It started to look up with the autopsy conference on blunt force trauma. Most intriguing. It improved still more when I went to see my patient and got to initiate a number of orders to get him off the PCU floor, get him vitamins, play with his coumadin. And I ran into critical care when I was writing on my ICU transfer, and Dr. Z (who has a very familiar last name) paused, said hello, proved not to be as draconian as my imagination had made him out to be, and complimented my writing. "I read the sub-I's notes, instead of my own, to know what's going on. Easier read." I pointed out some abnormalities, asked if I should be concerned. He explained. It was lovely.
The eye of scrutiny is not upon me. I am informed about my patients, I collect labs, I will never again forget to check up on a CT scan. I pre-round, I am here early, and I know the medications and the situations of my patients. The intern, the one I have spoken of earlier, he got a dressing-down, sotto voce, for not doing these things. I curried favour the rest of the day by seeming busy.
I tiptoed down to my patient's room, twenty minutes before lunch, and glanced at him, expecting the worst. Trepidation. "Mr. F?" He looks up. "I sure am glad to see you, Doc..." And there it was, a huge smile. I have been making social visits to the transitional unit and adjusting pain medications. Friday I started Neurontin for his foot pain, armed with an UpToDate article on the topic of diabetic neuropathy and a careful recounting of his symptoms (worse with rest, pain in the extremities, improves with exercise, negative workup so far). Today, the pain is almost completely gone. Today, I am a miracle worker. Home on Friday.
I caught up with my resident on his way to a code, ran there, watched. Stayed out of the way. There was so much I should have to say about the code - the manner in which, empty and naked and dying, dignity takes a back seat to desperation; the pulling of a curtain so that only pale shifting feet hinted at the force of chest compressions; the yells of "get back" just before the humming whine and jolt of the defibrillator; the strangeness of the sort-of-beat that it achieved in a heart wounded and weak. I met another doctor, a doctor whose complete and unruffled calm, politeness in the midst of the chaos, who got things done without any pushing or yelling or rudeness. I met a doctor that I would love to be, and I watched him, forgetting the patient. I want to be like that. No hurry, no stress, just making things happen, tickticktick.
"Oh, him?" N grins at me. "He's the best doctor in this hospital. It's a real joy to work with him." I can tell.
S feeds me, Indian food, little dumpling-y things that one pokes holes in to soop up spicy herbed water. His daughter, 2, eats the water with a spoon. There is pizza, too, in the call room. I do research. I have to present on Thursday - tomorrow, O Best Beloved, I will write the presentation and practise for Angel to critique.
Angel's gall bladder comes out a week from tomorrow; I am worried because he is my darling and I am not reassured by my understanding of surgery. I want to scrub, to help, but I will not ask. That would be an abuse of my understanding.
Two admissions for a call night, and they are good ones, interesting, one gentleman whose brother died at 29 of a heart attack and a woman with Turner's Syndrome, nausea, vomiting. I do the histories more or less myself, as S is working on a CV, and manage to present too. I think he gets some of the dictation wrong; he saw the patient, though, he should know it. Perhaps I am wrong. I don't correct him. I talk to GI on call and present the patient, nervous. He is not impressed with the patient. He is very nice to me. Admits done by 8:30, and I am free to do nothing.
And now, O Best Beloved, it is 11:30, and I am going to bed.