The Devil Wears Scrubs (13 page)

“No, I just appreciate you calling, sugar,” Thomas Jefferson says. Then he funds the Lewis and Clark expedition. Okay, I need to stop this.

Thomas
Jefferson actually seems like a really nice man, so I hang up the phone on a good note. I’m nearly done with my checklist, and I’ve made it through Call #2. I’ve been a doctor for a whole week, I haven’t killed anyone, and I haven’t even cried.

Yet.

_____

The decision of whether or not to take a nap post-call is a complicated one. Many factors go into this decision.

I hate taking naps.
When I was a kid, I really hated it. I remember being forced to lie on the mat in kindergarten, my tiny fists clenched tightly at the indignity of it all. I never slept. I just find it hard to sleep in the middle of the day. I also find it completely disorienting to wake up from a nap.

If I don’t sleep at all on call, such as during my last call, I pretty much
am forced to take a nap, because I just feel too damn exhausted. But now I’m on the fence. I slept a solid three hours. I could probably make it till tonight without sleep. On the other hand, I am pretty tired.

Finally, I
lie down in my bed and stare up at the ceiling, deciding to let my body dictate what it wants to do right now. After 30 hours of being in the hospital and having to bend to the whims of Alyssa, my pager, the nurses, and my patients, it feels decadent to just be able to do whatever I want right now.

A few minutes into my potential nap, my phone starts ringing.
I check the number, hopeful it’s someone I don’t recognize. Really, I’m hoping it’s Sexy Surgeon, having tracked down my number. But instead, it’s the opposite of Sexy Surgeon: namely, my mother. I see the area code of her apartment in Queens and hesitate only a second before picking up.

I pick up.
“Hi, Mom,” I say.

“So how’s it going?” she asks with breathless anticipation.

When I was young, my mother decided
for me that I was going to be a doctor. The decision was not made lightly. She dropped out of college because she was getting married and hadn’t been particularly good at school anyway. She was a housewife, then a stay-at-home-mom, then she came to realize that her husband was an alcoholic compulsive gambler who didn’t particularly want to reform. They got divorced, he took off, and then she was left with a small child and not too many career options.

I can’t remember a time in my childhood when my mother wasn’
t working at least two minimum-wage jobs. She was always shuttling me off to my grandparents for free babysitting because paying for a sitter was just out of the question. But when she took me to my pediatrician for my annual visits, she saw a woman who made a great living, was well respected, and in no position to have her entire life wrecked by a deadbeat husband.

And that’s my secret.
I didn’t become a doctor because of some great love of medicine and healing. I did it mostly because my mother convinced me that it would be a secure, stable career. Don’t tell the admissions committee at my med school.

“It’s going… okay,” I say cautiously.

“That’s great,” she says. “I’m so proud of you.”

I bite my tongue.
Mom and I had always been super close, which makes it hard to conceal from her my growing dissatisfaction with my career. That is, with the career
she picked for me
. I don’t feel like an independent, intelligent, respected career woman. I feel exhausted, dumb, and mistreated.

And what really sucks is that while no man is in any position to destroy me financially, I’ve done a pretty good job of that myself.
Thanks to college and med school, I am now a quarter of a million dollars in debt. Whenever I start to think about it, I feel a crushing weight on my chest. That’s a lot of debt. It’s going to dictate everything I do in life. I can never stay home with my kids because I’ve got to be working to pay back my debt. (Lucky for me, children are nowhere on my horizon right now.)

Sometimes I think I’ve made a huge mistake with my career and it’s all her fault.

“Did you get to save anyone’s life yet?” Mom asks.

I can’t help but think back to my one Code Blue, and how I spent the whole time cleaning up the mess from my
popsicle. “Not really.”

“It’s just so exciting,” Mom sighs.
“You’re going to have such a great life, sweetie. You’ll see. You made the right decision going to med school.”

Right now, I’m just having a lot of trouble believing that something making me so
suffocatingly miserable was really the right decision.

Short Call

The next day, I’m on short call, meaning our team takes new admissions until 1 p.m. at a maximum of two patients per intern. It means we can sleep in our own beds, but it’s still a rough day. Especially since we’re expected to meet Dr. Westin to round at 7 a.m. in order to leave time for everything else we have to do.

Since we’re meeting at 7
a.m., I’m expected to have pre-rounded on all my patients prior to that. I have eight patients, so at Alyssa’s estimate of thirty minutes per patient, I should rightfully be showing up at 3 a.m. That is not going to happen. Instead, I come in at 6 a.m.

The first patient I go see is Mrs. Coughlin.
Her biopsy came back, and it seems like her tumor is most likely pancreatic cancer. Pancreatic cancer is Bad Cancer. Not that any kind of cancer is good cancer, but pancreatic cancer has an especially poor prognosis. Dr. Westin broke the news to her, and I hid, because I was too scared to see her reaction.

Now oncology and surgery have decided that her best bet is a Whipple procedure, also known as a
pancreaticoduodenectomy (say that ten times fast). Basically, it involves removal of part of the stomach, the pancreas, the small intestines, and the complete removal of the gallbladder. The surgery team is going to be responsible for getting consent, and then she’ll leave our service and they’ll take over her care.

“I’m going to have nothing left inside me!” Mrs. Coughlin says to me
, but she smiles like she made a joke. She doesn’t seem as scared as I might have expected. Right now, she’s calmly knitting.

“You’ll have a few things left,” I say.

“Well, I hope so,” Mrs. Coughlin says.

“Someone from Surgery will come by to get consent,” I tell her.

“Oh, he already did,” she says. “Very early this morning. Dr. Reilly, he said his name was.”

Sexy Surgeon again.
Sometimes I’m beginning to wonder if there are any other surgery residents in the whole hospital.

“That Dr. Reilly
is so handsome!” Mrs. Coughlin says, clutching her chest. “Do you know him, Dr. McGill?”

“Sort of,” I mumble.

“And he’s single,” she says. She points to her left hand. “No ring. I told him he should ask you out.”

I groan.
“Thanks.”

Mrs. Coughlin continues to gush about the handsome Dr. Reilly for several more minutes, until I
finally interrupt her to listen to her heart and lungs. This is not my favorite way to start the day.

I just barely get through my work and am racing to Dr. Westin’s office, determined to be on time.
Of course, I’ll never be earlier than Connie. She only has one patient again, somehow.

Connie has already finished discussing her one patient, so I start in on my huge list.
It takes forever, because Alyssa won’t let me get one word out without interrupting me. I feel like I’m on trial, being cross-examined on the witness stand. “How come you didn’t mention the drop in Mrs. Jefferson’s hematocrit?” she demands to know.

“Uh…” I fumble through my notes to find Mrs. Jefferson’s most recent labs.
Her hematocrit was 34 yesterday. Now it’s 32. “It only dropped two points.”

“She’s already in heart failure,” Alyssa says.
“Do you really want to put more stress on her heart?”

“So…” I search Alyssa’s face, trying to figure out what she wants me to do.
“Should we transfuse her?”

“Transfuse her!” Alyssa looks at me in horror.
“Jane, you can’t be serious.”

No, I was just kidding.
Ha ha.

“Um,” is what I actually
say.

“Why don’t you start by doing a guaiac,” Alyssa sighs.

Medical jargon:

“Doing a g
uaiac”: Stick your finger in the patient’s rectum so you get some poop on your finger, smear the poop on a special card, and see if it changes color when you put a special solution on it, which would indicate the presence of blood.

“Okay,” I say.

Alyssa eyes me critically. “You really need to read more, Jane.”

I
t takes me so long to get through all my patients that Dr. Westin actually feels a need to comment on the size of my service. It’s a bit of vindication.

“You’re treating half the hospital, aren’t you, Jan?” he says.
And he’s getting ever closer to my real name too—only one letter left to go. Score!

I shrug modestly.

“Interns are capped at 12 patients, aren’t they?” Dr. Westin asks Alyssa.

“Yes,” Alyssa confirms.

“I think we better try to even things out a bit on this short call,” he says. “Jan, you can take one patient. Connie, you can admit three.”

Connie’s eyes widen for a moment, but she doesn’t say anything.

“That
would really help,” I speak up gratefully. It’s actually the first nice thing anyone on my team has done for me, although it’s probably more because he’s worried I’ll hit my cap and not be able to take any more patients.

Still, it will be a huge relief to do only one admission today.
My to-do list is already about ten times longer than Connie’s and it would be nice to get out of here sometime tonight.

The first place I go after I leave Dr. Westin’s office is
to Mrs. Jefferson’s room. I figure I may as well get the worst of it over with first. Mrs. Jefferson is sitting in bed, reading a magazine, flipping the pages with her chubby fingers. Her gray hair is all poofed out as usual, but now it’s covered in little sparkly clips. The clips don’t seem to be controlling her hair in any way and appear to be merely decorative.

“Well, hello, Dr. Jane,” Mrs. Jefferson says, her face beaming with a big smile.
“Come to visit me again, did you?”

“Hi, Mrs. Jefferson,” I say.

“Oh, didn’t I tell you to please call me Marquette?”

I nod, unable to bring myself to tell her about the rectal exam.
“I like your clips.”

Mrs. Jefferson pats her head and laughs.
“My granddaughter gave me these, so I got to wear them.” Her eyes light up. “Do you want to see photos of my grandkids?”

I don’t really, if I’m being entirely honest.
I’ve got a ton of work to do. But I feign enthusiasm as Mrs. Jefferson fishes out her phone and shows me about two thousand photos of her grandkids doing every conceivable activity. She’s even got several of them on the toilet. Speaking of which…

“Mrs. Jefferson,” I say.
“I’ve got to do a rectal exam.”

“Okay,” she says without batting an eye.
Then she adds, “I’m sorry.”

“No,
I’m
sorry,” I say.

“Oh, honey,” Mrs. Jefferson says.
“Don’t you worry about me. I’m used to it.”

I decide that Mrs. Jefferson has enough strength to turn herself with my help, so I don’t need to drag a nurse into the room.
She grabs the bedrail and turns herself onto her side, while I spread her butt cheeks with my gloved hands.

Sometimes I really,
really
don’t like being a doctor.

Her buttocks are so large that I really can’t see anything.
I fish around with my lubed finger, and I start to worry that my fingers literally are not long enough to reach her rectum. But then I find it, although not before Mrs. Jefferson laughs and says, “Don’t fall in!”

I’m sweating like a pig by the time I extract my
right hand, carefully holding out my index finger to preserve the specimen. I reach into my white coat pocket with my clean hand to pull out a guaiac card and…

Oh no
, where
is
it?

I’ve got a lot of
junk in my pocket, but I’m sure I had a guaiac card in there. Still holding my poop-smeared right index finger in the air, I use my left hand to start emptying the contents of my pocket. I’ve built a three-inch high pile of crumpled papers, pens, sticky notes, and gauze on Mrs. Jefferson’s night-table by the time it becomes obvious that I do not have a guaiac card in my pocket.

Shit.

(Literally.)

“I’ll be right back,” I tell Mrs. Jefferson.

I walk into the hallway, my right index finger still stuck up in the air.
I cannot believe this is happening. How could I have done a rectal exam without double-checking to make sure I was prepared? Now I have to walk around with poop on my finger, looking for a guaiac card. I’m not even sure where they are on this floor.

“June!”

I look up and am horrified to see Dr. Westin grinning down at me. I have no idea what he’s doing on the wards. Attendings never show up on the wards—it would be like God coming down from heaven and just, like, hanging out at the mall. And of course, the one time he chooses to do it, I’ve got poop all over my finger.

“Hello, Dr. Westin,” I say politely, trying my best not to let my finger get contaminated.
Or more accurately, not to let my finger contaminate something else.

“Is everything going all right?” he asks me.

“Great,” I say through my teeth. My finger is starting to ache, but there’s no way I’m going to tell him the dumb thing I just did. He’ll probably tell Alyssa and then I’ll never hear the end of it.

“I know intern year can be tough,” Dr. Westin says.

“Yes,” I say.
Is he done?

“Very tough,” he says.
“Did I ever tell you about the time when…”

I keep a smile plastered across my face as Dr. Westin recounts the story of his first call as an intern.
I swear to God, this is the longest story in the history of the world. Why won’t he leave me alone? Why does he have to choose this exact moment to take me under his wing?

“…and I’ve never been able to eat meatballs again after that,” Dr. Westin concludes, chuckling at his own joke.

“I’ll bet,” I say. Somebody shoot me.

“Well, I’ll leave you to it then,
June,” Dr. Westin says. “You look like you’re in the middle of something important.”

No, I just have crap smeared all over my finger.

The second Dr. Westin disappears down the
hall, I burst into the supply room. Keeping my finger elevated, I check every single drawer and shelf using my left hand. There is not one guaiac card in sight. This is unbelievable. Where are those goddamn cards?

Does poop expire?
Do I have a time limit to get this crap smeared on a card before the results will be invalidated? God, I hope not.

Finally, I suck up my self-respect and approach one of the nurses, a tiny blonde named Angie.

“Hi,” I say.
“I was wondering if you knew where the guaiac cards are?”

Angie looks me over, from my rumpled white coat and scrubs, to my gloved right hand with my finger still stuck straight up in the air.
Then she bursts out laughing.

“Oh, Doctor,” she giggles.
“You’ve got to go into the room
prepared
.”

“Yeah,” I mumble.
“I’ll keep that in mind next time. So, um, do you know where…?”

“I’ll grab one for you,” she says.

I stand at the nurse’s station, my blood pressure rising slightly when another nurse hijacks Angie on the way to get the card, forcing me to spend extra time waiting with poop on my finger. But finally she returns with about half a dozen guaiac cards and even a small bottle of developing fluid. “You can keep this,” she tells me, waggling the fluid bottle in my face.

“Thank you,” I say.

“That will make you
very
popular,” she says.

“I know,” I say.
And I’m not even joking. Guaiac developing fluid is a scarce commodity.

I smear the card, and practically rip off my glove with relief.
I put a drop of fluid on the smear and wait.

It’s negative.

I guess it’s good news for Mrs. Jefferson, but I’m a little peeved that I had to run around with poop on my finger for nothing. Not that I expected any other outcome.

I’m finding a trash to toss the contaminated card, when all of a
sudden, I’m face to face with Connie. I’m pretty sure her one patient isn’t on this floor, so I don’t know what she’s doing here.

I can’t help but notice that Connie
hasn’t dressed in scrubs today, but instead is wearing a fitted white blouse with a beige skirt, and knee-high boots. Knee-high boots has never been a look I could pull off. I always feel vaguely like an unhip cowboy.

“Can I talk to you for a minute, Jane?” Connie says to me.

“Sure,” I say.
I locate a trash and toss the guaiac card inside. “What’s up?”

Unlike me, Connie isn’t wearing her hair in a ponytail, s
o she tosses her long, dark locks back behind her shoulders. She’s actually very pretty. Her best feature may be her skin, which is completely flawless. Why do all dermatologists have such great skin?