Well, there’s only a little over a week to go and I’ll be out of here. And then there’s only one more month of internship left. That’s pretty unbelievable, but I’m finding the idea of me being a resident even more unbelievable. In a little over a month there is going to be a group of poor, innocent interns who are actually going to look up to me with respect. They’re even going to think they can trust me! My God, what a frightening thought!
Wednesday, May 28, 1986, 8:30 P.M.
Well, it looks like I made it. I just came home, which means I’m done with University Hospital. The rest of my internship consists of one measly month in the NICU at West Bronx. It’ll be a cinch compared with last night.
I had the feeling last night that what was going on wasn’t real. I figured this had to be a setup for Candid Camera. But nobody told me to smile, and no short, fat, bald guy came out and shook my hand. So I think it must have been real.
I was supposed to be on with Diane Rogers, but she called in sick and there was nobody to cover for her. So the chiefs asked if I would mind working on the ward by myself. Me mind covering a ward filled with twenty-five sick kids by myself? No, no way I’d mind it. I told them I looked forward to challenges just like this, that I welcomed just this type of adversity. In fact, I even told them I’d be happy to work every night next month by myself because that’s the kind of guy I am. I don’t think they realized I was being cynical, because somehow at around ten o’clock last evening I found myself rounding on the ward by myself. I even yelled at myself a couple of times for not following up on some scut I was supposed to do.
Anyway, everything was going fine, mostly because there hadn’t been any admissions in a couple of days and the place was really quiet, but then at about four o’clock this morning I got a call from one of the neurology attendings, who told me he was sending in a kid with a brain tumor who had been in status epilepticus for about four hours. Status for four hours! I told him fine, I welcomed these kinds of patients, that I looked forward to challenges just like this, and that I’d be waiting for him. Then I calmly hung up the phone, ran for the staircase, and started moving in a downward direction. I was getting out of there; I might be crazy, but I’m no fool.
When I hit the third-floor landing, something weird happened. I got this sudden rush of guilt and I realized I’d have to go back. So I slowly climbed back up, told the nurse what was happening, and got ready.
The kid got there at about four-thirty. He was seizing, all right, there wasn’t any doubt about it. I had no trouble figuring out he was seizing; what I had trouble figuring out was what I was going to do about it. So I called the neuro attending at home, and the first thing he did was yell at me for waking him up. I was expecting that; the first thing everybody does when you call them from University Hospital is yell at you. But then I asked him what I should do, and he said, “You’ve got a kid who’s seizing. What the hell do you think you should do?”
My neurons turned on and I waited a couple of seconds for an answer to come out of my mouth. When it finally did, it was, “Give him an anticonvulsant?” The neurologist said, “Brilliant,” so I knew I was on the right track. I said, “Should I start a line, give him some Valium, and then load him with Dilantin?” He told me that that sounded like a wonderful idea, so that’s what I did. I got the line in, I pushed the Valium, and the kid suddenly stopped seizing. It was great. By six-thirty I had him stabilized, lying in bed, sleeping, which was a lot more than I can say about myself.
This was pretty amazing. I have a lot of trouble believing I was capable of working by myself for a whole night and even admitting a seriously ill patient and not making any major screw-ups. I guess now that I’ve got pediatrics perfected, it’s time to try another field. Maybe I’ll become a heavyweight boxer.
Bob
MAY 1986
At the beginning of the month, Amy Horowitz told the chief residents that she was pregnant and needed to arrange maternity leave. Her announcement was met with the release of an explosion of venom aimed at her by the chief residents, who weren’t about to give any special treatment to Amy just because she happened to be pregnant. This reaction of the chiefs produced the release of an equal explosion of venom from Amy, who, fed up with what she viewed as the chronically poor treatment she’d received all year long, decided to call the Committee of Interns and Residents to find out exactly what she was entitled to. The situation, which was escalating, was finally defused by Mike Miller, who managed to put Amy’s ire to rest, at least for the time being.