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 ...

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...

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 ...

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...

 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...

Sometimes I drive around with the GrubHub app on and feel the urge to snap a few pictures of the scenery. I roam the city wide with the radio scratching its mystical fuzz as I scan the stations according to mood. Mine is an older car, without satellite radio or bluetooth connectivity, so the choices consist of AM and FM. I could play a cassette if so inclined; or set it to a hollow white noise synced to the electroencephalographic-equivalent beta waves of my unsettled brain. I’m being presumptuous: often while driving my brain activity, like tranquil beach waves coming and going, rests at a rhythmic, relaxing alpha pattern. And so it goes on, until I find NPR.  NPR can be a hit-or-miss. I enjoy their interviews and shows like This American Life, Radiolab, or the Moth Radio Hour. But when they cover controversial political issues, I recede into my shell like a startled turtle. Mostly, I eschew political coverage from any source, as it tends to bitterly divide people a...

Every morning, I wake up, make coffee, and forage through the great thicket of the internet in search of residency vacancies. The internet or 'web,' as you know, expands continuously just as the universe, and with it arise visions of alternate realties somewhere pleasantly distant and unmoored in the daily rut of routine. Navigating it requires skill and experience and I admit to possessing neither. However, I've built a steady habit of scouring specific websites in my search for residencies. When I come upon a position I like, I deploy the residency application algorithm now updated into my brain's latest software - it's an app - and switch the 'application mode' tab to 'on.' Hereafter the process is automatic - CV, diploma, dean's letter, transcript, and USMLE files are sent, along with a specifically crafted statement of interest. An e-mail is fashioned for each program director or coordinator with the attachment of aforementioned files, and o...

 Out of sheer luck, I have had a few interviews over the past couple of months ranging from video calls to the formality of on-site visits. I apply broadly within the large domain of surgery and its subspecialties, as "beggars can't be choosers," an oft-repeated phrase I utter like a mantra in times of insecurity about my current station in life. The most recent of interviews took place on-site at a University medical center. Six of us were selected to vie for a PGY-1 vacancy for a subspecialty surgical position, wherein the previously matched applicant had decided that surgery was not right for him. (This was a wise choice, as Surgery demands everything, will take your blood and soul, and if you harbor any doubts, then consider all your questions answered. Perhaps I'm being overly dramatic, but I've heard this said by other surgeons throughout my education and training and am merely repeating the gist of what they said.) I drove 5 hours on a cold gray morn...

I've been away from Medicine and Surgery for a couple of years, addressing health issues, for the most part. Now that my health is restored, I view the world with renewed optimism and am itching to return to my first love, practicing as a physician. I had completed two years of a surgical subspecialty residency which I enjoyed immensely before taking an indefinite medical leave, and eventually my time for returning to the position expired. My approach to The Return has been twofold: Stay busy with work - i.e. GrubHub - as well as fitness, running, and reading for pleasure. Also, when I read, I'm astounded by the gaps in my fund of general knowledge about the world and seek always to remedy it, only to find the gaps expand the more I read. Monitor residency vacancies through several online platforms, including inforesidency , ResidentSwap , FindAResident by AAMC, StudentDoctorNetwork , and a few other specialized sites.  This approach has yielded little as of yet, and ...