July 1
Hours Awake: 1
Chance of Quitting: 22%
I have been a Medicine Intern at County Hospital for ten minutes and I am already horribly, hopelessly lost.
I am supposed to meet up with my new senior resident Alyssa and my co-intern Connie at 7:3O a.m. in the resident lounge. It is now 7:25
a.m. and I have no idea where the resident lounge is. I swear, I knew where it was last week when we had our orientation. It was on the third floor, right next to the telemetry unit.
But now the room that used to be the resident lounge is boarded up. There are literally wooden boards blocking the entrance to the room. How is this happening? I feel like I must be in some Twilight Zone where I’m about to discover I was never actually a doctor and this is all just some TV show I am starring in. (At this point, I’d be thrilled to discover that.)
I pace the dimly lit hallway about ten times, looking for any room that seems lounge-like in appearance. The floors have recently been mopped and are slightly wet and slippery—at one point, I catch myself seconds before my feet slide out from under me.
I return to the former resident lounge and just stare at the door for a full minute. Finally, I kick one of the wooden boards with one of my Dansko clogs, which is the official comfortable shoe of medical residents. Then I kick it again. Mostly because this is really frustrating and it’s better than crying.
“You look lost,” a voice says from behind me.
I turn around. A guy wearing light blue scrubs and a surgical mask is standing a few feet away from me. He’s not wearing an ID badge, but I could just smell surgical resident on him. He emanates it. Also, and I really hate to say this, he’s incredibly handsome. At least the part of him that isn’t covered by the surgical mask is cute—he has intense blue eyes and a mop of dark blond hair. He’s got muscles that I can even see under
his scrubs, which is kind of amazing since I could be eight months pregnant under my scrubs and nobody would know. (Not that I foresee doing anything in the near future that might land me pregnant.)
Maybe he’s horribly ugly under that mask though. Maybe he’s got huge buck teeth and flared nostrils. I hope so, because it just wouldn’t be fair for someone that handsome to also be a surgeon.
“I’m a little lost,” I admit.
He pulls off the surgical mask, and damn, there are definitely no buck teeth or flared nostrils. He’s actually very cute. Don’t tell Jack.
“Let me guess,” he says. “You’re a Medicine Intern.”
“Why do you say that?” I retort, even though obviously he’s right.
But my badge is flipped over, so he’s got no proof.
He grins at me. Perfect white teeth, of course. When does he find time to brush? “Well, you’re wearing a white coat, so you must be an intern. And the white coat is actually clean. Plus you’re lost. Also…” He reaches out and tugs at the stethoscope around my neck. “I know you’re from Medicine because you’re wearing your stethoscope around your neck. Like a dog collar. You guys all do that.”
Great. S*xy Surgeon just compared me to a dog. “Well, how do you
wear your stethoscope?”
He snickers. “Why on earth would I wear a stethoscope?”
Seriously, I’ve had enough of this guy. It’s hard enough to find the missing resident lounge without being taunted by an arrogant surgeon. I’m out of here.
“Wait,” he says. “What are you looking for?”
I want to keep walking but I swallow my pride and say: “The medicine resident lounge.”
S*xy Surgeon nods. “Oh, yeah. That moved.” No kidding.
“It’s one floor down,” he says. “Thanks,” I say.
He winks at me. “Good luck, Medicine Intern.”
I’m not entirely sure, but as I step into the stairwell, I think I hear him say, “You’re going to need it!”
I do need it.
I enter the resident lounge at 7:31 a.m., after spending at least thirty seconds trying to correctly punch in the code for the door (3-1-2). I am
one minute late, but I can see from Alyssa’s face that I may as well have arrived at half past noon.
“You’re late,” Dr. Alyssa Morgan snaps at me before I even introduce myself.
It’s the first words she’s ever spoken to me in person. We had a phone conversation the day before, when she told me to show up at 7:3O
a.m. and she’d introduce me to my patients and orient me to the service. There was an impatient air to her voice, like I knew I had to listen to her very carefully because she would not be repeating anything.
In person, Alyssa just oozes impatience for some reason. Maybe it’s the way her left leg crossed over her right bounces up and down as if she can’t wait even one more minute. Or maybe it’s the way she keeps looking down at her watch then glaring up at me. I’ve known Alyssa for 3O seconds and I’m already terrified of her.
It doesn’t help that my co-intern Connie Lim is clearly a little shining orb of perfection. Connie has that fresh look of someone who very recently had a facial—her skin nearly glows. Also, unlike me, she’s not wearing scrubs. She’s dressed in a skirt and black boots, and actually looks stylish in her white coat. Connie is what they call a preliminary intern, which means that, unlike me, she’ll only be doing a year of internal medicine. After that, she’s going to do a residency in dermatology, which is one of the most competitive residencies in the country.
For the moment, I’ll withhold my opinion of interns who are planning to do dermatology. You know how they say if you can’t say something positive, don’t say it at all? Yeah.
I settle down on the couch next to Connie and it creaks threateningly under my weight, which makes me feel like I weigh about a million pounds. I blame the couch, which is clearly very, very old. In fact, every item in the room looks like it should have been replaced a decade ago. The shelves on the splintery bookcase are sagging under the weight of several dozen dusty reference books. There’s a copy machine that has an “out of order” sign on it that also looks rather dusty. The room has a single computer, which is the kind of early model you see in movies from the eighties and think, “Wow, did computers really used to look like that?” Even the window is covered in smudges—I’d imagine it’s due to medical residents pressing their faces against the glass and wishing they were outside.
“I’m sorry,” I finally say. I’m getting super good at apologizing lately.
Alyssa sighs and looks at her watch again, like she’s considering just calling it a day at this point because I’m just so, so late.
Seriously, I am one minute late. Get over it, Alyssa.
“Connie and I already reviewed all her patients,” Alyssa tells me. They have? I’m one minute late. How did they have time to do that? “So why don’t you tell me about yours, Jane? How were they doing
this morning?” Alyssa crosses and uncrosses her legs while she and Connie stare at me, waiting.
“Um,” I say. “I thought that you and I were… going to… see them… you know, together?”
Alyssa looks aghast. “Are you saying that you didn’t pre-round on your patients this morning?”
I look down at my hands, which are glistening with sweat. I wipe them off on my scrub pants. “I guess I didn’t, no.”
“Are you serious?” Alyssa asks me. “I guess I misunderstood,” I mumble.
Alyssa and Connie exchange looks. Neither of them can believe how dumb I am. I can just see Connie itching to grab her phone to Tweet to all her friends: “My co-intern just screwed up big time!”
“If you didn’t even see your patients,” Alyssa says, “then how come you’re so late?”
“I got lost—” I start to say, but then I can see that Alyssa doesn’t really care about the answer to that question. It’s clear that there’s no excuse for not doing what Dr. Alyssa Morgan wants you to do. Even if what she wants you to do is apparently completely different from the thing that she said she wanted you to do.
My first patient is a 63-year-old woman named Mary Coughlin. Mrs. Coughlin was admitted to the hospital with a kidney infection, but in the course of her work-up, we have discovered a mass in her pancreas. The mass could be benign—meaning, completely harmless. Or it could be pancreatic cancer, which is Really Bad.
Mrs. Coughlin is supposed to be very nice. So it’s probably cancer.
The best part is that Mrs. Coughlin doesn’t know about any of this yet. And even though I’m just meeting her for the first time today, I get to be the one to break the news to her.
Actually, the really best part is that Alyssa and Connie are going to watch me do it.
Mrs. Coughlin’s room is on the fourth floor. It’s one of the busiest floors in the hospital, and I have to duck to avoid getting smacked by nurses hurrying by. Most of the staff is congregated in the nursing station, which is the central area where the patient charts, phones, and computers are located. I race after Alyssa as she makes a beeline for the nursing station.
“Did the oncology service leave a note on when we should do the biopsy?” Alyssa asks me, looking down at a white flash card she whips out of her pocket.
“Um,” I say. “I don’t know. We can check the chart.”
Alyssa stares, gobsmacked. “You mean you haven’t even looked at the chart yet?”
Sheesh. What part of “I thought we were all going to round together” is Alyssa not understanding?
I flip through Mrs. Coughlin’s chart as fast as humanly possible, but it turns out it’s hard to read quickly when there’s an angry resident glaring at you and checking her watch over and over. Why check so frequently? It’s going to be the same time as it was ten seconds ago.
As I get to the last page of the chart, Connie says to me, “Jane, what’s that on your white coat?”
I just dry cleaned my white coat two days ago, knowing I probably wouldn’t get much of a chance to wash it once I got entrenched in my intern year. So it’s got to be clean. I’ve got to have that right, at least.
Except I notice that there’s a sunflower of some sort sitting on the table next to me. I’ve been inadvertently leaning against it, and now there’s yellow pollen all over the arm of my white coat. It looks like the flower vomited on me. I let out a screech and try to wipe it off, but that just spreads it around.
I cannot believe this. My clean white coat is now covered in yellow pollen.
“Clean it off later,” Alyssa says to me. “We need to see Mrs.
Coughlin now.”
Mrs. Coughlin shares a double-room with a patient who is not mine, but is apparently suffering from nausea, because as we walk in, we all hear her retching behind the curtains separating their beds. Fortunately, Mrs. Coughlin doesn’t seem to be bothered. When we reach her bedside, she’s knitting, which is just about the cutest thing ever. She peers at us through the upper rim of her spectacles and smiles. “What can I do for you?”
Alyssa gives me a look, so I step forward. “I’m Dr. McGill,” I say. It’s the very first time I’ve referred to myself as a doctor. It feels so weird. My tongue can’t seem to wrap itself around the words. I almost expect everyone to start snickering at me behind their hands that I just pretended I was really a doctor.
“Good for you!” Mrs. Coughlin says. “Are you still in training then?”
“Yes,” I admit.
“And how long do you have left?” “Three years,” I say. Minus one day.
“How wonderful,” Mrs. Coughlin says. “That will give you plenty of time to find a husband!”
I look over at Alyssa, who does not seem amused. “Dr. McGill is taking over for Dr. Reynolds,” she explains.
“And what happened to Dr. Reynolds?” Mrs. Coughlin wants to know.
“He finished his internship,” Alyssa says. “Dr. McGill will be your doctor from now on.”
Mrs. Coughlin’s eyes fill up with tears. “Oh no! But I really liked Dr. Reynolds! I’m going to miss him…”
Great. I’ve been this woman’s doctor for about five minutes and I’ve already made her cry.
Connie expertly whips out a box of tissues as Mrs. Coughlin sobs over the fact that I’m now her doctor. This is mildly insulting. I may as well tell her about the tumor though, since she’s already crying. Plus Alyssa is making a gesture with her hand like she wants me to wrap things up in here.
“Mrs. Coughlin?” I say. “There’s something we need to talk to you about.”
“Jane, dear,” she says to me, reading the name off my ID badge. She’s already decided she isn’t going to call me “Doctor.” And honestly, that’s just fine with me. “What’s that on your sleeve?”
I look down at my sleeve, which is now bright orange. Stupid flower!
“It’s pollen from a sunflower,” I explain.
“Oh, goodness!” Mrs. Coughlin exclaims. “I’m allergic to pollen, you know.” And then she sneezes loudly. But what am I supposed to do? Strip?
I clear my throat. “Listen, Mrs. Coughlin, I need to tell you that we did a scan of your abdomen and it turns out there’s a mass in your
pancreas.”
I expect a fresh wave of tears but Mrs. Coughlin doesn’t even react. “Okay,” she finally says. She seems way less upset by the possibility of cancer than she was over finding out I was her doctor.
“The mass isn’t that big,” I go on. “But obviously we need to learn more about it. And we may need to do another scan to see if there are any more masses.”
“Okay,” Mrs. Coughlin says.
Wow, she is taking this really well. If I ever have a scary mass in my pancreas, I want to be just like her.
“Mrs. Coughlin,” Alyssa says. “Do you know what a ’mass’ is?” Mrs. Coughlin shakes her head no.
Crap.
“It’s a tumor,” Alyssa says.
Mrs. Coughlin’s eyes grow wide like saucers, then fill up again with tears. “You mean I have cancer?”
I’m sure she’s going to burst into tears, but she doesn’t. Instead, she starts sneezing violently and won’t stop till I leave the room with my pollen-soaked clothing.
Hours Awake: 8
Chance of Quitting: 45%
