Monday, August 20, 2012

The intern.



I went to see a patient on my inpatient roster the other day who, for the most part, was doing pretty well. Her active medical issue was one that we were managing in tandem with one of the specialty services and by "tandem" I mean that the specialists were calling all of the nitty-gritty shots and we were on the execution of those shots. And though this may sound a bit odd, none of this is unusual for a hospital service. At all.

So anyways. I go to see my patient and toward the end of the encounter she asks me a series of questions about her active problem. The initial questions were easy for me to answer, but her follow up queries were rather specific and slightly beyond my expertise. So I admitted that and promised to speak with the specialists and get right back to her. That seemed to satisfy her so she shook my hand, nestled down under her hospital blankets and then instructed me to un-mute her television (which I had asked to mute upon my arrival.) Pretty uneventful visit.

"Light on or off?" I asked.

"Off!" she announced in her overly loud voice. That made me smile. She was up in age and her hearing was starting to dwindle. She'd refused to be fitted for hearing aids on multiple occasions for two reasons: partly cost which her primary doctor had managed to find ways to overcome but the other reason presented a hurdle that couldn't be jumped--"Look like when you got a hearing aid in you jest look like ya' OLD." So instead she opted for talking loud and having others to speak up. And that was working for her.

I flipped down the switch and stepped outside of her room. I didn't want to forget her questions so I immediately pulled an index card from my pocket and leaned against the wall outside of her room to jot them all down. The ambient noises of the hospital were all around me. The rolling cart of the cafeteria food, the ringing chimes at the front desk of patients calling their nurses, the phones ringing, and somewhere far down the hall what sounded like an elderly man moaning repeatedly. Just then, among those sounds I heard one that exceeded them all in decibel level.

"Hey there, BOO!"

It was my patient on the inside of that room. I was still beyond the threshold of her door and could hear her booming voice speaking over the phone.

"YEEAAAAH. The doctor was jest in here. I thank this one you ain't met yet. Her name Kimberly something-or-other."

That made me chuckle. I love how patients grab pieces of names and hold on to the parts that stick for them. For her, I wasn't Dr. Manning--I was Miss Kimberly. It certainly wasn't the first time I'd heard that and I was certain that it wouldn't be the last.

"I don't know which one she is. I THANK she might be the intern though cawse she kinda didn't look like she knew what she was doing toward the end. But she was nice. Reeeal nice."

I covered my mouth to keep her from hearing me laughing.

"Naawww. She had some grey hair a little bit but I thank it might be the early-grey. Boo, 'member when mama had that friend who wadn't no more than twenty-five with all that grey in his head? So yeah, she prob'ly is the intern. I don't know. I jest know her name Miss Kimberly and she said she gon' ask somebody else, you know, what the answers was to my questions I had."

I could not stop eavesdropping. I was loving every minute of it.

"Mmmm hmmm. She nice though. She a nice little intern. She said she'll be back when she speak to the supervisor-doctor who know all about my kind of health problem. The experts. Naaaww. I said she the intern not the expert."

Love. It.

So eventually her conversation moves to something else and I move to actual work instead of cupping my ear to her door like a kid sister. I run into my colleagues from the specialty service and relay her questions. They provide me with concise answers that I agree to take back to her and that they agreed to readdress when they see her on rounds.

Later that afternoon, I come into her room to see her. She is watching television and is now out of bed in a bedside chair. I tell her that I have some answers to her questions, and commence to share them with her.

"Thanks, Miss Kimberly. I 'preciate you for getting all that information!" she said in that still-loud voice. I was getting used to it now so it was cool.

"No problem. Sorry I didn't know the answers earlier!"

"That's okay, sugar. How much mo' time you got in school for you finish up?"

I smiled because I knew this was about to be fun. "Well. Actually I'm the senior doctor on the team and I've been out of school for some time."

"YOU? YOU the senior doctor?"

"Yes, ma'am. The attending physician. Does that surprise you?"

Here we go. Now I was beaming because this was a Grady elder and I knew that she was going to keep it ONE HUNDRED. (That's Harry's way way of saying 100% real.)

"Surprise me?Yeah, it do. When I seent you earlier look like you was the intern or something. Like you was new at all this."

I let out a chuckle that couldn't be stifled and then cleared my throat. "Sometimes I do feel new at all of this."

"Mmmm hmmm. Look like you ain't knew what you was doing so I thought you was still training. But you said you the senior doctor? I told my sister that you got some grey in your hair so I didn't know if you was the early-grey or whether you was older. You know there's this friend my mama had that wadn't no more than twenty-five and he had a head full of grey."

Aaaaah. Love it. "Is that right?"

"Mmmm hmmm. Sho' did."

"I'm almost forty-two. I have kind of a lot for forty-two."

"You look a lot younger. Then when you was saying you didn't know my answers to my questions I put that together to mean you was young and still doing your clericals."

"Clinicals?"

"Pardon?"

"Nothing."

"Alright then, Miss Kimberly. Go on unmute this TV, hear? I'll be seeing you a little later. I'm gon' see what these judges talking about today. I like the judge shows."

"Do you have any other questions I can answer?"

"Yeah. Can you get my light and pull my door flush?"

"Sure. Is that your question?"

She was already watching Judge Joe Brown.

"Alright then, ma'am."

"Okay then, Miss Kimberly." She took her eyes off of the television for a moment and flashed an edentulous grin. Her eyes went back to the screen mounted on the wall again.

I waved my hand and reached for the door.

"And Kimberly?  Good luck with your studies, hear?"

I glanced over my shoulder and smiled. "Yes, ma'am," I answered with a gentle nod.

Yes, ma'am.

 Best. Job. Ever.

***
Happy Monday. I know it will be a fun-day.

15 comments:

  1. You have been filed away under "intern" in that lady's mind and that is all there is to it.
    I love that it doesn't bother you.

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    1. I am SO the intern to her and no, I don't mind that one bit. :)

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  2. Love it. I , on the other hand , often get filed as the patient transporter and on occasion as the nurse-even after I have gone through my whole scphiel as being the attending anesesiologst. The positive spin I put on this is that patients find me " relatable". Hah!

    Maria, fellow Meharrian

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    1. Yep. It's better when they see us as something. . . even if it isn't the head honcho. Keeps things interesting.

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  3. Aahahaha! This is hilarious. And I'm so glad it's still ok to say, "I don't know, I will ask the experts" even when you are senior doctor.

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    1. Excuse me. I'm the intern, not the senior doctor, Miss Cathy.

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  4. Every time I read your blog, I start missing Jesse Hill, Jr., and the Pods.

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    1. BEEEENNNNN!!!! I was just, just, JUST thinking of you. Ran across an email you'd sent me a while back that I somehow had missed! Will be responding--want to catch up and hear how things are in Africa. Miss you so. . .Grady misses you, too.

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  5. Love. It. And when I'm 42, or 82, and fiddling with my own hearing aid so I can hear what my patients are asking me, I hope I still have enough questions and curiosity to slide back into that intern mindset. Medicine is the best!
    (P.S. I just overheard one of my patients explaining to her husband in a foghorn-worthy voice that I'm the nice little high school volunteer who will look up her questions. I guess I don't look my MS4 age.)

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    1. High school volunteer? Now THAT'S awesome!

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  6. She knows a youngster when she sees one, Miss Kimberly.

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    1. L, how much am I loving your posts these days? Your writing is awesome. Love when I get it in these bigger bites. Good luck with your Kindergarten King.

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  7. Hey!, I've been lurking reading and loving your blog posts for someone now and I just had to comment on this one....

    How does it not bother you that she thought you were an intern? I think... No I know I can probably say I know it would bother me. When I switched from volunteer to intern I was always inwardly upset to be referred to as a volunteer. I never really thought much of this- I guess with each step upward you have additional training, experiences, and responsibilities and I've always wanted to be I don't know, for lack of a better word acknowledged for that. However after reaching this post I'm beginning too rethink this but its hard.... How do you do it? How do you let go of stuff like this so easily and just live in and appreciate the moment? Your awesome!

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    1. Hey Jess!

      Ha. . .the reason why it never bothers me to be called an intern or even "Miss Manning" is because I really don't believe that it's malicious. I know who I am and that's all that matters. The patients always recognize me as a participant in their care and, quite frankly, most of the time it's endearing to me when they don't quite get which participant I am. The truth, Jess, is that the more confident we become in who WE are and what we KNOW about our roles, the less it matters when someone misspeaks (bless their hearts) or simply can't reset their assessment of who exactly you are.

      You said when you take a step up you want to be acknowledged for that. That's totally understandable! But that acknowledgement starts with you and your mirror. Hold your head up, poke your chest out, and care with all of your might. When it's all said and done, I want to be acknowledged as someone who genuinely respects and cares for the patients. If they call me "doctor" but think I lack empathy, that would bother me far more than "miss" and a belief that I care.

      Hugs to you and thank you for reading!

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"Tell me something good. . . tell me that you like it, yeah." ~ Chaka Khan

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