The way I really felt about it

I worked 9 am to 9 pm in the ER the other day, and the day went pretty fast. Until about 7:30 pm. I got a whole two and a half hours of sleep the night before, and the last ninety minutes of this shift felt like ninety years--the way it can when you spot the light at the end of the tunnel and can't wait to get there. I ended the night with a handful of patients, one of them a 19 year old girl. She was in the ER because she hadn't been able to keep any food down in days. She had a lot of other health problems and had met her share of medical students. Like most patients who spend a lot of time in the hospital, she had learned that the medical students generally know less than she does about how it all works. So, she didn't have very high expectations once she spotted my short white coat.

We laughed and joked a bit as I took her history and did a quick physical, though. She seemed to appreciate all the little things--the things I was taught to do by the nurses I worked with in college. When I got done feeling the pulses in her feet, I wrapped them in the blanket and gave her toes a little squeeze. She looked at me with such gratitude in her eyes. Like most people who are sick, she just wanted me to look past her parts and her pathology and see her. And, that look on her face reminded me that as much as I am interested in the biology of her parts and in her pathology, I went into medicine for the chance to see her.

I checked on her several more times between 7:30 and 9, updating her and her mom on her lab results and reassuring her that this looked like it was just a nasty flu bug that knocked her on her butt. At 9 pm, as I got ready to leave, I gave report to the next medical student on duty. I told him, "She's dehydrated. Make sure the attending stays on top of her nausea. She's going to need more Zofran than what we've given her." With that, I retrieved my backpack, and, as I walked past her room, I gave her foot one last squeeze.

Her mom said, "Uh, T, we hate to keep you, but she was wondering if (insert unnamed problem here) could be causing these symptoms. She didn't want to say anything because she was embarrassed, but she said that maybe we could tell you."

"And I'm glad you did," I said. "Yeah, that could be making you sick. I'll find a more private room and we'll check it out." Checking it out meant doing a pelvic exam. No one is supposed to be excited about staying late to do a pelvic exam. Excited may not really be the word I'd use to describe how I felt about it either. But, to connect with someone, to earn her trust, to be the person she lets take care of her...I would stay late for that any night.

After the exam, she and I had a little chat about what it means to take care of yourself in a relationship. She got my little "You have to use a condom. Every time. And you can't have sex with anyone who isn't great to you" talk. I gave her foot a little squeeze, and I headed home. I should say, I floated home. I floated partly because I was too tired to feel my feet touching the ground, and partly because I was in peaceful bliss--remembering why I chose this long, sleepless career path.

Remembering it's all worth it.