Sunday, July 10, 2011

we want to make him stay up all night

A semi-surreal moment this morning well encapsulated my last 24 hours. As I was walking to the parking lot, undoubtedly wobbling and weaving, a red sports car rolled backwards up the street until it was beside me. The window rolled down and the GI attending called out my name and I stopped to chat with him, wandering into the middle of the street as if I wasn't at any risk of getting mowed over by oncoming traffic. He asked me how it was. I told him it finally felt real.

It was my second week of internship, but my first night of being worked like an intern. I probably should have been more afraid, but I was obliviously tinkering around yesterday in the kitchen. I made a batch of chocolate chip cookies, and then I churned this up while reading about how to place central lines:

That, by the way, is the bomb. My friend RR had advised me some years ago that strawberry ice cream is the best choice when considering homemade ice cream, as he felt the fresh ingredients shone the best. As usual, I ignored his sage words until I'd finally found myself confronted with a ridiculous amount of strawberries and a kitchen that called out to be utilized. But let me tell you, this is the way to go.

After that, I marched off to the hospital, and got my world turned upside down in the best way possible. The last two weeks, I'd been a doctor, technically, but was still treated like what I classified as a "baby intern." Last night, I was prescribing meds and admitting patients and pronouncing death. Last night was the real deal.

I won't go into too many details, because it will come across as whining, but I rather enjoyed it. Besides which, I think it's the sort of thing that's not nearly as interesting as I think it is. What's probably more worth documenting, remembering and relating was a conversation I had with one patient.

He was 80 years old, sharp as a tack despite a stroke that had left him partially paralyzed on one side, but he'd come in with a fever and chills and a likely urinary tract infection. He was accompanied by his daughter. It's interesting to me, to hear how families come together in old age. After the stroke, the patient had been moved from his home in Missouri to California, where his son was living. At the same time, his daughter moved from Massachusetts to California to also be close to her father. The patient was going to be staying at an assisted living facility, but both of his children wanted to be close by to see him as frequently as possible.

His daughter was very involved in his care; she was the sort of person you dream about having accompany a patient to the hospital- a veritable journal of his past medical history and medications. As she was rattling off one detail after another, her father, my patient, said to me, "I don't know where I'd be if it wasn't for her."

I smiled and turned to his daughter, to make sure she had heard. She smiled, unphased, and simply said, "well, I don't know where I'd be if it wasn't for you, Daddy-o, so let's call it even."

Nothing fancy, no big swelling scenes with tears and drama. Just a simple exchange. But as any of us with complicated family relationships know, it's a precious gem to have that sort of relationship.

And I thought today that, yes, there was a lot that happened last night, a lot that I could colorfully relate to my co-interns when they asked me how my first night float was. The sort of stories that are badges of honor, that earn you your stripes in your training. But what I really want to remember, what I want to keep lodged in my memory years from now, was that little moment in the chaos and cacophony of the emergency department.