Of my eight patients, there’s only one who’s anything like a regular pediatric patient. It’s a three-week-old FIB [fever in baby; all infants under two months of age who are found to have a temperature of 100.6° or greater are admitted to the hospital, have blood work and a spinal tap, and are treated with antibiotics]. When she came in, I tried to do the workup but I had trouble getting the blood; I stuck her three times and I couldn’t get a drop. I know I’m not great at drawing blood so it didn’t bother me but then I called Diane Rogers [the senior resident assigned to the ward that month] and she tried five or six times and couldn’t get anything either. Diane got very angry, as if not getting the blood was a personal insult. Finally Dr. Windom, the baby’s private, came in and tried and he couldn’t get it either. We wound up just treating her as if she were septic [had an infection in her blood]. Windom told me to send off urine for viral cultures [a method of determining whether a viral infection is present]. What a waste of time and money! There’s nothing you can do if it’s viral, and besides, those cultures take at least two weeks. The baby will be completely better by the time we get the results back. But if that’s what he wants, then that’s what he’ll get. I had enough trouble last month with attendings. From now on I’m just going to do whatever anybody says and not protest at all.
I was on in the ER for the last time Sunday night and it was pretty quiet. Larry took Sarah with him to his team’s last softball game. They made it into the league’s semifinals but they got beaten and Larry’s depressed about it. I can’t get over how good he is with Sarah. But Sarah is a good baby. She really has developed a personality. And she’s growing like a moose! I took her to see Alan Cozza [the chief of pediatrics at Jonas Bronck Hospital; he also is Sarah’s pediatrician] yesterday for her three-month checkup; she weighed twelve pounds, two ounces. She’s gained over five pounds in three months. Alan said everything was fine. He told me we were doing a good job with her, that she seemed like a happy, contented kid. I think she is, too. I’m happy that my internship doesn’t seem to be doing her too much harm.
Monday, August 5, 1985
I could take a whole year of University Hospital. It’s almost like being on vacation. I’ve been on call twice so far and I got about six hours of sleep both nights. That’s more than I usually get at home. And things have been quiet enough for Larry and Sarah to come visit me while I’m working. They spent most of Saturday afternoon at the hospital and they even had dinner with me in the cafeteria. There are almost never emergency admissions at night, and on days I’m not on call, I’ve been getting out by three in the afternoon.
The other two interns have been having a pretty easy time, too, but they haven’t been leaving as early as I have. They stay until at least five. They don’t have more work than I do, they’ve just been hanging around, spending time teaching their medical students and basically just looking for things to do. When I’m on call, I tell them just to sign out and go home but they won’t do it. I think they feel guilty about leaving early, like it’s a sign that they’re goofing off. It’s not goofing off; it’s more like survival.
I’ll tell you, even if I didn’t have a baby to get home to, I wouldn’t want to stay at that hospital any longer than I have to. The place is so depressing! My patient Ricky, the six-year-old boy who got his mother’s kidney, stabilized last week and the renal team finally let me into his room. He’s a nice kid; he’s very small [the effect of his chronic renal failure], maybe the size of a three-year-old, but he’s smart and he’s got a good sense of humor. I talked with his mother who was discharged from the hospital on Thursday [she had been hospitalized for removal of her kidney]. She and her husband have been through hell since Ricky was born. Now, because of the transplant, they were hoping their lives might finally get back to normal again. But then over the weekend, Ricky’s BUN [blood urea nitrogen] and creatinine started to rise. [BUN and creatinine are measures of renal function. Elevations imply that the transplanted kidney may not be functioning well.] Renal decided today that he was in acute rejection; they had me order a renal ultrasound and started him on ATG [Antithymocyte globulin, a drug designed to prevent the immune system from making antibodies against the foreign kidney]. The renal attending told Ricky’s mother this afternoon and she started to cry and of course then Ricky started to cry. The whole thing really upset me, so I was glad I was finished with my work. I just packed up and came home.