โHow much Lasix is Mr. Sanchez getting?โ Dr. Westin asks me.
Itโs the twenty-eighth hour. Iโm sitting at the nurseโs station with Alyssa and Dr. Westin, near Mr. Sanchezโs room. Mr. Sanchez, the pregnant man, has now reduced his gestation to about four or five months. Weโre going to send him home. Iโm all set to send him home, and have been surreptitiously writing his discharge summary during every free moment. Iโve gotten to be really good at writing while walking up and down stairs.
โUh,โ I say. I start shuffling through the stack of papers Iโm holding. โJane,โ Alyssa says, โyou have to be ready to answer when the
attending asks you a question.โ
Good advice. Except it doesnโt make me find Mr. Sanchezโs med list any faster.
โIโll go check the nurseโs med book,โ Dr. Westin says, leaping to his
feet.
Alyssa watches Dr. Westin run off. As soon as heโs out of sight, she
leans in so close to me that I can feel her hot breath on my neck: โThe attending does not stand.โ
I stare at her. โWhat?โ
โIf the attending asks you a question,โ Alyssa says, โyou get up and find out the answer. You doย notย let the attending stand.ย Ever.โ
Hey, maybe I should just carry the attending on my shoulders during rounds. Would that be okay,ย Alyssa? And if youโre so gung-ho on never letting the attending stand, why didnโtย youย go look up the medications?
Iโve composed about ten angry replies to Alyssa in my head, none of which I have the courage to say, when Dr. Westin returns. โHeโs on 4O mg twice a day!โ
And of course, at that moment, I discover the paper with Mr. Sanchezโs meds on it. But itโs probably good I didnโt find it earlier, since I had the dose wrong.
โJane,โ Alyssa says in an inquiring tone, and I wince inwardly. No more questions, please! I am way too tired for this. โHow long did you spend yesterday waiting on the phone for the translator for Mr. Sanchez?โ
I donโt really understand the point of Alyssaโs question. Iโve been awake for a long time, and itโs not clear why it matters how much of my life I wasted on hold for the translator. Itโs over. Why waste more time on it?
โI donโt know,โ I finally say. โTen minutes?โ
โMr. Sanchezย speaks English,โ Alyssa says triumphantly.
I donโt know what she expects me to make of this revelation. All I can say is, โHe does?โ
Dr. Westin chuckles, โGina, you didnโt know your patient speaks English?โ
โDid you evenย tryย to talk to him?โ Alyssa asks me, shaking her head at disgust at my lack of effort.
I tried. He doesnโt freaking speak English! โI did.โ
โWe had a great talk this morning,โ Alyssa says pointedly. โI was telling him about the diet he needs to keep due to his cirrhosis and he asked me all sorts of really intelligent questions. Jane, you really have to make more of an effort to communicate with your patients.โ
I swear, Mr. Sanchez did not speak English when I met him yesterday. The only solution I can think of is that the man somehow learned to speak it within the last 24 hours. Itโs a miracle.
The three of us march into Mr. Sanchezโs room together. Heโs showered this morning, his face is scrubbed clean, and his black hair is brushed and slicked back. Itโs amazing how so many of my patients look like they just spent a night at a fancy resort.
โHello, Mr. Sanchez,โ Alyssa says cheerfully.
โHello,โ he replies. I swear, if he starts speaking fluent English, Iโll
cry.
โMr. Sanchez,โ she says. โI was just telling the team about our talk
this morning. About all the foods you said youโre going to avoid.โ He nods and a pleasant smile appears on his face. โAh. Yes.โ
She folds her arms across her chest, getting ready to show off. โTell the team what youโre going to avoid eating.โ
I hold my breath. Mr. Sanchez looks between the three of us.
Finally, he says, โQuรฉ?โ
Alyssaโs eyes widen. โMr. Sanchez, donโt you remember? Youโre not going to eatโฆ?โ
He keeps the pleasant smile plastered on his lips. โQuรฉ?โ
โSalt!โ Alyssa blurts out. โSalt. Youโre not going to eat salt, right?โ โSal?โ Mr. Sanchez raises his eyebrows. I look over at Dr. Westin,
who is trying not to laugh. Alyssaโs face is a shade of bright pink.
I love you, Mr. Sanchez. Just for that, Iโm giving you a few tablets of Percocet to go.
Hours awake: 29 Chance of quitting: 19%