I’ve been on call one night and so far I’ve had one patient die. It was a patient I’d met before: the kid I saw in the West Bronx ER a few weeks ago who got bitten by the horse. Her name was Melissa Harrison, and she had this horrible disease, metachromatic leukodystrophy. She’d been going downhill for a while. She came in on Monday in status epilepticus [the state in which constant seizures are occurring]. Dr. Ruskin, her neurologist, came in and spent about an hour and a half talking to the parents. At the end of the meeting Ruskin came out and told me they’d decided that this was going to be it. We weren’t going to do anything heroic, just fill the kid with enough morphine to keep her comfortable and then wait for the end to come. The end happened to come when I was on call Tuesday night.
This wasn’t exactly the most comfortable situation I’d ever been in. I mean, I didn’t know this kid from a hole in the wall. And here I was, being called on to stand by her bed and let her die without doing anything to prevent it from happening. Ruskin might have felt comfortable being in that situation, but she wasn’t standing there at the kid’s bedside. I was, and I felt pretty bad about the whole thing.
This kid’s mother was a saint, though. I guess she saw I was pretty uncomfortable, and she spent a lot of time trying to calm me down. She told me about what Melissa had been like before she started going down the tubes. Isn’t that wonderful? The mother of this dying girl had to spend the last minutes of her daughter’s life calming down the intern who had gone completely out of his mind. Well, listen, it isn’t completely my fault that I’m berserk; I’ll be the first to admit that I might not have started out this internship with a full complement of marbles, but most of the berserkness I’ve been demonstrating recently is the result of the deep frying my brain’s been receiving over the past few months.
Anyway, Melissa’s mother was really great. She’s a real Mother Teresa type. I can only imagine what kind of hell her life’s been over the past few years.
So that was a great way to start out the month. I’m on again tomorrow, and since I seem to have become the Intern of Death, I wonder which one of my panel of patients will be tomorrow’s selection in the Meet Your Maker sweepstakes. Will it be Nelly, the three-year-old with AIDS who has PCP [pneumocystis carinii pneumonia, a common cause of death in patients with AIDS]? Will it be Jesus, the one-year-old with yet another bizarre metabolic disease, the name of which I can barely pronounce? Will it be one of the parade of renal transplant patients who are constantly marching onto the ward to get treated with medication that might stop them from rejecting their transplanted kidney? Or will it be a completely different patient, one I haven’t even met yet, one who’s waiting in the wings to make my life completely miserable over the next forty-eight hours? Only time will tell. And I don’t think I want to know.
I’m going to sleep now. Maybe I’ll sleep through tomorrow and the entire next two months, and when I wake up, I won’t be an intern anymore. I can always hope!
Sunday, May 4, 1986
Great news! I was on Friday night and no one died. Nobody; no patients, no nurses, not even me! At least if somebody did die, I wasn’t told about it.
Actually, Friday night was nice, if any night spent in any hospital can be called “nice.” I didn’t get a single admission. I even got five hours of sleep in University Hospital’s very lovely intern on-call room. The on-call room is in reality a closet with furniture; it’s about six feet by six feet and it’s got a door, a telephone, and a cot. When they were building this hospital, they obviously decided to spare no expense when it came to the comfort of the interns. I shouldn’t complain, though. I heard that as of four years ago, the interns didn’t even have this closet to sleep in. They had to sleep in empty patient beds. That’s always very dangerous, especially here at University Hospital, where there’s an actual blood-drawing technician. There’s always the chance the tech will find you lying in bed some morning, mistake you for a patient, and suck out all your blood.
I discovered another good thing about University Hospital. There’s this porch attached to the cafeteria that you can actually go out on and get some sun. Actual sun in the Bronx! Anyway, I found this porch at lunchtime on Friday and I spent an hour out there on Friday afternoon. It was really beautiful. The weather’s been great all weekend, too. The temperature’s been in the seventies. Yesterday Carole and I went to this inn about an hour north of here. It was great, really relaxing, and we weren’t caught in a rainstorm, a monsoon, a tornado, or any other natural disaster. Amazing! Maybe my luck is actually changing. Nah, it probably was just a fluke.