"Roman Candle" turns 20: Secrets of Elliott Smith's accidental masterpiece (slideshow)
Elliott and the friends with whom he recorded in middle school in Texas (photo courtesy of Dan Pickering)
I was first exposed to the world of medicine through the window of TV. But though shows such as “St. Elsewhere,” “M*A*S*H” and “Trapper John, M.D.” dominated the ratings of my youth, my first experience actually came through a movie: “Naughty Nurses III.”
Of course, I’d been aware of the strange connection between sex and healthcare long before those days of peering through wavy lines in the hopes of glimpsing the Playboy Channel. It seemed to be something that permeated the subconscious of our culture, a part of humans’ archival memory stretching back before the days of Hippocrates himself.
But was this just a myth, used to liven up the image of a place known more for death than for procreation? Or was sex somehow inextricably woven into the tapestry of medicine? Intrepid journalist that I am, I decided to become a doctor and find out for myself.
What I’ve discovered is that there are many reasons for having sex, with love being only one of them. Of course, this is true everywhere. But not every work environment actually provides private bedrooms for its employees.
So what does the hospital do to people to allow their subconscious desires to make the jump to actual events? What effects does the hospital environment have over people’s sexual behavior?
One effect of working in a hospital is a feeling of helplessness mixed with frustration. Sometimes patients are simply too sick to live, despite everything medicine can offer. Just because you sit with a patient for eight hours, titrating three I.V. drips of heart-pumping medications on a minute-to-minute basis, doesn’t mean that she will survive. And as her heart rate decreases and her life slowly and steadily slips away before your eyes, there comes a sense of helplessness from knowing what’s happening to every single molecule in her body, yet not being able to do a damn thing about it.
Of course we know, intellectually, that it’s not our fault. But nonetheless, there is the lingering feeling of failure, the feeling that you could have somehow done something more. And it builds up within you over weeks, months and years.
Any adult knows that sex is, in fact, the best way to relieve frustration, with masturbation a distant second. Furthermore, it serves as an excellent means of taking control of some part of one’s life. When everything else around you seems to be falling to pieces, the ability to choose another person and experience intimate physical proximity with that person is a great reminder that you are still able to affect at least some of the daily events in which you are involved. These events were frequent for a tall, square-jawed resident I once knew, who was uniformly lusted after by every young nurse in the hospital and some older ones as well. After his first few distressing weeks on the wards, it became well known that if you caught him at the end of a bad day, especially one in which he had lost a patient, you could coax from him a trip to the call room. In fact, the nurses even began to send spies down to the E.R. on busy afternoons, just to see how he was faring.
Perhaps only God, and maybe some of the janitorial staff, know how many nurses he knew in the biblical sense. He certainly had our support, though no one had the foresight to keep count. Nevertheless, there he always was, with a freshly pressed shirt and chipper smile bright and early the next morning. And if the previous nurse of the day was working, too, there was never any sign of the tryst that may or may not have already been forgotten. And that’s how it went for three years.
The second reason for the prevalence of hospital sex is tension. The pressure of constant decision making, where the result often is a life-or-death situation, generates a great deal of stress. But rare is the time when you can simply go home and let it out at the gym, or on a neighbor’s dog, because most of your waking hours are spent in the hospital, and punching dogs is illegal. And as any good chef knows, too much time in a pressure cooker and your stew is bound to blow.
This is especially true in surgery, where death hangs as loosely and easily as the sterile drapes over the patient. The individuals in my friend’s large university surgery department have solved this problem by blowing their stew at the end of every academic year in an epic, Romanesque three-day orgy. At the end of June, they rent a suite of rooms at a downtown hotel, and the surgeons and nurses simply drink and have sex until passing out, waking only to repeat the process again. Rank plays no part, and there’s no yelling at underlings for incorrect technique. The event is simply a release of the kind of tension that builds up over an entire year of having people’s very lives in their hands.
And when the three-day explosion is over, everyone returns to the operating room to work side by side for another year, to collect 52 more weeks of stress individually before letting it out again together.
A third striking effect of the hospital is boredom. A hospital is one of very few work environments in which people are forcibly confined to the building all night, whether there’s anything to do or not. Often, when the patients are asleep and the E.R. is quiet, doctors and nurses find themselves sitting around, just waiting for something to happen.
Of course, there are many ways of passing the time — reading, crossword puzzles, Game Boys. And sometimes, when the floor is empty, when there’s a bedroom right down the hall that only you have the key to and when one of your co-workers shares with you a mutual attraction, there doesn’t seem to be a reason in the world not to disappear for a few minutes.
Of course, it’s vitally important to keep your pager and your wits about you when doing this, lest you end up like one now-famous resident who not only showed up to an emergency code late but arrived unzipped and unbuckled.
The fourth, and perhaps most important, feeling generated by the hospital is understanding. Simply because of the specialized nature of the job, a nonmedical person, no matter how hard you try to explain it to him or her, will never truly understand what we go through in a day at work. It’s not that someone couldn’t comprehend it; it’s just that the emotions, the proximity to illness and death and the feeling of never knowing exactly as much as you think you should even when others are depending on you for their lives are an experience unique to medicine. And as much as one wants one’s girlfriend or husband to understand exactly what it is one goes through, short of sending them through med school, the loved one simply never will.
Furthermore, many doctors spend more time at the hospital than at home — they sometimes get to know the staff as well as or better than they know their own families. And when you finally do get to spend time at home, you often don’t feel like recounting every single thing that happened at work; sometimes, you just want to leave it all behind.
But co-workers, who are there with you every minute of every day, not only understand but are going through the same events and sensations, often right by your side. That creates a very strong bond, because you share a connection that doesn’t need words or explanation.
A resident I knew loved her boyfriend so dearly that it became legendary. We used to hear about this guy so much, we felt we were not just friends with him but that we’d grown up with him. Every year, I still remember his birthday.
But one day this resident found herself in the rare situation of running a code on a young overdose patient who, if the code was successful, would actually have a good chance of continuing on with a normal life.
The code lasted almost an hour and a half, 90 minutes of frenzied pumping, injecting and shocking. But no matter what the resident did, the patient’s systems were just too depressed, and as the effects of each injection wore off, he would once again continue his slow, inexorable descent toward death. Finally, despite innumerable electric shocks to his heart and what seemed like gallons of excitatory medications, the patient died, with the resident still thrusting rhythmically on his chest.
Her shirt was soaked through with sweat. Wayward strands of hair fell everywhere, some plastered to her face with what might have been tears. She took several long, deep breaths, straightened herself up and slowly walked from the room, motioning for one of the male respiratory technicians to follow her. They disappeared down a hallway and into the call room, from which a soft symphony of creaking ensued.
Ten minutes later she emerged, posture erect, hair combed, and went back to work. Not a word was ever breathed of the incident again.
Now, I don’t mean to give the impression that the hospital is a den of sin, threatening to turn anyone who looks back at it into a pillar of salt. Plenty of people are able to work there, day in and day out, without causing an overflow in the obstetrics ward or a backlog in the STD clinic.
Sex is a daily, undeniable part of everyone’s life, even if only in our thoughts. It just happens that the hospital, a building and a culture that are unparalleled in our civilization, creates in us a unique set of pressures and emotions that every once in a while pushes sex from our thoughts right into our actions. Just as I learned so long ago on TV.
Jeff Drayer is the author of "The Cost-Effective Use of Leeches and Other Musings of a Medical School Survivor." He lives in Boston, where he is doing a dermatology residency.More Jeff Drayer.
Elliott and the friends with whom he recorded in middle school in Texas (photo courtesy of Dan Pickering)
Heatmiser publicity shot (L-R: Tony Lash, Brandt Peterson, Neil Gust, Elliott Smith) (photo courtesy of JJ Gonson photography)
Elliott and JJ Gonson (photo courtesy of JJ Gonson photography)
"Stray" 7-inch, Cavity Search Records (photo courtesy of JJ Gonson photography)
Elliott's Hampshire College ID photo, 1987
Elliott with "Le Domino," the guitar he used on "Roman Candle" (courtesy of JJ Gonson photography)
Full "Roman Candle" record cover (courtesy of JJ Gonson photography)
Elliott goofing off in Portland (courtesy of JJ Gonson photography)
Heatmiser (L-R: Elliott Smith, Neil Gust, Tony Lash, Brandt Peterson)(courtesy of JJ Gonson photography)
The Greenhouse Sleeve -- Cassette sleeve from Murder of Crows release, 1988, with first appearance of Condor Avenue (photo courtesy of Glynnis Fawkes)