I sat through all this in kind of a daze because I was so tired. I’ve got to try to get more rest. Well . . . maybe next year.
Tuesday, December 31, 1985, 11:30 P.M.
I know it seems pretty strange, but here it is, eleven-thirty on New Year’s Eve, and I’m lying in bed, talking into this stupid machine. I’m too tired to go out, so I’m here all alone. Carole went to a party by herself. I was supposed to go with her, but I called her a couple of hours ago and told her I was just too tired to make it. I’m pretty pathetic!
I had a long night last night. It took forever to finish my work today, and just as I was about to leave, a nurse came running out of a room yelling, “Hurry up, she’s not breathing right!” So I calmly got my stethoscope and walked into Cassandra’s room, and there she was, sure enough, breathing at a rate of eighty to ninety. Now even I know that eight-year-old girls aren’t supposed to breathe at a rate of eighty to ninety. I wasn’t sure what was happening. She’s got osteogenic sarcoma [a malignant tumor of the bone] and she isn’t expected to live very much longer, but I at least expected her to make it into 1986. When I came in and found her breathing that fast, I figured maybe she was having a pulmonary embolus [a clot in one of the lung’s major arteries]. But she had equal breath sounds. We did a whole workup and didn’t find anything. She’s not my patient, but we’ve all gotten to know her. I just called and found out that she’s still alive and she seems to be reasonably comfortable, which is reassuring.
I don’t know about these terminal patients; it’s really draining taking care of them. You don’t even want to go near the room because you know there isn’t anything you can do to help, and whenever you do go in the room, it’s to do something terrible, like draw blood. It’s very frustrating. The only thing we can do is try to make the last few months as comfortable as possible for her. If we can do that effectively, then we’ve really done our job. Dealing with these kinds of issues is really the hard part of this year.
There, now I’ve really cheered myself up! I’ll tell you, I’m not sorry to be seeing 1985 end. In 1986 I’ll be an intern for only half the year. That’s not so bad. I’m going to sleep. Good night. And Happy New Year, tape recorder! Now, that’s really pathetic!
Tuesday, January 7, 1986, 9:00 P.M.
This has been an interesting couple of days here. On Friday morning I had to get some blood from a patient before attending rounds started. I was late, and I was worried that Alan was going to yell at me. He still scares me to death. I was postcall and really crazed and I guess I hadn’t eaten in maybe sixteen hours. So I went into the patient’s room and started drawing the blood, and pretty soon I started realizing that I was feeling kind of light-headed. Really light-headed! So light-headed, in fact, that I grabbed on to the patient’s mother, who was helping me hold the kid down. She, of course, thought I was coming on to her, but I reassured her that I wasn’t trying to do anything nasty, I was merely trying to prevent myself from collapsing in a heap on the floor. I told her I’d be fine just as soon as I finished drawing the blood. I’m sure that reaffirmed her faith in me as her child’s physician!
Anyway, I drew the blood, got it into the tube (which I consider quite a save, considering how hard a stick this kid was), and then I started to kind of sort of lie there on the floor feeling very dizzy. Everyone came running; I thought they were going to call a code and start full-scale resuscitation on me. But they didn’t; I guess they realized that I hadn’t arrested, I had just fallen over, so they got me into a wheelchair, and the nurses checked my blood pressure, which was normal, and then they put me in the house staff room, where I collapsed on the couch. I felt dizzy every time I tried to lift my head. This was, needless to say, somewhat anxiety-provoking.
I stayed in there for a few minutes and then I tried to get up so I could get to attending rounds. I got myself in a sitting position and started to cave in again when Alan Morris showed up. I said to him, “You know, I’m really not feeling too well.” And he looked at me with a very serious face and asked what was wrong. I said, “Well, I’ve been dizzy for the past fifteen minutes.” Then he said (in a formal-sounding voice), “I suggest you continue to rest; if this persists for a few more minutes, I recommend that you be brought down to the emergency room for evaluation.” All in his usual righteous tone of voice.
Well, he went out and came back a minute later with the wheelchair and said (in the same formal-sounding voice), “You know what? On second thought, it’s been long enough. If you had been out in the street somewhere or in any place other than a hospital, you would have already been brought here by ambulance. I think we’ll take you down to the ER,” which he did. By the time I got down there, I was completely white and really uncomfortable. They slapped me down on one of the stretchers, they stuck an IV in me (at least I didn’t have to do that one myself), they drew blood; I got examined by one of the ER attendings, I got examined by one of the residents in neurology, and God help any of us if we really have a neurological problem and we have to be taken care of by a member of the neurology house staff, because this guy turned out to be pretty hopeless.