I met a boy on Sunday, too. Also in the ER. Only four years old, he came in with a grossly swollen right eye, a fever, and an impeccable ability to kick any examining hand that came within a foot of his personal space. This eye problem had been getting worse for a few days now, did not respond to outpatient antibiotic treatment, and he was admitted to our team as my patient after an exceedingly frustrating and futile attempt at a physical exam forced us to keep him around on IV antibiotics for further monitoring because we simply could not see if his eye was affected...
On Tuesday, after a particularly good day that included a trip to the mall situated across the street from the hospital with my co-medical student (in the middle of the day no less, after informing our superiors that we were going to go study since there was clearly nothing to do on the wards), I had the privilege of speaking with one of my former interns while I was on my way home. Asked how my day went, I responded enthusiastically that it had been a fabulous day and proceeded to explain why, much like I have just explained above. The mall. A glorious lunch outside, sitting on the top of the mall overlooking the city. No patients in sight, no hassles, no notes, no screaming kids, no vitals to be checked, no orders to be written, no phone calls to be made to people who will not even listen, no boredom to be endured watching our superiors write endless notes, no lectures, no demeaning tasks to be performed, no harassment from the nurses, no scut, no worries.
Six months into my third year of medical school, after getting a taste of what my internship and residency years will be like and only beginning to appreciate the demands, the stress, and the frustration of it all, I had to admit that an exhaustion had set in and explained to my intern, albeit more briefly than what I have just expounded on here, how refreshing it was to get away, even for just a few moments.
"That's why it was so good?", she responded quite innocently. "I guess I would have figured you'd say something like 'I saw an interesting case' or 'I met an interesting patient.' "
That evening I was walking home and it was dark outside. A little cold as well. Shoving my hands in my pockets and walking briskly to make it back to my apartment, I started thinking about the tasks that lay ahead in the coming morning. More notes to write, more vitals to check, more lectures to go to, more charts to grab, more superiors to please…
It was at that moment that I realized I could not even remember the names of my patients, much less who they really were, which may not seem like a big deal were it not for the fact that I was only carrying two at the time. Yet, somehow, in spite of this I had managed to take care of all of their hospital needs up to this point.
At that moment it occurred to me that, as was subtly suggested to me that afternoon by my intern (whether intentionally or not), I had somehow fulfilled all of those mechanical needs while clearly missing the point of what I was doing there in the first place. Putting aside the exceedingly common times I have moaned about the maddening frustrations of this profession, most recently evidenced by my previous post, up until six months ago I still believed that I was clinging to those profound moments I had experienced as an undergraduate, when I was truly helping people, as the sources of my motivations for going through with all this in the first place.
Yet, somehow, in a matter of months, I had begun fading from that which I had been into what I had now become, proficient in the mechanical daily tasks of being a physician (or at least a physician's scut monkey) but having completely lost sight of the simple human picture that I had once firmly understood and promised to uphold in spite of the sheer nonsense and stupidity inherent in the first two years of medical school.
Only six months into my third year of medical school, my first sixth months as a semi-functional physician, and I had already started veering down that path of apathy, that fade into indifference that I see so many of my superiors and peers having already disappeared into. I could no longer feel the coldness of my surroundings, as I was now humbled by a frigid sense of shame I had never before felt and never wanted to feel again.
Racing back now, eager to get out of the cold and into the comfort of my bed to get my five hours of sleep, I realized that I was lucky this time, that I had someone call me out for my behavior (even if it was not done consciously), and that I was wise enough to know I was not wise enough to know better.
Utterly exhausted, frustrated, emotionally spent. A final exam in a specialty I thought I was destined to pursue, but now had serious doubts about, looming in the coming week.
But The Fade would have to wait, even if only for a day…
I met a girl on Wednesday. Only twelve years old and coming off her second brain surgery, she cried with her family before her surgery, calling out for her mother after remembering her name, and she cried heavily again Tuesday night, begging her mother to let her go home so she could be with her friends from school. Her head was swollen, and there was a huge bandage running across her forehead concealing the incision below. The radiologist confirmed that the surgeons did not get all of her tumor, that she would definitely need radiation and chemotherapy but would still likely succumb to the terror growing inside her brain. I confirmed that she had big brown eyes that spoke her of innocence and youth, that she was growing up very close to where I had lived before going to college, and that she smiled widely and brightly for me every time I walked into the room in a profound effort to keep the pain, the agony, and the uncertainty of her condition from boiling to the surface and piercing her spirit.
I met a boy on Wednesday, too. Only four years old, and his eye was no longer as swollen as it had been just two days before. His crying had long stopped, as it had been replaced by the devilish grin of a healthy four year old with a vast array of donated toys at his disposal. He gladly showed me that he could not only move his eyes without pain, but also that he could spell out his full name when I gave him a piece of paper and a crayon to write with. He showed me his train set and he even let me play with it, if only for a moment. He showed me some of the pictures he had been drawing while in the hospital, and he even gave some of them to me as a present before he left the next day, pictures now proudly displayed on my desk.