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Attending

PUBLISHED: December 3, 2020

 

The pain was a steel orb, sitting just inside my left hip. It came on suddenly on a bright spring day, and as much as I begged it to blend away, it took up residence in my body, the physical feeling not nearly as disturbing as the torrent of thoughts, the questions of permanence, of entropy, of whether the disorder could be undone.

No doctor could explain the feeling, including me. Still, I carried it to the hospital and distracted myself by sliding needles into chests, titrating vasoactive drips, telling a gaunt man he had cancer in his liver and that it had probably been there for a long, long time. But that wasn’t the hardest thing. Worse was the icy nurse; the renal fellow who berated me at the end of my shift when I had no reserve, when I was already doubting myself.

After twenty-eight hours I staggered through a cognitive fog, high and giggling, and fell asleep at red lights on the drive home. My apartment on Oak Street was small and gloomy; I tried to enliven it with a colorful rug, but it never felt quite like sanctuary. Most nights, I retreated to my favorite spot: the bathtub. The water felt good on my hip.

Every fourth night, I stayed in the hospital. Lying in the call room at three in the morning, sleep interrupted every few minutes by the sound of the pager, my body learned a new form of clenching, of vigilance. Sometimes, I slid a pocket warmer down my underwear and pressed it against my skin, hoping to mute the pain which, surgery would later reveal, came from a piece of my womb, inflamed and stuck to my left ovary. The morning they cut me open, I shielded my face in the hospital waiting room, hoping not to be recognized. Doctors aren’t supposed to get sick. 

I’m out of training now. Same rug, new apartment. But things are still not right. We race against the clock, sensing our patients’ simultaneous need and resentment as we extract ourselves, repeatedly, from bedside conversations. We abolish spontaneity. We skip meals. We sit in rows at computers like drones, producing notes that lack flavor and leave us starving for literature.

Is doctor something I wanted to do, or something I wanted to be? As a child, my legs dangled off the exam room table and I gaped at the poster of the human ear—its trio of delicate bones, its spiral sac of fluid. At school I was obedient, creating color-coded study guides with perfectly imperfect handwriting, giving my a’s tails or pregnant bellies depending on my mood. The more I learned about cause and effect—about RNA and ribosomes and motor proteins that drag granules of cytoplasm on their backs—the calmer I felt.

A decade of study and a quarter of a million dollars later, doctor is a thread woven tightly into the fabric of my being. I don’t know what I pictured. Visiting a woman’s home, percussing her back, sliding the needle in blind. Accepting a cup of tea from her mother, sitting across the table from her, hearing a story.

I can’t tell you why I rented the theater downtown, other than that it was inevitable, like the notes of a song. Facing the rows of empty velvet seats, I felt the thrust of potential. At night, doctors stood on stage telling stories—not of helicopter rides and loss of blood, but of waffling, of wanting, of grappling with themselves. The audience arrived like spirits, craving not entertainment but something more fundamental and urgent. I sat backstage, eyes closed, living and dying in every pause, every ripple of laughter. This—a live storytelling event by those in health care, for those in health care—was the first thing I had ever originated, one that came from the roiling place inside of me and not a script.

The pager erupts: Please extend peripheral IV for 24 hours. It’s a click on a keyboard; a formality. Once I found Jan in his office listening to a frenzied piece by Prokofiev. He spoke of a time when doctors knew the nurses by name and all pages were heard through the public address. I imagine a voice booming over the loudspeaker every fifteen minutes at Grady Memorial Hospital, where he trained in the 1960s. Please extend peripheral IV for 24 hours. I smile. Hospitals had no computers back then. Jan didn’t click boxes, he poured purple dye over slides of fixed bacteria and talked to patients. He still remembers their names, their jobs, even their labs.

The road here was long. I opened a cadaver’s knee and found a metal hinge; I galloped through hours of multiple-choice tests; I infused my oral presentations with just the right amount of art. Now I’ve arrived, and there is nowhere to go but inward. Sitting at my desk, unfinished notes accumulating in my electronic mailbox, I see that health eludes us—both doctors and patients—a problem that is amplified in this time of crisis. Our collective fate depends on change, but I’m not sure if that change happens in the hospital, the theater, or somewhere else. 

What if I let go of it all? The white coat, the Dansko clogs, the stale cupcakes, the diagnostic approach to cavitary lung lesions. The medical students, so eager to grow; my colleagues, so anxious and tired and loving; the patients, with their warm skin and speckled gowns and ribbed socks, the weight of them on my arm, putting one foot in front of the other, finding strength in recovery and recovery in strength. There is so much to love about medicine, and so much to grieve. Its edifice, which once felt so stable, now feels stubborn. What if I shed my skin? What lies underneath, alive and raw? I am a verb. The world is a birth.

I startle again; another page. There’s a new patient in the emergency room. Minutes later I am downstairs standing over Gary, a slender tattooed man lying on a gurney with one thumb in a book. “Whatcha reading?” I ask, and he holds it up—some airport thriller—and says, “trash,” chuckling behind his oxygen mask.

Gary has AIDS, and is here for pneumonia. Last week he left the hospital against medical advice because he was tired of everything, but now he’s back because he can barely breathe. He tells me about how his life fell apart when his partner died by suicide. How he stopped his HIV meds, hoping he would die too. How scared he is. “I’m glad you’re back,” I say, pressing my stethoscope to his skin. With each inhalation, I hear a loud, coarse sound. “Thanks for saying that,” he says, tearful. “That’s really cool.” I savor the moment—a pearl among shipwrecks. 

 

2 Comments

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Amalia Melis's picture
Amalia Melis · 8 months ago

intense, passionate. love the last line. brave. 

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Joan's picture
Joan · 8 months ago

This is a beautiful story, it's exactly what I imagine when I think of The Nocturnists. 

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