Here I am, visiting relatives out west. The inhabitants of the house include two crazy cats, one of whom refuses to let me touch her with my hand, but gets quite a massage out of my foot. The other one jumps around on any elevated surface, and thrusts her face into yours begging for attention – including into the water glass, cereal bowl, toothbrush, and pillow in the morning. After my father’s house, where no animal is permitted even in the garage (except mice, and they’re not authorized), this is a little bit of a change.

Last night the TV was on, and ER was discovered. I’ve never seen it before, so I decided not to object too strenuously, and watched. (It was better than the show about the confused emotional lives of teenagers in Orange County that was on before.) One of the attendings pocketed some vials, apparently of potassium, and explained that they were for her father with diarrhea. This was obviously not meant to be believed, so I’m trying to guess whether she intends to kill her father or herself with them. In another story line, a girl comes in with appendicitis, and her parents don’t want her to have surgery. So two doctors sign orders overriding the parents’ objections, and whisk her away. 1) Can you really do that? 2) The doctor-patient interaction that led to their refusal was absolutely awful. If the doctor had simply talked a little slower, and had a less driven, focused-somewhere-else look on her face, it would have gone better.

Then there was the story line where a 15-yr-old needed to make a life-and-death decision about his father, contrary to his mother’s wishes. Another resident helped him reach a decision, promised to stand by him when he talked to his mother, and then signed out at the end of his shift and left without waiting to finish with the boy’s family. A different resident had to clean up the loose ends, and later confronted the first guy with the statement that “Medicine is not a day job,” implying that he was wrong to leave before completing his moral commitment to the boy. Sounds nice, and philosophically I agree. But as I understand the work hour restrictions, you get kicked out of the hospital at the end of your shift; whether you want to stay or not, you have to leave. You can’t even sleep in the resident’s lounge; you have to drive home. Especially with ER, which has always been a shift schedule. So I guess I sympathize with the residents’ situation, but I think ER is again contributing to the public having way too high expectations of the medical community. Especially since most of us aren’t as handsome as their actors.

[editor, 2007: regarding the “day job,” I was glad to be informed sternly by the seniors at my residency in July that surgery is not a day job: you don’t leave just because it’s time, but because you’ve finished all the work.]

Advertisements