The Devil Wears Scrubs (4 page)

Right??

“
It’s Jane, actually,” I finally say.

“
Oh!” Dr. Westin seems a bit flustered and Alyssa gives me an accusatory look. The attending is always right, I know. But seriously, no matter how tired I am, I’m pretty sure I know my own name.

Maybe not though.
Maybe Jean’s better.

I notice that Dr. Westin is staring at the arm of my white coat, which is drying into a light yellow color.
Stupid flower. I clear my throat and turn to the side, so that he can’t see what a mess I am.

“
Why don’t we discuss Mr. Garrison?” Alyssa suggests, referring to my one telemetry patient.

“
Excellent idea!” Dr. Westin exclaims. I really have to applaud his enthusiasm. I wouldn’t have sounded that happy if Alyssa suggested we go outside for an ice cream break.

Mr.
Garrison is a sick man, and that’s why he’s being monitored on 24-hour telemetry, which is essentially a bunch of electrodes that record the rhythm of your heart. He had esophageal cancer, and the chemotherapy caused him to go into heart failure, and now he’s having arrhythmias. It’s Alyssa’s assessment that he needs a pacemaker. “Jane is going to arrange that,” Alyssa tells Dr. Westin when I’m done presenting the patient.

I am? How do I arrange that? Could
n’t
Jean
do it instead?

“
Fantastic!” Dr. Westin says to Alyssa. “I think this young man will do very well.” (Mr. Garrison is not young. He is 72. I’m not sure if Dr. Westin is being generous or if he misheard the patient’s age.) “Jane, what medications do we have him on?”

Mr. Garrison is on a jillion medications. I realize that a jillion isn
’t a real number, but I really think a new number needs to be created to express the sheer number of medications this man is taking. I copied over the list in my pristine handwriting this morning and it covers two pages, which I hand over to Dr. Westin.

“
Oh, my,” Dr. Westin says, running his finger down the list. He adds, “My, my, my.”

Dr. Westin
’s “My” Scale is renowned hospital-wide:

One
My:
Patient is mildly ill, likely discharge in next day or two

Two
My’s:
Moderate illness. Patient probably needs some sort of invasive testing.

Three
My’s:
Severe illness. Possibly close to ICU level of care. Intubation is imminent.

Four
My’s:
Call the coroner.

When he finishes looking over the list, he beams at me.
“All right then, let’s pay this young man a visit!”

“
He’s 72!” is at the tip of my tongue, but I can’t say it. You only get to correct an attending once in a lifetime and I already blew my one time by telling him my name wasn’t Jean.

Dr. Westin leads the way to the room. I lag behind a little bit, and I feel Alyssa grab my arm.
“Hey,” she hisses. “What did you think you were doing back there?”

I stare at her, wide-eyed. She seems livid about something, although I can
’t imagine what. She already yelled at me for eating lunch. Was it the Jean/Jane thing?

“
You’re supposed to
read
the medication list to the attending,” she says. Her brown eyes are flashing. “You don’t just hand him the list. What’s
wrong
with you?”

I don
’t have a second to respond before she whips her head around and follows Dr. Westin down the hall. Is she right? I have no idea. At the time, the idea of reading off a jillion medications seemed crazy. I don’t think I did anything wrong. But clearly, Alyssa disagrees.

And to make matters worse, I’m about 99% sure Dr. Westin is on his way to the wrong room.

My first hint is when he passes Mr. Garrison’s room without even slowing down. But he seems so certain of himself that I feel like he
must
be the correct one, even though I found the patient in another room only an hour earlier. But after all, he’s the attending. And
the attending is always right
.

When Dr. Westin finally stops, it
’s in front of a room with the name Lopez on the door. Alyssa looks like she wants to say something, but Dr. Westin has already marched inside.

The man inside the room is dark-skinned with jet-black hair. He really is young, maybe in his twenties. He looks surprised to see us when we enter.
“Hello!” Dr. Westin booms. “I’m Dr. Westin.”

Now I may not be the attending
and it may just be my first day, but I’m almost certain this man is not Mr. Garrison. This guy is Mr. Lopez, or possibly
Señor
Lopez, and he is not one of our team’s patients. I can’t figure out why Alyssa hasn’t said anything. She’s got her mouth open, but can’t seem to get the words out.

Well, if she’s not going to tell him, I’m sure not going to.

“I’m very concerned about your heart,” Dr. Westin tells Mr. Lopez. “We think you’re probably going to need a pacemaker. I’d like to call the cardiology service to have it placed. If you don’t do that, it could be very serious. You could even die.”

Oh no. Dr. Westin is telling this young man, who is probably totally healthy (well, not
totally
healthy, since he’s in the hospital) that he might die. This is bad. Alyssa, say something!

“
Are you willing to consider getting a pacemaker?” Dr. Westin asks the patient.

Mr. Lopez stares at our attending for what feels like an eternity. Then finally, he says,
“
Qué
?”

That seems to snap Alyssa out of her trance. She gently taps Dr. Westin on the arm, and says,
“I think they may have moved his room. This is Mr. Lopez.”

The patient nods vigorously.
“Lopez.
Sí
.”

“
My, my,” Dr. Westin says, sounding a little annoyed.

After a brief apology (
lo siento
?), we make our way back down the hallway to Mr. Garrison’s actual room. As we walk, I fall into step with Dr. Westin. He’s much taller than me with longer legs, so I have to nearly jog to keep up. “Dr. Westin?”

“
Yes, Jean?”

I
’m Jean again, apparently. Whatever, let it go. Not worth it. “I just wanted to apologize for not reading you the list of patient medications earlier,” I say. “From now on, I’ll read you the list instead of handing it to you.”

“
Don’t be silly!” Dr. Westin says. “I love that you wrote out the whole list! You have great handwriting, Jean.”

Vindication! And a compliment! I flash Alyssa a triumphant look. In the short time I
’ve been in this hospital, I have actually managed to do something right. Well, maybe not
right
. But at least not
wrong
.

But my victory is short-lived. Just as Dr. Westin is walking into the (correct) patient
’s room, Alyssa grabs me by the arm again. Her long, wiry fingers dig into my skin, even under my white coat. I worry she may draw blood. “I don’t care what Dr. Westin says,” she hisses at me. Her tongue is just the slightest bit pointy. “You
always
read the medications to the attending. Even a medical student knows that. Even a
child
knows that.”

My, my, my, my.

Hours awake: 8

Chance of quitting: 63%

I arrive home at nearly 7p.m. that night. Connie, against all odds, left the hospital at 3. How did this happen? Let me just say one thing: it is apparently not easy to arrange for a patient to get a pacemaker. It involves sitting on the phone for over an hour and being transferred between lots of different people, all of whom seem baffled as to why I was told that they were the one who places pacemakers. Eventually, I gave up for the day since nobody was answering phones anymore. I’m hoping tonight the pacemaker fairies will pay Mr. Garrison a magical visit.

I
’m way too tired to even contemplate putting together a dinner for myself. Even a sandwich is too complicated. So on the way home, I buy a burrito at a sketchy Mexican takeout place. I suspect that eating the burrito in my room will be the highlight of my day, as long as it doesn’t make me ill.

When I get back to my apartment, my roommate (Julia!) is in the bathroom. I see the light on under the door. I know that Julia hasn
’t been super friendly to me, but I feel like since we’re both interns, it’s worth it to try to bond with her. I mean, she had to have had a bad day too, right?

I stand waiting in front of the bathroom door for an embarrassingly long amount of time before Julia yanks it open. Her hair is still i
n that severe ponytail—I wonder if she sleeps in it. She’s clutching a roll of toilet paper in her left hand. At first I think she’s stealing my toilet paper, but then I notice that my roll is still in place. Apparently, Julia and I will not be sharing toilet paper this year.

“
Hi!” I say cheerfully.

Julia looks me up and down. I
’m still wearing my scrubs, and the sleeve of my white coat has faded to a dull yellow. She narrows her eyes.

“
Did you take one of my eggs?” she asks me.

I stare at her.
“What?”

“
I thought I had ten eggs,” she says. “But now there are only nine. Did you take one?”

“
No,” I say.

I really didn
’t. I’m innocent this time.

But Julia doesn
’t look like she believes me. “Are you sure?” she presses me.

“
Maybe it hatched and ran away?” I suggest.

Guess what? Julia does not think I
’m funny.

In fact, she thinks I
’m so un-funny that she pushes past me, and goes to her room. There are no locks on the door, so I know she’s not locking it, but I imagine she’s wedging a chair under the doorknob to make absolutely sure I don’t ransack her room for eggs and forks tonight.

Days living with my crazy roommate: Too many

Chance either Julia or I will kill each other during the night: 38%

Call #1

I am on call tonight.

Call is this horrible thing that happens to you when you’re a doctor. It essentially means that if there’s an issue with one of the patients, the nurses can “call” you. All night long, baby.

In my residency program, interns are on call q4. What does that mean? Well, in medicine,
“q” means “every” (it’s probably a Latin thing) and “4” means “4”. Put it all together and this means that I’m on call every four nights. Every four nights, I get to spend the entire night at the hospital answering questions about patients and admitting sick people.

To be honest, I’m the teensiest bit excited about it. I mean,
this is what being a doctor is all about. This is what I’ve been waiting for. And now
I’m
the one in charge. I get to make important decisions, cure sickness, maybe even save lives. This is what I was writing about on that med school admissions essay.

(Excerpt from Jane McGill’s med school admissions essay:
Illness is a treacherous dragon, breathing fire on innocent patients, and as a physician, I want to be the shining knight who battles that dragon and saves my patients’ lives.
)

(
No, really. I wrote that. In my defense, I was only 21 at the time.)

I enter the hospital at 7:25
a.m., wearing a fresh set of green scrubs and a new white coat that is as yet unstained. Today I’m definitely going to be on the lookout for flowers, that’s for sure. I’m wearing my comfy Dansko clogs, knowing that I will probably spend the next 24+ hours on my feet.

Overnight calls in our hospital last 30 hours. Alyssa has told me to come no earlier than 7:30
a.m., so that I can stay until 1:30 p.m. tomorrow. County Hospital is very strict about us sticking to the 30-hour rule, because the hospital could get slapped with a big fine if we stay in the hospital longer than 30 hours. Along the line, someone discovered that tired residents perform at roughly the same level of competency as drunk people, so now there’s something called the Bell Commission, which ensures there aren’t a bunch of drunk people caring for patients.

In case you’re interested in the history of the Bell Commission, it all dates back to the olden days of medicine. Back then, residents would go for weeks at a time without sleeping, eating, or using the bathroom.
Sometimes
months
at a time. Truly, it was a golden age.

Anyway, t
his was all well and good, but then one day a woman named Libby Zion died in a hospital due to the tired resident missing a diagnosis. (Personally, I think stupidity could account for that just as well as exhaustion.) Zion happened to be the daughter of a big cheese reporter and it came as a huge revelation to the world that you can’t perform competently while awake 35 hours in a row. But apparently, you
can
perform competently while awake 30 hours in a row.

It’s all very scientific.

The elevator seems to be conspiring against me to make me late for meeting Alyssa. I’m standing there for at least five minutes, hopping impatiently between my feet. I probably look like I have to pee. At some point, an elderly couple passes me, and the wife nudges her husband and says, “Look! It’s a little girl with a stethoscope.”

This is not the best start to the day
.

In the elevator, I run into my lunch buddy from yesterday, Nina. The second she steps inside, I sneeze
violently. I can’t help but notice she’s covered in cat hairs. They are stuck to the back of her white coat, almost like she’s grown a layer of fur.

“Hi, Jane!” she says. “Are you on call tonight too?”

“Uh huh,” I say. I squint at her, wondering how to phrase my next thought as delicately as possible. “Um, are you keeping your cat in your dorm room?”

“No,” Nina says, all wide-eyed innocence.
“Of course not. That would be illegal.”

“Um,” I say
again. “You’ve got cat hair on you.”

Nina looks down at her scrub top
. I shake my head and do a spinning motion, so she wrenches her neck around to see the back of her coat. “Oh!”

“I won’t tell anyone,” I promise.

Nina lets out a breath. “Thanks, Jane. Honestly, I can’t make it through this year without little Valsalva.”

“Doesn’t your roommate mind though?” I ask.

“I’ve got a single,” Nina says.

Seriously,
some people have all the luck.

_____

Naturally, Alyssa and Connie are already waiting in the resident lounge when I show up. And what they’re doing makes me ill: they’re comparing diamonds.

No wonder Alyssa and Connie act like they’re BFFs. They’re both engaged. They can bond by talking about the fabulous w
eddings they’re planning. Chicken or fish. Color schemes. Flowers. DJ vs. live band. The conversation topics are probably endless.

“Hi,” I say as I walk in.

Alyssa barely glances up at me. “The diamond belonged to his mother,” she’s saying. “But we changed the setting. And I wanted platinum, of course.”

“Of course!”
Connie agrees.

Of course.

They spend the next five minutes talking in diamond jargon while I sit on the couch across from them and twiddle my thumbs. I suspect we would have spent the next 30 hours talking about diamonds, except then Alyssa’s pager goes off. Her pager alert is the happy birthday song. Way to spoil every birthday I’ll ever have, Alyssa.

“It’s the ER with a new admission,” Alyssa reports. She looks at me. “You’re up, Jane.”

“Goody!” Did I say that out loud? Alyssa looks at me funny.

Alyssa whips out an index card and takes notes as she says “uh huh” over and over again into the phone. She hangs up a minute later, and she’s already glaring at me.

“I said you were up next,” she says.

I just stare at her blankly.

She points her pen in my direction. “Why weren’t you writing down information about the patient?”

“Because...” I feel like this answer is too obvious, that there’s a trick that I’m missing. “They were talking to
you
on the phone. I couldn’t hear them. So I couldn’t write it down. That’s why.”

“And there’s no other way you could have gotten the information, huh?” Alyssa waves her index card in my face. “No other way you could think of?”

“Um,” I say. Did she really expect me to read her handwriting upside-down from three feet away?

“In the future,” Alyssa says, “I expect you to copy down the information as I’m writing it. That way, we don’t waste time.”

“Time that could be better spent discussing diamond ring settings?” I say. No, I don’t really say that. But I think it so vehemently that I’m sure Alyssa must be able to somehow hear it.

My first admission of the day is a R
ussian gentleman named Mikhail Petrovich. He is having chest pain. At least, we think he is. Nobody has yet located an interpreter. But apparently, he’s clutching his chest and looking short of breath. So either he’s having chest pain or he’s just incredibly surprised.

This is my very first time in the ER, but it’s hard to miss since the first floor of the hospital is plastered with arrows directing me there.
It’s apparently a busy day for the ER, because there are patients camped out in the hallway in stretchers, although many of them look like they’re “sleeping it off.” The stench of alcohol (not the rubbing kind) and old socks assaults my nostrils, and I start breathing through my mouth.

This place is a total pit.

As I’m slinking down the hallway, a guy
lying on a stretcher grabs my elbow. I look down and see his fingernails are embedded with dirt. So are the creases on his face, actually.

“Are you a nurse?” he asks me.

I shake my head. “No.”

He is undeterred by my response.
“Do you work here?”

“Yes,” I admit
after a brief hesitation.

“Can I have some Percocet?”
He offers me a hopeful smile.

“Let me find your nurse,” I mumble, despite the fact that I have absolutely no intention of doing so.
I detach his hand from my arm and see he’s left behind a big dirty handprint on my fresh white coat. As I try to brush off the dirt, a stretcher nearly runs me down.

The high level of activity in the ER
does not bode well for us, since we get our admissions from the ER. Busy ER = busy residents on call. So I better get a move on. I dodge a second stretcher rushing past me and attempt to locate Room 6, where Mr. Petrovich has taken residence.

I find Room 1 all right.
Then Room 2. Then Room 3, 4, 5... and then the next room is Room 7. Is this some kind of sick joke?

I lift my eyes, scanning the room for someone who doesn’t look like they’re rushing to save someone’s life. A nurse pushes past me with a full bag of dark red blood. At least I hope
it’s blood. Anyway, best to let her do her job.

My eyes finally settle on a familiar face: Sexy Surgeon! He’s talking to a
young woman in scrubs. As I approach them, I notice the woman is cowering a bit, and I can tell why: Sexy Surgeon is screaming at her.

“You’re completely wasting my time, you realize that?” he snaps at her
, his blue eyes flashing. “This is
obviously
a non-surgical abdomen. If you’d bothered to get a CT before you called me, you’d have been able to figure that out on your own. I mean, is everyone who works down here completely incapable of practicing basic medicine?”

Holy crap.
Sexy Surgeon is a complete asshole. Well, I guess that isn’t too huge a surprise.

I try to slink away, but it’s too late. He’s spotted me.
I freeze, but apparently he’s not a T-Rex whose vision is based on movement.

“Medicine Intern!” he cries out.
He actually looks pleased. The woman in scrubs takes this opportunity to slip away from him. She owes me big time. “What are you doing here?”

“An admission,” I mumble.

“Is this your first ER admission?” He grins at me. “That is really cute.”

“Thanks.”
I roll my eyes. “Listen, you don’t… know where Room 6 is, do you?”

“Ah,” he says.
“The elusive Room 6. Oh, yes.”

I can see a glint in his
blue eyes. He’s enjoying toying with me like this. I wonder if he finds one medicine intern to pick on every year.

“You see that crash cart over there?” he says, pointing to the cart stocked with supplies in case of the inevitable ER Code Blue.

“Yes…”

As he extends his arm, I can see the muscles popping out.
Sexy Surgeon’s got himself some nice biceps. But I’m not going to think about that. “Make a left at the crash cart, then it’s at the end of that hallway.”

“Thank you,” I say.

“My pleasure, Medicine Intern,” he says.

He may be cute, but if he calls me that one more tim
e, I swear I’ll punch him in the face.

_____

Nearly half an
hour later, I am no closer to getting a history on Mr. Petrovich. Mr. Petrovich is a disheveled man in his sixties, with tufts of gray hair protruding from his skull and his chest. He keeps moaning and clutching his chest. Whenever I try to ask him a question, hoping he’s magically become proficient in English, he always answers the same way: “
Nyet
!”

I hate County Hospital.

I’m on the verge of tears when a man comes in with a big ID badge that says “Russian Interpreter” and declares his name to be Boris.

“Thank God you’re here
,” I say.

“
You may begin, Miss,” Boris says in heavily accented English.

I don’t bother to correct him
by telling him that I’m
Doctor
McGill. Instead, I say, “Can you ask him where he feels pain?”

There’s an exchange of Russian between
Boris and my patient. I thought I asked a pretty simple question, but I swear they go back and forth like five times. “
Nyet
!” I hear Mr. Petrovich say.

“What did he say?” I ask.

“He said it’s on the left side of his chest.”

Five minutes of discussion for that answer?
“And does it radiate into his arm?”

Another long exchange in Russian follows.
At this rate, it’s going to take me five hours to get a history on this man.

Boris
hesitates. “To be honest, it’s a little hard to understand him. I think he’s speaking an unusual dialect. Also, he’s mumbling a lot.”

Mr.
Petrovich is probably difficult to understand because he’s
edentulous
, which means he has little to no teeth—where his teeth used to be, there are only gaping red holes. In medicine, we’ve got all sorts of fancy words for things that aren’t very pleasant to say in plain English: