Anyway, my first admission was a six-year-old with asthma. My first admission. What a moment! I wanted to have the kid bronzed so I could hang him from my car’s rearview mirror, but his parents wouldn’t give their consent. I managed to find my way back to the ward with the kid, who didn’t seem all that sick, and then I got yelled at by the head nurse: “You have an admission? Nobody told me about any admission! We’re not ready for an admission!” So I made a mistake, but she stood there, blocking the door to the treatment room like she wasn’t going to let us in. What’d she expect me to do, bring the kid back down to the ER and call and tell her I was coming up with him? The way things were going, I probably would have screwed up, gotten off on the wrong floor again, and wound up bringing the kid straight to the morgue (at least I knew where that was).
Well, I finally apologized, told her I wouldn’t let it happen again, and she let us into the treatment room. There really wasn’t much to do for the kid except take a history, do a physical, and write an order for aminophylline [an asthma medication]. Even I could do that! So it only took me about an hour to finish, and then I tried to get up to the lab but I got called back to the emergency room for another admission.
This went on all day. I got one admission after the other from about noon until after seven at night—six admissions in all. By that point I had a lot more lab tests to check and finally made it up to the thirteenth floor [the laboratory floor at West Bronx] at about eight. It took me an hour to check all those labs. Then I came down and had to show them to the senior resident and he told me what to do next. So it was about nine o’clock, I had gotten six new patients, I had done most of the scut that had been signed out to me, but I had missed three complete meals, I hadn’t even had a chance to pee (it was about then that I felt the top of my bladder hitting my rib cage). And that’s when all the IVs started falling out.
I don’t know what it was, but all of a sudden three nurses came up to me at once and told me that an IV had come out on one of her patients. Three IVs at once! It seemed to be too much of a coincidence. I went to find the senior resident to ask him if it was possible that the nurses were pulling them out to torture me. He said it definitely was a possibility but there was nothing I could really do about it and, no matter what happened or what I was thinking, I’d better not get into a fight with any of the nurses or my life would be ruined. I told him about what had happened when I had brought up my first patient and he just sighed and shook his head.
I got two more admissions in the middle of the night and more IV’s fell out and there was more scut to do and I didn’t get a chance even to lie down but somehow I made it through and nobody died. So I guess, all in all, I’d have to say it was a successful night. My only problem is, I don’t ever want to be on call again!
Well, after a night like that, at least today was pretty good. I met our team’s senior resident, and he seems great. His name is Eric Keyes and he’s got a weird sense of humor. Then I met our attending, Alan Morris, who’s director of pediatrics at West Bronx. He’s very serious and kind of stiff, but he also knows a lot and I’ve heard he’s great.
I didn’t get out tonight until after nine. I was trying to get my work done, but I kept getting lost around the hospital. I’m really hopeless. I’m going to have to get better organized.
Saturday, July 6, 1985
I am definitely on the chief residents’ hit list. I’ve been on 6A for a week now, and everything seems to have settled down. I’ve finally figured out where everything is; I know where the admission forms are kept and where the lab slips are stored. I’ve found the ER three straight times without getting lost. I liked the people I was working with. I even made up with the nurses; I brought them a box of cookies on Tuesday, and amazingly, no IVs fell out when I was on call Tuesday night. Everything was going fine and then, yesterday, just when I was really beginning to feel comfortable, one of the chief residents came up to me and said they’d decided to transfer me to the Children’s ward at Mount Scopus. I told her I didn’t want to go, that I was having a really good time on 6A. She said she was sorry but they were a body short on Children’s and there was an extra person on 6A that month (because we had a subintern) and there was nobody else who could be pulled. I argued a little more, but I could see there was no way I was going to change her mind. Finally I just gave up. So after figuring out 6A, I had to move over to a completely different ward in a completely different hospital, pick up a whole new group of patients, learn where the Mount Scopus labs are and where the forms are kept, and I have to meet a whole new group of nurses and probably go through another night of IVs falling out. Terrific!