A Story With a Moral and a Laugh
An inpatient unit in the Bronx, circa 2005.
I was a resident – and hence likely disheveled or groggy or exhibiting some other form of outward display of exhaustion – of the internal medicine program at Albert Einstein University Medical Center/Moses Division, aka Montefiore.
The fact that the program was considered ‘malignant’ by those in my industry – due to the strict nature of its training – likely strengthened the probability of my aforementioned look. Those of you who knew me back then can attest. But in quiet fashion, maybe by just nodding to ourself, or acknowledging this fact in your head. There’s no need to reiterate how badly I looked.
But I prevailed. I survived the rigorous training and long-sleepless hours of my days spent on the ‘inside’. Yes, it often felt like I was ‘doing time.’ Except I didn’t in fact do anything wrong. Or break any law, for that matter.
Nonetheless, it was a rite of passage – a ritual that needed to be completed. A bit like hazing, but differing in some of its finer points. While sharing similarities in the torture techniques that were used, they differed in their purpose – one ensuring loyalty, while the other, competency. You say tomato, I say tomato. Either way, I served my time.
But here I was, a third year resident physician, and in charge of my own team.
My very own!
The team was comprised of both interns – suffering through their first year of training, the worst year by far – and medical students, who were still solidifying their medical knowledge base. Together, as a team, we took care of the patients on the floor. Heaven help them.
I kid. But not really.
I was the boss of the team and we all reported back to yet another doctor in charge, the revered attending. These were the ones who had been through it all – completed this mission – the color in their faces already partially restored. I knew who they were by the glow on their newly exposed skin, bright from the sun, having ventured outside during their – dare I say it? – down time. *Gasp*. They were also easily identifiable by the way in which they walked through the hospital – clicks of pride in their stride – knowing they had made it through residency intact and now were truly in charge – the so called top of the food chain.
But during those early morning hours, the revered ones weren’t around. Instead, we graced the floors – the tight-knit group of us, tending to everyday minutia, checking in on patients and their necessities. And I was in charge.
The Incident Takes Place.
On this particular day, one of my medical students – incidentally a male – was called down to the floor where a nurse had been unsuccessful in drawing a patient’s blood. He was called on to perform the phlebotomy himself – phlebotomy the technical term for a simple blood draw.
This was standard procedure. We were called routinely to patient rooms, if the nurse was unsuccessful at ‘getting a vein,’ and it then became our responsibility to take over the poking.
Medical students followed their own patients, and were taught how to perform said procedures, but were still ‘getting the hang’ of things.
I decided to take the team down to the floor myself, after seeing the reflection of fear in my poor student’s eyes. They were silently pleading with me for help, at the thought of his own inexperienced hands. I envisioned the discomfort – both the patient’s and my student’s – in a prophetic sort of way – of the digging, repositioning, and once again the digging, that would take place, deep into the patient’s arm, and the anxiety that it would cause.
I made the decision, right about then. I, experienced third year resident and all, who was the quickest draw in the west (wing of the wards), would, in fact, sacrifice my time rounding by showing them how it was done.
I would perform the phlebotomy, I announced, and take away any possible inconvenience for the patient. I uttered this last bit to myself, of course, because they didn’t need to know. I had been through it many, many times before and considered myself quite the phlebotomist by that time *brushes the shoulder and looks to the side*.
I told the group as much – sans shoulder brush – and the student was instantaneously ecstatic – first relieved, then beaming at the thought.
The Patient Herself.
Our team walked down together, where we found the patient stationed out in the hall, comfortably in her chair.
We exchanged light banter, as I introduced her to myself and the team. She had already met the medical student, clad in his short white coat (the difference in lengths distinguishes an MD from a student, a little factoid unknown to many).
I was there to draw her blood, I announced, smiling.
She looked me up and down, spent the next few moments rather deep in a thought of some sort, her brows furrowed together, and then – Eureka! – she had it.
“Sweetie, you’re not touching me,” she said, and followed this by, “I know a medical student when I see one.”
Baffled, I chuckled. She must not have heard. An explanation ensued – I was indeed not the student here, I told her, but rather the resident physician, and had had much experience under my belt. I’d surely get her vein. Satisfied with my response, I turned to get the supplies, when, in back, I heard her exclaim in my direction:
“Sweetie, I’m not stupid. I know who the doctor is here.”
And as I turned around, a smile crept back up on my face, because I was confident I knew – once again, prophetically – who she had referred to.
My suspicion was true. I found her happily pointing to the student – now standing there, like a deer in headlights. She was oblivious to this, of course, or maybe just ignorantly choosing to take no notice of it, and instead focused her self-satisfied grin directly at me, to boast in the success of her moment of glory. She had called me out. A true detective’s work.
If only she knew that her detective was in reality a novice, just beginning, his first day at work. I pleaded, but she relented.
Trying to explain
The student came to my aid – explaining, under his breath, that he was not, in fact, the doctor and that, I actually was. But the woman just shook her head in disbelief. We were not about to fool her.
So we did as she wished.
This is where the moral of my story comes in. It’s an oldie, but still such a goodie.
Never judge a book by its cover.
Especially if that book is me, in doctor’s coat and heels, walking away with a group of interns and trainees in tow, a grin on my face as a medical student in a short white coat behind me re-inserts his needle on his second attempt at finding the vein..