Code Blues(10)

By: Melissa Yi

By the time I returned, Dr. Callendar had disappeared. All that remained of him was his rubber stamp. I found him in the nursing station, rifling through green slips of paper. He scowled at me, and shoved them in the pocket of his lab coat, but not before I saw the patient names and numbers printed on the slips. He was doing his billing for the night shift.

I pretended not to notice. "Dr. Callendar, did you want to review the UTI before I send her home?"

"Of course!" he snapped. "All your patients have to be reviewed. You're a resident!"

Thanks for sharing. And then he went on to share some more. Did I ask about risk factors? Was she sexually active? Had she had UTI's in the past? How recently? Did she wipe from back to front or front to back?

I had asked some of these questions, but not others, so I felt stupid but also annoyed; I doubted he was this thorough when he was the one on the line. If pressed, he'd probably just say it was a UTI for reasons NYD, not yet diagnosed.

At last he waved me away. "Go back and do it right. You can follow up with Dr. Dupuis afterward. He's the one coming on at eight."

Good news: Dr. Hardass was leaving. Bad news: maybe Dr. Dupuis was Dr. Hardass II.

Granted, I was here to learn as well as serve, but some doctors really like to put you in your place at the beginning. I didn't look forward to playing Who's the Boss for the next two years. Good doctors, secure doctors, don't need to belittle you.

Sometimes I feel sorry for the patients at a tertiary teaching hospital. You may have to battle your way through multiple layers: med student, junior resident, senior resident, staff. But it's all learning, and as a community hospital, St. Joe's had a thinner hierarchy than most. I headed back to the twenty-year-old to play another twenty questions.

When I came back, Dr. Callendar was doing "sign out" with a thin, blond, stork-like man in glasses and greens. They strode around the room, talking about patients' results and what needed to be done.

When I got within a five foot radius of them, Dr. Callendar flicked his fingers at me like he had water on them. "Go see more patients."

The blond doctor laughed and shook his head. "Wait a minute. You're a new resident?"

I nodded and held out my hand. "Hope Sze. R1."

He shook it. "Dave Dupuis. Welcome aboard."

"Thanks." At Western, once you were a resident, and therefore, a fellow M.D., a lot of the staff physicians let you call them by their first names. It sounds like a small thing, but after four years of undergrad and four years of medical school, I was ready for a tap on the shoulder.

Dr. Dupuis smiled down at me as if he were reading my mind. "Are you interested in working the ambulatory side or the acute side?"

Runny noses vs. potential heart attacks. No contest. "Acute."

Of course, Dr. Evil had to step in. "Dave, she's already started on the ambulatory side. She's ready to review a UTI." Dr. Callendar gestured at the chart in my hand.

I opened my mouth to object, but Dr. Dupuis was already on it. "Good. If you know that case, you can review it. But if a resident wants to work the acute side, she should." He turned to me and added, "Are you interested in emerg?"

"Yeah. I'm thinking of doing the third year."

"Good woman," he said.

We grinned at each other. Dave Dupuis was on my side. There was a hierarchy here, and Dupuis trumped Callendar. Good to know.

Some people, you just know you're on the same page. Like me and—Alex, I remembered, and my smile dimmed. But for only a second. If he didn't call back and beg my forgiveness, it was his loss. I had a job to do.

After sign-over, Dr. Callendar glared at me like I needed deodorant and a brain transplant. "So what do you think. Yeah, yeah, yeah. What do you want to give her? Okay." He scribbled his signature after my note, tore out the green slip, and stood up to go.

A mere 45 minutes after I first saw her, I handed my patient her prescription. It was the first time I'd written a script without getting it co-signed, and it felt good for about 60 seconds. Then Dr. Dupuis handed me a chart for a seventy-five-year-old woman with abdominal pain. "Have fun."

I drew the dirty pink curtain around bed number 11 before I began the interview. The patient's son helped swish it around his side of the stretcher. My patient turned out to be a tiny, white-haired, half-deaf woman who only spoke Spanish. Her family spoke a little French, but not much. I found myself yelling and playacting a lot. "Do you feel nauseous? Are you vomiting?" Grab stomach, pretend to retch. "Do you have pain in your chest?" Hands to heart, with tormented eyes raised to the acoustic tile ceiling, like I was Saint Hope at the stake. "Do you have diarrhea?" That one was hard. I made shooing motions around my rear end. Even the patient laughed.