the group was a young Chinese doctor. He held out his hand. “Tom Chang,” he said. “I hope you’re all as nervous as I am.”
Paige liked him immediately.
A man was approaching the group. “Good morning,” he said. “I’m Dr. Radnor.” He was soft-spoken, with sparkling blue eyes. Each resident introduced himself.
“This is your first day of rounds. I want you to pay close attention to everything you see and hear, but at the same time, it’s important to appear relaxed.”
Paige made a mental note. Pay close attention, but appear to be relaxed.
“If the patients see that you’re tense, they’re going to be tense, and they’ll probably think they’re dying of some disease you aren’t telling them about.”
Don’t make patients tense.
“Remember, from now on, you’re going to be responsible for the lives of other human beings.”
Now responsible for other lives. Oh, my God!
The longer Dr. Radnor talked, the more nervous Paige became, and by the time he was finished, her self-confidence had completely vanished. I’m not ready for this! she thought. I don’t know what I’m doing. Who ever said I could be a doctor? What if I kill somebody?
Dr. Radnor was going on, “I will expect detailed notes on each one of your patients—lab work, blood, electrolytes, everything. Is that clear?”
There were murmurs of “Yes, doctor.”
“There are always thirty to forty surgical patients here at one time. It’s your job to make sure that everything is properly organized for them. We’ll start the morning rounds now. In the afternoon, we’ll make the same rounds again.”
It had all seemed so easy at medical school. Paige thought about the four years she had spent there. There had been one hundred and fifty students, and only fifteen women. She would never forget the first day of Gross Anatomy class. The students had walked into a large white tiled room with twenty tables lined up in rows, each table covered with a yellow sheet. Five students were assigned to each table.
The professor had said, “All right, pull back the sheets.” And there, in front of Paige, was her first cadaver. She had been afraid that she would faint or be sick, but she felt strangely calm. The cadaver had been preserved, which somehow removed it one step from humanity.
In the beginning the students had been hushed and respectful in the anatomy laboratory. But, incredibly to Paige, within a week, they were eating sandwiches during the dissections, and making rude jokes. It was a form of self-defense, a denial of their own mortality. They gave the corpses names, and treated them like old friends. Paige tried to force herself to act as casually as the other students, but she found it difficult. She looked at the cadaver she was working on, and thought: Here was a man with a home and a family. He went to an office every day, and once a year he took a vacation with his wife and children. He probably loved sports and enjoyed movies and plays, and he laughed and cried, and he watched his children grow up and he shared their joys and their sorrows, and he had big, wonderful dreams. I hope they all came true … A bittersweet sadness engulfed her because he was dead and she was alive.
In time, even to Paige, the dissections became routine. Open the chest, examine the ribs, lungs, pericardial sac covering the heart, the veins, arteries, and nerves.
Much of the first two years of medical school was spent memorizing long lists that the students referred to as the Organ Recital. First the cranial nerves: olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, auditory, glossopharyngeal, vagus, spinal, and hypoglossal.
The students used mnemonics to help them remember. The classic one was “On old Olympus’s towering tops, a French and German vended some hops.“ The modern male version was ”Oh, oh, oh, to touch and feel a girl’s vagina—such heaven.”
The last two years of medical school were more interesting, with courses in internal medicine, surgery, pediatrics, and obstetrics, and they worked at the local hospital. I remember the time … Paige was thinking.
“Dr. Taylor …” The senior resident was staring at her.
Paige came to with a start. The others were already halfway down the corridor.
“Coming,” she said hastily.
The first stop was at a large, rectangular ward, with rows of beds on both sides of the room, with a small stand next to each bed. Paige had expected to see curtains separating the beds, but here there was no privacy.
The first patient was an elderly man with a sallow complexion. He was sound asleep, breathing heavily. Dr. Radnor walked over to the foot of the bed, studied the chart there, then went to the patient’s side and gently touched his shoulder. “Mr. Potter?”
The patient opened his eyes. “Huh?”
“Good morning. I’m Dr. Radnor. I’m just checking to see how you’re doing. Did you have a comfortable night?”
“It was okay.”
“Do you have any pain?”
“Yeah. My chest hurts.”
“Let me take a look at it.”
When he finished the examination, he said, “You’re doing fine. I’ll have the nurse give you something for the pain.”
“Thanks, doctor.”
“We’ll be back to see you this afternoon.”
They moved away from the bed. Dr. Radnor turned to the residents. “Always try to ask questions that have a yes or no answer so the patient doesn’t tire himself out. And reassure him about his progress. I want you to study his chart and make notes. We’ll come back here this afternoon to see how he’s doing. Keep a running record of every patient’s chief complaint, present illness, past illnesses, family history, and social history. Does he drink, smoke, etc.? When we make the rounds again, I’ll expect a report on the progress of each patient.”
They moved on to the bed of the next patient, a man in his forties.
“Good morning, Mr. Rawlings.”
“Good morning, doctor.”
“Are you feeling better this morning?”
“Not so good. I was up a lot last night. My stomach’s hurting.”
Dr. Radnor turned to the senior resident. “What did the proctoscopy show?”
“No sign of any problem.”
“Give him a barium enema and an upper GI, stat.”
The senior resident made a note.
The resident standing next to Paige whispered in her ear, “I guess you know what stat stands for. ‘Shake that ass, tootsie!’ ”
Dr. Radnor heard. “ ‘Stat’ comes from the Latin, statim. Immediately.”
In the years ahead, Paige was to hear it often.
The next patient was an elderly woman who had had a bypass operation.
“Good morning, Mrs. Turkel.”
“How long are you going to keep me in here?”
“Not very long. The procedure was a success. You’ll be going home soon.”
And they moved on to the next patient.
The routine was repeated over and over, and the morning went by swiftly. They saw thirty patients. After each patient, the residents frantically scribbled notes, praying that they would be able to decipher them later.
One