Anyway, he seems to be doing okay now. I kept standing around his bed all night waiting for him to crump but he never did. He hasn’t had any diarrhea since early this morning but we’re still keeping him NPO. I started an IV last night. What thrilling memories that brought back! I’ll tell you one thing: He may be a little bigger and two months older, but he still has shit for veins! I stuck him about a dozen times to get the line to stay in place. It felt so comfortable. Just me and him and a box of twenty-two-gauge plastic IV catheters.
While I had Jennifer on the phone, she told me what finally happened with Fenton, the kid on Infants’ whose grandmother was crazy and was getting him admitted to all the hospitals in the area for GE reflux that he didn’t really have. BCW took the grandmother to court, and Jennifer had to testify, since she was the discharging intern. The judge decided the grandmother needed psychiatric evaluation and ordered that the kid be placed into foster care until that was completed. So there’s another happy ending.
Anyway, there’s not much else going on right now. I’m going to sleep so I can be bright-eyed and bushy-tailed for call tomorrow.
Wednesday, October 23, 1985
Nothing much has been going on. The ward’s been pretty quiet, thank God, and I’ve been getting sleep most nights when I’ve been on. The most notable thing that’s been happening is that Carole and I have been talking a lot more about the future, which is starting to scare me to death. She wants to get married. I’m not so sure I do. I have to admit, she’s been very good to me since I started this insanity. She’s always been there when I’ve needed her, but marriage, that’s a really big step.
I’ll have to do a lot of thinking about this. Just as soon as I have enough time.
Bob
OCTOBER 1985
In October of my internship, my wife developed severe abdominal pains. She went to a physician who did an upper GI series and diagnosed a gastric ulcer. The doctor started her on Cimetidine, a drug that decreases the amount of acid produced by the stomach, gave her advice regarding her diet, and told her to take it easy. With time, the symptoms disappeared.
I was pretty surprised when Beth told me about her ulcer. After all, I was the one with the stressful life-style; I was the one who wasn’t getting enough sleep, who was taking care of critically ill patients and trying to cope with their families. All she was doing was working in her laboratory, the same as she had done for the previous three years.
Looking back on it now, it’s clear that Beth’s life at that time had become as stressful as mine. First, because I was in Boston and she was in New York, she had become a regular weekend passenger on the Eastern shuttle. Beth was terrified of flying, and these weekly excursions were rapidly taking their toll on her mental health. Second, upon finally reaching Boston after each of these hair-raising flights, she was finding that I, once a sensitive and loving human being, had been turned into a melancholy, self-centered wretch. She seriously questioned, at least to herself, whether this “new” me was a permanent change or whether it was just a temporary interruption in our relationship. And finally, she was worried about her work; it wasn’t going as well as it should. She was expending so much energy worrying about me and our relationship that she just couldn’t concentrate on what was happening in the lab. At the time, I didn’t understand any of this. That’s because I, like most interns, couldn’t see past my own problems.
It’s not surprising that Beth’s ulcer first appeared in October. It’s during October that internship begins to take its toll on everyone. To the intern, it’s the start of the winter doldrums: The thrill of being a doctor is gone (that usually occurs back in July), the “newness” of the on-call routine has worn thin, and exhaustion has begun to set in; in addition, the intern realizes there’s no end in sight.
October also is usually the time when interns lose all contact with friends and relatives. I clearly remember the routine that became established at about this time in my own life. I’d come home after shopping to pick up a pizza, take off all my clothes, climb into bed, and watch reruns of The Odd Couple and The Brady Bunch while wolfing down dinner. Then, by about eight-thirty or nine, I’d turn out the lights and quickly fall asleep. Unless forced, I would not leave my house; I didn’t go out to movies or to dinner with friends or even to the supermarket to buy food. I didn’t have the strength, and I didn’t have the interest. I just wanted to be left alone.
Andy Baron is taking to internship just like I did. When I visited him on the ward at University Hospital early in the month, he said he couldn’t talk to me. Figuring he meant he was too busy to take a break, I suggested we go out for dinner, and he said, “No, you don’t understand. I can’t talk to you, and I don’t know if I’ll ever be able to talk to you again. If I think about what’s happening to me, I’ll start to cry, and once I start crying, I don’t think I’ll be able to stop.”