It got back to me through the grapevine that my chief told someone, “Alice is a decent intern, but she’s just too nice to be a surgeon.” Which is a compliment coming from medicine people; but from my chief, who is good but not nice, I’m not sure. Anyway, as long as she thinks I’m doing my work semi-competently, it’s fine; she is good at what she does, and I respect her, but I don’t want to be good the way she is. I want to find a different way.
The other day I discharged the loveliest little old lady. This is the one who thinks I saved her life; at least I was present on the occasion. She reminds me so much of my grandmother: a tiny delicate little bird, perched in a cocoon of blankets, with wavy white hair and sparkly blue eyes. Like most of her generation, she hardly ever complained except when she was nearly dying. She always woke up with a smile when I came in at horrible hours of the morning. (It’s awful, but I’d rather wake the older patients up first on my pre-dawn rounds; they’re more likely to be pleasant about it than the younger folks.) On the day of her discharge, I finally made time to sit down and ask about her trip to Israel several years ago. She described how her son had bought her the tickets for her birthday, only a few years before he himself died. We reminisced about places in the Holy Land: the Mount of Olives, the Temple Mount, the banks of the Jordan, the hills of Galilee. What between her son, and Israel, and her rather unexpected recovery, and me missing my grandmother, we both ended up crying and hugging each other. (Contact isolation is for the birds, anyway. Especially when she’s being discharged.)
(I hate contact isolation. Not only is it a horrible waste of time, putting that stuff off and on for half the patients every morning, but you can never connect to someone the same way if you’re trying to hold their hand through a rubber glove. Explain all you like about disease prevention; those gloves and gown still say, There’s something wrong with you, I have to stay away from you, I can’t touch you. I’ll wash my hands in every room, I do believe that much about these bugs; but I want to touch my patients.)
I didn’t expect to . . . like – love? – my patients so much. Now that they’re mine, even though I’m scurrying in and out of their rooms so fast every morning, I care about them. I hate seeing them sick. I don’t like them staying longer, and having to be rounded on every morning; but I also hate to see them looking miserable. For the first time in a while, I really dislike sickness. I wish there were some way I could cure them all. If wishing would do it, I’d have cleared the hospital out already. It didn’t bother me as much when I was a student, somehow. Maybe the patients at this hospital are sicker. Maybe I’m paying attention more, now that they’re my responsibility.
That’s the problem with surgery (ok, one of the problems). If your patients recover, it’s fast and wonderful. But if they don’t recover, it’s a nightmare: months in the ICU, months on TPN, months of fistulas draining, wounds having to be changed and dressed; months of trying to create hope and optimism for patients to whom every day seems to run together with pain and sickness. Now that they’re mine, I can’t block their suffering out the way I did in medical school.
Anyway, today was good. I talked so fast I persuaded the senior attending to let a lap chole patient go home immediately, without staying overnight. I set him up with plenty of medicines, because if he calls the attending tonight, I’ll never hear the end of it. The patient is happy to get out of the hospital, and I’m happy to have one less person to wake up tomorrow morning.