Looking through some of my older writing today, I found a piece that I wrote in 2007. I am terrible at writing fiction, and when I do try it always feels forced and sounds silly when I read it back to myself. But this piece that I wrote back then isn’t all that bad, so I figured I would share it here. The medical details are all true, woven together from different patient experiences I had on the medical ward as a third year student. Enjoy.
The sun was shining, she could see it as she entered the room. Mrs. Johns lay as she always did, a lumpy potato sack on the bed sprouting limbs like toxic green shoots when the rot is near. Megan could hear the rasping breath she was called to assess; even without the stethoscope the wheezes were audible. For the umpteenth time that month the respiratory therapist would have to be called, and the comatose sack would breathe easy once more. That is what Megan was thinking as she auscultated the chest. Only months later would she remember the patch of sun lying gentle as a caress on Mrs. Johns withered cheek. Then, the quiet beat of her patient’s heart would blend with the birdsong outside the window and the radio next door, into an orchestra of meaning that Megan would recall over a breakfast of runny eggs and soggy toast, made soggier by the surprise of salty tears.
But that afternoon, as the Internal Medicine student on-call, all she wanted to do was watch American Idol – it was on in a few hours, and like usual she and the nurses would try to get in a few minutes of what she liked to call “brainfritz”. Punctuated by snores, coughs, farts, the beeping of monitors and kinked IV lines, the singing would at least drown out the quietest of the hospital’s cacophony of night noises. As she performed a silent rectal exam on Mr. Crenshaw (who after days of constipation had managed to poop out a whole wad of blackish stool) she mused about what Thai specialty she could order for dinner. Of course, there was no real question, vegetarian Pad Thai was her favourite with it’s peanuty goodness, but then again tofu in red curry had an edge to it…
Abruptly, the shriek of the call pager jolted her out of her Thai reverie; the stool on her gloved finger tested positive for blood as a disembodied voice called “Code Blue, E south” over the intercom. She hurried out of the room to find the ward a sudden frenzy of nurses, all propelling her down the hall and into Mrs. Jones room. The nurse taking Mrs. Johns vitals had noticed that suddenly her oxygen saturation was 80% and the wheezing was much worse, and had called a “pre-code”, to perhaps stave off the inevitable.
“ICU is on their way!”
“Want to intubate her?”
“Which meds would you like?”
“Should I call the family?”
The nurses all peppered Megan with questions as the patient’s respiratory distress worsened. It should have been simple – try drugs, intubate, stabilize, send to ICU – but Megan’s gut revolted at the thought of putting this months-unresponsive woman through all of that. She should have had some sort of back-up besides the ICU, but call at Santa Maria Hospital’s Medicine ward as a third year medical student meant she had no resident or attending physician in-house. Aside from the nurses, RTs, one emerg doc, the ICU attending and a few other medical students on other services, she was the sole person responsible for preventing the deaths of all the patients in the entire freakin’ hospital. Shrugging the angst aside, she quickly moved for the phone and before the ICU team arrived, she had managed to get the RT back in the room. After another course of inhalations Mrs. Johns’ saturation perked up to 95%.
Crisis averted (at least temporarily), the ward quieted down again and she finally got time for a pee break. Hospital toilets being what they are, the nurses on E-south had taken pity on Megan and given her the code to their personal throne. Squatting with her stethoscope hanging on the doorknob and her white coat pulled up out of reach of the wet depths below, the scene replayed itself in crisp detail in her mind. Had she acted correctly? Should she have anticipated the emergency before it occurred? Would Mrs. Johns do this again later, before night’s end? What would she have done if the meds hadn’t worked and the ICU team was busy with their own patients? Would she survive the rest of this night, let alone the rest of her career, if patients were always trying to die on her?
The night wore on, and she ordered her veggie Pad Thai along with a chicken one for the ortho student upstairs. Someone sang a terrible song on American Idol, and a demented patient pulled out their catheter, leaving a pool of blood on the floor and calling for his wife to cook the chicken. Mr. Romano harangued his 99-year old roommate for snoring, Mrs. Cordoza fell out of bed, Mr. Jenkins tried to jump out the window, and Mrs. French found scissors and tried to cut her hair off. The family of Mrs. Johns showed up at ten p.m. and wanted a family conference, a nurse fell ill with vomiting and had to go home, the fire alarm went off about ten times, and strong winds blew out a window in the conference room.
Meanwhile Mrs. Greenspan wandered down the hall in her open gown, 85 year old behind flashing its’ sagging self as she passed the nursing station on her way to the elevators and wished freedom before the nurses reined her in. Cantankerous and special, her temporal lobe seizures (that Megan had diagnosed!) caused her to become intermittently violent and abusive, which made her the least-loved patient on the ward. Having admitted her from the emerg and pushed for her initial EEG when the attendings were convinced it was just dementia, Megan felt a bond of sorts with this maligned lady and always kept an eye on her. After Mrs. Greenspan was man-handled back into bed, Megan went in to make sure she was all right.
“Time for bed, Elsie”, the young almost-physician said as she stood by the bed.
“Sit down, girl! I’m not tired yet, and I want you to sit with me.” Proud and feisty tonight, her patient commanded and was not to be ignored. Megan sat on the chair by the window, facing the bed, elbows on her knees and hands cupping her chin. “Did I ever tell you about my husband?”
For the next few minutes Mrs. Greenspan relived a trip to Israel with her family, illuminating beaches and markets, archaeological digs in desert sunshine and the walls of the Old City. Megan sat, fascinated, sleepy, privy to the internal wanderings of this woman’s wise mind in the moments before sleep, when doors thought closed are opened a crack and the subconscious peers out.
Silence. “Would you like me to go so you can sleep now?”
Pleading, vulnerable, – “Stay with me while I fall asleep, won’t you?”
A shaft of moonlight cuts the blanket, landing on a gnarled hand, the band of gold and a diamond glittering brilliantly in the night. Soon, the soft slowness of breath a lullabye, arms braced on the bed railing and head cradled above, Megan’s eyes close and for a few minutes she finds peace in the darkness of her patient’s room.