The Intern Blues(50)

It turns out that Harrison Boyd, the other intern on our team this month, is completely insane. He’s got a very funny, terrible sense of humor. Very bad jokes, the worst! And Laura Santon, who is always happy, actually looked depressed today for the first time. Maybe she was just spacing out, but she looked kind of upset. I was surprised.

Had pizza for the hundred and fifty thousandth time for dinner tonight. Seems that’s all I ever eat around here, pizza. Missed the shuttle [the bus that travels between Mount Scopus, Jonas Bronck, and University Hospital], had to take a cab home, and got a free, unguided tour of the Bronx, because they always take some strange route. Very interesting, the Bronx at night. Very exciting. I could have done without it.

Sunday, October 13, 1985, Morning

I’ve had so many nights of sleep in a row, I practically don’t know what to do with myself. Yesirree, I was on call Friday night and I got seven and a half hours of uninterrupted sleep, breaking all records heretofore known for all interns in this program. It sure is a record for me. And it was good timing because my parents are here this weekend, they came down on Saturday. So it was great.

I just came back from medical records at Mount Scopus. I had a lot of charts to complete and I had to go over today because they were threatening to withhold my paycheck if I didn’t finish them. It’s impossible to get over to the record room during the week when you’re on the other campus. It’s so weird: I went back to these charts, two of them for babies who died. One was on a baby that was born premature in the bed. When the baby had been born, I was the first one to get to the labor room, and I didn’t know what to do. Here’s this little chart and I’m supposed to fill out the discharge summary. There was the autopsy report; it said the baby weighed 460 grams and had atelectasis [collapsed alveoli, the air sacs in the lungs], visceral congestion [accumulation of blood in the circulation going to the internal organs], PDA [patent ductus arteriousus, a persistence of the opening of the structure that, in fetal life, shunts blood from the underdeveloped lungs to the rest of the body], and patent foramen ovale [a communication between the left and right atria of the heart that allows oxygenated and deoxygenated blood to mix]; no big deal. It was just a really preemie baby. Four hundred sixty grams, it might just have been SGA [small for gestational age]. At any rate, I still feel kind of sad about it. Maybe we could have done something, we could have resuscitated it. Months later and I’m still wondering. Well, anyway, it’s sad. The chart was wafer thin. There wasn’t much to it; a baby who was born and then died. All it had was a heartbeat; it never had an Apgar of more than one. [Apgar: a scoring system used in the immediate newborn period designed to measure neonatal well-being. The baby is evaluated in five categories: heart rate, respiratory rate, color, muscle tone, and response to stimuli. Zero, one, or two points are awarded in each category, and the maximum score is ten. Babies are evaluated at one and five minutes after birth. Apgar scores above seven are considered normal. Less than five are definitely abnormal.] It’s very sad. The mother was a thirty-one-year-old woman, she has three living children, maybe she was happy this happened. Maybe eight months from now I’ll get named in a lawsuit. Who knows?

You can’t focus on the negative all the time, you know? That’s what I’m trying to do now, that’s my new approach. I still haven’t found a way to focus on the positive. In fact, I’m still finding it hard to decide what is positive. I guess it’s positive when things turn out well, and when you have a good relationship with a family. That’s good. That’s the most positive thing I can think of right now.

It’s pretty nice having my parents here this weekend. My father rented this total junker of a car. It sounded like the wheels were about to fall off at any moment. It’s tiny, you can park it anywhere. I took them down to Soho yesterday; that was fun, they had a good time. Then we went to the Upper East Side and had dinner at this really nice Italian restaurant; nothing fancy, just very nice.

Then I went to sleep and Karen called at some point, I don’t know, I was half asleep, I don’t remember anything she said. I’ve had so many conversations with Karen over the phone where I don’t remember anything, or I remember hardly anything. It’s disgusting, it’s totally disgusting.

I found myself reassuring my parents last night that this neighborhood was really okay. Isn’t that funny? Because just a few months ago I was telling them how much I hated it. I don’t like it, really, but I don’t feel threatened so much anymore. I don’t think it’s a really bad neighborhood; it’s not beautiful, but . . .