poured out before bed
The pain is so great he’s involuntarily stridorous, every shallow breath a harsh rasping bark. Great beads of sweat mix with fierce tears down his gray face and soon his sats are dropping, the pulse ox beat becoming lower and lower in tone until it finally alarms.
The interventional radiologist steps back and claps his hand on the young man’s shoulder.
“John, you need to breathe. In and out, nice and deep, John… John, deep breaths… John, listen to me, breathe slowly. We can’t do this if you don’t breathe… John… OK, we’ll let him rest a little bit.”
He sighs gutturally, watches as the pulse ox reading steadily rises toward normal, then strips off his surgical gown and steps out of the suite to answer the 100,000 pages that came in as he attempted placement of guidewire after guidewire over the last hour and a half. I hear him yelling at some poor somebody over the phone, taking out his frustration on the invisible person at the other end of the line. The techs and fellow also break scrub, stepping out to take off their lead and cool down a little, their playful banter echoing in the hall. It’s just me and the nurse now, the nurse typing away absently at her procedure screen near the foot of the table, periodically checking the vitals monitor.
John’s young heart beats steadily, as it has for just a bit over thirty years. John is indeed young, but without youth. For more than half his life he has struggled with a painful, progressive disease – a condition which has stolen his health and will within the next few years likely steal his all. He now has a serious, hideous infection, multiple abscesses in an anatomically complicated area which the interventional radiologists have for two days tried to fully drain without success. As he is an extremely poor surgical candidate, he is here for attempt number three.
I don’t know John beyond the black and white characters in his electronic medical record, but I know suffering when I see it. And I know there is nothing I can do.
His breathing is less labored now, though his oxygen mask has fallen away, but the tears have begun to flow freely. I walk to the head of the bed and with one hand hold the mask over his face. I feel my own eyes begin to tingle as I catch his and place my other hand beneath the raised surgical drape on his shoulder, gently rubbing the back of his neck. His lids squeeze shut and sobs limited by pain fill the space between us. I can’t help but silently cry too as I wipe the tears from his face, stroke his temples and hair with my fingertips.
“I’m so sorry, John. It’s going to be OK,” I say, but the sound is anemic.
His sobs slowly subside, finally halting just as the interventionalist returns and starts to gown. Dr. A stops suddenly as he knots his outer gown tie and looks at me hard.
“I’m sorry, who are you?” There is an edge to his voice like a knife to the flank.
“I’m Mullberry – the medical student. We met earlier,” I say, smiling nervously beneath my mask.
“And what are you doing?” Another jab just beneath the ribs.
“I’m holding the mask, sir – it fell off.”
“Well, you need to stop manhandling the patient. He has enough problems beyond being assaulted.”
It takes me a moment to process this sucker-blade to the kidney.
When I have finished processing, I don’t know what to say.
Somehow I manage to step back, handing the mask to the nurse, who is now standing to the side of me, her eyes razor sharp.
“You shouldn’t even be standing here,” she says. “We don’t need a student contaminating the field.”
“I…I didn’t contaminate it…I stayed here behind the drapes…I’m sorry.”
“Well, now you can stay out of the suite. Go to the control room and watch.” She points to the door.
My face burning with shame and anger, I walk out of that door.
I walk out of the department all together, finding a favorite physician in the fluoroscopy department with whom to while the rest of my morning.
I’m sitting in the cafeteria in a later moment of quiet, still not sure whether to fume or cry, to feel indignant or stupid, when an IR tech touches me on the shoulder.
“Sorry about what happened in there – you did absolutely nothing wrong. I thought you should know John told Dr. A he’d rather have you to rub his head than all the fentanyl in the world. Really told him off. Oh, and the fellow finally got into all the pus pockets and put drains in – so that’s more good news.”
“I should’ve been there,” I say quietly, meaning it for so many reasons.