And finally, after all these emotions and worries, it started. I was on call on Saturday in the Mount Scopus emergency room. Once the day began, it really wasn’t so bad. There was just a resident and me. My first case was a little eight-month-old with a really bad case of cervical adenitis [swelling of the lymph nodes in the neck due to infection], and I thought, wow, here I am, a real doctor, with real pathology. I wound up having to admit the kid for IV antibiotics.
I did pretty good during the day, I was really enjoying it. I wasn’t scared, I wasn’t freaked out and I don’t think I made any really horrible mistakes. I went at my own pace, which was about half the speed of the second-year residents but I felt good about it. I did an LP [a lumbar puncture, commonly called a spinal tap, a test in which a needle is inserted through the back and into the spinal canal, so that a sample of spinal fluid can be obtained for analysis] on an 18-month on whom we had a suspicion of meningitis, and it went perfectly. I got the spinal fluid and I started an IV without any problem at all. I did a CSF cell count [counting the number of white and red blood cells in the spinal fluid specimen in order to diagnose meningitis], and I learned a bunch of good bench lab stuff that I never knew how to do before. Hell, it was a good day and we even got a chance to eat dinner. I got out of there at 12:30 A.M., which isn’t bad. I have to say my first night on call was a positive experience, which gave me a good feeling about coming to this program in the first place.
Sunday, July 7, 1985
Karen went back to Boston today. Even though she’ll be back in three weeks to visit for a weekend, I know things are not going to be the same as they were for at least this whole year. I took her to the airport, she went through the gate, and I stood there waving and she waved back until all I could see was her arm. Then that disappeared and she was finally gone.
I got back from the airport and putzed around the apartment for a while, feeling aimless. I dropped off Ellen O’Hara’s [one of the other interns] car keys—she had loaned me her car for the weekend—and Ellen and I talked for a while. She was a little spacey; she’d been on in the NICU [neonatal intensive-care unit] last night and didn’t get any sleep. Then I went out shopping.
I was in the vegetable store and I had this really funny feeling, like I couldn’t think clearly for a minute. I couldn’t figure out what was wrong at first, but then I realized that I was shopping for myself. I started feeling really bad because I’d be the only person in the apartment eating this stuff. When I got back from the store, I called Karen right away. She was home already. I told her how much I missed her and how lonely I felt. She told me she felt the same way. We talked for a while and when we got off the phone, I felt real down, real down, and I didn’t know what to do. I just walked around the apartment, feeling very empty. I felt like I wanted to cry, so I sat down at my desk but the tears wouldn’t come. I had to talk to someone; the only person I knew was Ellen, so I called her and told her I’d like to come and talk for a while and she said sure. I went up to her apartment, she opened the door and asked what was wrong, and I told her I was feeling real low. We sat down on her couch and I started crying. I kind of fell onto her shoulder and cried for ten, fifteen minutes, really crying, soaking her blouse. She held me and I held on to her. I felt a lot better after that. We talked about getting together for dinner, and so I went back down to the store to get more food.
That was amazing! That kind of thing, crying on a total stranger’s shoulder, is not something I’ve ever done before. I was feeling bad, really bad, and she was the only person I even knew here. All I can say is, I’m glad there are people like Ellen in this program.
But all is not lost. When I went out for food the second time, I found a store that sold Häagen-Dazs ice cream! Häagen-Dazs in the Bronx! Amazing! [Häagen-Dazs ice cream has always been manufactured in the South Bronx.] There’s hope for this place after all!
Work is good. I’ve finished my first week as an intern, and it’s shown me that I actually like being a doctor. I enjoy the people I’m working with, I like the kids . . . I’m rediscovering some of the things that made me go into pediatrics in the first place. This week, working in the ER [emergency room] and the clinics, I saw more kids than I had seen during the entire six-week rotation I spent in pediatrics in medical school. I love the kids, but I can see that the adolescents can drive you nuts!
There are a lot of things I don’t understand about adolescents. Do you examine them with their parents in the room? Do you throw the parents out, and if so, when do you throw them out? And there are all these hidden agendas going on between the parents and the kids. The other day, I saw a fifteen-year-old girl with a vaginal discharge. Her mother insisted on staying in the room the whole time. I felt pretty uncomfortable asking the girl whether she was sexually active or not with her mother standing right there next to her, but the woman just wouldn’t leave. So I wound up doing a pelvic exam and getting all the cultures and stuff without even knowing what I was looking for. I guess when I get some of these issues sorted out, I’ll feel better about them, but as of now, give me those toddlers and little kids anytime!