“Dear Sister,
So you’ve decided to pursue a career in the medical field. I chose the word ‘career’ for several reasons. First of all, the word ‘job’ implies that you simply do that position to earn an income… The word ‘career’ suggests much more commitment… A ‘job’ tends to have a set definition, whereas a ‘career’ means more of a field of experience and expertise you will work in…”
There's a resident who cannot talk cognitively and rarely opens his eyes.
I have to be extra careful to make him comfy because I never know if he is or not.
Often he spits his dinner out and is completely limp when I transfer him.
The gynecologist reached his hand and forearm into her womb. With a flick of his wrist, he popped the baby out. He immediately tossed her to a blanket draped between Lupita’s arms. The babe gasped and wailed at the shock. Lupita promptly carried her to the next room. While Dr.Wong and the gynecologist removed the placenta and began sewing up her mother, she was cleaned and weighed under a heat light. Behind the glass, Megan and I watched in awe. The baby let out a wail. We smiled, enchanted. Megan peered around Lupita’s back, “Welcome to our world little girlie.”
“… It is not a safe or secure job… There is no preparation, whether in a clinic or a hospital. There is preparation for procedures, education preparation for your patients and what they can possibly expect, but not preparation for your day…”
At 4 o'clock this morning, I was turning him over and tucking the sheets around him.
Imagine my surprise when suddenly he mumbled, "Good Morning."
I jumped, "Good Morning to you!
In 6 months of routinely caring for him, this was a first.
Second-guessing my ears, I stared and said, "How are you feeling?"
He opened his eyes, looked at me then turned to the football game on the tv, "Mgoodm."
It was amazing to hear his voice.
I wanted him to keep talking.
The gynecologist hurried into the operating room’s ‘mudroom’. After he had scrubbed up, he asked us all to bow our heads. He prayed over the surgery first in Spanish then in English. Then we all held our breath and kept praying as he made the incision in her belly. For a while, the only sound was Dr.Wong muttering instrument names to a nurse, Louis. I moved from the foot of the table to the side for a better view. Dr.Wong and the gynecologist deftly cut and cauterized through the layers. The epidermis. Cauterize. Sweat beaded on their foreheads. The fat. Cauterize. Dr.Wong glanced at the clock. The muscles. Cauterize. The stench of burnt blood vessels saturated the air. Maria sat on a doctor chair to the side. Tears rolled down her cheeks as she quietly prayed in Spanish. I sat with her for a few minutes until Mr.Kuhl said quietly, "There's the head." I walked to the foot of the table again, careful not to turn my back to it in the process. I had to stretch my neck to see over the nurses. Sure enough, they had cut down to the water bag. A slimy head was visible. Then, ever so gently, the gynecologist snipped the water bag to reveal a wet, curly head.
“…Often time is inconsequential as a PA [Physician’s Assistant], Dianne. It’s inconsequential because you simply don’t HAVE it. Time is working against you, you’ve got none left, or it is worsening your choices as the seconds pass…”
For once I knew that he was ok.
He was not "out of it".
He was not in a void, mindless coma.
He could hear me.
And he could reply.
"Do you like watching football?”
"Yup."
I really grinned now, but I had to finish my rounds.
"Ok, well, have a good morning!"
He closed his eyes, "You too."
Hands raised to protect them from germs, we backed through the door as the anesthesiologist numbed the woman from her chest down. Aids helped us don our gowns and gloves. Lupita and the nurses prepared the sterile field and set out the instruments using deft, precise movements. Dr. Wong stood by the woman on the table. Maria, Mr.Kuhl, and Megan joined me beyond the sterile field at the foot of the table. The hospital’s gynecologist was late. This was the woman’s first child and we could see the fear in her eyes, the fear of death in a white-tiled room. I tried to smile comfortingly though I was nervous too, “Esta bien.” I wished my Spanish vocabulary was broader than that.
“…Your choices, wrong or right, will eventually one way or another disappear. If your patient lives they will always remember and wear your decisions, so doing what is best for them is what is most important…”
Dancing down the hall, I tried to make sense of his shocking change in consciousness.
Was it a miracle?
An incorrect dosage?
A weird before-death experience?
Looking in the OR, the sights, smells, and sounds were so foreign to me that I almost retrieved my passport from the break room. White tiles ran up the four, windowless walls. The only thing breaking their flow to the ceiling was a solitary clock silently reminding us of the world outside. I smelled iodine. The smell shrank away from being noticed, and a relentless sound nudged my awareness. At first, I mistook it to be loud. The obstinate consistency with which it sounded made my ears ring. Yet when the Spanish jabber of the frightened woman dissipated the ringing in my ears, I recognized the unblemished sound of nothing. Even with nurses and aids slipping in and out, the heavy silence prevailed. Dr.Wong broke my reverie as he instructed me to scrub up; even though I was not ‘scrubbing in’, he wanted me to practice ‘scrubbing up’ so I could assist in our next hernia surgery. We vigorously scrubbed our arms, palms, between our fingers, and under our nails with iodine until they felt raw. Dr.Wong told me to watch the anesthesiologist during this surgery; he was the best Dr.Wong had worked with.
“…To figure out what it takes to invest your life into what you’re passionate about while still keeping it your passion each morning will never be easy…What really is a passion? I could look it up, but instead how about you figure out what your passion means…”
When I got to the nurse's station, I pulled his chart and read, "..."
Well, I can't really say what I read.
You know.
HIPAA and all that.
Slipping into my sterile booties and mask, I hopped over to the germ-free side of the bench. Three nurses wheeled a pregnant woman toward the operating room. I followed.
Let's just say, my curiosity was satisfied.
My dear resident was ok.
He told me himself.
