Can you feel it?

Med school, on call in the ER.

My job consists roughly in seeing patients, asking them what they’re doing here and for how long they’ve had whatever brought them (“Oh, well, some time…”), and shadowing real doctors in white coats who make diagnoses and ask for exams.

A woman in her 60’s. Stomach ache.

History of  cancer a few years ago, the nasty sort, never-fully-recovered-of.

Pain started several days ago, then it only got worse. She kept away from the hospital as long as she could but now it’s hurting too much. I sort of remember her writhing on the bed, her skin a vague yellow-greyish, but I might be making things up after all these years.

Since she’s really not that well, a real doctor comes with me right away to see her, so that we do not waste too much time.

And not any doctor if you please, the surgeon. So that even less time is wasted. Pronounced Suuur-geeeooon, with a capital S. Surgery resident actually, but that’s all the same.

Good morning Madam, I’m the Suuuur-geeeooon.

Chief complain, where does it hurt, since when, since when her BM stopped, since when she’s been losing weight, and he nods.

He puts both his hands on her stomach, he waves his fingers, methodically, quadrant after quadrant, eyes raised to the ceiling as if to look in it for inspiration.

All of a sudden, his face lights up. He hesitates, he checks, he ends up keeping on the same spot and you can tell something’s happening here, under his fingers, and he’s really happy about it. Right now he’s even smiling.

With a triomphal look on his face, he says « Here you go, touch right here… »
So I lay my hands too. Because he asked me to. Because I didn’t give it a second thought. Because it’s so surrealist that I’m lost, far far away, somewhere between stupor and disbelief. Because I don’t want to think that what I think is going to happen is really going to happen, and of course, happens:  

« So ? (smiling) What do you feel ? »

You. Sick. Bastard. You mean besides my wanting to disappear? You mean, besides the overwhelming urge to scream your hideous wickedness right back into your face? You’re asking me, you creepy piece of shit, if I’m feeling anything else than my itching fists trying to keep from smashing your pretty white teethy smile?
Yes, I can feel the tumor, you fucking son of a bitch, right under the skin of the stomach to which is attached, with a closer look, a torso, and oh, a neck and a head. Of a lady. Who’s got ears.

I said « Nothing ».

Because it was about the only thing I could think of.

And when we left the room, struggling half with my stupid sense of hierarchy, half with my own pride and half with my own cowardice – which makes way too many halves – I said:

“Well, actually, I could feel it, but well, you know….”

 

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Our daily cowardice

He’s young, 60 or 65. I don’t know what or whom brought him here first, most likely a stroke, or a nice cousin.

His room is right in the middle of the corridor. The « ER corridor », where we park for a few days patients who end up in the ER, too bad to go home, not bad enough for ICU, cases not simple enough to be quickly admitted to a traditional inpatient ward. We have room for only eight people in this ER corridor. If you take on your shift with a corridor full, you know right away that you won’t have room for the old lady showing up out of breath in the middle the night, that you’re in for four hours on the phone with every single hospital around. You know it’s a bad start.

Anyway, he ended up here. Lucky guy.

He screams, he’s agitated, he hits, he’s tied to the bed.

He screams. He never stops screaming. I somehow feel like screaming too.

He screams two things, only two things, tirelessly.

The first one in an echo of the last thing he heard. He starts crescendo, then higher and higher, over and over again.

« You have to caaaaaAAAAAAAAAALM DOOOOOOOOOWN ! YOU HAVE TO CAAAAAAAAALM DOOOOOOOOOOOWN ! »

Or « Please lie doooOOOOOOOOOOW ! PLEEAASE LIIIIE DOOOOOOOWN ! »

We could actually have a lot of fun with him. Go into his room, say « Pee pee poop » and watch out for the nurses’ face when he starts screaming…

The second thing he screams is the only one that is his own. I guess he keeps it for when he forgot what he was just screaming. His personal phrase is :

« The head is EMPTYYYYYYYYYYY ! THE HEAD IS EMPTYYYYYYYYYY ! »

His face is distorted, his eyes are way too wide open, way too fixed on me.

It’s true. It’s true that your head is empty. It’s been empty for four days, but before that it was perfectly full. That’s when a tiny piece of blood decided to block an artery in your brain, to see if it could be any fun. Your head is empty and you’re terrified.

And I’m terrified too.

What’s happening in this head of yours, just full enough to know it’s empty ?

And what’s more, what’s more, what can I tell you ?

Should I tap your hand saying « Nah nah nah, there’s a good lad, your head’s not empty, come on, come on, ahaha » ?

Should I say « There, there, it’s okay, everything’s all right, calm down » ?

Should I say « Hell yeah, buddy, well well well, there’s nothing in there, nope, no luck… » ?

What can I say ?

I cannot reassure him. Truth is, his head is empty, and most probably it’s not going to get any better. Truth is, he hits and spits on his wife who comes to visit him everyday, and who’ll end up not coming anymore, or maybe once a week, on Sunday, because one has to be a good wife.

Truth is, the best that can happen is we find him a place in some nursing home, with nurses who will sigh when entering his room and ask the doctor if the prescription of haloperidol couldn’t be raised a little bit, because he’s exhausting the team.

What can I say ? I thought about talking to him a long time, of anything, anything to fill his head a little bit, like when you rock a baby. Talk to him about what’s the weather like, tell him that his wife called and she sends him kisses, that it’s now 11.30 and lunch will be served soon, but today’s menu is nothing exciting.

That’s the only thing I could do, really, but I don’t have the time. Not the courage either. The ER keeps going, people keep arriving, the pager pages, and I can’t spend ten minutes trying to talk to you about anything, knowing perfectly that at best I could maybe (maybe!) soothe you for thirty-four minutes and you would have forgotten right afterwards.

So I do like everyone else.

At first, two or three times I get into your room and I say something meaningless and stupid to calm you down ; shorter and shorter, more and more stupid, feeling vaguely silly to try to change the world with my stupid sentence. (And absolutely silly when it’s my stupid sentence that you starts screaming to the world…)

Afterwards I’m not going in, I walk past your room looking at my feet, looking busy, like «I have lives to save ».

And when the nurse asks me to prescribe some loxapine, because for God’s sake no one can work in such conditions, I put my signature on it, and I can’t wait it works and puts you in a daze.

I would like to know how not to be ashamed of this prescription I’m writing only for myself because, for you, I’m not doing anything.

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Hospital by night

Haaaaaa, night shifts in the ER…

Clock, waiting room, patients, patients. Pager. Telephone, x-ray, stethoscope, clock, scalpel, patients, stitches, patients, clock, again, and again.

Serious stuff, dirty stuff, benign, mosquito-bite-like stuff, moving, emotional, funny stuff.

Anxiety, too much of, or not enough. Nervous mothers, sons falling apart, nice hysterical girls, aggressive folks.

They’re all different. They’re all alike.

So when it’s 3AM, when you begin your seventeenth hour in a row, when the patience and indulgence you’re usually so proud of have an unfortunate tendency to slowly fade away, you try nonetheless to keep some words for yourself. And you hope very hard that they won’t slip out some night.

To this guy who wants a knee x-ray, tonight at 10PM, for a pain he’s had for two weeks. And for which he has, in his pocket, an x-ray prescription from his doctor, for the next day. When he looks down on you and says « But tomorrow, I got to go to work ». (Really? Well, tomorrow I got to go run naked in a clover field, asshole.)

To this other guy, with a svastika tattooed on his shoulder, when you are doing your best to stitch up his eyebrow arch, while he’s conscientiously throwing up on you. And that’s before he starts yelling that you’d better leave him alone now, cause there’s no way he’s gonna be screwed like that, and we’re in a fuckin’ democracy and he can choose whoever he wants as a doc, and that sure won’t be some fuckin’ chick… (Aaaaaah, you see we finally have an agreement there, Sir, cause I don’t usually treat complete jerks.)

To the very nice old lady who doesn’t know anything about her medical history because her daughter usually takes care of everything, but she’s pretty sure that every morning she takes « a tablet, you know, doctor, it’s white and the blister is green and white ». (Oh, I see! It’s the tablet for the disease, you know, with those signs?)

To this girl who comes for a « lump under her arm » that she’s had for a month and a half. When you ask why she decided to show up, precisely now, at 3AM, she answers « A friend of mine this afternoon told me it could be cancer, so of course you see now I’m worried, could you just do a quick ultra-sound for me ? And while you’re at it do you think it’s gonna take long? Cause I’ve been waiting for 45 minutes already… ». (Oh yeah, it’s going to take some time… Plus we have to consider a CT Scan for your brain cancer…)

To those who are outraged to have to wait for one, two, or sometimes three hours in the waiting room, when they all cry out « But this is supposed to be an emergency department, for God’s sake! ». (Yup, but it doesn’t mean « emergency » in that way, sweet honey bee, so just shut up now.)

To those who answer « Oh, for a while » when you ask for how long it’s been that way. (Okay, now I have a diagnosis. It’s almost certain you have a disease.)

To this guy who flatly refused to get a CT Scan, because he wanted an MRI, and who ended up saying to me « After all, Madam, the customer is always right! ». (I have no words.)

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