I somehow always ended up on the top bunk. Although I rarely had problems falling asleep, I only succumbed to slumber after spending a few moments ensuring that I was laying flat on my back (to prevent myself from rolling off the railing-less bed and crashing into the tiled floor), planting reminders into my brain to refrain from bolting upright if my pager went off (to prevent myself from slamming my head into the concrete ceiling), and selecting the quietest volume and least annoying tone on my pager (to minimize the chances of waking the other medical students).
The room was simply furnished with three bunk beds. Some women tossed their backpacks onto the beds in the early evening to claim possession of a lower bunk, though we all universally agreed that this was unkind. What if she never returned to the call room for the duration of the night? What if she only slept an hour? Couldn’t we be egalitarians about this?
No, we couldn’t—since the pre-claimers never used the same bag and thus, we had no idea who they were. And it was considered poor form to hover over people who were sleeping and breathe heavily into their faces while trying to recognize any identifying features. While possibly murmuring, “I’m watching you… I’m watching you….”
Rude women would throw open the door to the call room, hastily flip on the light switch and flood the entire room with harsh, fluorescent light (another reason why the top bunks were suboptimal locations), and groan or make other utterances (including unmuffled expletives) while scanning the room for an open bed. They would eventually turn off the light (frequently after the other women in the room mumbled irritably about the light, the time, or the noise) before stumbling onto the flimsy mattress. They invariably were heavy sleepers, which meant that everyone else in the room would hear their pagers—set on the most screeching of tones that shredded eardrums—before they did. Instead of returning the page at the deserted nurses’ station in the hallway, they would call from the telephone in the room, making little to no effort to hush their voices.
“A 67 year-old woman with what? Wait, what? Altered mental status? What is her name? Can you speak louder? There’s a lot of noise in the background. Uh huh—wait, what?”
The five remaining women shared a collective sigh after they left the room—once they slammed the door shut.
Most of us, though, were considerate in sharing the call room. Armed with our pen lights that had earlier peered into sore throats, gaping wounds, and bloodshot eyes, we used them as tiny flashlights after opening the door as little as possible to allow ourselves to slip inside. After locating an empty bed (usually a top bunk), we channeled feline spirits to help us to climb quietly and quickly into the waiting bed. (My efforts were usually unsuccessful; the bed creaked as I scrambled along the post and if my eyes had yet to adjust to the darkness, I often was unsure where my foot was going to land. There were a few occasions that I clonked my head against the ceiling in my enthusiasm of finally laying down to rest, though I tried to say “OW!” as quietly as possible.) Our pagers hadn’t even sounded for two seconds before we silenced them with a heavy hand—and I’m surprised none of us ever fell out of bed due to disorientation or miscalculation of distance. Our escapes were quick and quiet.
As residents, we now are graced with individual call rooms (usually), though the walls are thin. This means I no longer need to stifle my laughter when I hear the irritation and clumsiness next door that we have all undoubtedly experienced:
(pager goes off)
(loud groaning and incoherent bursts of whining)
(bed creaking)
(click!)
(interrupted mumbling)
(more loud groaning and whining, now more articulate)
(heavy, schleppy footfalls)
(door opens)
(door closes)
(footfalls fade away)
(lather, rinse, and repeat)
(Part of the ongoing Relationship Series.)
31 May 2007 | Comments?
#5: Intimidation.
She was crying, though her mascara and dark eyeliner did not trickle down her rouged cheeks along with her tears.
“I’m okay,” she assured me upon seeing the concerned expression on my face. Her tinted lips parted into a genuine smile, revealing bright, aligned teeth. “I’m just tired.”
Skeptical, I cocked an eyebrow. She laughed in response, wiping tears off of her lovely face with her left hand.
“Really,” she insisted, “I’m fine. I’m just tired. I cry when I feel tired. We’re all tired. You know how it is.”
We were only halfway through our first rotation as third-year medical students and here we were, discussing a physical and mental state that was verboten in the world of general surgery.
“What happened?”
“You know Mikolas?” she began. “I was in the operating room with him earlier… and you know how he is.”
I nodded. Mikolas was the stocky surgical fellow with a perpetual five o’ clock shadow regardless of the actual time. He always laughed at his own jokes, though we rarely found them funny. What he found amusing we found annoying. For example, one uneventful afternoon in the operating room, he and I engaged in the following dialogue:
“You’re right, that is the splenic artery. Strong work, Mary.”
“My name is Maria.”
“That’s what I said, Mary.”
“I said Maria.”
“Mary.”
“Maria.”
“Mary.”
I rolled my eyes, tacitly extracting myself from the conversation and quietly thankful that the surgical mask at least partially obscured my annoyed facial expression. He was clearly smiling behind his. To no one in particular, he then declared, “I can call her anything I want as long as it’s not sexual harassment!”
He laughed, smug and charmed by his own wit.
“What happened?” I asked again.
“Mikolas was performing the operation and everyone else in the operating room was a guy,” she continued. “The scrub nurse, the anesthesiologist, the surgical tech, and two surgery residents. I was the only female in there.”
She shifted in her seat and wiped her nose on the right sleeve of her scrub top.
“So Mikolas and one of the residents were pimping me(1) left and right and saying stupid things—which is fine, I’m used to all of that. But then my period started. And this was only an hour or two into the procedure. I couldn’t just leave the operating room with all of those guys in there; what was I supposed to say? ‘Can I scrub out because my period just started?’ So….”
She trailed off. I was wincing.
“So I just stood there and retracted(2) for the next five hours. And bled.”
She wasn’t crying anymore. Her hazel eyes were downcast, the circles underneath her eyes were thick and purple, and the whites of her eyes were still pale red from her tears.
We sat together in silence, watching the scorching summer sun glow orange-red through the leafy, tangled branches of the old sycamore trees.
(1) “Pimping” refers to a teaching technique that is somewhat (read: not really) similar to the Socratic method, though the questions may tend towards “what” rather than “why”. For example: “What is the name of this artery? Where does it branch from? What other organ does it feed? What organs are affected if it is tied off?”
(2) Medical students are usually assigned the thankless job of “retracting” (occasionally referred to “water skiing”) in the operating room. Students hold onto sterile, metal objects (”retractors“) that can resemble large, tapered bookends, shoehorns, hammers, etc. to keep tissues out of the surgical field so surgeons can see what they are doing and manipulate the tissues with greater ease.
(Part of the ongoing Relationship Series.)
30 May 2007 | 1 comment.
#4: Humility.
It was the first day of the psychiatry rotation and moments before, the attending physician had enthusiastically pushed me out of the office and into the unit. The door swing shut behind me, the resolute click indicating that the lock had firmly latched into place.
“Just go talk to him,” the attending had clucked. “Tell me what you think when you get back. He’s got bipolar disorder. Manic. Go.”
The man in question spotted me from the opposite end of the hallway. His short legs propelled him briskly towards me and only when he was standing directly in front of me did he smile.
“Hi,” I began, reciting the same thing I had recited to every other patient I had ever met for the past eight months. “My name is Maria and I am a third-year medical student. Dr. Man Who Pushed Me In Here With Little to No Preparation suggested that I talk with you. Do you mind if I ask you a few questions?”
(In retrospect, my first question should have been, “Is that alright?” followed by “How are you?” I didn’t learn this until well into my intern year. Doctors can and should still exercise social graces.)
“Yes, of course!” he replied. “Dr. Man told me that a medical student would be dropping by today. Let’s sit down!”
He slumped down into a cheap plastic chair, folded his forearms onto the table, and leaned forward. He hadn’t shaven in probably two or three days. His brown hair was cut unevenly, though this appeared intentional. His blue plaid shirt looked worn and tired over his belly and his jeans hung loosely over his legs. A watch with a blue leather band encircled his thick, left wrist. When he smiled, he revealed the space where a molar once resided.
“I’ve been here for about three days. Dr. Man knows me. We’ve met two or three—or maybe four, five?—times before. He’s not bad. I ran out of my meds a few weeks ago and I didn’t get them refilled because I got caught up in work and then one day I got into a fight with my boss because he was giving me attitude and I don’t need to take that kind of crap because I do good work and I think he was trying to get rid of me the whole time and needed an excuse because that’s the kind of guy he is and I don’t know why those kinds of people have to pick on people like me because I never did anything to him because I do good work because I’ve been a welder for over fifteen years now and I’ve got experience like the county courthouse—”
I am certain I looked bewildered.
“—and City Hall and that kind of work needs experience and skill and I got that from my dad who was very good and he taught me everything I know and he also taught me about cars because I also work on cars in my spare time and I just got this beat up truck from a guy who lives down South and another truck from a guy across town and—”
“Sir?” I interjected.
“—and they both need a lot of work and I’m trying to find the right parts but that’s been hard because my usual supplier went away for vacation but he’ll be back—”
“Sir, can you tell me—”
“—because there’s only so much time someone can spend in Las Vegas before they run out of money because the last time I was there I lost about $6,000 but I was up about $10,000 for a while but those blackjack tables can really—”
I had an agenda and it wasn’t happening. I wanted to know what brought the man here, what medications he was taking, and what his symptoms were. I didn’t need to hear about his trip to Las Vegas.
“Sir, I’d like to know—”
“—get a lot of money out of you really quick like women like my first wife who was a gorgeous lady but would spend all of my paycheques on shoes of all sorts and I never understood why women like shoes so much—”
“Sir!” I curtly said, making no effort to mask my impatience. I no longer wanted to waste my time listening to his rambling stories about his life; did he even know what he was talking about? I had better things to do than put up with his illogical, disjointed blathering—I was paying money to get a medical education and here I was, squandering both my time and money. Buoyed by indignation and allowing my voice to rise, I belittled him: “I only have a few minutes and I’m trying to get some information from you—”
“You’re rude, you know that?” he snapped. Though I had tried to talk over him, this simple remark instantaneously silenced me. “You’re really rude. If you want to become a doctor, you need to learn how to listen. You weren’t listening to me. I’m telling you something important and you should listen.”
I felt my face flush in embarrassment. My eyes darted away from his face.
“If you don’t have time to listen to me, then don’t bother talking to me because I don’t want to waste my time.”
Frowning, he suddenly got up from the table, pushed the chair to one side, and briskly walked away.
I sat alone in stunned silence.
I never had the chance to thank him.
(Part of the ongoing Relationship Series.)
29 May 2007 | 4 comments.
#3: Hips Don’t Lie.
As a young ballerina, clad in a dark pink leotard, lighter pink tights, and pink ballet shoes, I often received the admonition, “Tuck your hips under!”
At the age of six, I didn’t understand the anatomy of hips—did they encompass my butt? or just the bony things just below my waist? I recall that, on more than one occasion, the teacher placed her hands on my waist (or, more specifically, the anterior superior iliac spines of my pelvis) and rotated my pelvis forward, thus eliminating the outline of my buttocks and minimizing any further motion of my pelvis.
In marching band, the concept of erect posture was drilled into my head: Pretend there is a string attached to the top of your head that is being pulled skywards. This image was meant to help us tuck our pelvises under, push our shoulders up and back, “engage our abdominal muscles”, and tuck our chins into our necks. Swaying hips are a detriment to the crisp lines associated with parade lines and to the sound produced with instruments: wobbling hips result in wobbling music. (This is also why marching bands spend so much time on the concept of “rolling your feet”—cushioning each step and minimizing the movement from the waist upwards fosters smooth sound and reduces the chance that one will inadvertently break a tooth from any jarring collisions with mouthpieces.)
Already taller than most girls, I was reluctant to wear high heels to high school dances and routinely took off the offending shoes for photographs so my dates would appear taller than me. Even now, my height is almost two standard deviations greater than the average height of women in the United States. This, in addition to the discomfort of these shoes, reinforces my avoidance of high heels (unless they are Danskos, as those do not contribute to back and feet problems). High heels, by shifting the center of gravity, induce women to stick their butts out for counterbalance purposes. Thus, although high-heeled shoes are often fetching, their true sex appeal resides within their abilities to highlight butts.
As a result of these experiences, I am not accustomed to sticking my butt out or unleashing my hips.
I’m at Camp Jitterbug again this year and I’m hearing the same suggestion I received last year: “Use your hips and stick out your butt. More. You need to lower your center of gravity to not only maintain your own balance, but to also help the lead with his.”
Ectomorphs have problems, too.
(Part of the ongoing Relationship Series.)
26 May 2007 | 2 comments.
#2: The Last Dance?
The first time I danced with him, he chided, “Don’t hold my fingers that tightly. It hurts when you do that.”
Ashamed, I subsequently avoided him. Not only were my burgeoning skills in lindy hop clearly inferior to his, but I was also causing him pain. This was embarrassing.
About three months later, I was dancing with an elderly man, a regular of the ballroom for over forty years. Upon learning that I was a physician, he commented, “Do you know Jonathon? He’s a flight surgeon.”
“Jonathon?” I repeated. “No… who’s Jonathon?”
“See that guy over there, wearing the shirt and tie?”
He rotated us around so I could see the man in question—and there he was, fingers still intact and functional.
“He’s a flight surgeon?” I said, surprised. I laughed to and at myself: He doesn’t look like a doctor.
“Yes; he’s in the Army.”
I still avoided him. Flight surgeons need their fingers to work.
Another three months passed. One night, while working in an emergency room, someone gently knocked on my closed door. On the other side was Jonathon.
“Hi!” I automatically greeted. He wasn’t just a flight surgeon—he was a doctor in this emergency room! I could be his consultant! Yikes!
“Hi,” he replied, politely smiling. He asked about a key. I stated that I had not seen it. He thanked me. I said good-bye.
The next time we saw each other at the ballroom, Jonathon asked me to dance. Hyperaware of the amount of pressure my hands were exerting on his, I followed his lead with my increased confidence in lindy hop. To my relief, the dance progressed uneventfully—in fact, it was actually fun. Over time, our dances degenerated into goofy antics involving impressions of Sasquatch, junior high dances, and tomatoes (don’t ask). He asked me about my residency training; I asked him about his experiences in the military. He told me about his travels to various military bases; I told him about why I started dancing.
About six months later, I walked into his emergency room a few minutes before his shift ended.
“Oh! Let me show you something—” he excitedly remarked to a nurse. My bag still slung across my back and my coat hanging over my arm, I found myself suddenly dancing with him as we demonstrated East Coast swing to the empty emergency room and the solitary nurse, who smiled at us.
“She’s an excellent resident and a great dancer,” he commented.
“He’s being kind,” I replied, embarrassed. He led me into a turn and sent me out so I could continue my way down the hallway.
Between dances at the ballroom, we discussed the current war in Iraq and its physical and mental consequences for the soldiers.
“Is there a chance you will be deployed?” I asked, though I already knew the answer.
“Yes,” he confirmed, “though if they need me, they need me—it’s a service to my country. It’s an honor.”
I nodded. We continued to dance, saying nothing.
“Well, I hope you aren’t called because that’ll be one less lead for us follows,” I cheekily said, though we both knew that why I was using humor.
Weeks passed and I didn’t see him. I worried that he had gone overseas—or, worse, that he had gone overseas and misfortune had fallen upon him.
When I unexpectedly spied Jonathon dancing with a young lady in the far corner, I eagerly slid across the dance floor and tapped him on the shoulder as the first few bars of a new song poured out of the speakers. Upon seeing me, he smiled broadly and greeted, “Hello!”
“Hello!” I replied. “I’ve wondered where you have been—I was worried that you had been deployed.”
“Oh—I’m leaving on the 20th.”
My brows furrowed in surprise and concern.
“Leaving for…?”
“Iraq,” he nonchalantly replied, as if he was merely commenting about the weather or telling me the time. The 20th of _____? That’s not even a month away—don’t act like it’s nothing.
Crestfallen, I simply replied, “Oh.”
“But I’ll be here—we have to dance with each other before I go, okay?” he insisted.
“Yes, of course,” I replied, distracted.
We have to dance with each other? Because what if—
(Part of the ongoing Relationship Series.)
24 May 2007 | 2 comments.