.

On Friday he enters the examination hall with trepidation. His plan to cheat off Miss Overachiever, which appeared foolproof while in the making, strikes him as optimistic and amateurish now that it's his only option. His feet drag to the extent that he's one of the last to enter the hall, and for a long moment he worries that all the seats around his target will be taken already. But he's lucky: she has opted for a spot in the front near the supervisor's desk, while everyone else drifts toward the back (which is what he, too, would be doing if his plans didn't involve her). He slides into the seat to her left and gives her a grin that's meant to convey intimacy. She gives him a cool nod before returning her attention to the notes spread out before her.

He considers further options. The girl on his other side is chewing gum and filing her nails with a bored expression. Her studied indifference could be an act; she might be brimming with knowledge that’s on the verge of spilling out onto her exam paper. He flashed her a smile too — Plan B, and all that — which she reciprocates with an annoyed eye-roll. Since her heart is not about to melt into a puddle at his feet, he returns his attention to Miss Overachiever.

"Well prepared?" he asks, because that’s the kind of question Mark would ask.

She huffs without looking up. "I don't think I understood what he said about diagnosing pheochromocytoma. Shouldn't elevated metanephrine levels validate the diagnosis?"

He has no idea, so he nods.

She flips through her notes. "Then why did Rounceville say that . . .?"

Whatever their professor said on the subject is forgotten as the supervisor calls for everyone to be seated and to remove all textbooks, notes, etc. from the vicinity of their desks. Miss Overachiever lines up a selection of pens and pencils on her desk and stares ahead in concentration while the papers are distributed. Then, when they are told to begin, she flips the paper over and starts reading the questions, her brow furrowed. Greg follows suit. He doesn't expect enlightenment from reading the paper, but he needs to figure out which questions to focus on and how many he needs to answer correctly in order to pass. And maybe, just maybe, he’ll be able to solve a few of them by himself without having to apply to his neighbor.

He has read about half the paper when he realizes that there's something very, very wrong: he knows the paper, every damn word of it! He has seen it all before, every stupid question right down to the final question mark. It is exactly the same paper as the one in his nightmare.

He sits staring at the question sheet, his palms clammy and his brain catatonic, for what seems like forever. Then he looks around furtively. Does anyone else seem fazed? No, all around him students are bowed over their desks scribbling like mad, pens scratching across the paper as though every word counted. Which it would if this was real.

But it can't be! If this was actually happening, then his fevered dreams predicted the exact wording of the questions in this exam. The mind may work in mysterious ways, but there’s no way he in his abysmal ignorance could subconsciously have crafted an entire exam paper.

There’s only one possible explanation for his prescience: last week was real; this week is a horrible dream. He intends to wake up from it as soon as possible.

He pinches the back of his hand, but to no avail. Then he tries the inside of his arm where the skin is tender. No success; he's still stuck in the hall surrounded by sweating students and the stink of despair. This is ridiculous! He picks up his ballpoint and jams it into his thigh, but his jeans absorb the brunt of the thrust. Other than a blue mark on his jeans and potentially a small bruise on his thigh, his status remains unaltered.

Desperate times require desperate measures: he reaches across to his neighbor's desk, takes one of her superbly sharpened pencils, and as she swivels her head towards him in amazed protest he rams the point into his right leg as hard as he can. The point slides easily through the cloth of his pants, punctures his skin, and delves into the muscle of his thigh. The pain is so exquisite that he can't suppress a short, sharp grunt, but contrary to his expectation, the room doesn't dissolve. If anything, it becomes clearer, every sound magnified, the colors and contours heightened. The pencil is stuck in his thigh, while the blood that is welling up around it stains his jeans. The girl next to him is rigid with shock. He grins at her, pulls the pencil out, and repeats the procedure on his other leg. Something has to give, and it won't be him! (Besides, this isn’t really happening, so he can self-harm as much as he likes.)

"Excuse me, we need some help here!" he hears Miss Overachiever call. When he pulls the pencil out of his thigh this time, he feels slightly nauseated.

"Are you okay?" The supervisor is looming over him, looking confused and challenged.

"Absolutely peachy," he growls.

"Jesus!" the supervisor breathes when he realizes what Greg has done to himself.

"I think he needs a break," Miss Overachiever suggests in a tone that brooks no contradiction.

"Right! . . . Why don't you come over here and have a glass of water?" the supervisor asks, gesturing toward a water dispenser in the corner of the hall.

Greg rises, pretending to stumble in pain so that he can drop to his knees next to the bag of the bubble gum chewer. While pushing himself upright again he slips a hand into her purse and extracts the nail file that she dropped into it when the exam commenced. In a few quick strides he crosses over to an electrical outlet in the wall and sticks the nail file straight into one of the holes.

Mark, visiting him in the hospital on Monday afternoon, kindly brings him the university's letter of expulsion. And on Tuesday he wakes, not in the hospital bed, but in his own bed with the radio playing ‘Satisfaction’.

After another dozen 'rounds' he is finally convinced that he is stuck in a rut. The parameters vary depending on whether he attempts the exam, cheats on it, sits there doodling idly, or simply plays hooky, but the net result is always the same: on Monday he gets expelled, on Tuesday at nine a.m. the cycle recommences. Staying up all night on Monday doesn’t help; sooner or later he has something akin to a blackout and finds himself waking up on Tuesday morning — the previous Tuesday morning. (Or would that be the Tuesday morning of X weeks ago?) How he cheats or whom he cheats off makes no difference; he always gets caught. And when he doesn’t cheat, he invariably fails the paper.

The other constant in the equation is the obliviousness of his fellow sufferers. Everyone around him seems unaware of the eternal repetition of a week in their existence. That only allows for one conclusion: it's all taking place in his brain. He has discarded the 'dream' theory, because other than the surreal element of repetitiveness there's nothing dreamlike about his experience. Between Tuesday and the following Monday there are no jumps in time, place, or circumstances, and he is subject to all the usual bodily constraints, right down to taking dumps.

Perhaps he's in a coma or suffering from a complex delusion. He spends a few ‘cycles’ (as he calls the repetitive week) in the library researching mental diseases and brain injury. Frizzy Head shows signs of irritation when Greg, carrying an enormous pile of books, descends on his corner table and occupies the lion's share of it, so Greg withdraws to a secluded nook of the library. He emerges only when hunger or exhaustion force him to the cafeteria or bed respectively. His hideout is nowhere near the medical section, being right in the middle of foreign languages, so he has to plunder the medical section and carry his booty through half the library. He never bothers returning books to their shelves; they are returned as if by magic on Monday night, so that he has to get them again on Tuesday.

A few weeks of research in the neurological section serve to dispel any vestiges of optimism. If Greg has a brain injury and is lying in a coma, then he's screwed, stuck in limbo with no way of freeing himself. His only chance of redemption lies in the diagnosis he'd rather not entertain: mental disease.

Since he can't stand shrinks it goes against the grain to consult a psychiatrist. The first two don't want to prescribe meds without attempting therapy sessions first, but he doesn't have the patience for such crap. Talking won’t solve his problem. The next cycle he fakes a referral stating that he has participated in months of therapy with no sign of improvement, upon which he gets a scrip for the 'good' stuff.

"Remember, it takes about ten to fifteen days before you'll notice signs of improvement," the prescribing physician adjures him.

What are ten or so days in the never-ending cycle of life? he thinks as he pops double the recommended dosage just to be on the safe side.

There's just one small hitch: his time loop is shorter than the time needed for the medication to kick in. He wakes up on Tuesday morning to the Rolling Stones — and no pill bottle on his bedside table. There’s nothing he can do about it. He hides pills around the place, he slips an extra scrip into a library book, he tapes a pill box to his leg, but no matter what he does, Tuesday dawns pristine, untouched by his efforts to leave an imprint of his previous sojourns on it. He tries different meds and even electroshock therapy, he mixes and matches, he switches to herbal remedies. All is in vain. (Besides, he isn’t sure whether he’s really taking the pills or whether they too are a figment of his imagination. Any sign of physical adjustment to the medication disappears along with his pill bottles.)

In despair, he agrees to the therapy sessions that his psychiatrist is so keen on, and having decided to give it a try, he wants as much in as short a time as possible.

“I’m afraid I can only offer you one session a week,” his shrink says, studying his calendar, “since you say you’re not suicidal.”

“Suicide didn’t work, so I gave it up,” Greg explains.

“You attempted suicide?” the man asks carefully, giving Greg a hard, assessing stare.

“About twenty times.”

“Ah. . . . I think I can fit in another two sessions this week. Tell me about your suicide attempts.”

There isn’t much to say. Suicide is an epic fail in this universe.

“When I manage to off myself, I wake up on Tuesday morning like I always do.” With the notable exception that he has vivid memories of the last moments before his death: the sickening interval between leaping from the twentieth floor and hitting the ground, the claustrophobic horror of water filling his lungs as he drowns, the panicked seconds while he asphyxiates dangling at the end of a rope. “When it doesn’t work, I land in the ER, getting my stomach pumped, my bones set, or whatever.”

Basically, suicide plays out as a choice between accelerating the inevitable return of Tuesday —because he wakes there immediately when he ‘dies’ regardless of whether he orchestrated his demise on Monday — or spending part of the week in the hospital. Even the library is more attractive.

During the third session his shrink gets around to discussing the putative cause of his ‘condition’.

"So, this examination is central to your issues, the key element, so to say," he ruminates.

Not really. The key issue is getting expelled. The circle closes, so to say, the day Greg is summoned to the Dean's office to be told that he has no future at the University of Michigan. (If he doesn’t go, then the Dean’s office calls the apartment and persuades Mark, who is obsequious to the point of stupidity, to pick up the letter of expulsion.) But for all intents and purposes, failing the exam is identical to being expelled.

When Greg offers no audible comment the psychiatrist continues, "Suppose you were to pass the examination."

It's Friday afternoon, and this morning he was caught cheating (for the umpteenth time). The fraud opposite him knows that, because Greg told him about it. Therapy sucks: this guy is just humoring him, because there’s no way he believes Greg’s story — Greg wouldn’t believe it either if it weren’t happening to him.

"Next week, or the week after, or when?" Greg asks.

"I'd say it doesn't matter. Any one time." The man is smug as anything.

"I won't." Pigs might fly.

"Why not? What's to stop you from passing it, now that you know the questions and can prepare for them?"

Greg blinks. Pass the exam legitimately? He has attempted to pass it by cheating with increasing sophistication, but so far he hasn't tried preparing for it, because he only has three days between the beginning of the cycle and the exam . . . Oh god, but he's an idiot!

He rises, grabbing his backpack.

"I’ll see you on Wednesday," the shrink calls to him as he opens the door.

Oh no, he won’t! In the very unlikely event that Greg escapes his virtual imprisonment, he will never return. Ever.

He spends two cycles in the library, this time with the exam questions before his mind’s eye as he leafs through endocrinology books. Then he gives up once again.

"Suppose you had to pass my endocrinology exam," he says carefully to Mark, "and you had all the time in the world, how would you go about it?"

"I’d attend the lectures," Mark suggests, "and take notes."

Not helpful. That ship has sailed.

"Get the books on the reading list and work through them," Mark continues.

That's what he attempted the past two weeks, but the experience was dampening. He isn’t able to glean relevant bits of information from the plethora of facts, statistics, and definitions with which the books flood him. He can’t seem to filter or discard irrelevant chunks of information. At the rate he is progressing, it will take him a minimum of ten weeks before he has a chance of passing the exam. He doesn't want to wait ten weeks. What if this crap starts all over again for every exam that he has to take? He’s only in his first year of med school; his studies could drag on forever!

"What else can I . . . would you do?" he asks.

Mark shrugs. "Join a study group and go through old exam papers, if you can obtain them."

The latter is easy. The only exam paper that counts is stored in his brain. . . . Again, there's a slight hitch.

"Uh, how do you join a study group?"

Mark stares. " Have you never . . .?"

No, he hasn't. He isn't the kind of guy who attracts company. Nor is he the type whom others want in their study groups. He’s a parasite who can’t repay by contributing knowledge in turn.

“Just . . . find one and ask if you can sit down with them. Go to the library. You know where the library is, don’t you?” Mark asks.

He’s about to tell Mark that he has spent months in the library when he realizes that from Mark’s perspective this isn’t true, so he shuts his mouth and departs.

“Take donuts with you!” Mark yells as he goes out the door.

The only study group he knows is the one with Miss Overachiever, Brash Boy and Mousey Girl, therefore they are his best option. Never mind that they don’t know him; he knows enough about them to get a foot in their door. He stops at the cafeteria to pick up a bagel with cream cheese, a turkey and cheese sandwich, and a donut with chocolate glazing, and then he makes a beeline for their table.

“Mind if I join you?” he asks, depositing his offerings on the table: the donut in front of Brash Boy, the sandwich next to Mousey Girl, and the bagel with a flourish right on Miss Overachiever’s notes.

“Who are you?” Brash Boy challenges him.

Mousey Girl squeaks, “Food is prohibited in the library. We’ll be thrown out.”

“Never mind that,” Miss Overachiever says, staring at the food. “How the hell do you know what we like to eat?”

He shrugs deprecatingly. “Educated guess. I’m Greg.”

They introduce themselves as Devin (Brash Boy), Tricia (Mousey Girl), and Lisa (Miss Overachiever). He hopes he can remember the names another three days.

“I’ve got a question,” he says. “Patient with type 2 diabetes being treated with glimepiride and something for a runny discharge. What medication could be interacting with glimepiride to cause hypoglycemia?” It’s a shortened version of the first examination question.

His three new study buddies look at each other. He must have violated study group etiquette. Mousey Girl (sorry, Tricia) murmurs, “You’re looking for an antifungal, Fluconazole or something.”

When he starts on a second question, Tricia shifts uncomfortably while Devin interrupts. “Greg, you don’t get to monopolize this study group. Do it our way or leave.”

“Wait,” Lisa says. “Give him a chance.”

She turns to him and explains how they learn: stuff about how it’s a group process and how everyone takes turns to ask questions and how everyone helps everyone else, etc., etc. He zones out for most of her explanation. He isn’t here to help anyone, and if they focused on his questions instead of insisting on asking questions of their own, they’d ace the exam.

He gives the study group a try, but he has the answer to less than a quarter of his questions when Devin loses his temper and kicks him out, while Tricia looks mortified and Lisa sighs resignedly. True, he made his lack of interest in their questions obvious and he didn’t contribute anything to the general discussion, but on Friday they’ll see that his questions were the only important ones, and then they’ll regret that they wasted everyone’s time with their stupid stuff! (But not as much as he does, because they’ll pass while he won’t.)

He takes the exam on Friday for the sake of practicing the questions that he can now handle. (If someone had told him half a year ago that he’d sit for an exam in order to get some practice, he’d have scoffed at the idea. But he’s desperate; anything that can shorten this purgatory is worth a try.) As he leaves the examination hall Lisa steps up to him. “Sorry about Devin and the study group. He isn’t a patient guy. Hope the exam went well for you.”

He mutters something about the exam being the same as usual. She looks puzzled, but then moves on to her real agenda. “There’s a dance tomorrow night at Myer’s. You coming?”

He can’t believe she means him, but a quick 360° glance assures him that he’s the only person in the vicinity. “Who . . . what?” he stutters.

“A dance; a hoedown. It’ll be fun.”

“You’ve got to be kidding!”

She huffs in annoyance. “Fine, be that way! See ya around sometime.”

He definitely will, though not in the way she thinks.

He gets better at manipulating the study group day by day, so it only takes him two more weeks before he has the answers to the entire paper. A few more weeks of this and he’ll have them eating out of his hand. Except, he doesn’t intend to stick around for any further weeks. This time he’ll pass fucking endocrinology.

Again, Lisa accosts him after the exam: Wouldn’t he like to go to the hoedown?

Why not? he thinks. Getting plastered and ogling scantily dressed girls will be a fitting conclusion to the ‘Purgatory of Endocrinology Examination’. (That subject will definitely not be his specialty!) The dance is more fun than he thought it would be. Not that he has any intention of dancing, but it’s fun watching drunk students in plaid shirts getting thrown off the mechanical bull, and he stuffs his face with caramel apples. A very tipsy Lisa tries to drag him onto the dance floor, but he resists valiantly and soon after makes his escape.

On Monday, he gets the usual summons to the Dean’s office. He walks in jauntily, buoyed by the certitude of having passed the exam. His exam paper lies on the Dean’s desk, his endocrinology professor sits in a chair next to it, the Dean thrones behind it. The Dean gestures toward a chair in front of the desk.

“Mr. House, we’ve asked you to come here to talk about your academic record.” (The interview in the Dean’s office always begins with that line.)

“I’ve passed the exam!” he states.

“Yes,” the Dean admits, “but —“

“But what?”

The Dean steeples his fingers. “Your previous record, Mr. House, leads us to believe that your sudden proficiency is, ah, unmerited.”

Rage wells up in him. “I didn’t cheat. You can’t prove anything!”

The Dean and his professor exchange glances. “No one has accused you of cheating,” the Dean says soothingly. “We suspect that the examination paper was leaked. A number of students have performed better than expected. We have spoken with these students and have come to the conclusion that although they profited from the leak, they didn’t do so knowingly.”

Greg leans back and crosses his arms in front of his chest. They can’t prove that he knew the questions.

“All suspects were able to answer further questions on the subject in accordance with the grades they received,” the Dean continues. “Professor Rounceville will now ask you some questions, Mr. House. If your performance today lives up to your examination grade, then there should be no problem.”

“You can’t do that!” Greg protests. “I’ve passed the exam. You have no proof that my means of passing weren’t legitimate, because I didn’t cheat!”

“You don’t have to answer the questions, and of course you are free to lodge a formal complaint if the outcome of today’s interview doesn’t satisfy you.”

The Dean pauses as though waiting for an answer, but Greg is struck silent. Even if he lodges a complaint right after leaving the Dean’s office, it won’t be settled for weeks. He doesn’t have weeks; he has less than twenty-four hours before he is transported back in time again.

“Derek?” the Dean prompts.

Professor Rounceville leans forward and asks Greg a question. Greg knows when he is beaten. He also knows what song he’ll hear first thing on Tuesday morning.

He’s down, but he isn’t knocked out yet. Next week, he can take the exam without attending a study group first. Then there won’t be any ‘suspicious’ leak of exam questions, because his former study group will wallow in ignorance.

But once again, Rounceville awaits him in the Dean’s office, because ‘his sudden improvement casts doubts on the legitimacy of his performance.’ He is therefore subjected to The Inquisition yet again. Outcome: identical.

No problem: if he could prepare for the exam, he can prepare for The Inquisition too, and what’s another week in limbo in the greater scope of things? He has a number of questions to go on from the two interrogations to date, so he researches those in the library. But when he prepares for growth hormones, Rounceville switches to thyroid hormones. Once he has grasped those, Rounceville pounces on insulin and diabetes. The more he learns, the deeper his opponent delves.

He spends day and night in the library, preempting possible questions and becoming an expert on endocrinology. He soon knows the place from all angles and in every kind of lighting: the dance of dust motes along the slats of early morning sunbeams; the breath-like sighs of the double front doors swinging to and fro in the first morning rush of arriving students; the swish-and-click of the drawers of the index card catalog; the murmuring ebb and tide of students leaving at lunchtime and returning an hour later; the cool blue of late afternoons in the reading room; the unearthly quiet of night when every sound is amplified and disembodied students, each in his own fishbowl of lamp light, float in the darkness like deep sea creatures caught in the beams of a diver’s flashlight. He can tell different publications apart by smell: the chemical tang of freshly-printed glossy magazines; the rich musky scent of leather-bound volumes of medical illustrations; the musty reek of outdated journals banished to the basement; the bland odor of medical textbooks whose pages are thumbed so often that they have a patina of sebum.

One week, passing his (former) study group, he overhears Devin ask a question about thyroid storm that he remembers from his first day in the library. At that time, he hadn’t known the answer.

“Tachycardia, high fever, excessive and persistent sweating,” he says casually, slowing down at their table. “Treat with propylthiouracil or methimazole.” Remembering something they’d discussed in one of the three sessions he’d spent with them, he adds, “And a decrease in renin isn’t caused by a drug that inhibits angiotensin converting enzymes, but by licorice.“

“Wait, what?” Lisa inquires, leafing through her notes frantically.

“We haven’t covered that,” Devin declares.

“Doesn’t mean you don’t have to know it,” Greg throws over his shoulder.

Later, when the other two have left, Lisa comes over to where he’s sitting at what he regards as ‘his’ table now.

“What do you know about the effects of dietary issues on hormone secretion?” she asks.

He sits back, regarding her with a superior smile. “Everything.” He lets that sink in. “Doesn’t mean I intend to tell you anything about it.”

Lisa drives a hard bargain; in the end they settle on a free meal and a six-pack of Budweiser for him in return for two hours of undiluted knowledge. She isn’t half bad once he gets her away from her books.

This week he readily agrees to go to the dance, and when she drags him onto the dance floor he doesn’t resist. He draws the line, though, at allowing her to take him to her place, because no matter how the week plays out, this can’t end well. Awakening expectations that he has no intention of fulfilling isn’t part of his agenda. If he breaks through the cycle, then he’ll leave UMich for some place where they don’t cross-examine students who pass exams. If he doesn’t, then she’ll continue her existence in a universe where the guy she slept with either doesn’t exist or can’t remember sleeping with her or . . . (He hasn’t quite figured out how his reliving the same week again and again affects the rest of the universe, but it’s possible that each week spawns two parallel worlds. Alternately, reality collapses every time he screws up the interview in the Dean’s office.)

When Greg knows everything worth knowing about endocrinology and then some, the interrogations in the Dean’s office diverge into other areas of medicine. While preparing for endocrinology, Greg has sampled a few choice morsels of knowledge from other specialties — but not enough to satisfy the Dean.

Greg puts up a stiff fight in the weeks that follow, because he has no other option; there’s no other way out of Wonderland. Surprisingly, getting the knack of cardiology, pediatrics, neurology, etc. isn’t half as bad as he fears. He’s pretty much at home in the library, he has acquired mnemonic techniques and speed reading skills that greatly accelerate the learning process, and now that he has a solid foundation in one branch of medicine, the others make a lot more sense. Besides, some of it isn’t half as boring as it used to be. He develops a morbid interest in rare genetic disorders and infectious diseases that has him delving into details far beyond any question that the Dean could possibly think up.

He loses count of the weeks he invests in a legitimate quest to survive the exam and the subsequent questioning session, but when the Dean switches from medicine to organic chemistry he finally admits defeat. It isn’t that he considers himself incapable of grasping chemistry, organic or otherwise, anymore. No, it’s obvious that no matter what he learns or how he behaves, the interview will always end in his expulsion.

The next Monday he buys a gun, marches into the Dean’s office, and fires until the magazine is empty. Better a lifetime in prison than an eternity on the campus of the University of Michigan.

Turns out that his weekly reincarnation can’t be aborted by acts of murder or mayhem. Furthermore, prison, even if it’s only for a night before Tuesday comes around again, is as unpalatable as time spent in the hospital after unsuccessful suicide attempts, if not more so. He gets a faint kick out of killing the Dean with assorted weapons such as a samurai sword, a crossbow, and a skull (filled with cement to give it the necessary clout), but after a few times the entertainment value declines.

 It’s time for sex, drugs, and alcohol.

He quickly drops alcohol from his list of hedonistic pleasures: he’s a lightweight, and regarded through the distorted lens of a hangover his present life is even less attractive than when he’s clear-headed. The one exception is Monday night: he always wakes up on Tuesday morning without a hangover, no matter how wasted he gets. He experiments with drugs of all kinds. The worst that can happen is an accidental overdose, which — given his particular circumstances — is not an outcome that he fears. Addiction isn’t an issue in this universe: he wakes on Tuesday with no physical reminders of substance abuse or bar brawls or other bodily mishaps — and even if it was, he’s well beyond caring.

He screws everything on two legs and quite a few things on four. (If he were a ‘glass half full’ sort of person, he’d be grateful that he isn’t eternally stuck on a solitary Greek mountainside with goats as sole companions . . .) He starts off with Miss Overachiever — his scruples are forgotten in his quest for total oblivion — because she’s at hand, willing, and experienced. (“Greg, have you never stimulated a clitoris? This is how you do it!”) Once he has learned everything she can teach him, he moves on. When he’s through every girl he wants to screw (and the Dean’s wife too, for good measure), he tries out guys. And then threesomes. And foursomes. He also gives S/M and bondage a try, but deep down he’s vanilla. And sated. And bored.

He quits focusing on the carnal pleasures of life when he unexpectedly finds distraction of a different kind. At first it is just a diversion of the usual sort, i.e. a sexual one. She catches his attention in a supermarket, stretching up to reach items on the top shelf. She isn’t his type: short, plump, hair dyed blonde, about fifteen years older than he is. But when her blouse slips out of her jeans, exposing a smooth bronzed midriff, he is turned on. It hits him with such force that he is instantly determined to sleep with her.

A more confident man would accost her under pretense of needing advice on some grocery, a more chivalrous one wouldn’t need a ruse: he’d help her get down the tins of refried beans that wobble perilously over her head. Greg watches while about ten tins topple down on her, and then he follows her to her home, a somewhat dilapidated house in the suburbs. He’s good at trailing people by now, and he’s even better at sussing out their private lives. A peek at the nameplate on the door, a chat with a neighbor who is walking his dog, and he knows enough to sally forth and conquer.

“Hi,” he says when she opens her door. “My name’s Greg. I’m a med student.” (This impresses people, so he doesn’t bother to lie about it.) “I’ll be going to Haiti this summer to volunteer at a rural health clinic, so I need to learn Spanish.”

She gives him a condescending smile that he doesn’t like at all. “Haiti?” she queries. “They speak French there.”

Damn, but he needs to brush up on his Geography! “I mean Honduras. Always getting the names mixed up,” he says, praying that she doesn’t come from there. “I heard you give Spanish lessons.”

“Yeah, I do. How many do you want?”

“As many as possible. How about we start now?”

“As many as possible?” she asks with a kinder smile this time. “How many can you pay for?”

Money isn’t an issue. He can safely spend whatever he has, because it’s always back in his wallet come Tuesday. Whenever that doesn’t suffice, he nicks cash off someone else. Mark, for instance. Or someone in the library who is careless enough to leave their purse unattended. Or out of the cash register in the cafeteria when the cashier is distracted, which is the case on Thursday at 12:37 p.m. when her son’s school calls to tell her that the kid has been admitted to hospital after an injury in PE class. If he needs a big sum, say, for a motorcycle, he breaks into the Dean’s place and steals his wife’s jewelry. (He’d gotten caught a few times, until he figured out how to disable the burglar alarm, and the first pawnshop that he patronized ratted him out to the police, but those were minor glitches in an otherwise smooth plan.)

“Let’s start with five hours a day for the next five days,” he suggests, digging out his wallet. “I can pay for today’s lessons straightaway, and you’ll get the rest tomorrow.”

It takes longer to soften her than he anticipated; having to start from scratch every week doesn’t exactly help. By the time he manages to get into her panties, he can hold his own in rudimentary conversations about daily life. Before he tires of her, he can decipher medical texts and get decent patient histories. He tires of her before he tires of Spanish, so he continues the lessons (without the sex) until he can write comprehensible patient records and hold short talks on medical cases.

Then he overhears two students in the library talking German. It isn’t the first time he overhears them, but it’s the first time he considers learning the language. They’re med students too, from the year above his. He offers to help them with their assignment in return for German lessons. They are skeptical (every week anew), but by now a paltry essay is child’s play to him. What they don’t know is that he writes the same essay for them week after week while they have to teach him something new each lesson. He finds German tougher than Spanish, but after a while he gets the hang of it. Then he moves on to Chinese and Japanese and Hebrew and Russian. And he has always wanted to learn how to play the piano. (One day he even ‘buys’ a Steinway grand with the money that he nicks from the Dean, but the music store can’t deliver before Tuesday . . .)

“Where did you learn German?” one of the German students asks him about four months into their lessons — from his point of view. From the Germans’ perspective, it’s still the first week of instructions, but he obviously isn’t a newbie. He anticipated the question, so he has his answer ready.

“My dad was stationed in Germany. He was in the marine corps,” he says.

That much is true, but the implication that the entire family lived there is false. His dad, posted abroad for most of Greg’s childhood, had left his family in Lexington, an arrangement that worked to everyone’s satisfaction. The explanation is so neat that he uses it to justify his language skills for any and every language — and no one calls him on it, regardless of whether his father could have been stationed in the corresponding country or not. In fact, the tales of his extensive travels and the little stories that he fabricates to give them authenticity are so seductive that he almost believes them himself. Especially the ones that he doesn’t tell anyone, such as . . . an encounter with a Japanese buraku inspiring him to study medicine. That tale is much cooler than doing it to get his father’s goat.

He spends very little time in the library nowadays, but one day, checking out an obscure point in Russian grammar, he spots a frizzy-headed guy at one of the tables and the sight rings a bell.

“’Looks like scurvy, but isn’t scurvy’, wasn’t it?” he asks, confident that he knows the answer to the riddle now.


“Your patient,” Greg says impatiently. “The one who’s dying.”

“What about her?”

“Weren’t those her symptoms?”

Frizzy Head scowls. “What the fuck gave you that idea?”

Greg riffles through his memory. “You said . . .” Didn’t he?

“I don’t know you; never talked to you in my life!”

“Well, no, but you do have a patient who is dying,” Greg half asks, half states.

“Yeah, but she isn’t dying of scurvy, or anything that looks like it. She has fever episodes and myalgia, and her kidneys are shutting down.”

“Intermittent fever, pain, and proteinuria?” Greg echoes, wondering how his memory could deceive him so badly, even as his brain sifts through possible causes. “Malaria. Or yellow fever. Has she been to Argentina?”

“Tested for both and no, she hasn’t.”

“Other symptoms?” Greg asks, intrigued. “Prior medical conditions?”

Frizzy Head sighs, but recapitulates everything that he professes to remember.

“That can’t be all; something is missing,” Greg says, snagging Frizzy’s notes from under his fingers and leaning back to read them. Remembering his forays into obscure diseases he asks, “Has anyone in her family died of unknown or unnatural causes?”

“No idea.”

“Your patient history sucks.”

“Gee, thanks! Why don’t you get a decent one, if you’re so good at it?”

Greg, rising, balls up Frizzy’s notes, and tosses them at him. “I will. Take me to your patient.”

“No way!” Frizzy straightens the crumpled notes, giving Greg a hostile stare. “I’m not helping some smartass student who wants to play at being doctor to harass my patient.”

Greg ignores the stare. “It could be Weil’s disease, scrub typhus, typhoid or paratyphoid fever, viral hepatitis, Henoch-Schoenlein purpura, adult Still’s, Blau syndrome — or ten other things. There’s no way of narrowing it down unless you get a decent patient history. If it’s something genetic, there’ll have been other cases in the family.”

Frizzy leans back and looks him up and down. “You’ve . . . heard of adult Still’s?”

“Hmm? Yes,” Greg says abstractedly, racking his brain for further diagnoses while pacing up and down in front of Frizzy. “It’s unlikely to be adult Still’s if there’s no rash. Has anyone noticed a rash?”

Coming to a decision, Frizzy rises and jerks his head at Greg in an unspoken invitation to follow him. He takes Greg to the second floor of the Medical Center, the university’s teaching hospital, where his patient occupies a room on a general ward.

Getting a decent patient history turns out to be slightly tricky: neither the patient, a young teacher named Eleanor, nor her family can distinguish between relevant information and trivia, between facts and gossip, between omitting unnecessary details and lying by omission. Nor do they take kindly to having their lies dismantled and their hypocrisies exposed; they complain to Frizzy’s boss, who promptly has Greg evicted from the premises. Frizzy — whose name is Arnold Linnebaker — gets a dressing down from his boss and refuses to give Greg the time of day afterwards.

Armed with his patient history, the Xerox copy of the patient file that he made secretly, and the lab report, Greg settles down in the library and gets cracking. He doesn’t care about Frizzy giving him the cold shoulder; in a few days Frizzy won’t remember his physiognomy and will be duly grateful for the solution to his problem. Then again, in a few days his copious notes and the illicit Xerox copy of the patient files will vanish, which means that he’ll have to return to the Medical Center to obtain them again — unless he commits them to memory. He opts for the latter course of action, because getting at the necessary information at the hospital cost him all of two days and he doesn’t feel like going through the entire hassle again.

He sneaks into the Medical Center on Monday night in order to obtain the latest lab report, only to be informed by a night nurse whom he has never seen before that Eleanor died during the course of the day.

“She died?” he mouths.

“Yes, her liver failed,” the nurse on duty says. “I’m so sorry. Was she a friend of yours?”

“No,” Greg says, turning away. “Just a patient. I’m, uh, doing a rotation in the department.”

Just a patient named Eleanor, with doting parents, a bitchy sister, a cheating boyfriend, two cats, and tons of get-well-soon cards, balloons, and teddy bears from her students. A thirty-three year old blonde, five foot four inches tall, with a slight lisp and a love for Charles Dickens and Latin beats. A loquacious young woman with a quirky sense of humor and blatant disregard for the truth.

“You win some, you lose some,” the night nurse says. “You get used to it — losing ‘em. It’s tough the first time, and the second time, and the third one.”

“And after that it’s a walk in the park, huh?”

“After that you know that the pain and the sense of failure don’t last.”

“They should,” he insists. “She’s dead!”

“Don’t shout, hon! If all that pain stayed put and increased every time a patient died, we wouldn’t be able to cope, would we? No one would benefit, least of all our patients.. . . . Throw a pity party by all means, but remember that it doesn’t help her at all.”

Good point: he can’t help Eleanor by drowning his sorrows in alcohol or drugs, but he can save her next week or the week after or . . .

He persuades the night nurse to pull the complete patient file with all the lab reports (“for study purposes”) and commits everything he now has to memory. Tuesday sees him in the library, jotting down everything he remembers and looking up various diseases, but avoiding Frizzy and all direct contact with Eleanor. He’d be quicker if he ran a few tests, but that would entail further contact with Eleanor and he’d rather not see her again until he’s sure he can save her. After ten days he has narrowed the cause of her demise down to three possible culprits. Nevertheless he waits until the following Tuesday to present his results to Frizzy, because he’ll need to see how Eleanor responds to treatment to decide which of the three it is, and even six days is cutting it tight should she not respond to his initial treatment.

“Familial Mediterranean Fever,” he declares, marching up to Frizzy on Tuesday morning.

Frizzy looks up from the textbook he’s studying. “What the fuck?”

“Your patient. She has Familial Mediterranean Fever — unless she was bitten by a copperhead snake. But given her sedentary lifestyle the snake bite is unlikely.”

“My patient most definitely does not have Familial Mediterranean Fever, whatever that may be. And he’s a he, not a she.”

“Thirty-three year old female, feverish episodes, myalgia, kidney failure. Name of Eleanor Giordano. Does that ring a bell?”

“No. You’ve gotten me mixed up with someone else. My patient is a fifty-five year old male with totally different symptoms. So leave me alone; go bother someone else. I haven’t got the time for stupid games.”

Greg eyes Frizzy suspiciously; as far as he can tell, Frizzy is absolutely serious. Besides, he has no reason to mess with Greg’s head: it’s not like Frizzy can remember meeting him before. Greg, for his part, has no evidence that Eleanor is Frizzy’s patient: the copies of her patient file ceased to exist two weeks ago.

“If Eleanor isn’t your patient, then whose patient is she?” Greg asks.

“Don’t know, don’t care.”

Since the question was rhetorical, Greg doesn’t take umbrage at Frizzy’s tone, but rushes off to the Medical Center, straight to Eleanor’s room . . . To what used to be Eleanor’s room. This week there’s no sign of Eleanor. A man of about fifty is occupying her bed. He’s sleeping, but the woman seated by his bedside raises enquiring eyebrows at Greg.

“I’m looking for Eleanor Giordano. This is her bed,” Greg says baldly.

The woman shrugs. “I’m afraid I don’t know who had this bed before Harry was admitted to the hospital. You’ll have to ask one of the nurses.”

“How long has he been here?” Greg asks, pointing at Harry with his thumb.

The woman grimaces. “Three weeks now? And before that we were . . .”

But Greg doesn’t stop to listen to the sad tale of Harry’s medical travails. He looks in on every room on the ward. Then he checks the floor above and the one below. Finally he goes to the nurses’ desk on the second floor, the one he is sure Eleanor’s room is on. “Do you have an Eleanor Giordano on this ward?”

“Giordano? No, I’m sorry. I’m afraid I can’t access admissions records from here. If you go down to the lobby, the admissions desk is through the glass door on the right. They can tell you where to find Ms. Giordano.”

“I’m not family. I’m a med student. I’m doing a rotation here and I’m supposed to check on Giordano.”

The nurse looks him up and down. “A student? We have no record —“

“Dr. Linnebaker is my supervisor,” Greg improvises.

“Oh, okay. He isn’t here. He has the night shift. Didn’t he tell you?”

That explains why Frizzy can afford to hang out in the library all day. “He did. He’s in the library researching the case. He sent me over to check out the patient file.”

The ‘library’ part of the story evidently sounds convincing, because the nurse sits down and pulls out the filing cabinet. “I’m sorry, but we have no one of that name on the ward. I’ve tried ‘G’ and ‘J’. Are you sure you got the name right?”

Greg scratches his chin. This time two weeks ago, Eleanor had been ensconced in the bed in Room 208. He’s sure of that. This week, ‘Harry’ has supplanted her for no apparent reason. That’s a major anomaly in Greg’s confined little world. So far, even minor changes in his surroundings were precipitated by his own actions; never ever has any deviation from the norm cropped up all by itself.

What does it mean?

“Nurse? . . . Nurse! Please! Something is wrong. Harry — he isn’t breathing anymore!” It’s the woman from Room 208.

The nurse looks up, but Greg doesn’t wait for her to react. He sprints to Eleanor’s room where Harry has indeed stopped breathing. His heart has also stopped beating.

“Need a crash cart here,” Greg yells as he positions his hands to start CPR.

He’s learned how to do CPR — on a living, breathing fellow student. Now that it’s the real thing, it’s anyone’s guess whether he’s doing it correctly. Is he pressing hard enough? He ups the pressure; if Harry dies, he won’t appreciate any effort to keep his ribs intact. One hundred compressions per minute: is he too fast or too slow? Thirty compressions, clear airway, two rescue breaths, he chants to himself. It seems like forever before the crash cart arrives and releases Greg from his labors. Breathing heavily, he steps aside and watches them shock Harry’s heart back into action.

“What’s wrong with him?” Harry’s partner wails. “We’ve been here for three weeks and he’s just getting worse. Where’s Dr. Linnebaker? I want to talk to Dr Linnebaker!”

Not quite looking her in the eyes the nurse says, “He has other commitments, but he’ll come as soon as he can.”

“Other commitments? My husband is dying and Dr. Linnebaker has other —”

Greg interrupts her. “He’s in the library,” he says. The nurse positively glares at him.

“The library?” Harry’s wife echoes dangerously. She’s just short of an apoplexy. “What’s he doing there?”

“Researching your husband’s symptoms instead of sitting here and twiddling his thumbs while your husband dies. Now go and sit with him; he needs you, and Linnebaker won’t be back any the sooner if you keep everyone from doing their jobs.” He makes a shooing motion with his hands.

“Did you have to mention the library?” the nurse complains once Harry’s wife is out of earshot. “Patients expect their doctors to be there for them around the clock. It’s unreasonable, but there it is. I’d better page him, I guess.”

Greg realizes that he doesn’t have much time. “Give me the patient file.”

When the nurse hesitates, he gives her his most charming smile. “Look, I must have gotten the cases Dr. Linnebaker talked about mixed up, but if I don’t know about old Harry here by the time he turns up, he’ll bite my head off.”

Armed with the patient file he settles down in a corner. He figures he has about half an hour before Frizzy reaches the Medical Center. Harry’s symptoms are not specific: difficulties in swallowing, followed by slurred speech, sleep disturbance, and finally incidents of memory loss. The brain scans show no sign of a blood clot or a tumor.

He jots down notes on a pad that he nicks from the nurses’ desk, and when his half hour is up, he returns the patient file to the ward before heading out to the library. Frizzy will doubtless find out that an unknown person invoked his authority in order to access patient data, but there’s no way that Frizzy will be able to identify Greg as the culprit. He’s safe as long as he stays away from the Medical Center.

Safe he may be, but by Monday evening he’s no nearer to a diagnosis than he was on Tuesday morning. (Oh yeah, and he’s been expelled for not attending the endocrinology exam, but that isn’t exactly news.) Maybe Frizzy has a diagnosis by now.

Greg goes to the nearest pay phone and calls Harry’s ward. “Hello, my name is Luke Nelson. My uncle Harry Nelson is on your ward, I believe. I’m calling to find out how he’s doing.”

“I’m very sorry, Mr. Nelson, but your uncle passed this afternoon.”

“He’s dead,” Greg says dully.

“Yes, I’m afraid so. My sincere condolences.”

“What did he die of?”

“I couldn’t say. You’ll have to contact his attending for details.”

“Okay, thanks.”

That’s the second of Frizzy’s patients dead. But maybe this week was a one-off and next week Eleanor (or Harry) will reappear in Room 208.

Tuesday morning he slaps Mick Jagger into silence and heads straight to the Medical Center without showering or eating breakfast. (Mark’s eyes bulge out of his head as Greg streaks past him towards the door.)

A child is lying in the bed in Room 208, a boy of about twelve.

As he watches the boy leaf through a sports magazine, Greg can feel his heart dive into his lower intestines. Both Eleanor and Harry are irretrievably lost, and if his hunch is correct, this boy will also be worm fodder by Monday evening.

One patient per week — that’s how many people have died ever since he’s gotten stuck in Exam Hell. (He has no idea how long he’s been in The Rut, because he has no way of keeping count, but he figures that it’s been a hundred weeks at the very least.) And unless he can work out a way to save Frizzy’s patients within seven days, that count will rise. The boy in front of him will be the third one he knows, but even if he shuns the Medical Center henceforth, he’ll know that someone there is dying — dying because he can’t figure out what’s wrong with them.

He’d thought it couldn’t get worse than the brain-rotting boredom of endless repetition. How often has he wished for the tiniest of aberrations, for a slight deviation from the norm? Well, now he has gotten what he wished for, with a vengeance. If boredom was purgatory, then this is hell! And the only way to make it bearable is to stop these people from dying, because unlike him, once they are dead they stay dead.

He needs to become quicker at diagnosing Frizzy’s patients. He has to find cause and cure within a week.

Step 1 comprises gaining the nurses’ confidence.

He returns to his apartment to get his lab coat — in the following weeks he never leaves the apartment without it — and then approaches the nurses’ desk.

“Hey, I’m the med student who has been assigned to Dr. Linnebaker. He asked me to report here today at 10 a.m. and read through his patient files before he returns.”

His cover story works wonders; Greg withdraws to the conference room with a pile of files, of which he ignores all but one. Armed with the file of one Leroy Miller he returns to Room 208 to interview the boy and his father.

Once he has as much information as he needs, he proceeds to Step 2: Working with Frizzy, not against him.

He steps up to Frizzy’s table in the library, slaps his notes down in front of him and says, “Twelve-year-old male with weakness of the extremities and the neck, swallowing difficulties, and respiratory issues.”

“What the fuck!” Frizzy exclaims, looking anything but pleased.

“Your patient. He’ll be dead by the end of the week unless we figure out what’s killing him.”

Frizzy tosses his head in a quick negating gesture. “He isn’t dying. He’s showing neurological symptoms, but he’s far from —“

“You don’t know that.”

“And you do? Who are you, anyway?”

“Name’s Greg. I know because I’ve seen cases like that before.” He hasn’t, but the white lie is necessary. He’ll tell a few more if they serve to find a diagnosis. “You’re running out of time.” He knows that for sure. Leroy’s sell-by date is a mere six days away.

Since Frizzy still seems unconvinced, Greg ventures an educated guess. “His neurological symptoms will spread to vital organs, and then he’ll crash.”

At that moment Frizzy’s pager goes off. He stares at it, then at Greg in disbelief. “How’d you know?”

Greg shrugs. “I’m that good.”

By the time Greg and Frizzy reach the Medical Center, Leroy is in respiratory distress. He develops a pulmonary infection that kills him on Monday afternoon.

The problem, Greg decides, isn’t that Frizzy and he aren’t working effectively. They deal well with each other (once Frizzy’s initial distrust is overcome) — maybe too well. They are like well-oiled machinery, their mental cogwheels interlocking without a hitch, Frizzy transforming Greg’s diagnostic torque into the motion of medical treatment. If medicine were motorcycle racing, they’d win the Grand Prix. But it seems that harmony doesn’t facilitate the diagnostic process. Greg doesn’t need someone who thinks in the same structures that he does; he requires friction, the stimulus of discordant ideas. He doesn’t want the blandness of steamed vegetables; he craves the variety of a good curry, with coriander, cumin, and turmeric vying with musky cloves and sweetish onions, while earthy lentils and solid potatoes provide structure.

No one regrets the need for Step 3 more than he does, but there’s no help for it: he’ll have to find suitable input sources for new ideas. Frizzy’s colleagues at the Medical Center are too busy with their own stuff and not exactly inclined to obey when a student whistles for them to come. So, the next Tuesday, after getting the patient file from the nurses Greg returns to the library and looks around.

Brash Frat Boy, the Mouse, and Overachiever aren’t stellar, but in sum they probably have an IQ of 400. With a bit of luck they’ll hit on an innovative idea or two. Greg marches up to the table where they are (still) preparing for the endocrinology paper and drops the newest patient file in their midst.

“Woman’s dying,” he says. “The attending is stumped. Care to share ideas?”

“We’re preparing for an exam,” Brash Boy says.

Greg rolls his hand expansively. “I know. Endocrinology, Rounceville’s course. He’s fixated on diabetes, hypothyroidism, and Graves’ disease. You can prepare for those later. I need your help now. Dying woman, remember?”

“What’s she dying of?” Overachiever — Lisa is her name, he recalls — asks, reaching for the file.

He sighs in mock exhaustion. “If I knew, I wouldn’t be asking you.”

Lisa rolls her eyes without looking up from the file. Brash Boy — he can’t remember his name, but it doesn’t matter — pushes back his chair. “I haven’t got the time for this. Come, girls, let’s go somewhere where we can learn in peace.”

“Wait!” Lisa says, holding up a hand commandingly. “This woman is really dying. Her liver values are plummeting.”

“’S what I said,” Greg says, pulling out a chair and straddling it. “Any ideas, anyone?”

They get kicked out of the library before the morning is over, not only because of their volubility, but also because Greg, finding notebook paper too small a format for brainstorming, writes down symptoms and possible causes on a big table with Lisa’s lipstick. So they traipse over to the Medical Center, where Greg finds an empty lecture hall with a blackboard — which is where they should have come from the start. (He stores the thought for the next week.) The Center has the added advantage of proximity to the patient: he can send Brash Blond, Mousey, and Overachiever to the ward if he needs more information from the patient or the medical staff.

They lose the patient, and the next three too, but Greg feels that he is getting closer to solving the problem. The format he now has pleases him: his three groupies take care of staff and patient enquiries, saving him a lot of time and bother. Besides, losing someone he knew every week, even if it was someone he’d only known for a few days, had taken its toll. He’d been increasingly frantic, pacing through the hospital and through his apartment (to Mark’s distress) and popping tranquilizers to keep anxiety levels in check, which in turn had slowed his thinking down. Now he can let the trio take care of all patient interaction.

His little team also provides valuable input — when they aren’t moaning about losing study time. Devin is good at sifting through reams of data in order to find symptoms or values that don’t fit, Tricia can combine seemingly random facts to form a viable hypothesis, and Lisa, while hopeless at medical stuff, charms or coerces medical staff and patients alike into parting with information or agreeing to medical tests and procedures. She has Frizzy eating out of her hand, which spares Greg no end of bother, and she’s also the one who stays when the other two give up for the night or return to their books.

Maybe they’ll get lucky sometime and save a life. He won’t be able to save all of them, but if he could save every third patient or so . . .

He can’t help feeling that all these people dying is karma flipping him the bird: You think you’ve settled down comfortably in Examination Week, Greg House, learning languages, playing the piano, screwing girls, and taking drugs? Every time you’ve made your peace with your lot, I’ll think of something new, something different, something even worse! I’ll change the game until you’re crawling on your knees begging for mercy, for oblivion, for utter annihilation!

 Well, he isn’t going to crawl, ever. He’s going to stay standing, no matter what, and every life that he pulls out of the clutches of the demon deity that rules this cosmos will be a fart in its face!

“What if the boyfriend is telling the truth and the bruises were caused by Tessa stumbling and falling?” Lisa asks. It’s Friday, it’s close to midnight, and they’re running out of ideas. Furthermore, their patient is running out of time. Her kidneys have shut down and her liver is failing.

“He’s lying,” Greg states. They all do.

“Okay, the boyfriend is abusive, but he knows where to hit so that it doesn’t show, and the bruises we can see were caused by falls, like he says,” Devin posits. “Then she has a neurological problem.”

Greg writes ‘neurological issues’ in the column with the patient’s symptoms. “Okay, we have a new symptom. Can we —?”

Two new symptoms,” Tricia says. “The bruising could be a symptom too.”

Greg tips his head, considering her suggestions. “Not bad,” he concedes, turning to the blackboard to put ‘bruising’ underneath ‘neurological issues’. He throws the chalk up in the air and catches it a few times while he considers possible matches to the list of symptoms on the blackboard. “Lisa, go and check the patient’s eyes. The others can go home.”

“What am I checking for?” Lisa asks.

“You’re looking for golden-brown rings around the cornea, Kayser-Fleischer rings. They’re indicators for . . . ?” He wiggles his fingers, as though tickling a reply out them. They stare at him blankly. He sighs. “Wilson’s disease. Copper accumulates in the liver and other organs.”

Lisa trots off obediently, the other two pack up.

“You’re sure it’s Wilson’s?” Tricia asks, hesitating in the door.

“Yes,” he says. When she still doesn’t move, he makes a shooing motion with his hands. “If not, I know where to find you. At the hoedown tomorrow evening.”

She nods and leaves. Greg goes up to the ward and watches from outside the patient’s room while Lisa wakes the patient. The patient blinks and yawns, but doesn’t protest when Lisa bends over her and shines a flashlight into her eyes. A moment later Lisa straightens and looks round. Seeing him, she nods.

Greg goes to the nurses’ desk. “Call Dr. Linnebaker. We have a diagnosis.”

Lisa joins him there. “What happens now?” she asks.

“Chelation, and then zinc acetate to prevent future copper build-up. That’s if her liver recovers. If not, . . .” He shrugs.

“When will we know?”

“Monday evening.”

Lisa arches an eyebrow. “That’s . . . a very precise estimate.”

Yes, well, so far none of his patients have survived longer than that. If this one dies, she’ll do so by Monday evening.

“Do you need to wait here?” she asks next.

He doesn’t watch over his patients once treatment starts. There’s nothing he can do for them from that point on, and so far, they’ve all died. That isn’t something he’s particularly keen to witness. “Why?”

“There’s a dance tomorrow evening —“

“A hoedown, over at Myer’s,” he interrupts her. “I know.”

He leaves her unspoken question unanswered, but come Saturday evening he downs a couple of beers and then goes to the hoedown.

Lisa greets him with tipsy enthusiasm. “I didn’t think you’d come.”

“I didn’t think so either,” he admits.

She drags him onto the dance floor, where he jiggles around uncomfortably. Finally she relents; they get beers and sit down on a bale of hay.

“Why did you do it?” she asks him.

“Do what?”

“Risk your medical degree for the sake of a patient. You missed the endocrinology exam yesterday. You could get expelled.”

He hums noncommittally.

She stares at him incredulously. “Don’t you care?”

Not at the moment, he doesn’t. He’s never felt better: they’ve diagnosed the patient and with a bit of luck she’ll live.

“I did it, because . . . I can do it and no one else can,” he says, thinking it through. “If I don’t do it, people will die. Isn’t that why we’re studying medicine: so we can save people’s lives?”

She nods. He crushes his empty beer can, throws it aside, and rises. Lisa, rolling her eyes, picks up the can and tosses it into the trash.

“Are you leaving?” she asks.

“Yeah. I’ll see you around sometime,” he says. “Tuesday, probably.” Another week, another patient.

“Wait!” she calls, rummaging around in her purse. She takes out a pen and a scrap of paper — a bill, he later sees — and writes something down. “Here, my number. Call me if . . . you need help with a patient again.”

He pockets the paper, although he knows that he doesn’t need it. Come Tuesday she and the other two will be sitting in the library again, leafing through endocrinology textbooks.

He returns to the Medical Center, where the latest blood test tells him that the patient’s condition — maybe he can afford to start thinking of her as ‘Tessa’ — is improving. Her liver values are stabilizing. He can hardly believe it; deep down he’d been sure that despite the diagnosis her condition was too serious for her to recover.

He hangs around the Center until Monday, monitoring Tessa’s recovery. Monday morning he drops by the Dean’s office to get expelled. (When he doesn’t go there in person, the Dean’s secretary harasses Mark with telephone calls, and Greg is feeling so at one with the world that he’s prepared to spare Mark the bother.) Then he’s back at the hospital.

“She’s doing fine,” Frizzy says. “Should be out of here in a week. You did well, Greg. Let me know if you’re looking for a rotation in gastroenterology.” He slaps Greg’s shoulder awkwardly.

He goes to a bar and gets drunk. Then he breaks into the piano store and plays their Steinway grand until the police arrive. On similar occasions he’d insulted the officers until even long-suffering Officer Trebbin voted in favor of a night in a cell at the precinct, but tonight he’s feeling so mellow that he plays the officers’ favorite songs, from Frank Sinatra to Danny Boy. In return the officers give him a ride back to his apartment, where he manages to reach his bed without puking all over the carpet.

The next morning he wakes up with a throbbing head and the Stones’ ‘I’m Free’ in his ears.

Wait, what?

He sits up so suddenly that the sharp stab of pain in his cranium robs him of his vision. By the time he gets a good look at his alarm the song is over. It is, however, definitely 9 a.m. (9:02, to be exact.) He moves slowly, keeping a close eye on the alarm clock, although he isn’t quite sure what he wants the device to do or play. Would he feel better if it suddenly started playing ‘Satisfaction’?

The clank of a saucepan in the kitchen reassures him somewhat: his head and his radio may be going wild, but Mark is behaving predictably. Greg shuffles into the kitchen — his headache precludes a quick sprint to the Medical Center — and feels his way to his seat, eyes squeezed shut against the bright morning light. A moment later a plate is slid under his nose.

“Pancakes,” Mark says unnecessarily. “Think you can eat?”

Greg squints up at him. Solicitous enquiries haven’t been part of Mark’s Tuesday morning repertoire so far. He isn’t even singing — for which Greg is duly grateful, but in sum he’s perplexed.

Mark pours two mugs of coffee and sits down opposite Greg. Pushing Greg’s mug across the table, he asks, “What are you going to do now?”

“Nurse my hangover,” Greg mumbles, playing for time. What the fuck is up?

“Think you’ll find another med school that’ll take you?”

“I’m . . . expelled?” he asks tentatively.

“That’s what you told me when you returned at 3 a.m. making a racket that would have woken the dead.”

It’s Tuesday morning and he’s still expelled! That means it’s Tuesday, March 22. He’s free! If it weren’t for his pounding skull, he’d be bopping around the kitchen like a bouncy ball. As it is, he buries his face in his hands and cries like a baby.

Mark clears his throat awkwardly, coughs a few times, and finally says, “I’m sure you’ll find a school that’ll take you. Or maybe you could try something else. Medicine was never your —“

“Yes, it is!” Greg cuts him off. “I’m a doctor. I will be a doctor.”

Mark’s expression is skeptical. “Look, if you need any help — money or assistance writing applications — I’d be happy to . . .”

“I’m fine!” Greg says. “I’m free. I’m fucking free!”

He’s leaving Ann Arbor, that much is for sure, before nightfall. There’s no way he’s risking getting into another loop here; if that happens again, it had better be somewhere new. So he packs a few belongings into a small suitcase and takes the cash that Mark offers him, assuring him that as soon as he knows where he’ll settle down, he’ll send for his remaining belongings.

“You can keep my alarm clock,” he says in parting. He never ever wants to see that particular harbinger of despair again.

On his way to the Greyhound bus station, he takes a detour past the dorms on the university campus. Lisa’s face, still bloated with sleep, lights up when she sees him. Then she spots his suitcase and it falls again.

“Going on vacation?” she asks.

“Nope, leaving altogether,” he tells her. “I got expelled.”

She leans against the doorframe. “You’re an idiot. Brilliant, but an idiot. What’ll you do now?”

“No idea,” he admits. “I thought . . . I’d say goodbye.”

“Well, goodbye then, Greg House,” Lisa says, straightening.

He takes it as a dismissal and turns to go.

“Hey!” she calls. When he looks back at her over his shoulder she says, “You’re really good at . . . what you do. You’ll be a great doctor. Don’t give up!”

“I won’t.” She seems to be waiting for some sort of return compliment, so he says, “You really suck at it. Find something where you can push paper and boss people around, and you should be fine.”

She laughs disbelievingly. “I’m going to be a doctor and I’m going to be the best. You’ll come to me begging for a job.”

“Right!” he says sarcastically.

“And when you do, I’ll actually give you one. Good luck, Greg.”

At the bus station he buys a ticket for the first bus to depart without checking the destination. He sits in the back row, grinning manically. For the first time in his life he knows where he’s going.