Friday, September 08, 2006

Why I Don't Eat Fettucini Alfredo

Work has been crazy lately… I typically wake up at 4:30 am to get to work around 5:30 and get home sometime around 7 pm. Over the past few days I have put in chest tubes, explained pathology results of metastatic lung cancer to family members, and cut myself with glass shards while snapping open a lidocaine ampule. It has been nothing short of crazy. The bonus is that my least favorite attending has been on vacation for the past week, and the sharp-tongued one and I have come to an understanding: she tries to intimidate me, and I just dish back the sarcasm. The intern last month got ripped to shreds on her evaluation… I will either have an awesome evaluation, or will be repeating the month in the near future—let’s just hope for the first.

Disclaimer: stop reading now if you are eating.


Last Sunday, a patient in the unit expired while I was on shift. She had been on our service earlier in the week, but was transferred over to the medicine team when her biopsy results revealed cancer.

After she died, I was called to remove her chest tube. It was an odd feeling, pulling a tube full of warm blood from her still chest. I was all alone with her, and though the nurse had already cleaned her up, the television was turned on. The noise of a ball game in the background was offensive, so I turned it off. I realize that the nurse had probably turned it on so that she didn’t have to deal with the quietness of her death, but it just seemed so inappropriate.

The experience took me back to a night about five years ago. My partner and I were hanging out in the station and we got called for a code. When we arrived at the address, the fire engine was already there. Laid out on a white carpeted dining room floor was an elderly gentleman. He had been having dinner with his wife that evening when he suddenly began choking and collapsed.

We started CPR immediately, but the paramedic on scene was not able to intubate successfully. We spent 40 minutes on scene trying to resuscitate him. Time after time, gastric contents kept resurfacing. And in case you never have the experience, there’s nothing quite like the smell of partially-digested alfredo sauce. The smell was so bad that two of the firefighters on scene started vomiting. To put a gross anecdote to an end, the call ended with me wiping off the patient’s face and closing his eyes so that his wife wouldn’t have to deal with the mess.

I guess that what I’m trying to express is that for me there’s something very sobering and solemn about death. It doesn’t matter how familiar the person is to me or not, I think that every death deserves a certain amount of respect. The patient last week didn’t have any family contacts that we could find. She went off to the morgue alone. I guess maybe that’s why I was so upset by the irreverence towards her death. After assessing her and having to page the covering team repeatedly to come and see her as she was expiring, I just felt like nobody cared. And maybe that’s a little revealing about me—I don’t want to die and be shoved in a refrigerator unceremoniously. I don’t so much care what happens to my physical body, but just the thought of dying without mattering to anyone else is chilling.


I know that I should be doing something healthy to get rid of my stress, but when I go home I just want to sleep or sit in front of the tv. I had to back out of the 5k because if I don't leave on that day I won't get any hang out time with "The Phoenix" during my vacation week. I was worried that taking a week off in September would be too soon, but I think I'm more than ready for it.


Chris said...

Yikes.....I am glad I didn't read this post earlier in the week or you would have ruined my dinner!!!!

Kate, I am so impressed with your respect for patients and their dignity. We have the BEST physician ever and you remind me a lot of her, just younger. I hope you turn out just like her.

Too bad about the 5k, although I am sure you could do it from a physical stand point.

Have a great vacation!

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Sarah said...

When I was a teenager and worked in the hospital I didn't respect human life that much. I reget it now because I do realize the respect a person deserves. A lot of Doc's I know get desensitized to that. The ones who don't, however, make much better doctors, in my opinion. Not, that I know a whole bunch or anything...but that is how I feel.

ru said...

I watched a few episodes of Six Feet Under, an interesting show with fascinating characters. The most memorable one was of this single lady who died. She had no kin, no friends. The two brothers who owned the morgue were pretty jokey about the whole thing, but their mother took the event to heart. Something about the poignancy of her death struck a chord with me. I'm glad you were there to give this woman the respect her passing deserves.

Good for you; you sound like a week off is much needed :)

RYC: I should start learning Latin; it may come in handy some day.

The Phoenix said...

Hey there is no need to worry about people not caring when you
die. I'll at be there with my
dancing shoes on :)
Your Best Friend who knows just what to say when your down!!!
The Phoenix