The Intern Blues(132)

It was really hard to keep a straight face while this guy was yelling at us because he was sucking on a lollypop the whole time. It’s hard to take this neurosurgeon seriously in the first place, but when he’s got a lollypop in his mouth, it’s damn near impossible!

And that wasn’t even the end of it. Today, when we were on work rounds, we ran into the neurosurgery team. In spite of how poorly we had managed the kid, she had awakened out of her coma last night and seemed just fine today. Now her prognosis is excellent, and the neurosurgery chief resident told us we had done a great job with the patient. The attending immediately yelled at him, saying, “How can you tell them they did a great job less than twenty-four hours after I yelled at them for doing a lousy job?” The chief resident apologized and told him that since he hadn’t been on rounds yesterday afternoon, he didn’t know the attending had yelled at us. Then the attending got real pissed and said, “Next time I yell at somebody, I want the whole team there. I don’t want to have to yell at people twice for the same thing!”

So last night I had a really quiet night. No admissions, just some coverage, and almost everyone remained stable. This was mainly due to the fact that Nelly, the AIDS kid, got transferred over to the ICU at Jonas Bronck. When Al Warburg, the daytime senior resident, found out that we had a patient on the ward on a Dopamine drip, he picked up the hot line to the chief residents’ office and told them they had to transfer Nelly. So after I had been up all night with the kid, she got whisked away to Jonas Bronck. Don’t get me wrong, I’m not complaining.

I guess the sickest kid on the ward right now is José, a one-year-old with this weird metabolic disease called argininosuccinicademia. The name of this thing is longer than the kid is! Anyway, having José on the ward is like taking care of an unremitting Hanson. He’s constantly crumping and then stabilizing and then crumping again. He’s lived in the hospital for the past couple of months, and all the nurses have come to love him. That’s always a bad prognostic sign.

This disease has something to do with the urea cycle, and the kid is being treated with all these weird chemicals that make him smell really strange. I spent a few minutes standing at his doorway yesterday, sniffing his bouquet, trying to figure out what in hell it was he smelled like. It took a while, but it finally came to me: He smells just like the bottom of a birdcage. The kid smells like parakeet droppings! It’s the strangest thing, but that’s exactly what it is. Since I figured that out, I’ve become fixated on thinking of him as a parakeet. I’m waiting for him to start singing. And I’m sure it won’t be long before he sprouts wings and just sort of flies away.

When you start sniffing the patients, I think it’s safe to say you’ve been an intern too long. I think it’s time to get out of here!

Sunday, May 18, 1986

Well, I haven’t recorded anything for over a week, and nothing much has happened. Working at University really isn’t so bad if you like taking care of kids with diseases whose names you can’t pronounce. It’s not like the other hospitals; they actually hire people here to do some of the scut work we’re normally expected to do. So workwise there just isn’t that much to do. But you more than make up for it in aggravation.

This is definitely the weirdest place I’ve ever worked in! At all the other hospitals, you really know what the score is. The rules are simple: They try to pile as much shit on your head as they can until you collapse, at which point a chief resident comes along, pats you on the shoulder, and gives you the weekend off to recover. Here the work isn’t that hard, but you always have the feeling that you’re missing something. You don’t have control over anything. There are always attendings around who are trying to do things without telling you, and the parents always know more about what’s happening with their kids than we do. It’s very frustrating.

Nobody wants their kids touched by an intern. The parents all want the private attending to come in and draw the blood or start the IV. That’s pretty funny because most of these private attendings haven’t started an IV on a kid in years. People always naturally expect the more senior people to be able to do everything better than the interns. I’ll tell you, at this point in the year there are very few people who are better than the interns at starting IVs, doing spinal taps, drawing blood, doing any kind of scut. But the parents still want to know why the private attending isn’t coming in to do the stuff. So even though there’s lots of time to sit out in the sun, I think I’d rather be in the wasteland of Jonas Bronck.