There is something about hearing the man you love is in pain. I was instantly awake. And a very strange thing happened to me, O Best Beloved. The wife and lover in me went to war against the doctor in me, and I used all my own weapons against myself. On the one side, I asked all the right questions, got a history that was brief but complete enough to point to the primary on a differential. On the other, I seized onto the lowest-probability item and panicked. What if it's a perforated ulcer? It's not, he's got biliary colic, he's had this pain before. A duodenal ulcer. Or pancreatitis. O havens, he's going to die. It's biliary colic. He has a stone. "Fever or chills? Throwing up?" Rebound tenderness! Ask about rebound tenderness!
I told him not to go to the ER, to tough it out and see the doctor today. Against everything my heart was screaming, I think I gave him the right advice. And he heard it somehow. "You're going to be all right," I said, meaning to make it a final reassurance.
I'll try, he says, I'll tough it out. And suddenly I am the one reassured.
This, then, carried me out of bed and into the shower this morning, carried me through the day. My Angel is in pain, and I am on call. My Angel is in pain, and I am not there.
My Angel is in pain, and I am presenting morning rounds much like paediatric rounds were, with laughter and merriment. We are distracted by my Board scores. "No, what's your two-digit." I tell them. There is general astonishment, and the inevitable. "You're going into Family Medicine?" I have already presented my patients, I try to redirect the conversation. It is marginally successful.
Patient presentation. "She's got a bit of low blood pressure." I mean to say, O Best Beloved, that her blood pressure is 85/45 and I am worried. So are they, but my next patient overwhelms that.
Irony directs that I have just listened to a talk on radiocontrast-induced renal failure and the proper pretreatment of patients with high creatinine. "We brought R in last night with chest pain radiating to back," I begin, and inform the team that he got a CT to check up on his abdominal aneurysm and evaluate for dissection. "And his creatinine was 1.8, and the ratio was 22." Staff, resident, interns all look at me, waiting for the punchline. "2.2 this morning." Everyone swears, and we quickly devise a plan to mobilize fluids and Mucormyst to repair the damage.
One patient for whose sake I make friends with another set of Social Workers, inducing smiles. "You've been very helpful." One patient for whom I telephone the pharmacy. One patient whose doctor has been causing her problems, in a bizarre side-effect of a treatment, and one who complains about no chocolate milk. No caffeine for stress-test patients.
One patient about whom the nursing staff is beginning to flinch; he is taking advantage of his invalid status to make advances at the young pretty ones. He calls me "baby" and asks for me to make sure his doctor comes to see him. I am his doctor. Rehab floor soon. I can't wait. He exhausts me.
I have been chasing problems all day - I took 20 minutes to eat lunch and an hour for noon conference and I grabbed dinner at 1900 - 12 hours after I got here to the hospital - and I have been smiling, laughing, joking. I love it.
But tonight, I do not want to be on call. I want to be at home, where my Angel is on a bland diet, low-fat, no alcohol, and I want to make him something to eat and hold him in my arms and see for myself that he is all right. I want to be a wife and a lover tonight.
Dear God: Watch over my Angel.