I have modified the names of the patients in my stories to protect their identities, and am writing these stories based on my memory alone. These stories are very close to my heart and are not meant to offend anyone. I understand that my view of the medical school experience is one of countless different views, and I am simply stating them.

For those who are used to reading my Lyme blog, please be aware this blog is much more graphic and uses adult language. The graphic nature of some of the stories are not meant for the faint of heart.

Wednesday, November 2, 2011


I wrote this one a long, long time ago in the medicine wards when I was only in my third year of medical school.  Years later I used excerpts from it in a talk I gave on sexual harrassment in the medical training . . .


Our school has immersion programs; Spanish Immersion for example, in which you get to spend a substantial amount of time in a foreign country to improve your understanding of another language as well as another culture.  Evidently, I have inadvertently signed up for the Testosterone Immersion program.

I am approaching the end of my rotation in internal medicine during which I was grouped with five guys.  That’s it, just little old me and five men.  I wish I were one of those girls that would bring out the fake gentleman – I’ve come to the conclusion that there are no real gentlemen – in all the guys.  You know, the type of woman that walks into the room, and all the guys stand up to offer her their chair, and then proceed to try to impress her by making clever remarks or finding ways to exhibit their masculinity, making themselves look like a bunch of monkeys in human clothing. I happen to be the opposite kind of girl.  I’m the type of girl that guys complement by allowing her into their males-only circle.  I actually once heard a guy say, “oh Shadow is not a woman, she’s one of us,” and then looked at me expecting expressions of gratitude, or perhaps waiting for me to prove my guy status by performing some sort of male ritual.  And so it is that for the past four weeks, I have been swimming in testosterone.

First, a little about my team.  Eddie is our senior resident, which means he’s been doing the doctor thing for over two years, and in less than another year he’ll be done.  He is of the rare species of doctor, Doctorus carious, who actually went to medical school because he wanted to take care of people. He is really funny and jokes around a lot, but never makes a joke about a patient.  I want to be like Eddie when I grow up – figuratively speaking, of course, as I’m quite a few years older than him already. 

Eddie gave us a little let-me-tell-you-how-it-works talk at the beginning of the rotation.  He believes in team work, which means we all have to stay at the hospital until every last one of us is done with their work.  It sounded like a good idea at the time.  But when I’m exhausted after fourteen hours of work, most of us are done and waiting for that last person, and Eddie is passing the time by pimping us about all the different ways a patient’s salt levels may rise, I find myself too distracted by my fantasy of shoving a couple of salt sticks up his nostrils to answer his questions correctly. 

We lost a patient once on our service with Eddie.  Lost - as opposed to found?  Lost; as in “I was walking up the stairs this morning and I found a patient on the corner of a step.  I picked him up and put him in my pocket, but he must have fallen out.  Because when I reached the top of the stairs, he was no longer in my pocket.  I lost the patient.” 

No?  I suppose more in the lines of “this patient came up to me and placed her life in my hands.  She told me it was very precious to her and asked me to take good care of it.  I did my best to hold on to it.  I gripped tight with all of my strength.  But it was like trying to hold on to water.  No matter how I squeezed my fingers together, how I cupped my hands, how gingerly I walked around making sure I wouldn’t trip, it just dripped through my fingers.  I lost my patient.” 
In medicine we learn many new words, but we also give new meaning to old words.  We lost a woman who was about my age on Eddie’s service.  Sure, she had made some mistakes in her life, in her lifestyle.  But to pay for them with her life?  Lost; as opposed to rescued; as opposed to saved. 

Every morning at rounds we had talked about her worsening condition, every morning we watched helplessly as she took a huge step towards death.  And yet I was shocked when it happened.  Patients usually don’t die in the medicine service; they die in the intensive care unit (ICU).  We cleverly sign them off to the ICU team and quickly forget about them before they have a chance to die.  That’s why it’s so rare to lose patients in medicine.  Eddie is unique in his habit of following the patients even after we sign them over to the ICU.  That’s how we felt her loss even though technically she was not in our service any more. 

Eddie was furious about her death.  Michael, the junior resident tried to pacify Eddie by reminding him that we can’t help them all.  Michael knows everything.  He is the type of doctor who spent his medical school years buried in books.  And he remembers, word for word, everything he had ever read.  He is brilliant.  It turns out however, that compassion is not taught in medical books, so he never had a chance to learn it.  I watched Eddie as he ripped Michael a new asshole for making such a cold statement.  As far as Eddie is concerned, no one in their thirties, regardless of who they are or how they live, should be allowed to die.  He is not in the business of losing patients.  You could say he’s a sore loser.  I am going to be like Eddie when I grow up.

Another junior resident in our team is Daryl.  He is short and stubby, very direct in his conversations, and can make anyone laugh despite themselves.  He himself never laughs or even smiles.  I remember distinctively meeting him and NOT thinking that he was handsome or attractive.  But it seems to me that every time he leaves our team room to go and talk to one of the nurses, he returns with a phone number.  There must be something in his wit that completely compensates for what he is lacking in his height.  He also reads a lot and knows everything, but even though he tries to paint a tough-guy picture of himself, it is a delight to watch him with patients and see that he cares about them, more than he’d ever be willing to admit.  Watching Eddie and Daryl together is like attending a two man stand up comedy act.  We just sit back and enjoy the show.

I’ve been working with Eddie, Michael, Daryl, and two other male students during this service.  It took less than four weeks to make a guy out of me.  Now I find myself scratching my crotch and belching in public, finding a connection to sex in all subjects of conversation, and every other word that comes out of my mouth is a profanity.  No, let me rephrase that last part:  Every other fucking word that comes out of my fucking mouth is a fucking profanity.  Not to mention the couple of times that I caught myself checking out the nice hooters on the nurses. 

It’s been quite a learning experience!  I’ve learned that nurses can be referred to by the size of their breasts.  Because heaven forbid we should actually try to learn their names.  For example, we have the-flat-chested-nurse taking care of bed eight, or the-nurse-with-the-nice-pair-of-jugs-on-her taking care of bed three.  One might ask about the possibility of two nurses with similar sized breasts.  How would we differentiate them?  There is no need for despair – or for the learning of names.  A secondary measure of identifying nurses is by the size of their ass.  So Ms. nice-jugs-and-round-ass can easily be differentiated from Ms. nice-jugs-but-flat-ass.  I don’t claim to be a saint in all of this myself.  I won’t deny that there’s a male nurse on our floor that turns my blood into hot lava every time he passes by.  But I simply hide it better.  You would never catch me referring to him as the-nurse-with-the-big-dick, or the-well-hung-nurse.  No, I didn’t learn his name either, but I just appropriately refer to him as the-male-nurse. I’m just grateful that they are rare a species, male nurses, otherwise I would have to find secondary measures of identifying them too. 

In defense of the nurses, I must mention that they never try to learn any of our names either.  They have a simpler strategy of identifying us; they just lump us all together – men and women, doctors and students – into one entity named “The Doctor”, or just “Doctor” for short.  On the elevator, you hear them say “which floor Doctor?” or in the hallways, “good morning Doctor.”  In the wards you hear someone ask “Who ordered this for patient B?”, and the answer is always “The Doctor.”  Apparently the individual whose name is The Doctor is known to everyone and does not need further identification.  Although I admit, I have not been initiated into the circles of nurses, so I couldn’t possibly know what other measures are used by them to identify individual doctors.  As I don’t think I’ll ever have the privilege of being admitted into the nurses’ secret society, I’m just going to have to be content with my honorary membership in the testosterone clan.

I was not very passive to these comments regarding women in the beginning of the rotation.  Let’s not forget that I have a little suppressed feminist living somewhere inside me.  So at first I tried to point out these insults to feminine identity by opening my eyes wide and gaping at the guy who had just made an offensive comment.  The gaping eye trick didn’t work.  I had forgotten that men were blind to any form of body language used by women, unless it comes in the form of an invitation to have sex, in which case it is promptly recognized and acted upon.  

After the failure of facial expressions, I tried to make intellectual comments that would suggest the language used was offensive to women.  In this case I was laughed at and made to admit reluctantly that I was indeed one of the guys and not really offended by these comments – which in all truth I really wasn’t offended, but was just trying to do the politically correct thing.  I knew these guys well enough to know that they were all good, harmless guys, perfectly capable of working with women and respecting them as peers.  After all, they worked well with me as their equal. I understood their desire to come across as strong macho men when put together in a group like ours.  This pattern of behavior is analyzed in TV specials on Animal Planet where a group of male baboons are put together and then observed for the actions that establishes one of them as the prominent male in the pack.  I guess these guys were each trying to establish themselves as the prominent male in our pack.  Our very own Animal Planet special! 

My attempts at curbing these comments were finally put to rest one day when in response to the above-described method of identifying nurses I protested by asking Daryl “How can you guys say these things about women?  Don’t you have sisters, or mothers?”  Poor Daryl started to say “Yes, I have a mother,” but then he was interrupted by Eddie, saying with a very thoughtful and serious face “That’s quite a coincidence really, because I have also had Daryl’s mother.”  After this conversation, since I spent five minutes laughing at Eddie’s response with water spewing out my mouth and nose, I decided to just go with the flow and let the conversations take their natural course.  Who knows, if I spend another year or two with these guys, I might even grow a penis.