Monthly Archives: October 2008

Tonight it is enough

Beside the wilted head of lettuce

in the refrigerator’s neglected bottom drawer

are two soggy tomatoes, now with soft gray fur.

And in the corner of the bedroom,

the treadmill, 8000 model, stands forlorn–

being better suited to holding today’s casually tossed

shirt and pants

than to counting endless miles I did not run

in the park

or beside the river.  No, all it has to count is up to two–

one brown sock draped over the rail, its mate

flopped on the shiny black tread.

~

All around the apartment I can find

little reminders

of the best intentions that came

to nothing more than the letter I did not write

to Grandmother on the card-stock

with the New York Harbor photo–

its royal water taking in the morning sun

and glistening towers rising from the surf-slapped slate;

or the Ives sonata I never learned

which now gathers dust on the music stand.

~

Perhaps better not to look

at the New England guidebook still with price tags

for delightfully abstract weekend getaways,

the pristine crock-pot in the kitchen cupboard

with the slow-cooker recipes–to save

all kinds of money–

and the print I never hung–you know,

the one of the woolen sheep

herded up the steep slope with the Irish cliffs

tumbling down into the wild blue sea.

~

No, tonight it is enough

as I pad across the hardwood floors

of my bedroom–now October-brisk–

and crawl under the comforter I meant to wash

last week,

to be satisfied with the things I did do

and leave tasks undone to the morning

with its bright ambition

and bushy energetic tail.

Yes, there is another day to mop the kitchen floor

and finally open that 12-pack of

mint-flavor floss, six yards per roll.

~

Yes, I think Emily would understand,

as I reach past the tome of her Dickensonian rhyme

and with a click of the lamp,

send the room into dark, peaceful sleep.

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Filed under Poetry

“A soft answer turneth away wrath…

…but a witty one can silence a fool.”

Living in New York City means living in close quarters with people who are at times cocky, arrogant, brusque, dismissive, and overbearing.  People do not sit on the front porch sipping lemonade here; they do not bring casseroles to new neighbors.  No, they run over others who happen to get in their way, they insult those in proximity who happen to annoy them, and they often have no regard for others they may be inconveniencing.

Thankfully, the hospital atmosphere usually smooths out the rough edges.  Usually.  I remember vividly when I was interviewing for residency at NYU, I stopped at the security desk and asked politely for a visitor name-badge.  That simple request at 7:30 in the morning apparently ruined that security officer’s day.

The other day, I was going to bring a patient back to the operating room.  One of the nursing assistants had already started an IV on the patient–a bit of a luxury at my institution.  I usually will just carry the bag of intravenous fluids as I escort the patient, but this time, without thinking, I started to push the IV pole with the patient as we headed toward the door of the preoperative holding area.

“I knowyou’re not taking that pole!” one of the nursing assistants said in a condescending tone.  I stopped, instantly feeling annoyed.  I usually don’t think about the medical hierarchy, but there definitely is one.  Attendings > Fellows > Residents > Interns > Medical Students.  Nurses have a bit of a different ladder, but I would generally place an average nurse somewhere between an intern and a medical student.  Interns write orders that nurses follow, but they are still credentialed professionals; medical students are not.  Otherwise, the nursing hierarchy is something like Nurse Manager > Charge Nurse > Nurse > Nursing Assistant.

As a senior resident (a chief resident at that) I intuitively feel I’m perhaps a couple rungs higher than this nursing asssistant.  And while rudeness (in the sense of condescension) is never professional, it seems particularly egregious when it’s directed up the ladder.

And so, I turned, and I said in the most neutral tone I could muster, “Are you asking me to leave this IV pole here?  Because if you ask nicely, I would be happy to.”  This was met with absolutely no reply, so I unhooked the bag from the pole, and escorted the patient out of the room.

On a different day, I happened to have a medical student on an anesthesiology rotation assigned to my room.  We were doing a complex case–a resection of a lobe of the liver for a living-related liver transplant.  The surgeons like the patients dry so the liver doesn’t bleed as much, and I was trying to accommodate, though the risk would be hypotension.  Throughout most of the case I was successful in walking the fine line of hemodynamics, though at one point the patient seemed a bit bradycardic (heart rate of 46, baseline of 60, running most of the case in the 50’s) and hypotensive.  I gave a dose of ephedrine and a little fluid, and explained to the medical student my rationale as we watched the monitors for the response.

Just then, I heard a voice say, “The patient is bradycardic.”  I turned around.  It was a woman who had been one of the two or three people floating mysteriously on the periphery of the room; she was now standing immediately behind me.

Rather than answering her, I asked, again with a neutral tone, “Excuse me, who are you?” “I’m with the liver transplant team, but I used to be an ICU nurse,” she replied.

I then asked her, “Are you asking me or telling me that the patient is bradycardic?”  She said nothing, so I turned around and went back to my job of taking care of the patient.

I think the thing I found particularly insulting is what this former ICU nurse’s interference with my work implied.  If I’d been sitting there working on a crossword puzzle while the patient was on the brink of death, that is one thing.  But I was clearly monitoring the patient, so this woman’s comment suggested that I was not qualified to recognize a problem.  This I found highly offensive.  This is my job.  I monitor patients.  I keep them alive while the surgeons hack out major organs. Not only did I already knowthe patient was bradycardic (not so worrisome) and hypotensive (more concerning), I had already treated it by the time this woman thrust herself into my area of sanity on my side of the drapes.

I will spare my gentle readers the story from the same day of the animal, er, older man, who resorted to pushing on the subway when people were in his way, rather than walking around or *gasp* saying “excuse me.”

I don’t know…maybe I’m the arrogant, dismissive one.  But better to be clever and arrogant and dismissive, than foolishly arrogant.

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Filed under Musings, Work

Doctors as professionals

I ran across this interesting post recently which contrasts physicians with other professionals.

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Filed under Health care, Musings

Ban Ki-moon likes my tie

My roommate Jordan recently sang the German national anthem for the German Consulate’s party at Central Park’s boathouse.  I think it may have been for  German Unity Day, October 3.

As a member of the Metropolitan Opera’s Lindemann Young Artists Development Program (and, like Renee Fleming, Susan Graham, and Ben Heppner, a winner of the prestigious Metropolitan Opera National Council Auditions), Jordan seems to get more singing engagements around town than I, with my two years’ experience in church choir during high school.

In any case, Jordan nearly left the apartment that evening wearing a brown tie with a navy suit.  Doing the only compassionate and reasonable thing, I stopped him.  He seemed to be under the impression his suit was brown, and after a confirmatory call to his girlfriend, realized I was, indeed, correct.

While Jordan searched for an appropriate tie, I realized that most of his ties were brown, so I pulled out a few of mine to show him.  There was the conservative red-and-navy striped tie, the rather loud orange tie with light blue stripes, and the demure blue tie.  He selected the last one.

The singing went well.  Jordan’s fairly comfortable with German, so while waiting for food afterward, he struck up a conversation with some German girls.  They seemed friendly, even flirtatious, perhaps not realizing Jordan’s girlfriend was waiting back at the table.  One of them told Jordan she’d written a song with the English title, “Why I like German boys.”  Jordan, thinking the conversation was taking an odd turn, smiled politely until they asked what part of Germany he was from.  “I’m not from Germany.  I’m American.”  The girls were surprised.

Only later did Jordan realize that the girl’s telling him about the song, “Why I like German boys,” was a rather robust failure of an attempt to flirt.  Not only did she not realize he has a girlfriend, the song’s title only confused him rather than clued him in to her interest.

The highlight of the evening for me (who wasn’t there) came when Ban Ki-moon himself complimented Jordan on his singing.  My tie came within inches of the Secretary-General of the United Nations!  I think Ban Ki-moon really wanted to compliment the tie too, but was too shy.

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Filed under Around town, Awkward moments