I think 8:30 is the latest I have ever stayed in the hospital yet this year. It felt kind of crazy, walking around to check on the patients, saying “goodnight, I’ll see you in the morning,” and considering that “morning” means 4am, less than eight hours away.

But I don’t particularly mind. I picked up a case in the ER, and got to take it to the OR within a few hours, and do a lot of the procedure. Quite satisfactory. Of course it was another one of those ugly, boring cases that no one but an intern wants; but I had fun.

That took till the end of the afternoon. Then, I got called to the ER for an intubated patient. I was trying to figure out what could cause a surgical patient, no vascular issues, to present, intubated. That’s not usually the scenario, when you’re not on trauma. Often enough we have to re-intubate people post-operatively; but to come in like that?

Turned out to be a nice old gentleman, holding his daughter’s hand and nodding at her, in spite of being intubated. His blood pressure was too low to handle any sedatives, and his mental status was poor enough, so he was on hardly any drugs at all.

I got a surprise walking into the room. I started to introduce myself – “Hi, I’m Dr. Alice, one of the residents. . ” – and the daughter interrupted me. “Oh yes, Dr. Alice, I know you!” She’d been identified as a respiratory tech, so I assumed she worked at the hospital, and we’d been together during some crisis or other. I couldn’t remember any crisis involving respiratory which would lead to such a warm greeting, but the patient was in too much trouble to spend time on reminiscences.

Half an hour later, one of her remarks finally clicked. She doesn’t work at this hospital, she’d been here as a patient on one of my previous months. She’d been one of the nightmare patients (the way healthcare professionals often seem to be when they do get sick): the nurses used to argue about who would have to take her, and the senior residents sent me to her room by myself, until something major required their attention. The catch was that I could never relax with her, because she actually was sick, and every so often one of her “crazy” complaints turned into a really serious problem. I learned a lot taking care of her. By the end, though, I did dread getting called by her nurse; but apparently I masked that feeling pretty well.

The whole time that a group of surgery residents spent in the room, working on her father, she kept smiling at me, directing all of her answers at me, and remembering things we’d talked about in the past (when I was being conscientious, and stayed in her room to chat). One of the chiefs was there, big, tall, impressive guy – and she didn’t pay any attention to him, just Dr. Alice.

I feel so guilty. I really didn’t like her at all when she was a patient, and I did my best to stay away from her. She seems totally different, quite a reasonable person, now that she’s better, and taking care of a sick relative. On one hand it’s good that I behave professionally enough for a patient to like me even when I didn’t particularly like them; but I feel bad about being on the receiving end of such good feeling, when I didn’t reciprocate it at all until I felt flattered by her memory and shocked by the difference in her behavior.

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