On your own terms

How would you like to die?

Peacefully? On your own terms? Is there dignity in early retirement, so to speak? Or does the dignity lie in the struggle, the fight to the very last gasp?

“Look at me.” I knew not to look. “How would you like to die?”

I doubled back without realizing. Sensing my surprise, my attending broke eye contact with the patient and returned my stare. Three seconds felt like an eternity.

“How,” there was a brief pause in his cadence, “would you,” another one, “like to die?”

He enunciated every syllable. There would be no doubt in his words, no question in his intent. He was soft, understanding, and at once cold, so cold, and calculated, and firm. Continue reading “On your own terms”

Big Day

Something like No Problem by the Chet Baker Quartet was playing in the ICU. It was one o’clock in the dark of the night. The barbershop was open for business.

Having been assigned to the Trauma ICU for the past week, I was comfortably familiar with the patients and their stories. I rounded on the unit at the start of my shift, making small adjustments here and there and hoping for a quiet night.

I began by saying my hellos to the family in bed 2, each relative clutching a hand and praying that the young woman, many years my junior, whose brain had swollen as a result of her injuries, would win the fight for her life. Visiting hours had ended but they were allowed to stay later given the circumstances. I drew the curtain behind me. Continue reading “Big Day”

Mother Tongue

On the way, echoing softly around the corner and down the hallway, I hear it. Maybe I’m imagining it – I’ve only slept four hours in the last two days – but I swear I heard a soft K and delicate L wrap around a guttural H. I could recognize these sounds anywhere.

I have to see someone. Nothing urgent, just a quick check. For the anxious or tired patients, especially those so soon out of surgery, I like to tuck them in at night. It’s a miracle move, probably the greatest secret in medicine, more tangibly impactful than the flowcharts and electronic doctoring that have come to define my training.

I am a building away. I can take the second floor shortcut and be there in a few, but I can’t escape the sound of my mother tongue. I take the right instead, my focus now at odds with my imagination. I realize I have been homesick this whole time and I wonder what or who I will see. Continue reading “Mother Tongue”

On my watch

Tell me what happened.

I was sitting in the workroom when the nurse rushed in.

What were you doing?

I can’t remember. Putting in orders or signing a note? I was sitting at the computer furthest from the door.

Tell me more.

She came in, breathing heavily. I can still picture the look of panic in her eyes. One of my patients was so hypotensive that the monitor wasn’t registering his pressure anymore. I chased her to his room. His nose was purple. He had taken off his breathing mask, I think. His nose was so purple, man. That was the first thing that caught my eye. Continue reading “On my watch”

Hospital Omelet

Ms. B gently asked me if I could cut her omelet into bite-size pieces. I gingerly handled the plastic knife and sliced into the delicate hospital-made omelet. I made three expert pieces, straight-walled and contained. Bacon bits spilled out of the first one, but it was an edge piece. It’s not my fault. The other two pieces held up nicely, the glossy spinach densely packed in between the warm folds of egg. I admired my handiwork. The J.D. in me began to romanticize: maybe I was meant to be a surgeon after all. But Dr. Cox interrupted. “Bite-size, Sami.” I looked at the plate. My resident was right. I eat like a giraffe. Most others don’t. Ms. B laughed as I cut the continent-sized pieces into thirds and turned her omelet into scrambled eggs, which she explicitly did not order.

The next day, she was set for discharge. Her transportation was due at 4 pm. It was 2 pm now. We had rounded earlier in the morning and finalized her paperwork, prescriptions, and orders. I wanted to catch her one more time. Continue reading “Hospital Omelet”

Hallway Dinners

I leave the hospital most days around seven o’clock and reach home by the time dinner preparations are in full swing. I can make out the sweet symphony of kitchen sounds through the old wooden doors if I listen closely enough. Occasionally, if I’m lucky, the neighbor across from me has her door propped open ever so slightly, enough for me to appreciate faint sizzles and clanging metal pots, the music to my ears.

As I walk down the hall to collect my mail, I am reminded of the value of our sense of smell. I arrive to fish – salmon, I think – on Saturday. Sunday is pizza day for the family living to the left, Szechuan stir-fry for the family to the right. Broccoli and cornbread on Monday. Someone left something in the oven for too long on Tuesday but the char complements the notes of chile de árbol I pick up from further down the way. Wednesday is an amalgamation of garlic, sweet potato, and something peppery. I imagine the spread of a potluck right now. Thursday smells like bread and, two doors down, fish again. I feel connected and international.

Friday is when the swift absence of kitchen notes hits me. Families are out for dinner, or perhaps things are delayed until after dark. The smell of the carpet running the hall is no longer masked by these hallway dinners, and my worn-for-fifteen-hours-straight scrubs smell like old carpet too. It’s quiet – it’s time to change – and there are no sizzles or Aha!s or caramelized onions to share. Dinner, tonight, will be alone.

Urban Procurement

Blue and just as dark, the operating room is the urban landscape,
Illuminated by fluorescent street lamps that flicker and fizz like the overhead lights.

Nighttime, a procurement running late.
Smoke from the grates along the side of the road dance in the light like the wisps of the Bovie tip’s smoke.

A man and his drum, beat after beat, flex like the heart.
Next to him another man, breath held, with saxophone in hand, clutched tightly at waist height, and silent.

Continue reading “Urban Procurement”

On family and all that is left at 7 pm

His kidneys failed, I’m told. The both of them. Tubes crisscross over and under his bed in a room crowded with empty seats, fuzzy television screens, useless nightstands, and a whiteboard that reads: “Goal: Increase activity”.

The lights are turned off and it’s 7 pm. Flash back to the days when we were young and restless.

With muddied hands (mama told us to stay away from the puddles but we never listened) we run to the kitchen sink without making eye contact. Because once we make eye contact, mama gives us that look that means we’d better be in bed in less than five. She asks whether we’re tired. “No,” we say, but we are. We are just too young and too proud to admit it. And at 7 pm, the lights go off.

Continue reading “On family and all that is left at 7 pm”

Embrace

After what felt like a relatively good day in OBGYN clinic — no new cancer diagnoses, no particularly life-threatening pathologies — I followed my attending to the women’s hospital entrance, the elevators, and to the eleventh floor. The door stood slightly ajar as though the patient expected us to round this late in the day. We peeked inside.

She was bundled neatly under two or three off-white linens that did a rather good job of concealing the tangle of wires and lines that hung from her arms. Her husband sat at her bedside. He bore a striking resemblance to an actor whose name was on the tip of my tongue.

Continue reading “Embrace”

The poetry and chaos of organ transplantation

Four teams of surgeons from three hospitals rapidly descended on the body of a middle-aged man lying face up in an unfamiliar hospital’s tight-fitting operating room. By nightfall, the room was ten surgeons and six organs emptier and this man had gifted a handful of patients with new beginnings.

I began my third-year clerkships on an abdominal transplant service. Lacking confidence in a hospital setting and unsure of how to integrate body systems in my patient assessments, the three-week surgical elective pushed me to my limits. There was no way to prepare for what I quickly discovered to be one of the busiest and least forgiving services in medicine. But despite the physical and mental exhaustion, the novelty of an organ transplant excited me every time. I sought out as many opportunities to return to the field as I could, happily completing one cardiothoracic and another abdominal transplant rotation by the time I graduated medical school. The details of my first procurement follow.

Continue reading “The poetry and chaos of organ transplantation”