toward really twisted and had made up a lie about my grandmother to try to steal away the patient I was working on. When I realized she was telling the truth, that Gram had been in an accident, I’d gotten upset, and I still can’t stand that Belinda saw me that way. I can’t stand to hear her mention Gram out loud now. I want to keep the rivalry between us all business, all about school.
The first two years of medical school took place in the classroom, which meant a lot of straight memorization. I aced every exam. I barely had to study. I went home while everyone else flocked to the library. My teachers held me up in class as an example. I enjoyed my special status to the hilt. I accepted that being number one meant being a loner. I kept the door to my dorm room closed to chatty people walking down the hall. I gave other students smug looks when I walked out of exams twenty minutes early. I lapped up every last bit of my professors’ praise. I consciously enjoyed each moment in the classroom, each semester that I was on top of my game and in my element.
But those days are over. We’re in the second half of medical school now and this part is termed “hands-on” experience. There are no more classes, no more books, and few exams. My days of easy excellence have ended. I am in the middle of my medicine rotation. My classmates walk around the hospital with circles under their eyes, complaining about how tired they are, how overworked they are, how overwhelmed they are. We are on call every third night, which means we have to spend the night at the hospital. The students are supposed to sleep on the rickety bunk beds tucked into various corners of the hospital, but no one ever actually sleeps. We make rounds with our assigned attending doctor, seeing every patient that comes into the hospital who isn’t clearly a surgical or neurological case. As part of a medical team, we assess each patient, take a history, diagnose, and give a prognosis.
This rotation is a lot of hours, but that’s not what bothers me. I don’t mind missing sleep. I like seeing how far I can push my body and mind. After three days of little rest, my personal worries go away, and there is nothing but the work at hand. But what does bother me, and what I do mind, are the people.
The hospital is teeming with them. Everywhere you turn there are doctors, medical students, nurses, nurses’ aides, nurse practitioners, anesthesiologists, specialists. Everyone has their specific job and they get in one another’s way despite the rigid hierarchy that has to be followed. The hospital system is based on education and seniority, so that even if you have the skills and the knowledge, you can’t apply either until you’ve spent a few years following some middle-aged attending around kissing butt. You have to say the right things, and act deferential to the right people. You can’t even find peace with the nurses, who think they know much more than the lowly medical students, and who, when the workload slows, want to chat and bond and talk about their lives and my life until I want to throw myself out of the nearest window.
The patients I can tolerate, because with them at least I can use my mind. I check their symptoms against what I have memorized. I consider the possible illness, the possible treatments, the possible complications. But still, there is no purity in the work because I am not allowed to do much, and because far too often the doctor sends me out of the sickroom to speak to the patient’s family. This is the worst possible assignment, because with few exceptions the families are a mess. It doesn’t matter if they are in the hospital because their ten-year-old is having his tonsils out or because their father is having an emergency triple bypass. The hysteria is always there. I see it in their eyes and hear it in their voices. People know that while they are at the hospital someone in the rooms around them is bound to die, and they seem to believe that if they speak loudly and often and shed tears, there will be a better chance of their loved one being spared.
I suppose I always knew on some level that I wasn’t crazy about