Hi, Jeremy here, the DAK amputee physician. It’s been a long time since I’ve written an update on my life, mostly due to the fact that my life has been fairly uneventful and a little depressing lately. As I wrote last time, I took some time off from my residency to try to learn to use prosthetics again. It didn’t work out like I had hoped and at the end of the grueling physical therapy, I wound up still relying entirely on my wheelchair to get around. It was a really big disappointment.
In this kind of situation, it is hard not to get really down on yourself. I’ve been through a lot in the last six years or so and maybe I’m a better person for it, but I’m the first to admit I get down on myself easily. I had been hoping to get walking again and when it didn’t happen, it was very hard on me. I can confess now that I spent a lot of time crying and isolating myself from other people.
I had a lot of regrets when I first moved back in with my parents because of money limitations, but now I realize this is the one thing that kept me sane last year. If I didn’t have my family near me, I don’t know what would have happened to me. When I closed myself off in my room and lay in bed all day, just eating take-out Chinese or something for dinner every night, this was a bad spiral I could have stayed in for a long time to come. I was taking some anti-depressants that a friend prescribed for me, but it didn’t seem like they were working too well.
It was around February when my mom came into my room one morning, got my clothes out of the drawers, and literally forced me to get dressed. On my part, I acted about five years old and resisted her every step of the way. When I first lost my legs, my mom helped me get dressed in the morning sometimes and I noticed she kind of avoided looking at my stumps too much. After all these years, she was still a little nervous-looking when she was near my stumps—I know they still bother her a little. But she grabbed them anyway, right on the bare skin, and forced them into the pants legs. She wouldn’t leave me alone until I had my clothes on and I was in my wheelchair.
She also got rid of all the alcohol from the house, which I’m a little embarrassed to say was probably necessary. I’m not saying I ever had a problem with alcohol, but sometimes it makes me feel a little better to drink when I’m upset, which is not a good habit to get into. Also I have an uncle who’s an alcoholic (no drunk Irish jokes, please), so there’s the family history.
So my mom made a big effort to make sure I was getting up every day and eating right and not just wallowing in self-pity all the time. On my own part, I took some steps to take better care of myself, especially my stumps. Like when I was doing my internship, there was no time for “stump care”. People think you can just ignore your stumps, but you can’t. I don’t have great-looking stumps to begin with and I made matters worse by not taking care of them. I let them get dried out and out of shape, which is why they got infected multiple times.
Now I’ve been keeping with a regimen to get my stumps looking better. Like when I first come out of the shower at night, I spread Eucerin cream all over the scars, and then cover the stumps with protective stockings. I also do some exercises before I go to sleep to keep the muscles from fading completely. Now I think my stumps look a lot better than they did before.
One thing about being an intern and constantly moving around is that you don’t know what to do with yourself when you finally have a break. I did eventually find some stuff to fill the days. I started spending more time with my sister and brother-in-law, plus their nieces and nephews. My nephew is really into science, so I took him to the science museum a bunch of times and it was a lot of fun. I think kids are great and I had expected to have at least one or two by my age, but I’m lucky I at least have nieces and nephews to play with.
I also tried to do some medical reading, to keep up my knowledge for when I went back. Another thing I did was buy some weights and start working out my upper body. I knew this wasn’t something I’d be able to stick with long term, but it was a good change. Since my arms are a lot stronger than they used to be before I used a wheelchair, it was fun seeing how much more weight I could lift.
One thing I didn’t work on was dating. My last girlfriend was a medical student named Claudia that I met on my ICU rotation. I know that I’m primarily at fault for screwing up the relationship, because she was really nice and I know she liked me. After she got back from some away rotations in England, we hung out a little bit, but she was dating someone else and we decided it was better to just be friends. I still don’t have a lot of confidence when it comes to approaching women and I know it’s something I need to work on. For the time being, it was easier to just avoid thinking about women for a little while.
By April, I was feeling like I was pretty much ready to go back to work. I thought it was going to be a big problem to get the residency program to take me back, but to my surprise, they welcomed me. They said I could start in July like the rest of the second year residents.
I was excited about going back to work, but I was also very scared. When I first started my internship, I was scared about the new responsibility I had. But then I realized that interns don’t have that much responsibility. Every time you screw up, you can just shrug and say, Well, what do I know, I’m just an intern. But the second and third year residents basically run the hospital. I had to go to all these lectures about how to effectively run a team and manage my interns. It was scary.
I started on July first. I met my team, which consisted of two interns, a third-year medical student, and our attending. The interns were both guys, named Phil and Jason. The medical student was a girl named Patrice (married, so don’t get ideas). Our attending was Dr. Porakis. It was a relatively small team, with no sub-interns or anything to help ease the workload on the interns. Sub-interns are fourth year medical students who act like interns, except for the fact that they can’t sign anything. It’s nice for the other interns to have them around, but it’s more work for me, because I have to look over their shoulder more and co-sign all their orders. Third-year medical students are kind of a liability for everyone, especially in July, because they don’t know anything.
My goal was to try to model myself after the better residents I’ve worked with. The first day, I took some time to sit down with Phil and Jason to go over some key things like electrolyte replacement and fluids, and of course, how to write a perfect progress note. They seemed pretty receptive and smart, although Jason kept looking at his watch. I remembered when I was an intern, a resident had said to me in a really obnoxious voice, “Oh, do you have to be somewhere?” I vowed I wasn’t going to be like that though. Everybody wants to go home at the end of the day and I wasn’t going to give Jason a hard time about it.
I felt like I had a lot of obstacles to being a great resident—more than most people. First, the fact that I had been away from medicine for a year was a problem... I had forgotten more than I thought. Second, the fact that I couldn’t walk was still an issue. No matter what, you’re going to get less respect as a doctor in a wheelchair, especially when my disability was so obvious. No matter what hospital you’re at, there’s only a limited amount of space at the bedside, with the IV and all, so sometimes it’s a trick to get a good physical exam. Plus I can’t run up and down stairs like everyone else. I hoped these things wouldn’t keep me from effectively managing my team.
There wasn’t much adjustment time. Almost right away, our team got slammed with admissions. We got four pancreatitis patients in two days. Pancreatitis makes me very nervous because I’ve seen it get very bad very fast. One of Jason’s patients was a young woman with an enormously elevated lipase, a high fever, and her CT was read as possible necrotizing pancreatitis. Considering everything that was going on, Dr. Porakis decided that this patient needed to go to the unit (which was fine with me). I asked Jason to get her ready to be transferred (i.e. write the orders and touch base with the ICU) while I took care of some urgent issues with the other patients.
By two thirty, I was feeling overwhelmed and hadn’t eaten anything all day. I went down to the cafeteria to grab a quick bite to eat, which was when I saw Jason sitting at a table with a bunch of other interns, laughing and joking around. I wheeled over to them. “Jason, is Ms. Gomez taken care of? Did she go to the unit?”
“Yeah, I was just eating and I’ll work on it after lunch,” said Jason.
“Do you have the orders yet?” I asked.
“No, I’ll do it as soon as I’m done with lunch.”
I almost blew up at him. “Jason, you have to do this now. She’s really sick.”
It was hard not to sound really angry, because I was. I couldn’t believe he was sitting in the cafeteria like he had all the time in the world. I tried to tell myself that he was just starting and he didn’t realize how urgent the situation was. And it was really my fault too, because if it was that urgent, I should have overseen him and made sure it got done. It was only his first week as an intern, after all, and it was a lot of responsibility.
Jason looked at me like I had just punched him in the face. Worse still, I had to walk him through every step of writing the transfer orders. A few times, I almost said to him, “Did you really go to medical school?” But I think I was pretty patient, everything considered.
You might think that with all that was going on at the hospital, I didn’t have any time for a social life, but that wasn’t completely true. My mother decided that she was tired of waiting for me to find my own dates and she set me up with the daughter of a woman she knew from church.
I was against it from the start. I was too busy to start dating again, first of all. My hours were very long and I needed to do a lot of reading to keep myself skills up to par. But more importantly, I didn’t like the idea of my mom setting me up. I didn’t think she had any idea of what I was looking for in another person. Plus while my mother is a religious person, I am not religious at all (which she hates), and I didn’t like the idea of being set up with someone she knew from church.
So this girl’s name was Elizabeth and she worked in a hotel, although I’m still not exactly sure what she did. My mother said she told them that I was 29 years old and a doctor. The first thing I asked was if she told them that I was disabled. My mother said, “But you’re not disabled, Jeremy.” This is a little game she always plays that I felt really annoying, that I’m not disabled because I wasn’t born with no legs. I know, it doesn’t make any sense at all, but she’s very stubborn about it. So I said, “OK, does she know I use a wheelchair?” The answer was yes (which surprised me, knowing my mother).
Apparently, Elizabeth also had a kind of minor disability. She was born with asymmetric legs. That was all my mother said about it. I had never dated a girl with any kind of disability before and I was kind of anxious about it, although a little bit excited. Maybe I’d feel less self-conscious about my stumps if she wasn’t entirely perfect either.
I arranged the date for my pre-call night, thinking that I’d be least tired on that night. I know it’s pathetic, but my bed time is about 9PM these days, sometimes earlier. I talked to Elizabeth (Liz) on the phone and she seemed pretty nice, although kind of quiet.
I was almost late for meeting her because of Jason. I was really exasperated with him. Not only did he page me about every single little thing, but his physical exam skills were shit. I will say that it’s not so easy for me to get a good listen to a patient’s heart or lungs while I’m in my chair, but I’ve worked at it a lot. It seemed like every time Jason did a lung exam, he’d report that the chest was “clear to auscultation bilaterally.” Then I’d go listen and the person sounded like they were in florid pulmonary edema. And he’d whine that it was hard to get a good listen because the patient was really fat or something.
“You have to make an effort, Jason,” I said. “Do you think it’s easy for me to get people to lean forward? I can’t hold them up like you can. You just have to work on it, okay?”
“Okay,” Jason said.
“All right, now how much fluid did Mr. Peters get yesterday?” I asked.
“Uh... around... uh, not sure,” Jason said.
I wanted to reach out and smack him in the head. “Okay, when a patient is in heart failure, you have to watch their ins and outs. I need to know exactly how much fluid he got yesterday. It’s not my job to keep track of that—it’s yours.”
“You want an exact number?”
It was beginning to feel like Jason was so far below par, he was never going to catch up. I really don’t have a temper, but he was testing the limits of my patience. I was lucky I at least had Phil to pick up the extra slack. Phil very rarely gave me any grief.
Anyway, onto my date with Liz. I met her at this restaurant that I picked out. I got there first and while I was waiting for her to arrive, I realized it had been over a year since I had been on a real date. I was pretty nervous. I nearly jumped when I heard a voice say, “Are you Jeremy?”
“Yes, I am,” I said. “You must be Liz.”
As soon as I saw Liz, my nervousness turned into disappointment. I don’t want to sound shallow and I’m sure I will, but Liz was not attractive at all. I haven’t gone out with that many women, but most of them have been very good looking girls. I wouldn’t say that Liz was completely hideous, but I definitely didn’t feel any kind of sexual attraction to her when I saw her. She had kind of a long face with a large forehead and crooked teeth. She wasn’t overweight exactly, but her weight was distributed so that her stomach and hips were very large and she had a double chin. She did have one leg that was quite a bit shorter than the other and she was wearing a shoe with a lift, and she had a cane.
I don’t feel like I should have to settle for someone I don’t really like a lot. Yes, I am a double amputee, but I’m also a doctor, I’m young, and I think I’m fairly good looking. I should have known anyone my mother would set me up with wouldn’t be that great.
The dinner was pretty awkward. Liz was very soft-spoken and didn’t talk much. I tried to draw her out a little bit, ask her questions, but it was painfully hard. I am not the most outgoing person ever, but I talk to a lot of people because of my work, so I know how to be sociable by necessity. Worse, she kept staring down at my pants legs, which sometimes people do, but she wasn’t even making an effort to hide it. All in all, it was a really bad date.
After dinner, we shared a cab that was going to go to her apartment, then back to my parents’ house (where I was still staying). When we got to her apartment, there was this long awkward moment. “I had a really good time,” she said.
I wondered if she was telling the truth and that this was actually a good date for her. I couldn’t believe it, but maybe she thought that because I was nice to her, that meant I liked her. “Me too,” I lied.
She didn’t leave the cab and that’s when I realized that she wanted me to kiss her. I definitely didn’t want to kiss her, but I knew it would hurt her feelings if I didn’t. I allowed a homeless patient hug me once, so I figured it wouldn’t be that awful to have a quick kiss on the lips. As a doctor, you get used to doing things that are kind of physically unpleasant (like prostate exams, for example).
I leaned forward and kissed her, slight tongue. Her lips were actually pretty soft. I was being all high and mighty, but it was my first kiss in a while and I sort of enjoyed it.
When I got home, I had to put up with the usual nagging from my mother, who wanted to hear every detail. I just said I was tired and wanted to go to sleep, which was the truth.
The next day at work, I unfortunately overhead a conversation between Phil and Jason that I wasn’t meant to hear. They were sitting at the nurse’s station, checking labs and I was around the corner, but I could hear them very well.
“Guess who I saw on a date last night,” Jason was saying.
“Who?” Phil said.
“Jeremy.”
“You mean our resident?” Phil sounded completely amazed, which bothered me a lot. “He dates? Wow. What kind of girl would go out with him?”
“She was pretty nasty,” Jason said and he laughed. “She looked like she had polio or something.” Their conversation continued in a quieter tone, but I’m sure it involved more about how amazing it was that a double amputee could find someone to go out with him. Phil was married and Jason was living with a girl, from what I’ve heard. I thought it was kind low for them to be making fun of me like that, like I’m some kind of freak. Part of me wanted to confront them and assure them that there are plenty of really attractive girls who would go out with me.
After hearing that conversation, I didn’t want to go out with Liz ever again. I didn’t want to go out with her in the first place, but that officially decided me. Unfortunately, my mother had other ideas. She kept saying what a nice girl Liz was and why didn’t I call her? Also, that Liz liked me a lot and she wanted to see me again. Her nagging became more and more persistent, until she actually sat me down one day and said, “Jeremy, you are almost thirty years old. You have to stop being so picky.”
So the punchline is that I did call Liz and we went out a couple more times, none of which were any better than the first time. But we did wind up having sex.
YES, AFTER OVER SIX YEARS, I FINALLY GOT LAID.
I was surprised to find that Liz is actually a very affectionate girl, even though she is not great at expressing herself. After that first kiss, things got a little more heated the next time. She invited me to her apartment, which she shared with a roommate, and we wound up “necking” in her bedroom. Even though I said I wasn’t that attracted to her, I don’t get much action, so it was a big turn-on for me to make out with her and be touching her. Plus she had pretty nice breasts, although you’d never know it with the way she dressed.
I would say the sex was completely initiated by her. She was the one who said, “Let’s move to the bed.” Then she asked me if I wanted to take off my pants and I said yes. One thing that I was right about was that I felt a lot more comfortable with my stumps because I knew she wasn’t perfectly beautiful either. I had worn briefs, so my stumps were completely showing and exposed. And even though I had been making an effort to take care of them and they looked better than in the past, I think most people would have been a little turned off.
But not Liz. She was great. She cupped her hand over my right stump and massaged it gently. “They’re pretty soft,” she said.
“Is that okay?” I said hopefully. Even though she seemed very accepting, I was still a little anxious.
“Yeah, I like it,” she said. I felt pleased. It seemed like all that stump care I had been doing the last several months had paid off.
She began touching my other stump then. It goes without saying that my stumps are very sensitive. Sometimes I feel like I have three dicks now. I had a huge erection, but she was just rubbing my stumps and I was loving it. I got her to take off her shirt too, which she was a little reluctant to do at first. I began rubbing her chest as she touched my stumps.
“Am I doing good, Jeremy?” she asked me.
“Yes, definitely,” I said.
“I really like you,” she said. “Do you like me?”
“Yes,” I said.
The way she kept rubbing my stumps, I felt like I was going to cum before she even touched my dick. It was amazing. Nobody had ever touched my stumps like that before. My eyes were watering.
Finally, she said, “Can I take off your underwear?”
I said yes. She pulled off her panties, but she didn’t take off the long skirt she was wearing. I stayed lying on the bed and she got on top of me. It took a little bit of fumbling, but then I was inside of her. You have to understand that I hadn’t been inside a woman in over six years and it took all my self-restraint not to cum as I was sliding into her.
I tried my best to make it pleasurable for her too, but not having legs for support make it hard to control the rhythm. She had to do most of the work. Also, even though I tried to hold out, I came within a few minutes.
Liz climbed off me and we lay next to each other in bed, holding hands. I felt really good. I didn’t think she had cum and she didn’t masturbate or anything, but I felt awkward suggesting anything. “Are you okay?” I asked her.
“Yeah,” she said. “Did you enjoy that?”
That was a dumb question. “Yes, very much.”
It wasn’t until a little bit later that I got nervous about the fact that I had just fucked her bare-back. I had no idea what her sexual history was (although I couldn’t believe she had been with that many guys) plus I really didn’t want to risk her getting pregnant either. But I didn’t think there was a tactful way to bring it up and it was too late anyway.
We did wind up talking about it later. She said she had been with only one other guy and I told her that I had been with only one other girl (my ex-fiance). She said she was on birth control pills (for irregular cycles).
I got this feeling that she was really into me. I wasn’t sure if I felt the same way about her, but I was beginning to like her a lot more. The problem was that I was so in love with my ex Wendy and I wind up comparing everything to that. It is hard to accept that I might never find anyone else like Wendy again.
Also, I was still a little bothered by the conversation between Phil and Jason that I overhead. Yes, they were just being stupid, but I don’t want people to look at me and Liz and think that I’m dating her because this is the best that I can do. I didn’t want to feel like I was dating someone I didn’t want to be seen with. I know this all sounds very shallow, but face it, that’s the way people think. I didn’t want people looking at us to say, “Hey, look at those two gimps.”
So right now, I’m not sure where Liz and I are, relationship-wise. We are dating, but I wouldn’t call it serious. I do know that I like her and I enjoy having sex with her. While those two things are true, I don’t see any reason not to keep seeing her.
Anyway, within the hospital, things just got worse with Jason. He wasn’t on top of his patients at all. He was always forgetting to order morning labs and even check vitals in the morning. I was more than a little bit exasperated with him. Every time he made a serious mistake, I would scold him briefly, but try to let it go. I just kept hoping that he would suddenly improve overnight.
What I probably should have done was to speak to the chief residents about him, but I didn’t do this, because I didn’t want to get him in trouble. Instead, I tried to get advice from people outside of the hospital. I spoke to my best friend Michelle, who is currently a third year resident in psychiatry, about how to effectively manage a team (since she’s had more experience than me). “You can’t be afraid of telling him that he’s fucking up,” Michelle said. “It’s the only way he’ll learn. But for god’s sakes, be nice about it.”
“Aren’t I always nice?” I said. I think I’m nice. I very rarely yell at anyone, even the nurses when my patient is running a temp of 103 and they don’t call me, even though I specifically wrote in the orders to call for a temp above 101.5. That takes a lot of self-restraint. Michelle agreed that I was pretty nice, but also added, “It’s very easy to lose your temper around these interns.”
I also talked about it to Claudia, my ex-girlfriend. Claudia was a good person to talk to, because not only was she starting as an intern, but she had been a med student on my team back when I was an intern, so she knew me as sort of a leadership figure. “Was I a good teacher back then?” I asked her.
“Yes, definitely!” Claudia said. “You were awesome. You were like the only person who was really nice and patient with me. It sounds like from what you’re saying, this guy just has issues and it’s not your fault.”
That made me feel better. I tried to be as patient as I could, but that didn’t help. What really bothered me was that our attending, Dr. Porakis, was so laid back that he barely seemed to notice how poorly Jason was doing. I felt like if I didn’t pick up the extra slack, it was the patients who were going to suffer.
Two and a half weeks into the rotation, there was an incident that made me realize that I couldn’t look the other way anymore. We were on overnight call as a team and at about 10PM, I heard Jason being paged overhead to the transitional care unit. I was concerned, but didn’t do anything until I heard the second overhead page. I called back the unit. “This is Dr. Andrews. I’m returning the page for Dr. Moreanu. Is there anything wrong?”
The nurse on the other line sounded very nervous. “Dr. Andrews, Mr. Brown is having bad chest pain. Ten out of ten, he says. We gave him nitroglycerin and it’s not helping.”
Brown. He had come in earlier tonight with chest pain that had subsided with nitro. His first set of cardiac enzymes was negative and his EKG had some T-wave inversions that didn’t look much different from a previous EKG. If he ruled out that night, we were planning to get him a stress MIBI then send him home.
“What are his vitals?” I asked.
There was a shuffling on the other line and I heard the nurse’s voice again. “Dr. Andrews... I was just told he is not responding to nitro at all and his sats are down to 82 percent.”
Oh no, I thought. “He’s on oxygen?”
“Two liters nasal canula.”
“Shit. Is Dr. Moreanu around? Did he respond to the page?”
“No.”
“Okay, put him on four liters and get an EKG stat. And get another set of cardiac enzymes. I’ll be right over.”
I couldn’t believe Jason wasn’t responding to his page. And unfortunately, transitional care was two floors down, so it was going to take me some time to get there. I scanned the floor and saw Phil going into one of the rooms. I quickly wheeled over to the room. “Phil, I need you to go to transitional care now. Mr. Brown is having chest pain and he’s desat’ing.”
Phil’s eyes widened. “Oh wow. But he’s not my patient.”
“Yeah, but I don’t know where Jason is and I need help. We need to get his sats up and I need you to get over there and look at his EKG. If you see anything bad on it, we’re probably going to have to wake up the cardiologist. He might need to go to cath tonight.”
The thing I like about Phil was that he just nodded and said OK and he was gone. No annoying questions, no nothing.
I wheeled quickly toward the elevators. One thing I didn’t research enough when I picked the hospital to do my residency was the elevator situation. The elevators at our hospital are terrible and it definitely hurts me that I can’t rush right over if there’s an emergency. It’s really bad when I’m on the code team—it’s going to be a serious problem when I have to run a code.
Tonight the elevators were being even worse than usual, especially considering the late hour. When one of them finally came, it was filled to the brim. It looked like some patient’s entire family or something. I started to wheel inside and that’s when I realized there wasn’t going to be room. Ordinarily, I would have just backed out to wait for the next elevator, but this was an emergency. I wasn’t going to let a patient die because I couldn’t fit into the elevator. I explained to the family that I had an emergency and I had to get in the elevator now. They were nice about it and made room for me.
When I got to transitional care, I saw Phil’s face and knew what was going to be on the EKG before I even laid eyes on it. “Shit!” I said as I saw the huge tombstone ST elevations in the inferior leads.
But it all worked out in the end. Mr. Brown got to cath and he survived, probably better than he would have if he had this episode in his own home. But it didn’t change the fact that we lost valuable time because Jason was missing in action.
Jason popped up a few hours later and I yelled at him where the hell had he been. He looked at me, all surprised. “I was just taking a quick nap in the call room,” he said.
“Mr. Brown had an ST elevation MI and they were paging you for twenty minutes!” I said.
“I’m sorry, Jeremy,” he said. “I guess I didn’t hear it. Is he OK?”
“I hope so,” I said. “Look Jason, we need to have a talk about what’s expected of you during this rotation. We need to have a talk right now.”
We went to the resident’s lounge. I pulled my wheelchair up to the table and Jason sat across from me. “I’m going to be honest with you, Jason,” I said. “You haven’t been working up to the standards that I’ve expected. What sort of training did you do for residency, other than the basic third year clerkships?”
“Well, I did a sub-internship,” Jason said.
“And?”
He shrugged.
“You really haven’t been doing a good job up to this point,” I said. I knew it was a harsh thing to say, but it was actually pretty kind, considering. “Your knowledge base is... not much better than a third year student. And I really feel like you haven’t been making an effort to improve your skills at all. Am I mistaken?”
“I think you are,” Jason said. “I think I’ve been doing a better job lately and getting the hang of things.”
“Well, maybe.” I didn’t agree with him, but I was trying not to be a total dick. “And maybe I expect more from you because I can’t get around as easily.”
“That’s for sure,” he said.
I took a deep breath. “Do you think there’s anything that I could do better, to try to help you?”
“Yeah,” Jason replied immediately. “Like, just because you can’t get someplace fast, you expect us to run up and down the stairs to do it for you right away, but it’s not like we don’t have other things to do too. I mean, it’s not our fault you can’t take the stairs.”
“Right, that’s true,” I said. I didn’t know exactly what he was talking about, since he’s supposed to take care of all the scutwork on his patients anyway and I had been picking up a lot of his slack, which wasn’t my job. But I was trying to work with him. “All right, I’ll try not to do that anymore. But Jason, you really need to be more on top of your patients. I can’t always be writing for your morning labs for you.”
“I remembered the last three days,” he protested.
That was inaccurate, but I didn’t feel like pointing out that he had forgotten to get a morning CBC yesterday on a patient with a possible upper GI bleed. “Anyway, new rules: no sleeping when you’re on call until everyone is set for the night. And when you sleep, you must be able to return your pages. Do you understand me?”
Jason lowered his eyes. “Yeah, fine.”
Jason was sulking as he left the room. He stormed out and left the door open behind him. I heard Phil’s voice asking, “What did he say?”
“Just telling me that I suck and I’m not allowed to sleep anymore,” Jason told him.
“He said that?” Phil asked.
“Pretty much, yeah. He’s being a huge dick about the whole thing.”
“He’s just bitter.”
I try not to be sensitive about these things, but I had pretty much had it by then. I wheeled out of the room in time to catch Phil and Jason. “Listen to me, Jason,” I said, trying to control my anger. “What you did tonight was completely unacceptable! If you don’t at least recognize that, then you have no business being in medicine. I don’t care if you think I’m being a dick, but it can never happen again.”
Jason stared at me, his face turning very red. I guess he thought I was deaf too that I wouldn’t be able to hear what he was saying right outside the room. “I’m sorry, Jeremy,” he mumbled.
I didn’t say anything. I just nodded and wheeled myself over to the nursing station to answer a page. I sort of regretted yelling at Jason, but what else could I do? Now I had to face an awkward working environment for the next week and a half. But if it forced Jason to improve, it would be worth it. This wasn’t just about him and me. This was about what sort of doctor he was becoming. I know that sounds melodramatic, but I think the habits you develop as an intern can stay with you for the rest of your career.
And believe it or not, Jason did improve after that. He was a lot more careful. He forgot less. He answered all his pages. By the last day, I told him honestly that I had seen a major improvement in his abilities and I thought that he was going to make a great intern. I know he still hates me a little bit, but I’m hoping he’s also grateful to me for kicking his ass a little bit and helping him to be a better doc.