In Training

People often ask me what it's like being a resident.

It's remarkably similar to distance running. The beginning of a run is always painful, as is coming to the hospital at pre-dawn and waking up one's patients. Once awake, they tell me their woes from the last 24 hours and I review their labs and X-Rays. At 8am we convene as a group and discuss new patients. During this time, the pages begin and occur about every 15-30 minutes for the rest of the day.

Team rounds are a bit like the one hour mark during a run. This is when I desperately want to stop but unfortunately things are just getting started. Time for a power bar (coffee). I try to stay sharp to answer questions but dissociation begins to deal with the pain. We finish rounds just before noon and I have a few minutes to complete discharges and write orders before noon lecture.


Noon lecture is like an aid station. We sit and eat, getting paged every few minutes to ensure indigestion, and listen to a lecture about neurology. By the time it is over, I have a list of things I need to accomplish before new patients start arriving. This is the sweet spot in the run where I am totally focused and feel no pain. I race back to the workroom and hammer out discharge summaries, page other physicians, and do other forms of scutwork. Scutwork is a nebulous term depicting the daily tasks required to take care of inpatients. Examples include ordering medications, placing consults with other services, reviewing MRIs with neuroradiologists, performing spinal taps, and speaking with patients and family members. Residents are often lovingly referred to as scut monkeys because of their endless scribbled lists of tasks and checkboxes. I find nothing so gratifying as checking little boxes as I complete my scutwork for the day.

In the mid-afternoon new patients file into the hospital. The local Dartmouth elite are recognizable by their fair trade herbal tea and down pillows with satin covers. They are Ivy League and command respect. They expect immediate service, and I am experiencing another bonk. I sneak into the second aid station (the call rooms) and make a peanut butter and jelly sandwich. Then I keep running, although the pace slows considerably. Pain returns and dissociation becomes the norm.

The finish line is elusive and depends upon how many admissions we have and whether I am on call for the night. On call is the ultra-marathon version of neurology where one stays overnight and repeats the above over and over until noon the next day. A regular day ends between 5 and 6pm with enough time to exercise, eat, and prepare for another day. Welcome to residency, I hope you trained for this.

Silence of the Fam

Home in two days, I won’t be here for dinner.

Going home for the holidays brings about a tempest of emotion. The house I grew up in now has plastic covering the furniture and fake flowers. The clutter of my childhood is long gone, as if strangers now live there. Even the familiar smell is replaced by a foreign one. How did this happen? Oh, right, now I remember.

My parents separated when I was ten. I chose to live with my dad because I could not bear the thought of him being alone. We initially had a nanny, but she was let go during a brief reconciliation. For a while things were good. We shared household chores and cooking duty. Eventually my dad wanted adult companionship. He tried his hand at dating, but it did not work out as planned. American women were just too damn independent. One day he came home with a brilliant idea.

We spent the evening perusing a booklet with pictures of exotic Asian women, complete with profiles detailing their perfect mate and hobbies. We circled possible candidates then we went to the store and bought fancy stationery. I helped him write letters to potential contenders about how he loved long walks on the beach and poetry.

Two years later a 28 year old porcelain doll was in my father’s bedroom when I came home from school. She was kind and spoke in broken English. Neither of us was sure what to do, so we ignored each other. This worked pretty well so we continued for the rest of my teen years. My father joined in the game, and sometimes we went weeks without speaking more than a sentence to each other. He wanted to give the household a more congenial and respectful touch, so he insisted that I let my stepmother know if I would be home for dinner. So I left notes, never saying where I was going but always saying whether I would be home for dinner.

On days when we ran out of sticky notes, I wrote on napkins or magazines. Soon the entire house was filled with notations on every writable surface. When I come home now, I still look for them buried under the new life that now exists. I guess they were thrown out after I went to college. By then they realized I would not be home for dinner for a while. But I still make it every once in a while.