I stumble out of bed the next morning, my one remaining hour of sleep having been interrupted by a call to inform me that a patient was allergic to Lithium. I hadn’t ordered Lithium on this patient so I have no idea why this warranted an urgent 5 a.m. page, but I gave my verbal consent to add Lithium to the patient’s allergy list. At least, I think I did. I only vaguely remember it, as if it were some kind of dream.
While in the communal bathroom, I brainstorm what I can do to make myself feel more like a human being. I readjust my ponytail, which helps very slightly. There’s a travel-sized tube of toothpaste on the sink. I squeeze about half an inch of toothpaste onto my finger and start massaging my teeth. Funny how I feel more like I’m about to do the Walk of Shame after a sexy hook-up than finish my first shift as a doctor.
I quickly pre-round on my patients, which means I essentially look into their rooms to make sure they are still alive. Everyone is still alive. We’ve all somehow survived my first shift as an intern. Apparently, people are harder to kill than I thought.
I arrive at Dr. Westin’s small office, where we’re meeting to discuss our patients from the night before. Dr. Westin looks very chipper, especially compared to the three of us. He’s clean-shaven, and his shirt is so blindingly white that I have to avert my tired eyes. He beams when he sees me, which almost makes up for the way Alyssa glares at me and looks at her watch.
“Did you have an exciting first night on call, Jess?” Dr. Westin asks
me.
Apparently, I’m Jess now.
“Yes,” I mumble as I sink into a chair in front of his desk. If there
weren’t a chair for me to sit in, I definitely would have cried. As is, I’m only barely keeping it together.
Connie, who apparently arrived an hour ago or something, has already reviewed her patients, so I’m up next. I tell Dr. Westin about Mr. Petrovich and his maybe chest pain, an elderly lady named Mrs. Thompson who has a mild kidney infection but seems better now, and Mr. Swanson and his abscess.
“What did Surgery say about the abscess?” Dr. Westin asks me. I squirm. “I wasn’t able to reach the consult resident last night.”
Alyssa’s eyes fly open. “Are you serious?”
“I paged him twice,” I say lamely. And I realize that twice was not nearly enough. I should have been paging him every ten seconds all night long.
“I’ll page him right now,” I promise.
Alyssa just shakes her head. “You need to speak with him before you leave.”
It’s official. I will be spending the rest of my life in this hospital on this call.
After we pop in on my patients and Alyssa gives me a mile-long list of things to do, I slink away as quickly as I can. When I finish my to-do list, I can leave. Yet I don’t know how I can possibly get through this nearly infinite list. I feel like Cinderella, when she was given that huge list of chores before the ball. I will never get to the ball at this rate.
The first thing I do is find a quiet spot on one of the wards and page Dr. Reilly again. After ten minutes, it’s pretty clear he’s not going to call me back. This asshole is wrecking my life right now.
And that’s when I lose it.
I call Dr. Reilly’s pager number again, but this time instead of leaving a callback number, I leave a voice message. “Dr. Reilly,” I say. “This is Dr. McGill with Medicine. I have been calling you the entire night to talk to you about a patient who has an abscess and is extremely ill, and you have not had the courtesy to call me back. Apparently, you have absolutely no concern for patient welfare. I want you to know that I am going to report this behavior to your attending. If anything happens to this patient because you were unwilling to do your job, I intend for you to be found personally liable. Thank you very much.” And then I hang up.
Holy crap. I didn’t really say all that, did I?
Yet there was something cathartic about it. It felt good taking out my frustrations on another person. No wonder Sexy Surgeon enjoys it so much.
I’m discharging Mrs. Thompson with the kidney infection, which means I have to find the sheet to write out her discharge summary and medications. I go to 3-North, where Mrs. Thompson is located, and find a file cabinet in the back room that supposedly contains all the forms. I pull open the drawer to the file cabinet.
Wait. What was I looking for?
Oh right… discharge paperwork.
I start rifling through the papers: antibiotic forms, radiology forms, insulin sliding scales… oh my God, I am so tired…
Wait. What was I looking for? Crap.
I check my notes. Right, discharge summary form. I am really, really tired.
“Medicine Intern!”
I look up and see none other than Sexy Surgeon himself standing in front of me. Or Ryan, I think he said his name was. His thick blond hair is slightly mussed and his scrubs a bit wrinkled, but other than that, there’s no sign that he’s been awake most of the night. I’m sure he hasn’t spent the last ten minutes searching for a discharge form because he was too tired to think straight.
“Hey,” I mumble.
“You look tired,” he observes.
Gee, thanks. “Yeah, I’m kind of tired.”
“Well, you’re in luck,” he says. “I’ve got a huge treat for you.” I raise my eyebrows. I admit, I’m intrigued.
Ryan grins at me, showing off his perfectly straight, white teeth. He’s close enough that I can smell his minty breath. I wonder if he brought a toothbrush with him to the hospital. “In a few minutes,” he says proudly, “you are going to get to see me completely rip apart one of your co-interns. I am going to destroy her. I’m going to make her cry, Jane. I’m going to make her wish she’d never been born.”
And now I feel guilty because the idea of seeing someone else get yelled at is not entirely distasteful. I remember how good it felt when I let off some steam on Dr. Reilly. Maybe this is why everyone in medicine is so damn mean.
“So what horrible thing did this poor intern do?” I ask.
Ryan snorts. “You wouldn’t even believe it. She left this really bitchy, completely inappropriate message on my pager. About how she was going to hold me personally responsible for her patient or some bullshit like that, just because I didn’t return her page the second she snapped her fingers. I mean, she’s a freaking intern. Can you believe the nerve?” He shakes his head. “You haven’t seen Dr. McGill around, have you? Someone told me she was on this floor.”
Oh no.
I am a complete idiot. Seriously. How in hell did I not realize that
Ryan had to have been the surgery resident on call for consults last
night? And now, for the first time, his badge is flipped around the right way and I can see his name. Ryan Reilly, MD.
I am so screwed. Sexy Surgeon is about to make me cry.
“I don’t think I’ve seen her,” I say carefully. I’m such an awful liar. “Oh.” Ryan frowns, disappointed. “Do you know where she went?
The nurse on the phone said she was here like five minutes ago.” “Maybe the nurse was messing with you,” I suggest.
Ryan laughs. “Oh, no. That would never happen.” Yeah, I’ll just bet.
“Damn,” he says. “Well, I’ll catch up with her eventually. Too bad you won’t get to see it.”
“Too bad,” I mumble. And the Academy Award goes to… Jane McGill!
And I almost get away with it. I am so close. Except at that moment, a tiny Philippina nurse named Mary peeks her head into the back room and says to me, “Dr. McGill, you forgot to sign the order you wrote for Tylenol.”
Ryan’s eyes light up and he looks around for the elusive Dr. McGill. The whole thing would be almost amusing if it wasn’t so terrifying. It actually takes him a good fifteen seconds before he realizes that we’re the only two people in the room. That’s when his face darkens. “You…”
“I am so sorry,” I say. My voice has taken on an unattractively whiny, pleading tone. “I was paging you all night. And Alyssa was really mad at me that I couldn’t reach you. I didn’t realize that you were Dr. Reilly.” I can’t help but add for good measure: “And I’m really tired.” I take a shaky breath. I wonder if I should get down on my knees and beg. “Please, please don’t make me cry.”
Ryan is just staring at me, still trying to decide how angry he should be with me. Finally, he shakes his head. “Okay.”
“Okay?” I raise my eyebrows. “Meaning…?” “Okay, I’ll see your consult.”
Well, gee, thanks for doing your job. Still, I am nothing but relieved. “Thanks.”
“And I won’t even yell at you,” he adds, grinning now. He is way too handsome when he grins like that. And unfortunately, I’m pretty sure he knows it. Handsome surgeons are the worst. “On one condition…”
Oh great. “What is it?”
“I’m getting together with some other residents at a bar tonight to get drinks,” he says. “I want you to come with.”
I stare at him. “Are you serious? We’re post-call. I’m not going drinking.”
Ryan snorts. “Come on, you’re all of… what—26 years old? Nap for a few hours and you’ll be good to go. We’re not meeting till like eight o’clock.”
“Well, forget it. I’m not going.”
“Gee, that’s too bad,” he says. “I guess your patient is going to die of septic shock.”
The really sad part is that I’m less worried about something bad happening to Mr. Swanson than I am about Alyssa yelling at me. “You’re not serious.”
Ryan folds his arms across his chest. “Try me.” He’s not serious. He can’t be.
Except he really might be. He’s definitely a big enough asshole. “Fine,” I hiss at him. “I’ll go get drinks with you tonight.”
“I had a feeling you would,” he comments, looking so self-satisfied that I wish I could smack him. He winks at me. “I hope this is a hell of an abscess, Dr. McGill.”
I hope so too. But really, what do I know?
My only small victory of the morning is that Ryan is impressed enough with the abscess that he agrees to take the patient to the OR to drain it. I’m really patting myself on the back for that one as I report the news to Alyssa as we “run the list” one last time in the resident lounge before I go home. “Running the list” seems to involve going through the checklist of all the things she told me to do so she can explain how I did each of those things wrong.
“Dr. Reilly is taking the patient to the OR this afternoon,” I tell Alyssa.
Alyssa narrows her eyes at me. “And who’s going to admit him back to the floor after he comes out of surgery? Do you expect me to do it?”
“No, Dr. Reilly said he’d keep the patient on the General Surgery service.” And then Alyssa is left speechless. At this moment, I forgive Ryan Reilly for everything.
“All right,” Alyssa says reluctantly. “Now let’s see your discharge paperwork on Mrs. Thompson.”
I hand over the stack of papers. I’ve handwritten a discharge summary, which includes a detailed account of how Mrs. Thompson had a fever and back pain, and we discovered it was due to a kidney
infection, also known as pyelonephritis. I wrote about her exciting night on the ward of County Hospital. I left out the part where she yelled at me for waking her up “too goddamn early” this morning.
The next page is the list of medications we’re sending her home with. I was careful to sign it, because I’ve now gotten paged at least a dozen times for forgetting to sign an order. You’d think I’d learn my lesson after the first eleven times, but no.
Alyssa looks over my paperwork. I already know I must have done something wrong, based on the way her narrow eyebrows are getting closer and closer together, but also based on the fact that I seem to be doing pretty much everything wrong lately.
Alyssa smacks down the list of medications in front of my face. “Did you forget something?”
“Um,” I say. I look down at the list of Mrs. Thompson’s medications. She’s on a lot of medications, but I really thought I got them all. “No?”
She raises her eyebrows. “Are you sure?”
Based on the way she’s saying it, it’s pretty clear the answer is yes. But I feel like we may as well go one more round like this: “I don’t think so.”
Alyssa sighs. “You forgot to write for her antibiotic.”
Wow. Okay, I have to admit, that was incredibly dumb. I mean, that was really, really stupid. A lady comes in for a kidney infection and I almost sent her home without antibiotics. In my defense, I’m pretty tired. I quickly scribble an order for ciprofloxacin after taking way too long to double check the dosage as Alyssa continues to glare at me.
“Sorry,” I mumble.
She nods as if my stupidity comes as no surprise by this point. “And how about Mrs. Coughlin? Did you arrange for her biopsy?”
“Yes,” I say. “Interventional radiology is coming by to do it this afternoon around three.”
“Fine,” Alyssa says as she makes a note about it on her index card. “By the way, you should go watch the biopsy.”
My stomach sinks. In about 15 minutes, it will be 1:3O p.m., which means I’ll have been in the hospital for 3O hours. After 3O hours, the rules state that I am allowed… nay, required, to go home.
Alyssa notices the look on my face and says, “I know it’s painful to do these things post-call, but it’s the best way to learn. You should try to go.”
I may be afraid of Alyssa, but right now my exhaustion trumps my fear. The only way I’m going to that biopsy is if she hog-ties me, tosses me over her shoulder, and carries me there. Which isn’t entirely out of the question.
“You can sign out first,” Alyssa says. “All right,” I say.
“Did you get the sticky notes yet?”
I close my eyes for a brief second and an almost dizzying sensation comes over me. I wonder if I’ll be allowed to leave this hospital without sticky notes. I fear not.
“No,” I admit. “I didn’t.”
Alyssa looks incredibly disappointed.
“I can go to the drug store across the street and buy some?” I offer. “Jane!” Her eyes widen in anger. “You are not allowed to leave the
hospital while on call. That is totally inappropriate!”
Hours awake: A jillion Chance of quitting: 91%
