Well, a week from tonight I’ll be on call for the last time on Adolescents. And a week from tomorrow, we’ll be on our way to Israel. I can’t wait.
Saturday, October 26, 1985
I can talk for only a minute. I’m very busy tonight, but I wanted to get this down on tape before I left on vacation. This is a terrible story.
Tuesday I admitted this seventeen-year-old named Wayne who’d had leukemia in the past but had been in remission for years. He came to the hospital because of shortness of breath, and as soon as he hit the floor, it was pretty clear that his leukemia had recurred. His shortness of breath was due to his enormous spleen. His white count [while blood cell count in the peripheral circulation] was over a hundred thousand [normal is between five thousand and ten thousand], and he was anemic and thrombocytopenic [thrombocytopenia: low platelet count; platelets are factors that aid in clotting of blood]. The hematologists jumped on him right away. They gave him all sorts of poisons to bring his white count down. He was sick, but he was in pretty good spirits, considering what was happening.
Then yesterday morning, we were on work rounds and Wayne’s mother came to tell me he was acting funny. I didn’t think much of it, but I went to check him anyway. He was acting really strangely. He was shifting around in bed making gurgling sounds; he didn’t respond to questions; it was like he was in a coma, but his eyes were open and he was moving around. I got him to respond to pain, but he didn’t respond to anything else. I called for help, and everybody came running. The resident noticed that his right pupil was fixed and dilated [a sign of an acute and serious change in neurologic function]. Then he arrested.
We all worked on him for about an hour. We were never able to get anything back. Everybody was in there: Alex George [the director of the intensive-care unit], the chief residents, everybody.
That was my first death. All I kept thinking about through the whole thing was Sarah. A patient’s death always bothers you, but when you’ve got a baby, it means a lot more. I went home after work and just hugged her and hugged her. She’ll never understand it. I don’t think I’ll ever forget it.
We’re in the middle of packing. I’ve got to get everything done tonight because I’m on call tomorrow and there’s no other time to do it. I explained the situation to the chief residents and they told me they were sorry but there was no way they could force anybody to switch with me against their will. They at least said that if everything was under control, I could sign out to the senior who was covering at 7:00 A.M. and leave. I’ll still never have enough time to get home. So it looks like I’m going to be going on a twelve-hour plane trip after being on call. If it’s a busy night, I may not even get a chance to change my clothes or take a shower. I’m really pissed off.
The fact that nobody’d switch with me when I really needed it has made me incredibly angry. It may be a little thing, but I’ll tell you, I’m never going to help anybody around here. Except for Susannah, maybe.
Mark
OCTOBER 1985
Friday, October 4, 1985
They’re trying to kill me. I know they’re trying to kill me. I’m just surprised I’ve survived this long. I’ve been at Jonas Bronck since Monday, and so far everyone’s tried to kill me, the chief residents, the nurses, the elevator operators, the lab technicians, and especially the patients, but no one’s managed to finish me off yet. They’re all trying, so I know it’s only a matter of time.
See what a vacation will do for you? It clears your head, makes you see things in a new light.
Actually, my vacation wasn’t exactly what I’d call wonderful. No, wonderful is definitely not the word I’d use. How would I describe it? What word would I use? Lousy; lousy is definitely a word I’d use, lousy bordering on shitty.
It started off with my brother and me in my car driving south as fast as we could to escape from the Bronx. We didn’t have any real end point in mind; I was just trying to reach a place where cockroaches don’t exist. Actually, that’s not true. We were heading for Cincinnati. We both have friends there, and we decided to go visit them. Yes, there’s nothing more romantic than spending a week with your younger brother visiting friends in Cincinnati in late September. The whole experience almost made the Bronx seem nice.
Okay, so it wasn’t romantic, but Carole and I sure made up for that in the second week of my vacation. We went to the romance capital of the East, Pocono Castle, a resort hotel catering to the honeymoon crowd. What a place! I knew we had made a big mistake when the first thing the bellboy showed us was the heart-shaped bathtub in our room. Carole said she liked it; I thought I showed great restraint by keeping myself from puking right there on the spot. But that wasn’t the worst of it. We went down to the dining room for dinner that first night and discovered that everybody there, every last couple, was there on their honeymoon. It was Carole and me and four hundred newlyweds! The place was disgusting; the food was horrible, the decorating job was ostentatious, the rooms were dirty, and it rained all week. All for two hundred bucks a day! Just the kind of relaxing environment I needed.