Sneak Peek of Summer House with Swimming Pool

I am a doctor. My office hours are from eight-thirty in the morning to one in the afternoon. I take my time.

Twenty minutes for each patient. Those twenty minutes are my unique selling point. Where else these days, people say, can you find a family doctor who gives you twenty minutes? – and they pass it along. He doesn’t take on too many patients, they say. He makes time for each individual case.

I have a waiting list. When a patient dies or moves away, all I have to do is pick up the phone and I have five new ones to take their place.

Patients can’t tell the difference between time and attention. They think I give them more attention than other doctors. But all I give them is more time. By the end of the first sixty seconds I’ve seen all I need to know. The remaining nineteen minutes I fill with attention. Or, I should say, with the illusion of attention.

I ask all the usual questions. How is your son/daughter getting along? Are you sleeping better these days? Are you sure you’re not getting too much/too little to eat? I hold the stethoscope to their chests, then to their backs. Take a deep breath, I say. Now breathe out nice and slow. I don’t really listen. Or at least I try not to.

On the inside, all human bodies sound the same. First of all, of course, there’s the heartbeat. The heart is blind. The heart pumps. The heart is the engine room. The engine room only keeps the ship going, it doesn’t keep it on course.

And then there are the sounds of the intestines. Of the vital organs. An overburdened liver sounds different from a healthy one. An overburdened liver groans. It groans and begs. It begs for a day off. A day to deal with the worst of the garbage. The way things are now, it’s always in a hurry, trying to catch up with itself.

The overburdened liver is like the kitchen in a restaurant that’s open around the clock. The dishes pile up. The dishwashers are working full tilt. But the dirty dishes and caked-on pans only pile up higher and higher. The overburdened liver hopes for that one day off that never comes.

Every afternoon at four-thirty, five o’clock (sometimes earlier), the hope of that one day off is dashed again. If the liver’s lucky, at first it’s only beer. Beer passes most of the work along to the kidneys. But you always have those for whom beer alone isn’t enough. They order something on the side: a shot of gin, vodka, or whisky. Something they can knock back. The overburdened liver braces itself, then finally ruptures. First it grows rigid, live an overinflated tire. All it takes then is one little bump in the road for it to blow wide open.

I listen with my stethoscope. I press against the hard spot, just beneath the skin. Does this hurt? If I press any harder, it will burst open right there in my office. Can’t have that. It makes an incredible mess. Blood gushes out in a huge wave. No general practitioner is keen to have someone die in his office.

At home, that’s a different story. In the privacy of their own homes, in the middle of the night, in their own beds. With a ruptured liver, they usually don’t even make it to the phone. The ambulance would get there too late, anyway.
Excerpted from Summer House with Swimming Pool by Herman Koch. Copyright © 2013 by Herman Koch. Excerpted by permission of Hogarth, a division of Random House LLC. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

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