Then finally on Friday night, one of the nurses called me around midnight to come to see her. She was blue and gasping for air. Her heart rate was down to about forty, so I figured the end was near. I called the resident on call to tell her what was happening, and she came down and checked Kara; she agreed with me that she was dying. We didn’t do anything; we just sat by and watched.
She finally stopped breathing at about twelve-thirty. We covered her with her blanket and just walked out of the room.
I called the mother. I had met her last Saturday night. I had been on call and she came in at about eight o’clock. She didn’t say much to me, only that she was pleased to meet me. It wasn’t much, but at least I knew who she was and she knew who I was.
I got her on the phone and told her that Kara had died. She didn’t cry at first. She seemed very composed. She asked if I thought Kara had felt any pain; I told her I didn’t think so, that she had seemed comfortable the whole time. She asked if I knew what the cause of death was, and I told her about the fever and the breathing problems and the fact that she had probably developed pneumonia. Then the mother said, “I guess she’s up with the angels now,” and that’s when she started to cry. I couldn’t think of anything to say; I just sat at the nurses’ station with the receiver up to my ear.
When she finally stopped crying, she apologized to me. She told me she’d been prepared for Kara’s death for months and that she didn’t think she would cry when the time finally came, but that she just couldn’t help it. She said, “They told me she was going to die and I came to accept it, but I never really believed it.” She started crying again at that point, but only for a minute or so. After we hung up, the rest of the evening was quiet; I didn’t get any admissions, and the ward was calm. I went to the on-call room but I couldn’t get to sleep. I kept thinking about Kara’s mother.
Tuesday, June 24, 1986
Tomorrow’s my last night on call as an intern. I’ve made it! It’s hard to believe, but I actually survived. Believe me, it’s not something I’d want to do again.
Looking back at the year, there have been a lot of things I’ve disliked; I didn’t like the way I was treated by the chief residents, I didn’t like the fact that I had to be on call every third night, I didn’t like being tired and exhausted all the time, and I didn’t like having to take care of sick, sick children. But definitely, the thing I disliked the most was being away from Sarah. I know I’ve said it before, but it’s still true: I’ve missed some of the most important moments of my daughter’s childhood.
I’ve asked myself a lot lately whether I’d have done this internship if I knew then what I know now. I’m not sure what the answer to that question is; over the past few weeks I’ve tended more toward, “Yes, I would do it.” But there are some days, when things are very stressful, when the answer is, “No way!” I guess it’s silly to ask the question, though. I mean, it doesn’t really matter. I’ve done my internship, I’m finished with it, and I never have to do it again. That’s all that’s really important.
Mark
JUNE 1986
Sunday, June 1, 1986, Noon
I just got back from my first night on call in the neonatal intensive-care unit at West Bronx, and I’m really starting to get the feeling that I’m not going to become a neonatologist when I grow up.
I got to the unit a little before eight yesterday morning. I got sign-out from Elizabeth, who was on the night before. I wouldn’t say she was exactly sad to be leaving. Then she left and I started running around, and I continued through the night. I ran to the labs, I ran to the DR, I ran to the babies who were trying to die. The only time I sat down during the entire twenty-four-hour stretch was when I had to write those endless, pointless progress notes that go on for pages. It’s a total waste, me writing notes. It’s definitely gotten to the point where I can’t even read my own handwriting anymore. Anyway, the whole day was horrible. Yesterday made my month in the nursery at Jonas Bronck seem almost pleasant!
Monday, June 2, 1986, 8:30 P.M.
I just got home. It’s eight-thirty and this is supposed to be my good night, and I just walked through the door. Oh, this is a nightmare. But do I care? No, I don’t care at all. Why don’t I care? Because I just stopped at the supermarket on the way home and found blueberries. When blueberries appear, the end of the year is nearly here. They can do whatever the hell they want to do to me, but I don’t give a damn anymore. Because I’ve made it. I’ve made it to the blueberry season.