It is now creeping past 1:3O p.m. There are two things I have not done since I arrived at the hospital this morning:
- Eaten
- Used the bathroom
Alyssa and I are seeing a new hospital admission and I’m beginning to lose hope that I will ever escape from her long enough to perform either of these bodily functions. Does becoming a doctor mean I’ve given up my right to pee? I’m scared it has.
Note to self: Drink less coffee tomorrow morning.
My stomach lets out this super-human growl while I’m bending over my new patient to examine his abdomen. Super embarrassing.
The patient raises his eyebrows at me. “Was that you?” “Just a little hungry,” I say with a strangled laugh.
Alyssa, who has been watching me like a hawk from the other side of the bed as she writes little notes on an index card, cocks her finger at me. I follow her out of the room, and I see her brow is already creased in disapproval. I can’t imagine what I’ve done wrong. Aside from everything, that is.
“Never tell a patient that you’re hungry,” she says. “Why not?” I can’t help but ask.
Alyssa blinks at me, as if stunned I had the nerve to question her words of wisdom. “It’s unprofessional. Even a medical student should know that.”
I just stare at her, and finally, she sighs.
“The cafeteria is going to close in ten minutes,” she says. “Go grab some lunch and page me when you’re done.”
She doesn’t have to tell me twice. I race down to the second floor to the cafeteria, making a brief pit stop to relieve my bladder. (Which feels glorious, by the way.) Then I head down to the cafeteria to eat the fastest lunch in the history of the world.
Hospital cafeterias are divided into two categories: Awful and Not- That-Awful. I have a bad feeling ours falls into the former category. There’s a hot food option, which looks like soggy deep fried fish, with
sides of mushy cauliflower and grayish rice. A salad bar would have been nice, but the only other option seems to be a bunch of pre-wrapped sandwiches.
I strongly suspect that these sandwiches are older than my medical school diploma, but I’m too hungry to care. I grab a random sandwich without even looking to see what’s in it (chicken, I think) and a bottle of soda. I get in line, cursing the old man ahead of me, who is one of those guys who has to have a big conversation with the cashier. Something about his granddaughter and/or his prostate.
When it’s finally my turn, the middle-aged female cashier rings me up and announces, “Four dollars, eight cents.”
Four bucks for a crummy chicken sandwich and some soda? Are you kidding me? Don’t they realize how poor I am?
I dig around in my white coat pocket, which are already clogged with gauze and scraps of paper and about twenty pens. But no wallet.
Oh crap. I forgot my wallet in my locker. This is just great.
“Hang on a second,” I say to the irritated-looking cashier as I start rifling through all my many pockets, trying to gather coins. I fish out a dollar from one white coat pocket, a quarter and three pennies from the other. I check my scrub pockets and find only lint and a red button.
Why do I have a red button? I don’t think I own anything red that has buttons on it.
In any case, it’s not nearly enough. I can’t even afford this crummy chicken sandwich. I’m seriously going to cry.
“I’ll pay for her food,” a voice says from behind me.
At this moment, there are no sweeter words in the English language. I whirl around to thank my savior, until I see who it is. It’s Sexy Surgeon, now sans surgical mask.
“Thank you,” I mumble, as he hands over the bills.
He grins at me. “How many times have I saved you today, Medicine Intern? Five… six times?”
“I’ll pay you back for the sandwich,” I say quickly.
He shakes his head. “I wouldn’t hear of it. My treat.” He cocks his head at me. “How’s it going so far?”
“Great,” I lie.
“That bad?” he laughs. He opens up the package of beef jerky he’d purchased and sticks one in his mouth.
“Is that your lunch?” I ask, incredulous.
“Oh, I don’t eat lunch,” he says, as if I’d suggested something crazy. “Surgeons are the camels of the hospital. I’m fine with one meal per
day.”
He’d get along great with Alyssa. Maybe I should set them up. “What happened to your arm?” he asks me. He’s staring at the
sleeve of my white coat, which I drenched in water just after peeing, in attempt to get rid of the flower stains. Apparently, nothing gets out flower.
“I had an accident,” I mumble.
Sexy Surgeon raises his light brown eyebrows at me, but there’s no way I’m going to tell him that I had an unfortunate encounter with a flower.
“Well, I’ll see you around, Medicine Intern,” he says. “I’ll probably be by sometime later to save you again.”
He takes off jogging out of the cafeteria, still chewing on jerky. Whether he likes it or not, I am going to pay him back those four dollars. I’m determined. The last thing I want is to owe money to Sexy Surgeon, no matter how sexy he is. No matter how great he looks in his blue scrubs.
Jane, stop staring at Sexy Surgeon and eat your lunch. Right now, Jane!
I pick the table nearest to the exit, even though it’s stained with some sort of sticky brown sauce. I’m preparing to gobble down my chicken sandwich in one bite, except when I open the sandwich, it turns out that it’s not chicken—it’s tofu!
I hate tofu—really hate it. There’s nothing intrinsically bad about it, but I just feel like I’ve been fooled by it too many times. There’s nothing worse than thinking you’re eating a piece of chicken and mid-chew realizing that it’s actually tofu.
I’m glumly staring down at my sandwich when a tiny dark-haired girl with green scrubs and a white coat that’s even whiter than mine used to be plops down across from me at the table. She looks like she’s eight years old and playing doctor, but I suspect she’s an intern, just like me.
“Mind if I join you?” she asks, even though she’s already unwrapping her own sandwich.
“Sure,” I say.
“Jane, right?” she asks me. “I remember you from the intern orientation.”
“Right,” I say. I don’t remember her at all, but lucky for me, her badge is pointing the right way. Nina Castellano. “And you’re Nina.”
“Totally,” she says. She grins at me with a tiny row of teeth. They make her look a little like an elf. I surreptitiously check for pointy ears,
but her ears are normal. “Lay low. I’m trying to escape the other intern on my team.”
I glance up and see… my roommate! She’s wearing a white coat, her black hair still in that ultra-tight ponytail. I guess she’s an intern too. “That’s my roommate!”
“Poor you,” Nina says, chomping down on her sandwich. “Oh God, this sandwich is awful! What is this—tofu? I thought it was ham!”
“Hey,” I say. “Do you know her name?” “Who?”
“The other intern on your team.”
Nina frowns. “Wait, I thought you said she was your roommate?” “Yeah, but she won’t talk to me.”
Nina laughs so hard that little pieces of tofu escape from her mouth. “Too funny! Her name is Julia. And she’s very evil. I would lock your bedroom door at night.”
“It doesn’t lock.”
“Then sleep with a knife in your bed.” Nina chews thoughtfully. “I can’t figure out her accent. I know she’s an IMG, but I don’t know what country she’s from. There’s no country I dislike enough to associate it with her.”
An IMG is an International Medical Graduate, meaning she went to med school in a different country. It’s usually hard for IMGs to find spots in American residency programs. Luckily for Julia, nobody is chomping the bit for spots at County Hospital.
“Maybe she went to med school on another planet,” I suggest. “Yes!” Nina cries. “She’s an Intergalactic Medical Grad.”
I laugh with Nina and it’s the first time I’ve laughed all day. It feels nice, actually. I have a feeling it might be the last.
“Hey,” Nina says. “Do you want to see my babies?”
And then Nina whips out her phone and I spend the next five minutes gulping down my sandwich (everything but the tofu) and looking at photos of Nina’s cat and dog.
I don’t even quite manage to finish my sandwich before I get paged. I’m still surprised by the sound of my pager. Last night, I tried to set it to the least grating beeping noise, but they were all pretty horrible. And I know that even if I find a sound that isn’t intrinsically horrible, after a month, I will come to hate it with every fiber of my being.
I hurry to the first phone I see and answer the page. “This is ’Doctor’ McGill,” I say. It still feels so weird to say that. Will I ever get used to it?
“Jane?” It’s Alyssa. Crap. “Where are you?”
I look down at my watch. Only ten minutes have passed since she gave me permission to go to the cafeteria.
“I’m getting lunch,” I say. “You said I could.”
“Right, I told you to get lunch,” she says. “I didn’t tell you that you could eat it.”
What? Am I being punked here? Is she serious?
“I meant that you should get lunch and stash it somewhere for later,” she says. “We’re really busy, Jane.”
“Right,” I say. “Sorry. I must have misunderstood.”
“Get over to the telemetry unit right now,” Alyssa says. “Dr. Westin is ready to round with us.”
Dr. Westin is the attending physician in charge of our team. In teaching hospitals, the hierarchy is that the senior residents are responsible for interns, and the attending is the old guy in charge of the whole team. The attending is a little like God:
- He knows all.
- He is never wrong.
- There’s only one of him.
- When he says to do something, it is done.
- If you screw up, he will unleash his wrath.
Actually, I’m not sure how wrathful Dr. Westin is since I’ve yet to meet him. But judging by past attendings I’ve worked with, I’d have to guess he’s at least a little wrathful.
I find Dr. Westin sitting on the telemetry unit, flanked by Connie and Alyssa, who are both standing. Alyssa has her arms crossed and she’s looking at her watch. How did everyone know we were meeting here but me? Couldn’t someone have warned me about this?
Dr. Westin is thin and slightly balding, but still relatively fit and attractive for a man in his mid-forties. He has a kind face, but I refuse to be lured into letting down my guard. Unlike the residents, he is without a white coat, although like us, he’s wearing his stethoscope like a dog collar (thanks for the analogy, Sexy Surgeon).
In normal human society, a man might have offered to give up his seat for one of three young ladies. But not an attending. I mean, you
can’t expect God to stand up and give you his seat, can you? That would be crazy.
If there’s ever a seat available, there exists a very clear hierarchy of who may sit. First, the attending gets to sit. Then if there’s another seat, the senior resident can sit. Then if there’s another seat, someone can put their purse there. Then if there’s another seat, a homeless drug addict who wandered into the building can sit there. But after the attending, the resident, the purse, and the homeless guy are all settled, any available seats are all mine.
When Alyssa spots me, she waves me over, all the while giving me the frowning of a lifetime. I sense an enormous sigh looming on the horizon. Dr. Westin waves to me with a broad smile on his face.
“Hello, Jean!” he says to me. “It’s nice to meet you.”
Crap. He called me by the wrong name. I freeze up, unsure what to do. I don’t want our first interaction to be my correcting him. But I’m pretty sure I can’t let him keep calling me by the wrong name for the next month. So I guess I have no choice but to say something. Right?
Right??
“It’s Jane, actually,” I finally say.
“Oh!” Dr. Westin seems a bit flustered and Alyssa gives me an accusatory look. The attending is always right, I know. But seriously, no matter how tired I am, I’m pretty sure I know my own name.
Maybe not though. Maybe Jean’s better.
I notice that Dr. Westin is staring at the arm of my white coat, which is drying into a light yellow color. Stupid flower. I clear my throat and turn to the side, so that he can’t see what a mess I am.
“Why don’t we discuss Mr. Garrison?” Alyssa suggests, referring to my one telemetry patient.
“Excellent idea!” Dr. Westin exclaims. I really have to applaud his enthusiasm. I wouldn’t have sounded that happy if Alyssa suggested we go outside for an ice cream break.
Mr. Garrison is a sick man, and that’s why he’s being monitored on 24-hour telemetry, which is essentially a bunch of electrodes that record the rhythm of your heart. He had esophageal cancer, and the chemotherapy caused him to go into heart failure, and now he’s having arrhythmias. It’s Alyssa’s assessment that he needs a pacemaker. “Jane is going to arrange that,” Alyssa tells Dr. Westin when I’m done presenting the patient.
I am? How do I arrange that? Couldn’t Jean do it instead?
“Fantastic!” Dr. Westin says to Alyssa. “I think this young man will do very well.” (Mr. Garrison is not young. He is 72. I’m not sure if Dr. Westin is being generous or if he misheard the patient’s age.) “Jane, what medications do we have him on?”
Mr. Garrison is on a jillion medications. I realize that a jillion isn’t a real number, but I really think a new number needs to be created to express the sheer number of medications this man is taking. I copied over the list in my pristine handwriting this morning and it covers two pages, which I hand over to Dr. Westin.
“Oh, my,” Dr. Westin says, running his finger down the list. He adds, “My, my, my.”
Dr. Westin’s “My” Scale is renowned hospital-wide:
One My: Patient is mildly ill, likely discharge in next day or two
Two My’s: Moderate illness. Patient probably needs some sort of invasive testing.
Three My’s: Severe illness. Possibly close to ICU level of care.
Intubation is imminent.
Four My’s: Call the coroner.
When he finishes looking over the list, he beams at me. “All right then, let’s pay this young man a visit!”
“He’s 72!” is at the tip of my tongue, but I can’t say it. You only get to correct an attending once in a lifetime and I already blew my one time by telling him my name wasn’t Jean.
Dr. Westin leads the way to the room. I lag behind a little bit, and I feel Alyssa grab my arm. “Hey,” she hisses. “What did you think you were doing back there?”
I stare at her, wide-eyed. She seems livid about something, although I can’t imagine what. She already yelled at me for eating lunch. Was it the Jean/Jane thing?
“You’re supposed to read the medication list to the attending,” she says. Her brown eyes are flashing. “You don’t just hand him the list. What’s wrong with you?”
I don’t have a second to respond before she whips her head around and follows Dr. Westin down the hall. Is she right? I have no idea. At the time, the idea of reading off a jillion medications seemed crazy. I don’t think I did anything wrong. But clearly, Alyssa disagrees.
And to make matters worse, I’m about 99% sure Dr. Westin is on his way to the wrong room.
My first hint is when he passes Mr. Garrison’s room without even slowing down. But he seems so certain of himself that I feel like he must
be the correct one, even though I found the patient in another room only an hour earlier. But after all, he’s the attending. And the attending is always right.
When Dr. Westin finally stops, it’s in front of a room with the name Lopez on the door. Alyssa looks like she wants to say something, but Dr. Westin has already marched inside.
The man inside the room is dark-skinned with jet-black hair. He really is young, maybe in his twenties. He looks surprised to see us when we enter. “Hello!” Dr. Westin booms. “I’m Dr. Westin.”
Now I may not be the attending and it may just be my first day, but I’m almost certain this man is not Mr. Garrison. This guy is Mr. Lopez, or possibly Señor Lopez, and he is not one of our team’s patients. I can’t figure out why Alyssa hasn’t said anything. She’s got her mouth open, but can’t seem to get the words out.
Well, if she’s not going to tell him, I’m sure not going to.
“I’m very concerned about your heart,” Dr. Westin tells Mr. Lopez. “We think you’re probably going to need a pacemaker. I’d like to call the cardiology service to have it placed. If you don’t do that, it could be very serious. You could even die.”
Oh no. Dr. Westin is telling this young man, who is probably totally healthy (well, not totally healthy, since he’s in the hospital) that he might die. This is bad. Alyssa, say something!
“Are you willing to consider getting a pacemaker?” Dr. Westin asks the patient.
Mr. Lopez stares at our attending for what feels like an eternity.
Then finally, he says, “Qué?”
That seems to snap Alyssa out of her trance. She gently taps Dr. Westin on the arm, and says, “I think they may have moved his room. This is Mr. Lopez.”
The patient nods vigorously. “Lopez. Sí.”
“My, my,” Dr. Westin says, sounding a little annoyed.
After a brief apology (lo siento?), we make our way back down the hallway to Mr. Garrison’s actual room. As we walk, I fall into step with Dr. Westin. He’s much taller than me with longer legs, so I have to nearly jog to keep up. “Dr. Westin?”
“Yes, Jean?”
I’m Jean again, apparently. Whatever, let it go. Not worth it. “I just wanted to apologize for not reading you the list of patient medications earlier,” I say. “From now on, I’ll read you the list instead of handing it to you.”
“Don’t be silly!” Dr. Westin says. “I love that you wrote out the whole list! You have great handwriting, Jean.”
Vindication! And a compliment! I flash Alyssa a triumphant look. In the short time I’ve been in this hospital, I have actually managed to do something right. Well, maybe not right. But at least not wrong.
But my triumph is fleeting. As Dr. Westin is entering the (correct) patient’s room, Alyssa grabs my arm once more. Her long, wiry fingers press into my skin even through my white coat, and I fear she might draw blood. “I don’t care what Dr. Westin says,” she hisses, her tongue slightly pointed. “You always read the medications to the attending. Even a medical student knows that. Even a child knows that.”
My, my, my, my.
Hours awake: 8
Chance of quitting: 63%
