Dwayne attacks so many people on his “rampage,” that a “special ambulance known as Martha” is called to the scene. The ambulance can hold up to thirty-six “disaster victims,” and it has an operating room and enough food to last for an entire week. The ambulance is named for the wife of a Country Commissioner who died from rabies after she was bitten by a bat. “My psychiatrist is also named Martha,” Vonnegut writes. Martha is on vacation now, but Vonnegut “likes her a lot.”
By mentioning his own psychiatrist, Martha, Vonnegut again underscores that mental illness is commonplace in society and attempts to destigmatize it. By writing about his own illness, Vonnegut attempts to start a conversation about mental health, which will ultimately shine light on the problem and, hopefully, help those who suffer.
Aboard Martha is two physicians, Cyprian Ukwende and Khashdrahr Miasma, who is from Bangladesh. A young “white American” named Eddie Key is driving the disaster vehicle, and he is the direct descendant of Francis Scott Key, the man who wrote the Star-Spangled Banner. Eddie knows the history of over six hundred of his ancestors, which includes “Africans, Indians, and white men.”
Eddie’s relation to Francis Scott Key firmly establishes him as an American, and his diverse family tree reflects the country’s own diversity. Dr. Ukwende and Dr. Miasma also reflect this diversity, which Vonnegut implies is something to value, not discriminate against.
Dwayne boards the ambulance wrapped “tightly in canvas restraining sheets.” He is unaware of his surroundings and yells, “Goodbye, Blue Monday!” as Kilgore boards the ambulance unassisted. Kilgore is one of the “walking wounded,” and he holds up a bloody hand for Dr. Ukwende to assess. Kilgore had grabbed Dwayne from behind as he gave Francine Pefko the beating “his bad chemicals made him think she richly deserved.” He had already broken her jaw and several ribs by the time a crowd began to form. “Best fucking machine in the State,” Dwayne yelled. “Wind her up, and she’ll fuck you and say she loves you, and she won’t shut up till you give a Colonel Sanders Kentucky Fried Chicken franchise.”
When Dwayne boards the ambulance he is wrapped in a straight-jacket (“canvas restraining sheets”), which reflects the total deterioration of his mental health. Sadly, Dwayne’s illness has caused him to assault Francine, whom he believes to be a robot programmed to sleep with him and then expect money and gifts. Dwayne’s comment about Francine echoes popular stereotypes in American society that assume woman are made simply for the pleasure of men, and that they are entitled and expect gifts in exchange for that sex.
When Kilgore tried to stop Dwayne from beating Francine, Dwayne bit off Kilgore’s finger and spit it into Sugar Creek. “This isn’t the kind of book where people get what is coming to them in the end,” Vonnegut writes. Except for Don Breedlove, who raped Patty Keene behind the Bannister Memorial Fieldhouse. Don was in the kitchen fixing a gas oven when Dwayne went crazy in the lounge of the Holiday Inn. He stepped out of the kitchen to see Dwayne, whom he already knew because Dwayne had sold him a “lemon” from his dealership.
The fact that Vonnegut’s characters don’t “get what is coming to them in the end” is another example of his own efforts to “snub” traditional storytelling and write the antinovel. Vonnegut does, however, give Don Breedlove what he believes he deserves, which implies that Vonnegut considers rape and violence against women one of society’s most troublesome and offensive atrocities.
Dwayne didn’t actually sell Don a “lemon”—the neighborhood kids had poured maple syrup in the gas tank—but Dwayne had tried to fix it anyway. As Dwayne approached Don at the Holiday Inn, he shook his hand, then Dwayne punched him hard in the side of the head. Don will “never hear anything with that ear, ever again.”
The fact that Dwayne tried to do good for the car even though it wasn’t really a lemon implies that he is actually a good person, and that it is his mental illness, not his innate self, that is causing him to behave so violently and cruelly.
Aboard Martha, Dr. Ukwende tries to remove Dwayne’s shoes, but he has waded through Sugar Creek as well, and his socks and shoes have turned to plastic. Dr. Ukwende is plenty used to “plasticized, unitized shoes and socks.” He sees it all the time when kids come into the emergency room, and he even has a special pair of tinsnips he uses to cut them free. “Get some shears,” Dr. Ukwende says to Dr. Khashdrahr.
Dr. Ukwende’s familiarization with the “plasticized, unitized shoes and socks” is another reflection of the severity of the pollution and destruction of the planet. While Kilgore’s plastic pantlegs seem ridiculous and far-fetched, Dr. Ukwende is used to seeing the pollution of Sugar Creek come through his emergency room.
For a moment, Dwayne’s “awareness returns to Earth,” and he begins to talk lucidly. He tells Dr. Ukwende that he is going to open a new health club in Midland City. Dwayne plans to open the health club and sell it for a profit as soon as possible. “People get all enthusiastic about getting back in shape or losing some pounds,” Dwayne says. “They sign up for the program, but then they lose interest in about a year, and they stop coming. That’s how people are.”
The fact that Dwayne is still scheming ways to make money and open a new business even during an acute episode of insanity speaks to how deeply money and capitalism has affected society. Even though he is sick and about to be arrested, he is still trying to make more money.
Dwayne never does open a health club. Instead, he is mercilessly sued by all the people he attacked and is “rendered destitute.” He loses his fancy house and moves to “Skid Row” to live at the Fairchild Hotel. When people in town pass him on the street they say, “See him? Can you believe it? He doesn’t have doodley-squat now, but he used to be fabulously well-to-do.”
When Dwayne goes from rags to riches, this again underscores the unequal distribution of wealth in American society and emphasizes how differently the poor live from the wealthy in America.