The day five-year-old Harry is discharged from the hospital, his mother thanks us profusely. I pay little attention to her gushing compliments; rounds have already lasted four hours, and there are eight of us total on the paediatric team (including the off-service residents and nurse practitioner student). Her attention is focused on the attending, anyway, so it seems safe safe to allow my mind to wander to my presentation the next day, reciting lines in my head as I whirl through invisible PowerPoint slides.

As we were leave the room, however, Harry’s mother tugs on my arm, a silent plea for a moment more of my time. Or a moment, period. Feelings of guilt erupt for not listening to her more closely. She is a kind lady, and a good mother. She deserves more respect.

“I truly meant it,” Harry’s mother says, as the guilt bubbling in my heart surges to a boil. “I can’t thank you enough. Harry loves you, too. You’ve done a lot for us.” Her voice is soft, as if she is sharing a secret. Perhaps she is; Harry’s mother works in the hospital, and is likely acquainted with the rigid hierarchy medical staff adhere to. A compliment to a subordinate in the presence of the wrong attending can effect a living hell. I’ve seen it firsthand.

Her comments surprise me, though. Although Harry is my patient, I know I haven’t been providing the best care for him. Ten months ago, I would have checked on all of my patients five to six times per day, allaying their fears, answering their questions, passing their concerns on to the attending physician. Now, though, Harry is lucky if I came in twice each day.

It isn’t from a lack of empathy, or a lack of interest, or a lack of concern. I spend my days running, always busy, always doing things, yet never seeming to get things done. I know the rumours about medical students: that we’re lazy, we avoid work, we spend all of our time on Facebook, Instagram, Snapchat and the newer sites whose names I can’t recall. And those are true, just as all Americans drive pick-ups, or all Germans are beer-guzzling drunks. My personal emotional sensitivity is as sharp as ever; it’s as difficult for me to hold back tears now as it was on Day One. I still care, perhaps even more than when I started.

But I am tired. Exhausted. Even as Harry’s mother continues to whisper words of encouragement, I find my focus slipping. On the paediatric service, we are required to contribute 75 hours of work weekly. This does not include the time required for presentations, essays, exams, or off-service teaching sessions. I’d become robotic, functioning with a haze in my eyes which faded only when I fell into the few hours of senseless slumber I was permitted at the end of a nerve-wracking day. A nervous wreck, two blips from an explosion.

“We’ve bought him a D-R-U-M set for his birthday,” Harry’s mother says, watching her son race two tongue depressors across his bed, like boats. “He’s taken a liking to heavy metal and punk rock.”

It was mechanical. Wake up to the alarm, run, run, get to the hospital, run, run, get cursed at, push back tears, run, run, run home, try to study, try to write, fall asleep to nightmares just as the alarm beeped again.

“So, anyway, thank you for everything.” Harry’s mother now speaks so softly, I have to lean in to hear. “You’ll do well in the future. Take care of yourself?”

I smile, lacking the energy to invest in a lie. Nothing is in my control anymore. Certainly not my own well-being.

Yet, why are we whispering, as if all of this is some sort of secret?

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