Mark
FEBRUARY 1986
Monday, January 27, 1986
Today was my first day in the nursery. What fun I had! I love staying until ten-thirty, running around like a chicken with my head cut off, having no idea in the world what the hell I’m doing. It was a million laughs! I can’t wait to go back there tomorrow!
Well, let’s see: How can I describe what the day was like? I came in at about eight o’clock, and Ed Norris, the director of the neonatal ICU at Jonas Bronck, tried to give us an orientation lecture. He certainly made things very clear; it was like listening to a lecture in Swahili! I couldn’t understand a good 50 percent of the things he was talking about. He kept referring to the inhabitants of the unit as “your patients.” You know, “your patients this” and “your patients that.” And then we walked around and he showed us these so-called patients. My God, those things weren’t patients! They’d have to quadruple their weight to be classified as patients. Right now, they’re mostly tiny portions of buzzard food with lots of ridiculous wires and tubes coming out of them. This is going to be a long month!
They gave me eight of these things to take care of. For most of them, the kid’s chart weighs more than the kid does, which is a very bad prognostic sign. And, of course, I didn’t have a clue about what the hell was going on with any of them, so I spent the whole day sitting in the nurses’ station trying to read these ridiculous charts, which were filled with words I had never seen or heard before and numbers I couldn’t even attempt to figure out. I was trying like hell to make sense of all of this before one of these things wound up dying. At least I didn’t have to go to clinic this afternoon; it was canceled. Thank God, because there’s no way I would have made it anyhow.
I really can’t believe this! It’s ten-thirty, I’m just getting home from work, and this is my good night! It’s just amazing! I have eight patients, they’re all stable, and none of them is really that complicated, but even uncomplicated preemies have this long, annoying history, most of which I don’t give a damn about. I mean, truly, I just don’t care! There was a point there, about five o’clock tonight, where I swear I was this close to just taking all the charts, throwing them out the window, and saying, “Forget it! I’m sorry I ever applied to medical school! I never really wanted to be a doctor anyway!” I just couldn’t take it anymore: just all these little runts who shouldn’t be alive in the first place! Damn! Really annoying! But hey, I stuck it out, because I have such great self-control, and here I am, celebrating by eating my favorite food, Sno-Caps. This is the first thing I’ve placed in my mouth since breakfast. That was over fifteen hours ago! Working in this damned ICU is like being on a self-imposed fast! I feel like Gandhi, for God’s sake!
I better try to eat neatly. This looks like it’s going to be one of those months where I’m not going to get to wash the dishes or do the laundry! Maybe I’d better just start using paper plates right now. It’s too bad they haven’t invented paper clothes. That’d be perfect: disposable clothes for the house officer. Maybe if they could be made edible, that would solve both problems at once. I’m not making any sense anymore. I’ve got to get some sleep!
This place really sucks. What am I going to do?
Wednesday, January 29, 1986
Well, I’m home again. It seems like only yesterday I was last here, but actually it was the day before yesterday. I’m exhausted. I was on last night and I didn’t get any sleep. No one ever gets any sleep in the nursery, so saying you didn’t get any sleep on a night you were on call is redundant. I spent the whole night running around from bed to bed, doing stuff I didn’t understand on babies I didn’t think were human, for reasons that are totally beyond me. What a rewarding experience.
Here are a few more of my thoughts about the neonatal intensive-torture chamber. What a fun place it is. Starting to work in the NITC [neonatal intensive-torture chamber], or the NICU, as the neonatologists like to refer to it, is like being thrown into prison in a foreign country where you have no idea what the fuck’s going on. I really don’t know anything! I’ve never even taken care of well babies before. I can barely tell the difference between the respirators and the babies. Before Monday, I’d never seen a kid with jaundice. [Neonatal jaundice is caused by immaturity of the liver, the organ that removes bilirubin from the bloodstream; it’s a common problem in infants and is treated with phototherapy, placing the infant under banks of fluorescent lights.] I don’t know when to turn on the lights, when to turn off the lights. I don’t even know what a normal bilirubin is for a baby!