Thursday, November 24, 2011

So not fair.

Schedule is in. November wards. Thanksgiving month. A big family month. At least in his family. But this year, not so much. Because of that schedule. On the wards. At Grady, no less. Damn. Not fair. So not fair.

Call schedule is posted on line. "Just check and see," his wife said. Too scared to even look. Just got married at the end of medical school. First Thanksgiving in this city away from immediate family and also first Thanksgiving with new immediate family--his wife. She nudges more. "Just check. And see."

He checks. He sees.


Thanksgiving day ------> Long call.

This was before the no overnight rules for interns so this meant one thing. This meant no Thanksgiving. At least not for real Thanksgiving. Not fair. So not fair.

"I'll come to the hospital and have a meal with you in the cafeteria, okay?" his wife offered.

He decided that this was better than nothing.

Thanksgiving day. Busy, busy, busy.  Someone ate too much gravy and shook too much salt. Heart failure exacerbation. Another person forgot to get their blood pressure medications. Hypertensive emergency. One young guy couldn't say no to pecan pie. This wouldn't be such a big deal if he didn't have insulin-dependent diabetes. That admission was a doozy--diabetic ketoacidosis. One step away from what the Grady elders call being in "the diabetic coma."

"Is now good?" his wife asked.

"No. Not now. I'm getting bombed."

"Okay," she answered warmly. "I'll call you in an hour."

And she did. And it still wasn't good. So she called two more times and finally decided that this night just would not be good for quaint cafeteria dining. Visions of toasting with paper Coca-cola cups and gazing into his eyes over mystery hash faded away.

Not fair. So not fair.

"I am downstairs," she said in the most cheerful voice she could muster. "I have a plate for you. All of the classics. Everything you love."

And he scampered down the stairwell and out to the hospital entrance where his bride stood wrapped in one of his college sweatshirts over her nice sweater-dress. She extended her arms with this special offering--a plate of homecooked food.

He peeked under the foil. All of the trimmings and all of the trappings. And dessert on the side.

He hugged her tight and silenced his beeping pager. "I'm so sorry," he spoke softly. She kissed him on his scruffy cheek and scurried back to the car.

Not fair. So not fair.

So angry. Angry he signed up for this, a job that doesn't close on major holidays and that is open 24 - 7. Felt good about being a doctor. But not so good about being one that has to work on Thanksgiving day.

It was ten o'clock when he finally got around to heating up that plate. And just as the microwave beeped, so did his pager again. Damn. Not fair. So not fair.

One of the cross-cover patients. A youngish man with throat cancer. Unable to eat foods by mouth and receiving nutrition through tube feeds. He was in pain. That's all. Just wanted something more for pain.

"Okay," he said. "I can give you some morphine. Is this okay?"  And the patient nodded because this was okay. He prepared to leave the room and get back to that plate.

"You know what I wish? I wish I was eating some turkey and dressing. Or even just around people eating that kind of food. This doesn't even feel like Thanksgiving."

The intern looked around the room. No flowers or cards or balloons. No beloveds perched in bedside chairs determined to bring a festive atmosphere into the hospital. Nope. None of that. Next he looked up at the television. NFL football with a big banner at the bottom of the screen that read "Happy Thanksgiving." Beyond this, he wasn't sure if there was any other way the patient would even know it was turkey day. This made the intern feel even sadder because football was a part of his family's Thanksgiving tradition. And even his wife was a supreme trash-talker on NFL Sundays.

"My wife brought me a plate of food from her aunt's house. I haven't even touched it. I'd sit down here with you if I didn't think it would be cruel for you to see all that food."

"Do you like football?" his patient asked.

"Do I?"

"Oh, then. . .man. . . .it'd be great to have Thanksgiving together. You with your plate and me with my tube feeds."

Both men laughed. The intern thought for a moment about the offer. His pager had finally calmed down. Things seemed to be a little less crazy than before.

Why not? 

A few minutes later he returned to the patient's room where they shared Thanksgiving together. One intern and his twice reheated plate and one patient with his twice restarted tube feeds.  They shared and laughed and even talked a little trash about the New Orleans Saints. And funny thing. That pager didn't go off once.

The next day, the intern went home to his loving wife and shared a belated Thanksgiving dinner together. The next week, that patient he broke bread with passed away.

Not fair. So not fair.



  1. This is one of the most beautiful posts Dr. Manning. Perspective. Thank you. Joanne

  2. Life ain't fair. Nope. Not one bit. But sometimes, we can help each other through the unfairness. Sometimes.

  3. Ahhhh . . . What a lovely Thanksgiving story! I hope in time he will remember it as one of his best.

  4. Just beautiful.

    Hey Shugsie, when my first boy was born I used to call him "Shug" even those his name is Elliott. Go figure.

  5. Yet another nudge, in a long standing group of recent nudges, for me to abandon Pathology for Hem/Onc, when the time comes.

  6. That's a lovely story. Even if it ends in death. It was nice of the intern to do that. I worked in news for 3 holiday seasons. Instead of treating and caring for the ill, we got to write about the ones who didn't make it. It can take a difficult time away from your loved ones and make it worse or put it in perspective. Either way I'm glad to be able to spend the holidays with the ones I love.

  7. I love, love reading these blog posts, but for some reason this one really got me, even more than some of the others. Thank you for sharing these experiences - yours and your residents' - with us.


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