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None of this would have happened if the Medical School of Manhattan hadn’t decided to raise tuition by $5000 at the start of my junior year. There I was, thinking I’d saved just enough cash to get me and Beryl through, when all my careful calculations were shot to hell in one fell swoop by the Board of Trustees.

Beryl incidentally is my six-year-old. She’s cute as a button and about as precocious as Phyllis Diller. She is also the only kid in the first grade who can spell “idiopathic hypertrophic subaortic stenosis” which puts her one step ahead of her mother.

I have always wanted to be a doctor. While all my friends were dressing their dolls in wedding gowns, I was giving mine an appendectomy on the kitchen table. 

Mother was a hairdresser. She worked in Phil’s beauty shop in the Bronx, putting hairspray on the heads of Grand Concourse matrons. I can’t tell you much about my father, except that he was Irish and had a drinking problem. Mother threw him out of the house when I was four. Despite her lack of education, Mother had a good deal of common sense and was ambitious for me. Whereas most of my cousins routinely got married after high school,  Mother insisted I go to college and redirected my medical aspirations toward the noble goal of nursing.

Sometime during my senior year, I was deflowered by Nick Conner, a recent college graduate who had embarked on a career as an insurance salesman for Prudential. He was about thirty pounds overweight and tended to sweat when he got nervous. I had always imagined that some devastating young man would rip the clothes from my body and carry me up the staircase at Tara. Nick and I made it in the back seat of his Pontiac while parked by the Bronx Reservoir. 

It hurt like hell and I had to take hot sitz baths for the next week. The only saving grace was that it didn’t last too long. Nick always tended to come quickly. As luck would have it, I got pregnant, and worse still, Nick insisted on making an honest woman of me. 

And so, dear reader, we were wed.

The marriage lasted two years, which isn’t bad, considering that our IQ difference was at least two standard deviations. To be fair, Nick was a good husband. He was kind, considerate, and terrific with Beryl. It’s just that he was excruciatingly boring. Imagine living with someone whose most exciting subject for post-coital conversation was claims adjustment. 

After the divorce, Beryl and I moved to Manhattan, and Nick and I agreed on joint custody and child support. I felt too guilty about leaving him to ask for alimony. I got my first job as an RN at a large prestigious teaching hospital. Mostly I pushed pills, changed bedpans and bed linen, measured inputs and outputs of various body fluids, and spent a good deal of time on the phone, trying to track down doctors for clarification of illegible and frequently incomprehensible orders.

It was the interns who finally ended my glorious career as Florence Nightingale. Every July they were let loose on the wards, cocky as hell and twice as green. Naturally, they thought they could tell me what to do, I who had read Harrison’s Principles of Internal Medicine cover to cover three times!

The final straw was Mrs. Horowitz’s myocardial infarction. Mrs. Horowitz was the ultimate hypochondriac, the patient you always wanted to round on last. An inquiry about her health invariably produced a half-hour diatribe detailing her aches and pains. She had been admitted with abdominal pain, and her upper GI series, not surprisingly, showed a large duodenal ulcer. 

She rang for me one evening, complaining of severe, substernal chest pain. I paged the intern on call, who, aware of the lady’s formidable reputation, prescribed Mylanta, over the phone and without an examination. Now, I had seen Mrs. Horowitz, and I knew this was no ulcer. She was cold and clammy, with a blood pressure of 90/50 and a pulse of 120. I conveyed that information and suggested he really should come and see her. 

“Just give her the Mylanta,” he said. “I’ll be there in about half an hour. I’m busy.”

Well, I was pissed off, so I called for a stat EKG, a chest film, drew some blood for electrolytes and cardiac enzymes, and sent off a blood gas. I was in the process of giving a little morphine IV push for the pain when the intern finally sauntered in. 

My diagnosis of heart attack was correct, and my diagnostic procedures were impeccable, but the repercussions in nursing administration were not pleasant. I had overstepped my authority. The next day, I registered at City College for premedical courses. 

I will not bore you with the tedious saga of my medical school interviews. Suffice it to say that, during the early 1970s, women in general, and Beryl and I in particular, were not on their most wanted list. However, I am, if nothing else, persistent. We were finally accepted at the Medical School of Manhattan, which was trying to comply with recent affirmative action legislation by recruiting women and African Americans with Spanish surnames.

Equipped with my meager savings, my child support money, and a king’s ransom in student loans, I enrolled. I had calculated that Beryl and I would just make it through the four years when the Medical School Board of Trustees demolished all my careful financial planning. 

The day the news broke, I was in a blue mood. Beryl usually cheers me up, but she was at her father’s for the weekend. I decided to head for the second-best consolation I could think of, which happened to be the corned beef and rye at the Carnegie Deli.  On the way, however, I noticed the elegant bar at the Beecham Hotel and decided to start the evening with a drink. 

I was sitting at the bar, about three-quarters of the way through a Brandy Alexander, when a middle-aged gentleman with a strong Brooklyn accent sidled up and offered to buy me a second drink. In my current financial condition, I was in no position to refuse. I soon learned that my benefactor was in the garment business and had a wife and two children who didn’t understand him. I told him I was a waitress, but studying to be an actress, and was saving my money so I could afford the plane fare to Hollywood. Pretty soon he suggested we get a room. 

Normally I would never go to bed with a total stranger, but I was depressed, and by that time I was into my third cocktail. Between the divorce, Beryl, and my job, I hadn’t had time to do much dating. What the hell! He wasn’t a bad lay for a garment manufacturer. 

I was so exhausted from the stress that I fell asleep right afterward. When I woke up, I found a note pinned to the pillow. It said “Thanks, honey. You were terrific. Here’s a contribution to your plane fare.” Attached to it was a one-hundred-dollar bill. 

Well, I had never been so insulted. Then I realized I’d discovered a potential goldmine. I could close the tuition gap with only 50 nights like this over the next two years. New York was a mecca of male adventurers from all over the country, coming to the Big Apple for business and a little illicit sex. So long as I varied the hotels, insisted on condoms, and avoided medical meetings, I was safe.

To make a long story short, that’s how it started. After a while, I got pretty good at it and commanded even higher fees. For one thing, if I do say so myself, devoid of my hospital greens and without the usual blood on my sneakers, I’m quite smashing, and I can carry out a conversation, a small but definite asset in a profession not known for its high IQs. I told Nick I had a moonlighting job on weekends, when I wasn’t on call, and he was more than happy to increase his time with Beryl. She was unhappy that Mommy was never around on Saturday nights, but I tried to make it up to her on Sundays. 

Everything went smoothly for over a year. By then, I’d finished all my basic clinical rotations with honors and was well into my electives. I had started a six-week rotation in Cardiac Intensive Care when disaster struck.

I was at the bar in the Sheraton, which was hosting a large meatpacker’s convention when a well-dressed, elderly gentleman joined me. In retrospect, he seemed much too erudite for a meat packer. The warning signals should have gone off right then, but frankly, I was tired and in a hurry. After the usual preliminaries were taken care of, my gentleman friend, who represented himself as a businessman from Chicago, and I, repaired to his bedroom. 

Never again, dear reader am I going to make it with a man over 60, at least not in the missionary position. He breathed like he was climbing Mount Fuji. You can’t imagine how relieved I was when he finally came. I asked if he was okay because he looked a bit pale and sweaty, but he assured me he felt just fine. Then he handed me a few large bills and politely asked me to leave.

I arrived in the ICU at seven the next morning for turnover rounds. The surprise admission of the night before had been Doctor Arthur Foyle, Chairman of the Board of Trustees of the Medical School, who had suffered a posterior wall infarct the previous night. Fortunately, he was now stable. Plans were underway for a stent later that morning. 

The senior resident asked me to draw some blood gases on him.  I grabbed a syringe, collected some ice, and knocked on the door of Dr Foyle’s room, wearing my brightest bedside smile. I don’t know which one of us was more taken aback. He took one look at me and turned an apoplectic red. I was fearful that his Left anterior descending coronary artery was about to suffer the same fate as his Right. Fortunately, he regained his composure before the nurse appeared to assist me. I got the blood gas on the first stick, which was a miracle. After the nurse left he signaled me to close the door.

“Well,” he said, carefully reading my ID badge, which said Medical Student IV, “what do you have to say for yourself, young lady? Give me one good reason why I shouldn’t have you thrown out of here as a disgrace to the medical profession?”

The best reason I could think of was that he would be hard-pressed to explain how he had discovered my extracurricular activities. However, I decided rapidly that it would be wisest not to press the point and to throw myself on his mercy instead. I told him about Beryl, the rise in tuition, and what it was like to be a nurse when you were destined to be a doctor. Tears dripped down my cheeks and onto my white coat. 

Now Dr. Foyle was an eminently reasonable man, and if it hadn’t been for the heart attack, would have thoroughly enjoyed himself the previous night. We agreed that I would give up my moonlighting immediately in exchange for a full tuition scholarship. It seemed fair. I considered advising him to stick to somewhat less strenuous sexual positions in the future but decided against it. Some things are best left unsaid.

Beryl and I finished medical school in style and commenced my residency. I am going into Obstetrics and Gynecology. After all, since fornication got me my MD, it seems only fair to dedicate my life to treating its complications.


Paula Bernstein is a physician, a scientist, and the author of the medically-themed Hannah Kline MysteriesHer short stories have been included in the Anthologies, LAst Resort, and Avenging Angelinos, and will be published in the upcoming A New York State of Crime. She has been an active member of Sisters in Crime and served as President of the Los Angeles Chapter and chair of the California Crime Writers Conference. Her website is


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