Doctor GrubHub

Preface : I have written several views into my experience on Trauma and Acute Care Surgery, a rotation in which I spend the majority of my preliminary surgery year. The description that follows is the mildest of these. The underlying theme in all of the writings is that Trauma Surgery purposefully maintains a culture of malignancy, perhaps out of some warped fealty to a stern, militaristic tradition of the past century. This has been my experience while working in different hospitals and in talking with other Surgery/Surgery subspecialty residents. It is important to note that my description of trauma/acute care surgeons does not apply to all attending surgeons. At my institution, there are a few very intelligent, civil, and able trauma surgeons, but their general decency is often overshadowed by the bad actors, of whom there are not just a few. 09/15/2019 A few months ago, I made food deliveries for GrubHub. It was simple, honest work. A notification would pop up on my phone i...

( 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 ...

It's finally here: Moving tomorrow. Fright versus Fortitude. Life flashes. Past errors and triumphs reel in sequence getting to now. Sit and wait. Get up and go. Wait, but consider the beckoning challenges. They taunt and goad. Go, and don't think. "Don't think...Feel. It's like a finger pointing at the moon. Do not concentrate on the finger, or you will miss all of the heavenly glory." Look up at the sky. It is the same sky you will see a few hundred miles away tomorrow evening, momentous and vast, unsettling and quiet. Before bed, you will think about running to help fall asleep. The simplicity of it. Remember you were called "Russian Rocket" in Track. Before the gun goes off, you line up, crouch with head down, and wait for the signal. Can't see the finish line. Crowd hushes. Heart beats against chest wall attempting escape, going nowhere. And then it stills. Time slows to pure silence. No more anticipation or worry. This is where you ...

Large: I've been having these really intense headaches. They only last for a split second and then they're gone. It's like a lightning flash; almost like a surge of electricity and then it's gone. Doctor: You're Gideon's kid. I didn't even put the two together. Large: Yeah. Doctor: I'm sorry about your mother. Large: Yeah. Thank you. Doctor: I must have missed you at Shiva last night. Large: Yeah. Doctor: So how long have these headaches been going on? Large: Well I think I've had them in some form since I was a little kid. But they've been getting more and more frequent over the last year. Doctor: (looking at chart) How long have you been on Lithium? Large: Oh uh, I've been on some form of it since I was ten or so. Doctor: And what about Paxil, Zoloft, Celexa, Depakote; did any of that ever help you? Large: No. I mean I don't know. It's recently occurred to me that I might not even have a problem. Only I'd...

How much time is spent in a room, spine bent in attentive position, reading, writing, and unbending to sleep? Or what do you make of the things on your daily to-do list, written in earnestness, but failed from procrastination? What drama pervades everyday life more exciting than an unexpected e-mail, unveiling new possibilities - "now I must respond decisively, proving my worth." Much daily work is performed in a hip-flexed posture, sitting stationary but restless. Exercise is scrawled on the to-do list but gets passed over for the comfort of bed - an easygoing old friend - and a movie or two. Every few seconds to minutes, a notification pops up, and the attention wanders: GrubHub - More blocks available for Today. Piqued, I think: "Why not? I'll go for a ride." Two orders in, 13 dollars and 25 dollars (good), another comes up for 13. I accept. On closer inspection, it's actually split into two orders from one place, an ice cream shop. In examini...

As a child wandering the globe, I brought along a healthy dose of Soviet skepticism. Upon exiting Russia and arriving in the UK at London's Heathrow Airport, I looked around at the Brits and asked "What are all these foreigners doing here?" My parents laughed, finding it 'cute.' In order to acclimate, I read various books handed to me by my parents, and first among these was a general encyclopedia, written in English, of course. Daily I scanned numerous entries with an insatiable drive to understand, while at school the only words I dared utter to my young British peers were "let's go play" (It was the first grade, with plenty of recess built into the curriculum). Unbeknownst to me or my peers, an intricate set of neural processes allowing accelerated learning and memory formation were underway in my ripening 7 year-old brain, and they were made possible by an ancient, highly-evolved need to survive. During sleep, I was terrorized by the recur...

 I am a cheesecake. Or rather, I have become one. Of course, I'm not actually a cheesecake, but my organ systems are now thoroughly suffused in cheesecake. For the last 6 weeks, I have been on what can only be labeled a 'cheesecake diet.' Let me describe it in further detail, for those interested in trying it themselves (don't). Before I do, I will note that my body weight has remained stably at ~190# despite a change in my overall intake from 'healthy' to 'dessert-based.' At 6'1", this amounts to a body mass index (BMI) of 25.2, shyly breeching into the 'overweight' category. I'm slighly uncertain about this designation. Should I feel insecure? Of course, BMI does not distinguish lean from fat mass, but let's stay on task. Here's the diet: 1. Morning Coffee (!) with milk and 2 sugars, 16-24 ounces; total caffeine content ~250mg Dannon Greek Yogurt * 1 (80 kcal)  2. Afternoon Small piece of chicken Small salad, no d...

I left my dream residency a few years ago in ill health, and I did not, for the life of me, want to be a patient. So I procrastinated on seeking treatment. I had become used to being a physician who diligently and compassionately tended to the needs of his patients, but I did not initially have the guts to carry out what was necessary when my role was reversed to that of a patient. Away from Surgery, my life lacked purpose, and an abiding darkness shrouded my days. The cruelty of life is the free choice we are given, as it can be harnessed responsibly for good or frittered wastefully into emptiness. The emptiness of my existence built on itself and eroded who I once was – physician, son, brother, athletics enthusiast, and so on. Nothing mattered anymore as I progressed into a learned helplessness. To pick up this laptop and write would have been a colossal undertaking. Sometimes, I would go for a 5-mile run, perform 60 meter sprints at the local track, or lift weights a...