Truly it is written, “Why do the heathen rage, and the people imagine a vain thing? The kings of the earth set themselves, and the rulers take counsel together. . .
He that sitteth in the heavens shall laugh; the Lord shall have them in derision.” (Psalm 2)

I’ve been reading Elizabeth Elliot’s Keep A Quiet Heart, and thinking, “How much she trusts God, and how calm she always is. I wish I had more opportunities to practice this.” And then, “Boy, I really shouldn’t wish for things like that. . .” That is one prayer God always answers immediately and unmistakably.

Around 12:40 I was sitting in the cafeteria, chatting with one of the chaplain nuns (not that I approve of women chaplains, or nuns who don’t wear habits, but she was nice), on the policy that the chaplains show up at the trauma bay and in the ICU frequently, and it would be good to be friends with them. My beeper went off. When I called him, the attending said, “So, Alice, are you going to come give that talk at 12:30 today?” I looked at the clock (still 12:40), and shook my head to make sure my ears were working. “Um, talk? I’m not sure I know what you’re talking about.” I didn’t have this attending pegged as a joker, but if he did joke, this just might be the kind of joke he would go in for. “I told you last week that you’re supposed to give a talk today.”

Images float through my mind. The problem is, in the loud cafeteria, with my heart in my throat, holding the phone and trying to hang on to the conversation, I can’t straighten out whether the picture of me sitting in his office and being instructed about a speech comes just from my nightmare on this exact topic last night, or from an actual event two weeks ago which subconsciously triggered that nightmare. “I don’t remember that at all, sir. I guess I just completely forgot.” “So you don’t have a talk ready?” “Um, no, I completely forgot. What was it supposed to be about?” Thinking, I could go print something off UpToDate, and have a talk in half an hour. . . “You were supposed to pick a topic.” Thanks a lot, doctor – no lifeline there, huh? “Well, I will definitely have a talk ready by Monday.” “Ok, I’ll talk to you about the topic this afternoon. Don’t work on it till you talk to me.” And he hung up.

He’ll talk to me this afternoon? It is afternoon. Why is he hanging up on me? I am going to be in so much trouble. I ran out of the cafeteria, up to the quiet students’ lounge in a corner of the top floor. All the way up I was trying to think, Did he actually tell me? Am I so insanely incompetent that I can’t remember something as major as a presentation assignment from the attending? I must be losing my mind. There’s no hope for me to be a competent surgery resident, if I can’t even remember a point-blank assignment. I thought I was the kind of person to research this and have it ready a week and a half ahead of time. I must be so totally out of my mind. . . And if he didn’t tell me, there’s no way I can think of to tell an attending that his memory, not mine, is playing games, and it’s his fault, not mine, that I didn’t have the talk ready.

In the lounge, there’s another student, so I have to calm down and chit-chat. We discuss residency plans, while I’m thinking, this is no way for a surgery resident to behave. After a while, I semi-calm down, figuring, he can’t flunk me from medical school for this, and it’s actually pretty easy to prepare a speech by Monday. An hour later, he paged me again. “You know what, Alice, I was thinking, I must have been talking to the resident about her presentation today, and thought that I had talked to you, too. So, have you thought of a topic?” “Um, surgical wound infections?” I could hear his eyebrows go up. “That’s a pretty broad topic. How about, the use of hyperbaric oxygen intraoperatively to prevent post-op infections?” “Intra-operatively?” I didn’t know you could manage that inside an OR, and I saw on ER that it gives everyone panic attacks, not sure you could do that to the scrub tech and circulator. “Yes, intra-operatively. There’s a good article on it.” Ookay, so this obviously won’t be covered on UpToDate, but, it is nice of him to have a topic picked, and a surgical one at that.

Then he sent me to see a consult, which was wildly complicated. Half the important information (like the result of the in-house EGD two days ago) doesn’t show up on our new computer system (after I begged yet another nurse to let me in); nor does the positive blood culture which was the whole reason for us being consulted. The patient is very hard of hearing, and tangential. After spending a long time with him, it turned out that I had failed to elicit the really important pieces of history. (I thought it was only on tests that patients traveled to New Mexico and then presented with a mysterious chronic illness – coccidoidomycosis, which this guy probably does not have, but he was in NM.) As we left the consult, he mentioned the oxygen again, and the resident pointed out that he really meant, supplemental intra-operative oxygen. Which is much easier than hyperbaric. I found three articles easily.

I bet God thinks that’s funny. I ‘spect I’ll think so too in a couple more days.