Today, the first of many major holidays spent at the hospital! I arrived at 6:45 again, looked up labs, and then rounded on my patients from 7:15 until 10:00. This was a bit slow given I only had 7 patients, but I was distracted chatting with some of the other interns and then spent some time in my stroke patient’s room with her family, again answering questions and explaining the neurolgist’s plan to start coumadin in spite of the recent head bleed. One of the granddaughters asked about prognosis, and again I told her, “Sometimes in stroke patients we see gradual improvement over days to weeks, but in other patients there’s really not much improvement. At this point I’m sorry to say we can’t tell. We just have to wait.” Teary-eyed, the granddaughter looked at her grandmother and said, “So I guess we just have to hope and pray for the best.”
I also showed a rather embarrassing display of poor phone etiquette today. Clay and I were at a nursing station, sitting across the desk from each other, working on discharge paperwork. I told Clay I was calling one of our attendings—Dr M, and asked if he had any patients to run by her. He’d been trying to page a neurologist and was unsuccessful thus far. Clay said that yes, he’d like to speak with the attending after I did. Very soon after paging, the phone rang. The unit clerk announced, “Did anyone page Dr L?” who happened to be another of my attendings. I said, “I did not, but I’d like to talk to her.” No one else spoke up, so I picked up the phone, and out of the corner of my eye I saw another nurse shuffle off to look for whoever paged Dr L. After discussng one patient with the attending, I heard the clerk announce that Dr M, the other attending who I had paged, was calling back. I asked Dr L if I could finish up with her later, and hung up the phone just in time to see the nurse arrive with another nurse who HAD paged Dr L! They gave me a look which was a mixture of annoyance and amusement! I offered a look of helpless apology and then answered the phone line with Dr M. After quickly discussing our patients, I hung up. Just then, Clay sighed and said, “I needed to talk to her too!” I apologized to him, and went back to my note-writing. The thought crossed my mind that I needed to make one more page, so I reached for the phone. In the split second before the phone left the cradle, it began to ring. I held the phone up to my ear, didn’t hear a dial tone, and returned it to its cradle. This all took place in the span of 2 seconds, which was not enough time for my mind to register that perhaps this phone automatically answered the ring, and perhaps this was Clay’s neurologist finally calling back. Both of these un-supposed suppositions were true. In a matter of five minutes, I’d hung up on the attending returning a nurse’s page, didn’t give Clay a chance to talk to a different attending, and then inadvertently hung up on Clay’s neurologist!
After finishing my work, I grabbed lunch with Clay and another ophtho intern Mark. Today’s lunch consisted of a personal size vegetable pizza and coconut cream pie. The lunch was redeemed by the fact it was a vegetable pizza, as well as the accompanying skim milk and banana. My last task of the day was to dictate for the first time at this hospital. I journeyed down to the basement Medical Records office since I needed the patient’s chart with its H&P. There I stumbled through my anything-but-eloquent-and-concise dictation and swung by the O.R. to pick up some scrubs. On my way out of the hospital, I stopped and remembered my stroke patient. I returned to the third floor and visited with the patient’s daughter-in-law a few minutes. I mentioned, “I heard your niece say that you all are hoping and praying for the best. Are you people of faith?” In my somewhat round-about question, the daughter-in-law understood I was asking about church and said that the patient was sad to miss church a week ago. When I asked where she went to church, the daughter-in-law said that it was a Korean church. “Presbyterian?” I asked. Yes, it was. At that point, I offered to pray with them, and a look of gratitude passed over the daughter-in-law’s face. As I sat in the chair next to her, she turned to her mother-in-law and spoke a few words in Korean. The patient, much more alert than I’d seen her before, looked at me, extended her hand to hold mine, and said in English, “Thank you.”
This was another one of those moments in which I realized and experienced the amazing privilege of practicing medicine. Here was a patient who was sitting on our service; we could do nothing to improve her stroke and could only offer preventative care. But this was a real and a definite opportunity to be a healer, and a moment, I hope, of grace.