People enjoy newspapers and éclairs for the same reason—they’re filled with bad stuff that is fundamentally satisfying.
People enjoy ER, on the other hand, because it is filled with sad stuff that somehow answers a human need.
The astute reader will note that the bit about the newspapers and éclairs doesn’t really lead into the second thought in any obvious way. It’s just there, honestly, because it jumped out at me as a funny thing and I thought we might need a laugh before this blog was done because this blog is about Sam Gasner.
Of all the sad stories that populate the many episodes of ER, Sam’s is among the saddest. It is, in my estimation, right up there with the security guard laid low by the massive chemical burn—that, by the way, is a very, very sad story and one that I hope to have the courage to tackle one day, but for the moment, I’m afraid, I’m just stalling for Mr. Gasner’s sake, and for my own, as though the longer I take to tell the tale, the longer he has to live.
Sam Gasner is a building supply salesman in from out of town to attend the big building supply convention. He knew his ticker was on the fritz—he was on the list for a heart transplant—and he knew he probably shouldn’t be traveling, but the convention—well, that’s where business gets done, and with a wife and nine-year-old kid, you don’t just walk away from your bread and butter.
When Mr. Gasner arrives at the ER, he has this kind of alarming but endearing quality of slipping in and out of normal sinus rhythm mid-sentence, clocking off for a bit, responding rapidly to the doctor’s attempts to revive him and then carrying on with his conversation in a voice that is soft, weak but somehow honest and kind.
“Wow,” he says after the first dip in and out of oblivion. “I’ve never done that before.”
And therein lies the problem. Mr. Gasner’s heart has taken a turn for the worse. The bad news is, without a transplant he won’t make it through the night. The good news is, he’s in Mark Greene’s ER and nobody fights for a transplant with more conviction than Mark.
“I need that heart,” we see him saying into the phone, gripping the handpiece like he’d like to shatter it.
“Yeah?” he says, holding the phone away from his face and shouting at it. “I know that. ... If I don’t get that heart, this man is going to die. ... OK ... well, call me if anything changes.”
What’s the guy on the other end saying, you’ve got to wonder.
“Hi, Dr. Greene, thanks for holding. I’ve looked through our database and we don’t have a match right now. I’m sorry.”
“I need that heart.”
“And I would give it to you instantly if we had it, because that, after all, is our whole business over here at the transplant bank.”
“Yeah? I know that.”
“But we still don’t have one right now.”
“If I don’t get that heart, this man is going to die.”
“Dr. Greene, I’ve checked the database, I’ve asked around the office, I’m looking under my desk right now. We are tapped out over here.”
“But we will call you if anything changes.”
“Well, call me if anything changes.”
“That’s just what I just said—what? He hung up on me. What’d I do?”
It reminds me, oddly, of a conversation I had with a client recently, though the stakes were much lower. We had the opportunity to run an ad—some credits had come up out of nowhere, it’s a media thing I don’t really understand, except that I knew we needed to run an ad, and, as luck would have it, we had this awesome ad all ready to go, part of the ongoing campaign, and dead on for the demographic mix of this particular media opportunity. It’s an adorable ad, a fun ad, an ad for our times, an ad which was, furthermore, loved by nine out of ten clients.
Problem? The tenth client. He just didn’t like it.
“This ad,” I say, “ is the embodiment of everything we’re trying to communicate in this campaign.”
“I know that you’ve got a lot of heart for this ad," he says, but somehow it sounds like bad news.
“Yeah, but I’ve got heart for it because it’s really great.”
“Well, you know, I didn’t want to do the ad with the wildebeest and we gave you that one.”
“And now you love the wildebeest.”
“Of course I do. The wildebeest is great.”
“So maybe you’ll love this one, too.”
“But see,” he said patiently, “I don’t love this one.”
I don’t love this one. I don’t have a heart for you, Dr. Greene.
“OK, but what I’m saying is, you kinda went with us on the wildebeest; maybe you do that again and you surprise yourself.”
“I hear you,” he said. For those of you not in marketing, that means “no.”
So, it’s a rough comparison, but it has its points. Just as no amount of righteous indignation on Mark’s part will make the transplant bank magically come up with a heart, there was nothing I could say that would make our client magically come up with the organs he would need to change his mind and run the ad.
Big deal. We ran another ad, and a pretty nice one, too. I waited all weekend for the world to end but nothing happened, so I moved on. Well, now I have.
Mark’s argument was, of course, far simpler and much more grave. As subplots b and c swirled through the ER, inside Trauma One it was a grim waiting game.
“He’s not putting out fluids,” Haleh says in something just above a whisper. This is not good news and Greene reacts with a look of, well, it’s almost irritation, as if he is personally ticked off at the course this disease is taking.
“One-sixty of lasix,” Greene replies.
“Hey Doc,” Gasner says from the table. “Do I look stupid? Why don’t you tell me.”
“We looked at your echo and, if we don’t find a donor heart, you probably won’t make it through the night, Mr. Gasner,” Mark says, in his talking-to-a-foreigner voice, all slow and clear. “Without a transplant, you may not make it through the night.”
Gasner takes this. He’s so pale already and so gently feeble, you wonder what he has left. He looks at Dr. Greene and says:
“It’s two in the morning. I’m dying. The least you can do is call me Sam. This is no time for formality.”
It’s a nice moment. And it would be doubly nice if Dr. Greene would say to him, “OK, Sam,” or “I’m sorry, Sam,” or just somehow use his name, but he doesn’t. This is one of those ER things, right in there with the way people always walk out of conversations just when the crucial bit, the thing that will resolve everything, is about to be said, thus preserving the tension through another commercial pod.
To me, it’s the writers showing through—and I hesitate to criticize them since we know they are a touchy lot and, after all, they’ve got all these great episodes to their credit and I’ve just got this blog—but I picture the guy—in my mind it's a guy —in some small street level office in Santa Monica, just back from a long lunch at Hama or wherever people go these days, and they get to this point where obviously it would be nice for Dr. Greene to use the dying man’s name, like he just asked, and the writer says, “That’s exactly what people expect me to do so I won’t do it. Did Fitzgerald write what they expected? Did Dickens? Did, uhm, fucking Faulkner or whoever?” he asks the empty room.
Yes, the empty room wants to answer, yes they often did when that’s what worked.
“No!” our writer concludes, unable to hear what his empty room is trying to tell him. “And neither will I. I will do the opposite of what is expected. I will do the unexpected. That’s it! ... Now, what’s the least expected thing possible here? Hmmm … maybe we bring in a wildebeest! No, no, that’s just silly … Let’s just have him sit there and do nothing.”
So Greene says nothing just then but he does manage a few kind-hearted “Sams” as the night continues. Mostly, though, it’s quiet in Trauma One; everything is pitched to the volume of Sam’s fading voice.
“You feel crummy waiting around for a kid to smash up his car so you can get his heart,” Sam says at one point.
But he needn’t worry. There will be no heart. No last-minute miracle.
“That’s it,” Sam says. “I’m dying. I guess I’m getting ready.”
And then in the next moment he bursts into tears and says, “I’m not ready. Damn it, I’m not. I don’t want to leave them. Sarah needs me.”
It’s not the way we’ve come to expect heroes to behave and, I have to say, I’m with the writer on this one. It’s a brave, brave thing to look at something you can’t change and admit the truth about it, to say out loud that you’ve measured your share and found it wanting. And if you’re going to do that, you might as well let the tears flow freely.
Then Sam’s wife and daughter arrive in time to say goodbye. This is what kills me about Sam’s story—as well as the chemical burn victim I mentioned earlier, and the paramedic who gets the terrible burns—he knows he’s going and yet he’s able to talk and think and even manage a smile. He’s in a kind of holy place.
You can’t watch him talk to his family without asking yourself what you would say if you were in his place. It’s one thing to see him talking things over with his wife—they’ve had years and years together and they’ve had time to prepare for this moment—but to see him say goodbye to his girl is, well, tough.
What would you say to someone you loved, to tell them everything they needed to know forever? You’d want to be honest about the loss but also give some courage and hope. You want to be remembered well but not too well. You’d want to tell them that somehow you’d keep an eye out, should it prove feasible, from the other side.
Sam ends up talking to her like he’s going off on a long business trip—be sweet, listen to your mother, I love you, darling—but she gets it. She’s the one who’s going off on a journey. He’s gone as far as he’s going to go. He’s not going on ahead to heaven. He’s taking a step back, into the earth, and it’s up to her to carry on and see what she can see.
If you think about time geologically, our lives here are so breathtakingly brief—should we live nine years or ninety it’s the difference between a gnat’s wing and bug’s eyebrow. Which would be a great comfort if we were made of stone or dirt or sand.
My young son—I should say, my second son (see the events of 12/10/07)—sat by my side throughout this episode and when the show was over I checked in to see if he was ok. I needn’t have worried; the same mechanism that lets him manage Santa Claus and the Easter Bunny had apparently allowed him to take in this show as if it weren't actually real. But he did have a question for me:
“So, how old are you?” he asked.
“Forty-five,” I said.
“So when the baby is as old as you are now, you’ll be ninety.”
I couldn’t fault his math, and I appreciated his apparent confidence in my longevity, but the thought has stuck in my brain. If we are on this journey and we know that it has its limits, why don’t we, being rational people, spend every day holding the people we love, stroking their hair, telling them sweet things? Why do we go to building supply conferences in Chicago? Surely there is time for that when we are dead.
Well, of course, the answer is we have to live in the real world. We have to work and struggle, take some chances, face some losses. We have to learn what it is we have before we even understand how to value it. It’s a stupid, romantic notion to think we could just have the sweet things all the time.
But, if you’d like a little more of that in your life, it’s probably not a bad thing to try for.
This episode of ER I been talking about is titled Into That Good Night, after the Dylan Thomas poem I first heard in high school and never much cared for. I’ve taken a look back at it now (you can find it here) and I’ve got to admit that it's gotten better over the years. I don't know if he's been working on it or what, but reading it now, I'm thinking maybe Mr. Thomas is on to something.