A White Coat Is My Closet (10 page)

T
HE
next day at work was like an exposé on contradictions. On one hand, I was floating, feeling like the afternoon I had spent with Sergio was like having been given a free pass to spend a few hours in heaven. On the other hand, it was torture. How should I proceed? Should I call him that evening? Tell him how much I enjoyed meeting him? Or was this one of those situations wherein I was obligated to follow the three-day rule: when you met someone and exchanged numbers, you should wait three days before calling them so as not to give them the impression of being too desperate.

Those were but the beginning of the contradictions. Any memory of him lightened my mood, and I caught myself smiling even at staff who I ordinarily thought were incredibly obnoxious. The downside, however, was that the day dragged. I kept looking at my watch and tried to convince myself that when I got home, there would be a message from him waiting for me on my answering machine. In fact, I had to resist the urge not to check my messages every fifteen minutes because I knew that, in the event he hadn’t called, dealing with the disappointment would consume so much mental energy I would be prevented from working effectively.

Shit! I felt like a fourteen-year-old girl struggling with her first crush. If I didn’t keep myself in check, I was going to start to menstruate and break out in acne. I sighed at my own ridiculousness, and as I pushed myself away from the nurse’s station, I subliminally chided myself.
Get a grip or get a tampon.

I began to review the list of the patients on my service and groaned with the acknowledgment of how much work I had yet to do. At that moment, Peggy, another resident from my year, walked over and offhandedly said, “Hey, Zack, the ER just called. They’ve got an admission for you downstairs.”

I cast a glance up at the clock above the nurse’s station and then fixed my gaze on Peggy. She was the designated resident on call that night. It was two minutes before four. The official policy was that any patient requiring admission before four would go to the daytime admitting team, and any patient requiring admission after four would go to the night call team. I cast another dejected look down at my list of patients, and in as conciliatory tone as possible, said, “You know, Peggy, it’s two minutes—correction: it’s one minute before four. I still have a shitload of work to do. Could you just go ahead and take the admission?”

She looked at me as if I was speaking Greek. “The admission request was received before four; rule is that it goes to you.”

I felt my ears flush. Peggy was such a bitch. Any of my other colleagues would have taken the patient without question. We all worked hard and understood the concept of protecting one another’s free time. The on-call team was going to have to work all night anyway. One admission more or one admission less at that time of afternoon wasn’t going to be a deal breaker. But a four o’clock admission assigned to the day team could delay being able to leave the hospital by two hours or more. And, because of the amount of work I had yet to finish, I knew I had another three hours ahead of me regardless.

My voice tightened. “The rule doesn’t apply to when the request is received; the rule applies to when the kid hits the floor. If you get a call at six fifty-nine tomorrow morning, or one minute before you’re supposed to sign out to me, about a kid coming from Santa Barbara, do you think you should be expected to wait the four hours it will take for the kid to arrive because the rule says that the request was received on your shift?”

Peggy flung her hair over her shoulder dismissively and smiled condescendingly, “Hell no, but in this case,” she said, her smile oozing sarcasm, “the kid’s already here. Just waiting for you down in the ER.” She turned and began to walk away to indicate definitively that the discussion was over, but hazarded a parting comment over her shoulder. “Let me know when you’re ready to sign out. I’ll be in the resident’s lounge.”

Not even the memory of spending an incredible afternoon with Sergio did anything to squelch my anger. My blood pressure skyrocketed so quickly I thought I was going to have a stroke. The only thing that prevented me from telling her to go fuck herself was that technically, with an emphasis on the word “technically,” she was right. The fact remained, however, that had it been anyone else, it would have been a no-brainer. The conversation would have been more along the lines of, “Zack, I’m going to run down and see the kid in the ER. When I get back, let me know what else I can do to get you out of here.” The sacred expectation that trumped any rule was that we had one another’s back. Peggy was the exception. She only had her own back. And for that reason, most of us could barely tolerate her.

I looked up at the charge nurse, who had overheard most of our exchange. She was shaking her head in disbelief. She mouthed the words “Prima donna” and rolled her eyes. Her reaction made me laugh. Another recruit into the “Everyone Knows Peggy’s A Bitch” club. I smiled at her broadly and, with a feigned inflection of forced enthusiasm, said, “An amazing opportunity to impact the life of yet another sick and suffering child. I think I’ll skip on down to the ER.”

When I got down to the ER, I was directed to a room where I found a four-year-old with asthma. He was cute, had initially been pretty cooperative, but now was apprehensive about wearing the mask the respiratory therapist was trying to put over his mouth and nose. The mask appeared to be belching steam. It was connected to a compressor, and the mist escaping from it was actually medicine intended to improve his breathing. The respiratory therapist, who was apparently more accustomed to working with adults than with children, was getting frustrated and just kept repeating the same instructions to the little boy over and over.

When I entered the room, I heard him trying to maintain a sense of calm but detected the irritation in his voice. “I said, all you have to do is put this on and take deep breaths. It won’t hurt. Come on. You have to do it. It will make you feel better.”

The child’s eyes widened in fear. He was sitting on his mother’s lap, and he tried to press himself more forcefully into her chest. He had blond, closely cropped hair, big blue eyes, and rosy red cheeks. I wasn’t sure if his cheeks were naturally that color or if they were redder from breathing hard.

I pulled the chart out of the door, read the patient’s name, then directed my comment to the therapist. “I’ll take it from here.” He handed me the mask and grunted an unintelligible response, either out of irritation or out of relief that I’d rescued him from having to deal with an uncooperative four-year-old.

I rolled a stool over, nodded to his mom to ensure that she knew we were forming a team, then sat down so I’d be at eye level with the little boy. “Is your name Logan?” I asked.

He nodded but didn’t answer. Instead he just eyed me apprehensively.

I smiled. “Did I see you ride in on the fire truck parked outside?”

He looked at me and his eyes displayed an expression of complete bewilderment. He remained transfixed but curious. I continued, “Yeah, I saw a big red fire engine parked right outside, and I thought that I saw you climbing down off of it. Some of the other firemen were telling me that their friend Logan had done a great job helping them put out the fire. Wasn’t that you?”

If possible, his eyes became even larger, and though he still didn’t speak, he began shaking his head.

“Hmmm.” I tried to look confused. “You look an awful lot like a fireman to me. If they need help putting out a fire, do you think that maybe you could lend a hand?”

Now, with his interest piqued, he whispered, “Yes,” and nodded. It wasn’t loud but it was enthusiastic.

“Okay, I know they could use your help, but before you can get on the fire truck, you have to pass the fireman test. See this mask?” I held up the mask and realized as I looked at it that most of the medicine had been expelled uselessly into the air. I’d have to add more before I could give an adequate treatment. Nonetheless, I looked intently at Logan. “All the fireman have to prove to me that they can use one of these masks. Haven’t you seen pictures of firemen going near a fire? All of them are wearing a mask. It protects them from the hot air. If you want to become an official fireman, you have to take the mask test.”

I held the mask up again and shrugged indifferently. “You want to give it a try? Or should I see if I can find another little boy to help the firemen?”

Suddenly, he leaned forward with eager determination. “I’ll try. I can pass the test.”

“You sure? I mean, they said they were looking for a guy named Logan, but if you don’t want to do it, I’m sure there’s another little boy around here somewhere who would love to become a fireman.”

“No, I can do it.” Now he was reaching for the mask.

I helped secure the strap around his head and watched him as if I was evaluating a critical test. “Wow! You’re doing great. You already look like a fireman. Let me see you take some deep breaths.”

He beamed with pride and took a few deep inhalations without even modest hesitation. Such a concerted effort would ensure the medicine had optimal benefit. “You’re doing great, Logan. The firemen are going to be really happy that they’ll be able to add you to their team. Let me ask you something. Do you think you and your mom can stay here one or two days so you can do some more of the fireman training classes? It looks like you’re on your way to becoming one of the best.”

Logan turned to his mom and began pleading through the mask, “Can we, Mom? Can we stay here so I can learn some more fireman things?”

“Well,” his mom said, trying to appear as if she was hesitating, “I suppose so. If you promise to do all the tests, I guess we can stay a day or two.” She smiled at both of us.

I grinned at her warmly, and though I continued to direct my comments to her, I returned my gaze to Logan. “I’ll need to take a more complete history and will still have to examine your son, but I hope that we’ll have him as good as new within a couple days.”

I then ran my hands through Logan’s short hair and spoke to him teasingly. “Well, before you can become a fireman, I have to look you over head to toe. Are you ready?”

I had to push him gently back onto his mother’s lap to prevent him from leaping into the air. What a transition. From trepidatious four-year-old to enthusiastic participant in little more than four minutes. If he could recover from his asthma attack at the same impressive rate, we’d have him home in no time.

I completed my exam and filled out both the paperwork and admission orders as expeditiously as possible. I was still irritated with Peggy for being such a bitch but had kind of enjoyed having been able to meet Logan. With any luck, I’d be able to complete the rest of my work and still be ready to sign out by seven. If Peggy thought I would expend even minimal effort to make her night on call go more smoothly, she was sorely mistaken.

I went through the list of all my patients and even went back and reexamined some of them. Most were doing well, and I didn’t anticipate any major changes in their conditions overnight. I pulled a few of their charts to ensure I had reviewed all the recent labs, and then, satisfied I had fulfilled all my obligations, I sighed in preparation of paging Peggy to let her know I was ready to sign out for the evening.

I went into the residents’ office and punched her pager number into the phone. She didn’t call back for a full eight minutes. I was ready to page her again when the phone finally rang. “Hey, Peggy.” My voice was completely without warmth but wasn’t overtly hostile. “I’m ready to get out of here. Should be an easy sign-out. Are you ready?”

Forget a lack of warmth: Peggy response’s came back to me like water dripping off a glacier. “I’m in the middle of eating. I should be up there in about twenty minutes. You can sign out then.”

For the second time that day, I had to choke back the desire to tell her to go fuck herself. Instead, as calmly as was humanly possible, I responded, “Look, though I know this makes no difference to you, I would actually like to go home and have the opportunity to get something to eat myself. I’ve been here more than thirteen hours and have to be back in little over ten. Where are you? I’ll bring the sign-out to you. I’ll talk to you while you’re eating. Shouldn’t require that you even stop chewing.”

She knew she really had no argument, so she begrudgingly replied that she was in the cafeteria.

“Fine,” I said shortly, “I’ll see you in two.”

When I got to the cafeteria, I found her sitting alone at one of the back tables. A group of interns was sitting a few tables over, and a couple of them smiled and waved when they saw me come in.
Figures
, I thought.
Not even the intern working with Peggy for the night can tolerate being with her more than is absolutely necessary. If she wasn’t such a pain in the ass, she wouldn’t have to eat most of her meals alone.

I smiled as I walked past the interns and joked facetiously with them, “You guys really have time to eat? Man, when I was an intern, we had to walk to the hospital in three feet of snow. We had no shoes, and if we wanted to eat, we had to scrape scraps off the patients’ abandoned trays. You guys have it so easy.”

I had to duck to miss being hit by a dinner roll that came soaring past my head, but it was accompanied by good-natured laughing. “Yeah, Zack,” one of them shouted lightheartedly, “haven’t you heard the song? It never rains in Southern California, and it sure as hell doesn’t snow. If you had to walk through three feet of snow, it was because someone was trying to save patient lives by dropping your ass in Antarctica.”

I laughed too. “Yeah? Well, apparently it didn’t work. I succeeded in finding my way back, am here now, and am determined to make your lives miserable, so eat up. I’ve got a list of scut a mile long to keep you all from getting any sleep tonight.”

Scut was a word that went down in infamy with interns. It referred to all the tedious, disagreeable chores that had to be done to keep a hospital running. Since shit rolled downhill, those jobs were usually delegated to the interns. Some scut was unavoidable. I was relatively popular with the interns because I was pretty conscientious about dividing it up equally with them. My philosophy was that the sooner the work got done, the sooner we could all relax, so even as a senior resident, I ended up doing as much scut as they did. Peggy was another story. Her attitude was that she had done her share of scut as an intern, so now, as a rite of passage, it was someone else’s job. Thus, she was sitting alone and I was dodging flying dinner rolls.