What happened today with Winston and Salem is a perfect example of what’s going on. Salem developed some pimples on his chest this morning. I was pretty sure it was chicken pox and I had Susannah look at them and she confirmed it. And Winston’s had a cold for the past day or two, now he’s probably coming down with it also. Susannah and I got very worried. We both know that varicella [the virus that causes chicken pox] could kill them [varicella, usually the cause of mild illness, can cause an overwhelming infection in persons who are immunodeficient], but we didn’t know what to do. Neither of us wanted to ask Barry; we knew he wasn’t going to have anything helpful to say. So I went to Jon Golden right away and he said it probably won’t be a problem because both of them are getting gamma globulin treatments [a treatment modality that has had some success in children with AIDS] and that the gamma globulin had antibodies to varicella so they probably wouldn’t get an overwhelming case. Going over Barry’s head worked out okay this time, but what’s going to happen on those nights when there’s nobody else around except him?
At least I have Sarah and Larry to come home to, and that makes me feel much better. Even after a day like today, ten minutes after I saw my baby, I was back to my old self. You know, when I started this internship I was concerned because I didn’t know if I’d be able to be a good mother and a good intern. Now I don’t understand how you can be a good intern without also being a good mother. I’ll tell you, though, if I had to choose at this point whether I wanted to be a mother or a doctor, it wouldn’t be a hard decision to make.
Sunday, September 29, 1985
I don’t have much time. We’re waiting for some friends to come for dinner. What can I say? I made it through the month, but it took a lot out of me. I’ll never speak to Barry Bresnan again, that’s for sure, but I survived it. It’s now three months down, nine months to go. Eight if you count vacations. I’ll survive it, I’m sure of it. I’ve managed to make things at work relatively easy for myself, but trying to be a mother and a doctor is taking a lot out of me. So far I think I’m doing a reasonable job at both; I just hope I can keep it up.
Mark
SEPTEMBER 1985
Sunday, September 1, 1985
Ah, one day on call in the emergency room and suddenly I remembered exactly what it was that made me become a doctor in the first place. Yes, I’m sure the reason I became a doctor was so hundreds of mothers and fathers who don’t speak a word of English could curse at me in their native tongues while expecting me to cure their little darlings completely within minutes. What a rewarding experience yesterday was!
Actually, it wasn’t all that bad. It wasn’t too busy. I spent most of the afternoon taking care of a six-week-old who came in with fever and a cough. Everyone, even a lowly intern, knows that a six-week-old with fever is an automatic admission. But apparently that’s not something that’s taught to the interns at BEPI [internese for Bronx Episcopal Medical Center, a voluntary hospital in the South Bronx] because this kid had been seen there a day before, had been started on amox [amoxicillin, an antibiotic], and sent home. Sent home, for God’s sake! The mother brought him to Jonas Bronck only because his fever hadn’t gone away and she happened to be visiting a friend in Jonas Bronck’s neighborhood, so she decided to stop in and spend a few hours watching TV in our waiting room for a change. So not only did I have to do a whole sepsis workup [spinal tap, blood, and urine for cultures] on the kid, I also had to explain to the mother that the baby would have to be admitted. This must have sounded a little strange to her. After all, the kid was better than he had been the day before, and if he was so sick, why didn’t the doctor at BEPI say that he needed to be admitted?
What can you say in a situation like that? “Oh, the doctor at BEPI didn’t admit him because he was a malpractice major at Our Lady of the Offshore University of Medicine and Hair Design”? It’s hard to tell a woman that the last doctor to whom she trusted her kid was a moron who might have killed him! So I told her that some doctors are more conservative than others about these things and that keeping the child was mainly a safeguard. That’s the first time I ever used the word “conservative” as a euphemism for “competent.”
Anyway, the story doesn’t end there. That was really just the beginning. I finally convinced her that the kid needed everything, including a workup and admission. I went ahead and drew the blood and did the spinal tap. I also did my first bladder tap, which is a pretty nasty procedure [to do a bladder tap, a needle attached to a syringe is passed through the abdominal wall and plunged downward until urine appears in the syringe]. So I finished all that and I told the mother to go back out to the waiting room and hang out until someone from the ward came down to pick her up. Up until that point, everything was fine.