by Anthony Youn
That night in the call room, between a barrage of pages—Nancy has once again honored me with the privilege of being her screener—I think about my mother. I think of how much she must worry about her family. I know she prays for all of us. Then, even though I’ve sort of pushed religion aside since I started medical school, I decide to pray for Frank. I’m not in very good standing at the moment, so I’m not sure my prayer will be heard. But I figure praying can’t hurt. So I pray. I ask God to help Frank through the surgery.
The next couple of days waste me. The nights I’m on call, I eke out a couple hours of sleep, but never consecutively. By the time I finish prerounding Nancy’s patients at five-thirty, I can barely stand. I’m back on her good side, though. She sees how hard I work and notices that I actually help her more than get in her way. Plus, I greet her every morning with a Starbucks venti latte and a glazed doughnut, my treat. Her cheeks puffed out like a chipmunk’s, she slurps her latte and, with a foam mustache riding her upper lip, says, “Tony, if you think you can win me back with coffee and junk food, you’re right.”
Rotation one. Day four. I get a page. It’s from the fifth-floor nurses’ station. Come to 507. Bring your tern. No emer.
“We’re wanted in 507,” I tell Nancy.
Nancy does it again for the second time in four days. Her lips twitch and slide into that weird narrow uptick that may be a smile. “Let’s book.”
She barrels down the hall. I speed-walk to keep up. She’s like a human boulder on wheels. In a flash we hit 507. Nancy, her breathing rolling out in huffs loud as drumbeats, blocks the doorway. I stretch and peek over the top of her head.
Frank, IV tubes stabbing him everywhere, lies in the hospital bed. He looks even thinner, paler, but astonishingly, his cheeks shine pink, as if someone has dabbed them with makeup. A woman in mom jeans and a heavy sweater sits at his bedside. He catches my eye. He speaks without moving his lips. “There he is.”
The woman cranes her neck. “Please, come in.”
I squeeze by Nancy, whose head has begun to rotate. She grunts as I move by her. The room smells of Lysol.
“You did it,” I say.
“I feel like shit,” Frank rasps.
“He did well,” the woman says. “You’re gonna be fine, Dad.”
“This your daughter?”
“Dottie,” Frank says.
“Nice to meet you.”
Dottie presses my hand between both of hers. Her eyes fill up. “You saved his life,” she says. “Thank you, Dr. Youn.”
A groan from the hall. Nancy. No doubt gagging on her doughnut.
I touch Frank’s shoulder, which feels as brittle as a bread stick. “Hang in there, Frank. You’re on your way. Proud of you.”
He sniffs, holds up a tubed hand. “You say hi to your mom,” he says.
Later that night, lying in the call room, staring at Nancy’s pager, mercifully silent for almost three minutes, I replay my first week as a medical student in the hospital. Two thoughts spin through my mind.
The first is a quote by Hippocrates: “It is more important to know what sort of person has a disease than to know what sort of disease a person has.”
The second comes out of the mouth of Intern Nancy. As we walked away from Frank’s room, she whispered loud enough for the entire hospital staff to hear, “Dr. Youn, my ass.”
IN THE END, after our two months together, Nancy admits grudgingly that of all the medical students she’s worked with, I have been, by far, the least pain in her balls. She rewards me with a high grade and glowing recommendation. I’m thankful for that and for clarifying what I already know for my future: I have no interest in dealing with disorders of the heart, liver, pancreas, kidney, and spleen—I don’t find human physiology and how organs work all that fascinating—and I will not pursue a career in internal medicine.
As it turns out, neither will Nancy.
Nancy will change career paths and become an orthodontist.
I can see her now, plowing her fingers into strangers’ mouths and sadistically bending and tightening small strips of metal around their disfigured and mangled teeth until they squeal.
I’ve no doubt that she’s happy.
13
“Miracle of Birth Occurs for 83 Billionth Time!”
Clinical rotation two.
Obstetrics-gynecology.
I love babies. Who doesn’t? But I will never be a baby doctor.
No offense, Dad. Nothing personal. It’s the lifestyle. It’s just not me. I always saw you as a great ob-gyn. A warrior. A hero. A champion. You kept our phone number listed and gave it out to all your patients, just in case. They took you up on that. They would call our home days, nights, weekends, and holidays. One Saturday night, I’m sixteen, hanging out in our basement playing Super Mario Brothers with my nerdy friends, and the phone rings.
“Hello?” I cradle the receiver into my neck so as not to jar my controller.
“Dr. Youn!” a frantic woman shrieks.
“No, this is Tony—”
“GET THIS FUCKING BABY OUT OF ME! IT HURTS LIKE HELL! AHHHH!”
“Dad, it’s for you.”
I place the receiver down with a clatter and return to the game. Screaming mothers in labor don’t faze me. I’m used to these calls.
I’m also used to hearing my dad leave the house in the middle of the night, the wheels of his car crunching down our driveway, enduring his crankiness due to exhaustion and overwork, and accepting his absence at school events because he’s been called away to perform an emergency C-section. And while I am awed by the miracle of birth, I tend to embrace the sentiment put forth in a headline found in the satirical newspaper The Onion: MIRACLE OF BIRTH OCCURS FOR 83 BILLIONTH TIME!
I won’t be going into the family business.
DAY ONE.
The night before.
I practice suturing.
Every night for at least an hour, as I have for the last three months, I stitch.
I started with a rudimentary suture kit I picked up from my dad. Over time I advance. I head over to the hospital and collect packets of old sutures the lab guys are about to toss in the trash.
I work through a half-dozen knots, beginning with a surgeon’s knot we saw demonstrated first year. I maneuver over and over and in and around the clamp called a needle driver. I manipulate all of the knots with ease and master all of the instruments until they feel like a part of my hand. Then I stitch some more.
I practice on a pig’s foot.
I keep Porky’s piggies in my freezer.
I stuff the foot in a Ziploc bag between a frozen pizza and a pint of Ben & Jerry’s Cherry Garcia.
One night while we’re snuggling on the living room couch, allegedly watching an old movie on TV, Amy announces that she has a craving for ice cream. She charges into the kitchen and rummages around inside the freezer. She returns dangling the Ziploc bag containing Porky’s foot.
“Explain,” she says.
“Oh, that. It’s my lucky pig’s foot.”
“Am I supposed to rub it and make a wish?”
I snag her hand. “Worked for me.”
I reel her back onto the couch and tell her that one of the gunners in my anatomy class told me that the skin of a pig comes closest to approximating the texture of human skin. When our local supermarket meat department sells out of pig’s feet or misses a weekly shipment, I go for the next closest thing—a chicken breast.
So every night I practice suturing on my pig’s foot or chicken breast.
I know in our rotations that doctors will not require us to remove a gallbladder. I’m doubtful we’ll be called on to take out an appendix.
I do know they expect us to suture.
I’ll be ready.
I believe in practice—putting in the time—and discipline. Always have. Whether I’m playing the same chord on my guitar until my fingers cramp up, or hitting a thousand backhands, or spending hours and hours suturing a pig’s foot, when I’m called on
to perform, I want to be prepared. No, that’s not right. I need to be prepared. I refuse to be that medical student who excels in the classroom but screws up in the field.
I also pride myself on my manual dexterity.
That’s why I’m shocked at how clumsy I am the first time I pick up a suture kit. I feel like I have ten thumbs. It takes me a full hour to get the hang of the surgeon’s knot. Once I do, I practice it so many times that I can tie the knot blindfolded. I offer to demonstrate on Amy. She declines. Wuss.
THE OB-GYN ROTATION feels like a reality show.
Day one. Our intern hands us each a checklist of procedures we need to observe or perform in order to pass the rotation—perform cervical checks, rupture membranes, attend a cesarean section, and assist in a designated number of natural births, meaning catch a bunch of kids.
Ever the vigilant student, I study the huge dry-erase board at the labor and delivery nurses’ station that displays the patients’ names and the stage of labor they’re in. On call nights, I locate the patient who’s furthest along, dash into the delivery room, introduce myself to patient and doctor, get into a squat, receive the baby, then hose down my shoes—newborns arrive into this world with a splash of goo, guck, ooze, warm fluid, and the edible though not quite delicious placenta. Or so I’m told. I’ve never been tempted. Perhaps someday when I’m a father. As an appetizer with fava beans and a nice Chianti. After the requisite amount of oohing and ahhing, I leave mother, child, and sometimes father, retire to the call room, and add one more check to my list.
One day I get the call.
I drop onto a stool into receiving position as the delivering mom hits high notes only a dog can hear and pushes her baby out into my awaiting mitts.
“Yes!” I say, thrilled that I’ve caught the baby properly and successfully handed the newborn off to the doc. I scream also because, with this birth, I meet my quota for the required number of natural births I have to assist.
“Good job, Tony,” says Dr. Singer, the attending physician.
“Thank you, Doctor. Well, congratulations. Beautiful baby.” I start to leave.
“Hold on,” Dr. Singer says. “You still need to stitch up her episiotomy.”
Not sure why he’s picked me to suture up the small incision he’s made in this particular woman’s vagina, but I’m not going to complain.
“You ready for this, Tony?”
I picture my pig’s foot. “Totally.”
I’m ready but nervous. I realize this is the first time I’ve sutured anything but frozen meat. I take a deep breath, close my eyes, and visualize myself suturing.
You’ve done this a thousand times, Tony. Ten thousand times. This is a small tear. Nothing to it. Piece of cake.
I open my eyes. I’m not even consciously aware of starting. Within seconds, I’m into it. With Dr. Singer guiding me, I begin by tying a surgeon’s knot. Then, slowly, I start suturing. Smoothly. Effortlessly. Flawlessly.
“He’s good,” the mom says, nuzzling her two-minute-old baby.
“He is,” Dr. Singer says. “You’ve got surgeon’s hands, Tony. And great dexterity.”
“Thank you. I practice a lot. I bought my own pig’s foot. Got it in the meat department at Kroger.”
“Nice. A lot of students aren’t aware of the similarities of the fleshy membranes in a woman’s vagina and a pig’s foot.”
“The texture’s surprisingly similar.”
“Although once you get into the actual folds—”
“Guys,” the mom says, “I’m right here.”
I stitch on in silence.
FUNNY WHAT FREAKS you out.
Of course, you never see it coming. That’s partly what freaks you out. The element of surprise.
One of the last days of my ob-gyn rotation.
I’ve met all my requirements, finished checking off everything on my list. I join a pack of med students and follow them into a delivery room to observe a woman in active labor. I walk in as the mom—attractive, young, her face drenched in sweat, sitting up in stirrups—begins to push. She grunts, groans, screams, and heaves forward with her pelvis. The baby begins to crown. The air crackles with excitement. But I am grossed out.
Because she’s got six toes on each foot.
Two pinkies on each foot. Doubles. Four pinkies in all.
She’s pushing out her baby with every last ounce of her strength, she’s yowling, swearing, huffing, and all I can think is My God, she has six toes.
I cannot take my eyes off her feet.
It’s like I’ve wandered into a sideshow at the circus.
That’s wrong. That’s not fair. I’m sure she’s a wonderful, lovely person. But—
Six toes?
What about the baby?
Will her baby have six toes? What about fingers? Will the baby have two pinkie fingers? Or two thumbs? Or two middle fingers? Maybe this kid will grow up to be a super freak and be able to flip off four people at the same time.
What is wrong with me? I have to stop staring at this woman’s six toes and become a professional. Right now. I’m sure that everyone in here is staring at me staring at her. I sneak a glance around the room.
Everyone is staring at her toes. We’re all so focused on the woman’s feet that I hope one of us snaps out of it and remembers to catch the baby.
In the realm of the unusual, I doubt that a woman with six toes giving birth will rank as the most bizarre thing I will ever see in my life, especially if I spend longer than ten minutes on the Internet. I’ve already encountered the teratoma, a cancerous mass with its own teeth and wisp of Troll doll hair, and gazed at photos of the guinea worm, a parasite that burrows into the flesh and has to be wound out over a stick, but for some reason, seeing the six-toed mom creeps me out. Go figure.
Finally, the baby, a butterball, flies out of the womb as if kicked down a waterslide. We duck to avoid the splash—ob-gyn students should be issued ponchos instead of scrubs—cluster around her, and deliver a group gasp.
Five toes. Five fingers.
The attending nurse gently lays the baby on the mom’s breast (only two of those) and pulls the thin white monogrammed hospital sheet over her feet.
I feel as if I’ve made this whole thing up, as if the mom’s six toes existed only in my mind. One by one we straggle out of the delivery room. I’m the last to leave. Something stops me. The hairs on the back of my neck bristle. I turn back. At that moment, the mom shoves her foot out of the sheet. She wiggles—
Six freaking toes!
Like a hand shooting out of a grave.
No. I will never become a baby doctor.
14
If You Don’t Cut, You Suck
Clinical rotation three.
General surgery.
Surgeons, I’m told, call their corner of the hospital world the home of the gods. They revel in their motto: “To cut is to cure.”
Or as Shelly the gunner warns me after completing her surgery rotation, if you’re planning on becoming a doctor other than a surgeon, you’re not becoming a doctor at all. She, of course, plans to become a surgeon.
I walk the corridor with Intern Dan, lean, lithe, muscles rippling through his scrubs, aloof soap-star looks, a hundred-dollar haircut sculpted in place by product assuring that his flowing perm shall remain impervious to hurricane-force winds, a tiptoe walker and low talker, so low I have to strain to hear. Dan doesn’t waste any time.
“You gonna be a surgeon?”
“Yes. I think so. I’m leaning that way.”
“It was a yes-or-no question.”
“I’m strongly considering it.”
Dan slows up, plops a condescending hand on my shoulder. “It’s the only way to go.” He speaks so softly that I find myself trying to read his lips.
“I hear you. It’s just that, you know—”
“What?”
“No, no, nothing. With these rotations, you get to sample—”
“Sample? Sheeeet.”
Dan
plucks a limp orange Stimudent from his pocket and starts picking his teeth like a rancher.
“If you don’t cut,” he murmurs, low, “you suck.”
DAY ONE. EIGHT A.M.
Tim, Shelly the gunner, and I sit in the hospital cafeteria an hour before our daylong orientation, during which we will watch videos detailing the rules of surgery, including the proper way to put on our scrubs and where and how to stand during operations. Shelly and I scarf a breakfast of bagels hard as hockey pucks, cream cheese that spreads and tastes like spackle, and scrambled eggs that bounce. We wash it all down with murky lukewarm coffee. Tim, his complexion wan, his motions jerky, eats nothing. He sips orange juice, eyes front and vacant.
“The orthopedic surgeons make the real money—three, four hundred K a year,” Shelly says, scraping eggs onto the fat half of her bagel with a knife. “They’re studs. The jocks of medicine. Smart, too. Like that hottie Intern Dan. Right, Tim?”
“I guess,” he says.
“They make that much?” I say.
“Oh, easy.”
“But that shit, man, that’s not even surgery,” Shelly says, flagging her fork like a conductor’s baton. “That’s like carpentry.”
Tim coughs.
“I was talking to Eddie Graham? You know him? Fourth-year? Former lacrosse player? Anyway, he did a monthlong orthopedic elective. Insane. You wear like an astronaut’s suit. You take these spikes, jam them into the unconscious patient’s knee, and pound away, bang, bang, bang. Every time you whack the thing, bone splinters, chunks fly everywhere, bone juice spurts and splatters over everything, and blood gushes, whoosh. It’s hilarious.”
Shelly takes a massive bite of bagel and egg, somehow shoving the whole half into her mouth at once. “You know the best part? The accessories. You have to wear these boots, like waders, because you literally slosh through a river of bone juice. Plus, you have to wear waterproof scrubs over your scrubs. And goggles thicker than regular goggles. They’re like a splash shield. By the end of the day, they’re completely caked with bone juice—”