Finished!

Ah, now I can relax. I have finally sent my residency applications out.

The whole process felt like applying for medical school, but I was probably less drunk this time. I’ve discovered that it takes about three beers to say to myself: “Why NOT spend four years in Duluth?” As a result, I’ve applied to waaay too many programs.

Either way, it’s a relief to have it out of my hands. Whatever happens, happens. The only thing I need to do now is chase down a handful of people to finish writing my recommendations.

To be honest, I’m still kind of shocked that they let me into medical school.

Welcome to 666

Good news! As of July I am officially a fourth year medical student. Mostly this means I feel like slightly less of a dipshit. I learned a great lesson over third year, which I think is best expressed by Douglas Adams:

“There is a theory which states that if anybody ever discovers exactly what the Universe is for and why it is here, it will instantly disappear and be replaced by something even more bizarre and inexplicable.”

That also happens to be a great description of how medical school works. Now that I’m in my fourth and final year, I’m finally on to it. These days, I expect to be a moron.

I decided to kick off my fourth year with the sickest of the still-living in the medical intensive care unit. The unit happens to be on the 6^th floor of the hospital. On my first day I walked over to the row of charts and immediately noted that most of them were numbered starting 666. Heh.

I pulled a random chart and started reading. A little panic swept over me as I mentally ticked off the problems. The guy in 4 (666-4, that is) had been in the hospital for two months already, on a slow, and painful decline. He had AIDS, CMV colitis, MRSA meningitis, etc, etc. Staph-scalded-skin-syndrome for chrissake. The only unafflicted organs were his eyes, which tracked me around the room as I attempted to sort out his lines. “Hey…I don’t know if you can understand me...my name is Simone.” We’d put tubes in his body wherever we could find a spot. He couldn’t speak for himself, but his wife decided he’d be a Full Code. Apparently she was living with her boyfriend hours away from here, and had not come to see him. I don’t think she fully grasped the situation, but the law is the law. After a couple of days pumping drugs and fluids in him, his eyes stopped following me. The wife finally decided to withdraw care, but could we keep him alive until she came for a visit? We tried, but when I came in the next morning his room was empty. I asked if the wife had come. She never made it.

It’s been over two weeks now, and my panic has subsided. It’s been replaced with a feeling I don’t have words to describe. Maybe it’s just numb? Yesterday I coolly helped rid the unit of a body. First the nurses and I zipped it into a white body bag. Then we launched it onto a a large metal cart, one-two-THREE! Over the body went a rectangular box made out of white canvas. The whole ensemble resembled a large buffet, like what you might see at a wedding. As he got wheeled out of the room I wondered how many people would think that crab cakes were under there.

After that I sat down next to my intern, who happens to be mega cool. “Man, this kind of blows.” I announced.

“Yeah…how many people have died since we got here?” He began counting off on his fingers… “Let’s see…the guy in 4, the guy in 8..oh another went to comfort care. Oh, and the nines.”

So far, everyone that had gone into room 9 has died. But not before they spent a couple of days breathing on The Oscillator, which is basically a last-resort ventilator. It makes a machiney-death-rattle so loud you can hear it across the floor. It makes the patient shudder with each mechanical mini-breath. It makes me shudder when I hear it, but I can’t block it out.

Not that there aren’t any bright spots in the rotation. First of all, my friend Andy is working the ICU with me. Andy’s cool. He’s confident. He knows shit, a lot more shit than I do, which is actually kind of annoying to my puny ego. We have fun torturing the third year medical students (until they figure out that we actually have no power over them). It’s mean, but we have lots of pent-up rage from when we were picked on as third years.

This is a side note, but it just so happens that my ‘extra-small’ scrubs are humongous on me. I don’t get it, because yes I am kind of small but I’m not that small. Still, there is enough fabric in the ass of my scrub pants to fit a couple of basketballs under my butt. If I really really wanted to, I could pull the top of my pants up over my boobs and tie them close to my neck. That way I wouldn’t have to wear a shirt. Anyway, the enormity of my pants didn't escape Andy. “Hey MC Hammer!” There was no way I could argue with him. So I did the Hammer-dance. If I remember it correctly, it means pointing your toes outward and quickly scampering side to side, making your pants billow in the wind like sails. I have no idea what I look like while I do this, but the appalled look on Andy’s face probably meant I succeeded. I was just about to collapse into a fit of giggles when it hit me: Whoa! I’m in ICU! Suddenly I had to stop. It was as if I’d just Hammertimed right into the Grim Reaper’s icy breath. My giggles froze in my throat and I stood at solemn attention for the rest of rounds.

Sometimes people live. When that happens it’s fucking awesome. They come in like vegetables, and leave awake and talking like real people. I met a young woman with cystic fibrosis while she was sedated and on a ventilator. Something about her made me think about Sleeping Beauty. Each day I carefully listened to her lungs, praying for a change. I met her worried family one by one, as they each took turns at the bedside. When we were finally able to get the breathing tube out of her, I was ecstatic. When she could speak, I introduced myself jubilantly.

“Hi, I’m Simone!”
She glared at me. “I haaaaaate it heeeeere!”

Not that I blame her. Over the next hour or so she complained about the bed, the nurses, the ceiling, the air, her mom. But I just smiled. The bitchstorm was like Bach in my ears, a glorious sign of life. To celebrate I did a little victory booty-dance behind the nurses’ station. Take that, Grim Reaper …Well, for now anyway.

Poop

I’m 5 weeks in surgery rotation. It’s been amazing. I wake up some time around 4 am. Hit snooze, repeat. I stumble into the hospital and run up the stairs to the 8th floor. Then I race to the staff lounge in search of coffee. (I don’t know who it is, but some angel makes fresh coffee just before I get there at 5am. Whoever you are, I love you.) But just before I make it to the coffee maker my nostrils fill with the now all-too-familiar smell of shit. Not any old shit, but hospital shit.

Hospital poop is extra special because it is bursting with especially malevolent multi-drug resistant bugs. Superpoop, I think, and stick my nose in my coffee cup.

“Miss Jenkins, did you fart today?” I begin my pre-rounds on a 70-year old lady who had some pretty invasive abdominal surgery.

Miss Jenkins rolls her elderly eyes at me. “What? YOUNG LADY what in God’s name are you doing up at this hour?”

“Did you fart.” I don’t have the energy to explain. Might as well get to the point.

We stare at each other, determinedly. I will know about her bowel function. Then I will make my report to my intern at 6 am. Who’s going to report to the chief resident. Who will tell the attending. Who was going to ask her anyway. But in some insane world, knowing if Miss Jenkins farts before anyone else knows makes me a good medical student. I might even get a recommendation for Honors.

“Doc, have you lost your mind?” She peers at me.

I love Miss Jenkins. While she’s the one who just had some internal organs surgically removed, it’s my state of mind she’s worried about. She might have a point. I've been chronically exhausted. It's so bad I've been thinking about sleeping with all my patients. Literally. I think about crawling under the covers with them, the only place I might be able to hide from the rest of the surgery team and actually get some sleep.

“How ‘bout poop?” I scream, partly because she’s hard of hearing. Mostly because I'm trying to drown out my inner voice, which is mocking me. Either way, it doesn't help my case.

Yes she pooped and farted for chrissake. Good, I say, and I change the dressing on her wound, knowing that with every pee, poop, and fart she is that much closer to getting out of this stinky, super-bug infested place, the center of my world. I’m not very eloquent at 5am, so I don’t explain this very well. But it matters tremendously.

I used to imagine that the rest of our organs pretty much existed for the sake of the reproductive ones. To breed human life! Now I’m pretty sure that reproductive organs exist so we will never run out of poop factories.

Basically it required two and half years of medical school to truly appreciate crapping. I won’t bore you with all the details, but bottom line is: Want to know how well your body is working? Want to see the end result of a complex yet perfectly orchestrated effort between brainesophagusstomachpancreasgallbladdersmallnlargebowelsbloodmuscle, etc?

Just look in the toilet. And there it is, the final movement to a perfect symphony. What once was breakfast is now a poop. Maybe it’s obvious, but I bet you’ve never really thought about it: no matter what you put in, poop always comes out. Even computers can't do that. So next time, before you flush – take a moment. Congratulate your body on what it has created. Well done! Now you’re at least partly ready to attempt breeding.