At first, it seemed like good news: my wife, along with all the other first-year medical students, was being given a free stethoscope — which meant one less costly instrument to buy, a little help for our loan-inflated budget.

Who’s giving it to you? I asked.

The Lilly Company, she said.

The Lilly Company? I was appalled. The Eli Lilly Company?

The very same. And, my busy wife suggested, with the look of a practiced mountain climber sensing an approaching avalanche, she had no time to hear a lecture about it. She had another exam tomorrow.

But it was futile. Sharp stones were already flying.

This is no gift, I said. It’s a bribe — and about as subtle as a guy in a dark car offering a little girl a chocolate bar if she goes with him for a ride.

Norma didn’t say anything.

The pharmaceutical industry! Norma, you know how sleazy these guys are. They make a fortune selling people drugs they don’t need. They sell drugs that make sick people sicker that cripple, that kill. They may as well be selling guns. And if the government now and then clamps down, bans something — what happens? What do these benefactors of higher education do then? They peddle it somewhere else, where the politicians are easier to buy, or just don’t care.

Norma still had nothing to say.

I nodded vigorously, as if she’d just agreed with me. That’s right, guns. What could be more criminal? No answer. In the old days, the bad guys would shoot up the town, rape the women, and disappear into the hills. So what’s changed? Now the bad guys convince the doctors to shoot bad chemicals into our veins, they rape the women with shoddy IUD’s and little pills that are the dark seeds of cancers, then they disappear on the twentieth floor to plan the next raid, the next multi-million dollar ad campaign, to persuade us that a new drug, no different from a dozen others on the market, is more important to our well-being than the air we breath.

That’s enough, Norma said. More than enough. For one, she knew all this. For another, did I imagine she was going to be bought for a thirty-dollar stethoscope? Is that how much respect I had for her?

If I didn t respect her, I assured her, I wouldn’t be trying to change her mind. I went on quickly; I didn’t want that one held up to the light. Why, I wanted to know, if she knew all this, if she couldn’t be bought for thirty dollars, was she accepting the stethoscope?

To save thirty dollars, my wife replied, with the finality of a last heartbeat. She opened the fat textbook in front of her, told me for the second time she was too busy to talk about it, and went back to her studies.

 

I sat there, brooding. I knew this could go several ways, most of them bad. In a marriage, you have to argue once in a while; passionate argument, like passionate sex, like any good storm, chastens and cleanses, and drives out some ghosts. But it’s important to pick your fights, know how and when to fight.

It had been a year of no small temptation. Medical school challenges a marriage — isn’t that how we say it now? — the way a front-end collision challenges your car. I’ve had to make more than a few trips down the narrow stairs of my heart, to what dim vault where some true generosity of spirit lay gleaming. What do lovers give each other, after all, but some time and a little kindness? Take away the time, which medical school does, and too great a burden is placed on kindness. Sometimes hers would give out; more often it would be mine, as I’d sweep the cellar of myself for gold and come up with dust.

Then there was money. I thought I was a pretty frugal guy until we got together a few years ago. On my salary, I didn’t have much choice; besides, my keenest longings are for things money can’t buy. I live lightly, no doubt about it. But if I’m a feather, Norma is the wind. Household economy? She reminds me of the woman I read about who had little cloth bags to hold pieces of string, each bag labelled carefully as to the length of the pieces — with one small bag of string labelled “too short to save.” When she asks me what I spent at the grocery, I hesitate, like a general being ask to explain a thirty-million-dollar cost overrun at the Pentagon. I don’t mean to suggest Norma isn’t generous; indeed, she gives abundantly of the only thing we really have to give: ourselves. But if that can be accomplished without writing a check, I think my wife is happiest.

To argue about the thirty dollars seemed silly. To argue about the principle — well, it’s taken me three marriages to figure out that arguing over a principle almost always guts the principle. I mean, have you ever heard yourself, in a voice shrill with injury and impatience, insisting what a loving guy you are? Or, during some fatal pause in the middle of a fight — the blood still hammering against your temples, your vision misted over by your own eloquence, the whole body throbbing with the profoundly physical delight of having made a point — have you ever wondered who’s the bigger fool: the person across from you, for thinking something so foolish, or you, for thinking you can talk him or her out of it?

Anyway, I wasn’t even sure what the principle was. Did I imagine my wife could be bought for a thirty-dollar stethoscope? Of course not. Would anything be accomplished by Norma refusing it — except perhaps being called in by the dean, branded as a troublemaker? Is that what I wanted — for my wife to stake out a claim as an idealist, in a system so corrupt that her moral stance wouldn’t even be considered a threat, but rather laughable? I had read somewhere that the drug companies collectively spend an average of $4,000 a year per physician on promotional gimmicks — prizes, gifts, vacations. The real corruption, of course, is deeper, and eats at the heart of Western medicine, which pretends the body is a machine run by chemical switches. What an idea! What an ugly tumor that is! It grows unchecked, just like drug company profits. Was I sending my wife into battle against the Eli Lilly Company, or against our whole modern way of life — and whose fight was it anyway? Not hers; she didn’t even want to fight with me. So what was I doing, here at the kitchen table, other than keeping her from studying? Who was I fighting? And why was my voice so shrill?

 

Back in the Sixties, when I set out to save the world, to raise my voice made sense. Marching for civil rights, inveighing against the war in Vietnam, facing down the generals and the bigots — this was no argument around the kitchen table, this was Us versus Them. It wasn’t just a bad law or a venal President we were fighting, but an establishment, a whole outlook that filled us with contempt.

How heroic it seemed, to be aligned against the darkness, sure of ourselves and our friends. To say no to evil was something, all right; to shout it, with your brothers and sisters — well, that was a new kind of holy, a war-whoop, a death-defying chant.

The truth is, though, our words were braver than we were; so much of what was heralded at these protests as a change in awareness was about as short-lived as the protests themselves; to be a hero is easier in the company of friends. Marching at the World’s Fair in 1964, amidst thousands of other students and, it seemed, just as many police, I was probably safer, at least from the muggers, than ever before or since. The violence a few years later, at the Democratic convention in Chicago, or at Kent State, not to mention the bloody civil rights marches in the South, obscures the modest truth that most protests back then threatened you with nothing worse than a bad sunburn and a worse headache, from listening to too much talk. The whoop turned into a litany — an endless round of speech-making by student leaders honing their skills; soon they could sell anything, and most did. As to my stand against the Vietnam War, I was so prescient as to escape risk entirely. One of the first college editors to come out for U.S. withdrawal, before most people had even heard of Vietnam, I was applauded and booed by no one, but simply ignored. But let me tell you, it took more nerve to ask out the dark-haired girl in my English class. For me and most of my friends, losing our virginity was more immediate a concern than whether the country lost, or won, a war. That most of the Sixties rebellion petered out as soon as student activists graduated and got married was no surprise to me; I knew that nearly half the people at those marches were there to find a girlfriend, and the other half to find a guy. The science fiction writer Theodore Sturgeon once said, “Sure, ninety percent of science fiction is bullshit, but ninety percent of everything is bullshit.”

To take a stand for or against something didn’t require real courage until I became aware of the disfavor it could bring; to someone like me who put such a high premium on other people liking him, this was no small cost. (Like most of us, I started out confusing my need for love with my desire for my parents’ approval, and my desire for their approval with the need to be accepted by everyone I knew.) There were practical considerations, too. The first time I said no to a politician’s gift, a bottle of whiskey routinely delivered to all the reporters at Christmas, I knew he’d not be calling me with a story anytime soon. The next time I turned something down, from the chamber of commerce, my editor called me in to explain the facts of life. My job wasn’t jeopardized, but clearly I’d slipped a notch in his assessment of me as a realistic guy.

I chafed at the criticism. Realism, it seemed to me, wasn’t very real if it didn’t include ideals. We’re more than the contents of our wallets, or an endless stream of worries. Who we are includes what’s out of reach, all the stirring possibilities; to deny them, as too idealistic, isn’t realistic at all. So I wasn’t happy that, in the eyes of the people around me — no longer sympathetic student friends but older men and women, sunk into their lives and their miseries — I was, as an idealist, a bit of a jerk. It hurt, and made me resentful, and eventually, a little self-righteous, too. That is the price of idealism when you still need to hear applause.

Nearly twenty years later, the applause isn’t that important anymore. (After all, to whom shall I look for approval — someone with just as many contraditions as I?) But living my convictions is. Otherwise, how could I respect myself? This, to me, is where real politics has its start — not in crusades to reform human nature, which only deny the heart; not in crude giveaways of ourselves to spiritual leaders; and certainly not in defense of a system that brands betrayal of self as realistic and rewards our early suicide with a weekly paycheck and a Japanese car.

But getting Norma to live my convictions, my way, was another matter. Ten years younger than me, with a different temperament and a different style, she wasn’t given to the same gestures. One of my fears about her being in medical school was that she’d trade her sense of self for the role of student, and then of doctor, and that we’d no longer share the same values. But what more was there to say?

Besides, I knew the question was arguable: what Norma could do with the stethoscope was more important, perhaps, than where it came from. Robin Hood wouldn’t have turned down a stethoscope from the Lilly Company; indeed, he might have unburdened them of a few more, and seen to it that they got into the right hands. That’s a morally risky but time-honored strategy, and it makes a hell of a story. Anyway, does it really matter where something comes from? We live on land stolen from the Indians; does that mean we can’t love it and use it well? And what about THE SUN? Do I ask subscribers how they came by the twenty-five dollars they send for a subscription? If one of them was a chemist for the Lilly Company, would I send back the check?

The obvious distinction is that our discerning chemist would be paying for a subscription, not engaging in crude press agentry to convince me of Lilly’s noble intent. The brochure accompanying Norma’s stethoscope crowed that the Lilly Company marketed 700 “pharmaceutical items” in 130 countries; it didn’t say how many were worthless or dangerous, or how many were grossly overpriced.

On the other hand, if Norma didn’t accept it, what kind of statement was she making about herself? That, ironically, she was someone who could be bought? That she was more afraid of the Lilly Company than she was convinced of her own imagination and power, her ability to transform one kind of energy into another? Wasn’t that kind of spiritual alchemy easier to talk about than to do? Or was I, in fact, encouraging her to deny her own possibilities?

One thing was certain: each time I brought up the subject during the next couple of weeks, I drove her away. She was ambivalent about keeping the stethoscope, she told me, but couldn’t make up her mind — sort out her desire to agree with me from her true feelings — unless I stopped talking.

I shut up.

 

Another week went by. One day, Norma called me at the office. It was the first day of her Spring break, after a hectic month of exams. She’d just written something, she said, that she wanted to read to me. It was a letter to the dean.

Norma said she had accepted the stethoscope mainly to save money, but “it was not without misgiving” that she carried it home. “We were in the midst of midterm exams and I didn’t relly have time to think about it but it sat in my room like a heavy undigested meal. Was I going to use this instrument as a tool to help me heal? Whenever I would pick it up in the future a stream of unanswered questions and compromised ideals would follow. How could I be clear-minded enough to listen to a person’s heart through all that?”

Spring vacation arrived, she continued, and she went to the library to see if she could find out anything about the Eli Lilly Company. “Not surprisingly, they were involved in the predictable drug company scandals — DES, the drug given to pregnant mothers that caused cervical cancer in their female children; Oraflex, the anti-arthritis drug they pushed through the FDA, even though tests in Europe indicated harmful side effects; including death, and indeed it ended up killing people here; overseas sales of questionable products. Clearly, this was a company like every other, motivated by the profit margin. But how did I fit into this margin? I find it hard to believe that Lilly is motivated by some idealistic sense of goodness when it supplies thousands of stethoscopes to medical students across America. It must profit them — or else they believe it does. Perhaps they think we will view them as benevolent, less likely to believe that they are more concerned with selling drugs than with helping people.”

Norma noted that a few of her classmates had accepted the stethoscope without question; others said they would take the drug companies for all they’re worth; one friend is sending hers to an impoverished country; another friend decided to send a donation of equivalent worth to Ethiopia. “I am choosing to send my stethoscope to you. I don’t know what I expect you to do with it, except perhaps to know that there are still a few students who find these gifts unacceptable.”

When Norma read me the letter, I felt both moved and annoyed — on the one hand, my wife had shown her warrior spirit; on the other, she had ruined my piece with a happy ending. A friend had just chided me for too often wrapping up these essays with some moral revelation or spiritual victory. It makes it too neat, he said; that’s not the way life is. (Indeed, the dean had even congratulated Norma; he said he was glad students were thinking about these things, while neglecting to mention what deans thought about these things.)

Well, maybe life is this way and maybe it isn’t. Here’s another ending — take your pick. Another friend of Norma’s decided to keep the stethoscope. But, he told me, he didn’t want to be reminded constantly where it came from, so he threw away the box with the Eli Lilly name on it. And he pulled off the little piece of tape with the Eli Lilly logo on it. And he was quite pleased, until he used the stethoscope for the first time. For there, on the metal shank, was ELI LILLY, permanently engraved.

— Sy