Doctor GrubHub

( Note : Specific details of individuals depicted below have been altered for full anonymity. See upcoming article about "Levels of Anonymity in Medicine.") Lately, it seems all I do is scuttle to and fro around the hospital: Emergency room, operating room, clinical wards, emergency room, and so on. A mental checklist reels and menaces in my head, always brimming and never complete. Then, as I scurry from Emergency to the OR, anxiously praying to do things well and on time, I glimpse outside through the vast hallway windows : Mountains stretch the horizon, leaning to kiss low-hanging clouds that blend with the sun into a golden vanilla foam. An elderly man sits by the piano next to an elevator, playing Segovia on his guitar for patients and visitors. A boy in a hospital gown walks by with his therapy dog German Shepherd. His mother beams proudly, smiling with cautious relief ("I'm so glad he is doing better now.") With the mountains, the music, and the bo

It's a lazy morning admixed with calm and dread. 9 AM. I try not to think of how many (few) hours remain in the day and the horror show of the week to come - more Trauma Surgery: Attending surgeons yelling at each other and residents, residents yelling at junior residents, and everybody constantly on edge. There is hierarchical abuse in this particular system. Don't get me wrong: I have appropriate respect for the orderly nature of hierarchies; it's the abuse and incessant displacement of blame I don't care for. Everybody is told to take responsibility, but nobody does. I could go on ruminating over the absurdly dysfunctional nature of Trauma Surgery, in a specialty that one would think requires a practiced coolheadedness, but then I would succumb to the same nerve-fraying, time-sinking vortex of worry as I and my co-residents experience when actually at work. In an unusual turn of events, I have had the bright fortune of having two consecutive weekends completely

Hospitals with residency programs tend to be large, and residents are usually instructed to park in the most far-flung, inconvenient lots, so I have been walking a lot lately; 15,000 steps per day, on average. I am still getting used to the layout of the place, so I'll often walk in one direction for a bit, only to realize that I'm going the wrong way. So I turn around, and my Garmin logs the extra steps. The pager, once just an inanimate object, without feelings, has become a serial harasser. I've daydreamed about filing a restraining order against it at the local court. Every time it shrieks, the strident sound tears at the middle of my chest - a deep, unquenchable affliction - and I recoil in trepidation at what the ensuing phone call might bring my way. More consults. I have yet to start the previous one. Busywork piles on. I become nauseous, beaten down, resigned to the heavy burden of constant rushing. When the day's work ends, there is no satisfying completi

I got chewed out by the attending in a protracted, daylong affair. In one scene, the medical student stood silently with her head slightly bowed. She and I had built a sense of mutual respect and camaraderie. It was a veritable massacre, a public execution. The nursing staff stood at a distance, perhaps overhearing, as the guillotine slammed down again and again, just to be sure the job is completed. After our last operation, the attending turned to me in this public setting and said: "You know, you really have to be prepared for cases. If you're not prepared, attendings won't let you do much." And so on. The implication was clear: I am lazy, stupid, and incompetent. My belly was soft when it received the torturous blows. This was one of several recent attacks launched by this particular attending at several of the residents. I had, in fact, prepared for the surgery. I had been the one to see the patient on a consultation basis just the day before. I obtained consen