In the dining room, they put us at a table with another couple. These two were great: They had just been remarried for the second time. They were reformed drug addicts. We spent every meal chatting about AIDS!
And then we got back to the Bronx last Sunday night. I started on the ward at Jonas Bronck Monday morning and it’s been hell, absolute hell! On Monday we started work rounds at eight o’clock and didn’t finish until three in the afternoon. Seven solid hours of rounds! I’m sure all our names are going to be listed in the Guinness Book of World Records under the category of “World’s Longest Work Rounds.” Every time we’d try to leave one patient and move on to the next, some disaster would occur and we’d have to stop and sort things out and then try to start again. I picked up five patients: a pair of twins with AIDS who, if you can believe it, are actually named “Winston” and “Salem” (as a result of taking care of them, I’ve decided to name my first two kids “Chesterfield” and “Lucky Strike”); a brain-dead kid who inhaled a little too much carbon monoxide when her apartment caught on fire; and the “specialties of the house,” a couple of asthmatics. That wouldn’t have been so bad, five new patients, but you’ve got to remember, this was my first day on the inpatient service at Jonas Bronck, and I never got a chance to get myself oriented. I didn’t know where the labs were, I didn’t know how to get results of anything, it took me a day and a half just to figure out where the damn bathroom was! I had to hold it in for thirty-six hours, which, if you’ve never done it, is not the most comfortable thing in the world. It got so bad, I started to feel like a water balloon. And to make matters worse, the intern who had been on the ward before me hadn’t written off-service notes on any of the patients. How considerate! So even if I had had a chance to read the charts, which I hadn’t, I still wouldn’t have been able to figure out what was going on with my patients.
Then I was on call that first night. I picked up five additional patients and I didn’t get any sleep. And the way the schedule worked out, I was on Monday and again on Wednesday and I was postcall on Tuesday and Thursday, so my brain’s been in hyperspace for an entire week. I wasn’t sure I could find my way back home today, let alone try to figure out what was going on with my patients.
I’ve been completely helpless. Mike Miller is my attending this month, and he and the senior resident have asked me a lot of questions on rounds and I haven’t even been close on any of them. I feel like a real idiot, which I probably am. And since Miller’s a friend of my family’s, I’ve felt even worse about it. I mean, I’m sure I’ve gone a long way to convince him I got into medical school on the one scholarship given every year to the most deserving mentally retarded individual in the United States. I’ve also had this fantasy that he’s been calling my mother at home every night and telling her what a moron I turned out to be.
But hey, it hasn’t all been my fault. I’ve gotten some really sick patients over the past few days, and working in Jonas Bronck isn’t exactly my idea of living in paradise! What a place! The elevators don’t work; people have died waiting for them, and those weren’t patients, those were interns! The people who work in the labs have a combined IQ of about 3. If you’re nice to them, they’ll screw you; if you’re not nice to them, they’ll screw you. I’m convinced they sit around up there trying to come up with the most difficult ways to give out results. If you call them on the phone they’ll put you on hold for ten minutes and then hang up on you. If you call back and say you were cut off, they’ll yell at you and say it’s not their job to give results over the phone. I walked into the bacteriology lab Wednesday night at ten o’clock and a woman pushed me out of the door and said they were closed. They were closed! What does that mean? You’re allowed to diagnose infectious diseases between the hours of nine and five only?
And the food stinks! That hellhole downstairs is the worst excuse for a coffee shop I’ve ever seen! I was wondering how they could get away charging only a dollar and a half for a turkey sandwich, so I tried one and I figured it out: They don’t put any turkey on the bread; they don’t sell turkey sandwiches, they sell mock-turkey sandwiches, for God’s sake! And the place keeps the same hours as the bacteriology lab, which is pretty telling. So when you’re up all night, when you really get hungry, you can’t even get a mock-turkey sandwich.
And how can Miller and all those other guys who run this department and who say they’re really concerned about our well-being not provide us with a shower? If I don’t get to take a shower after a night on call, I’m worthless. I feel like shit! Just working in this hospital, you wind up covered with about an inch and a half of municipal hospital crud, and if you don’t get a chance to wash that off, you just can’t work effectively.