Wednesday, December 27, 2006

Christmas Elements


I work in a teaching hospital, which means that the hospital itself is a training ground for doctors as they come up through medical school. You may see a white coat, you may see "Dr." stitched on the lapel, but said man or woman may still be in training. All baby docs in training answer to/ are taught by an "attending." I'm not sure if I'm totally clear on the nuances, even after 12 years of nursing, but an attending is the real deal. Residents wear white coats. Attendings wear grey. When you see a doc with a grey coat, sit up, take notice, and listen, because it's the real deal. Not a staging, not supervised practice. They are important. I say this with all seriousness. And as much as a resident might bite, attendings have been through enough that they may be just frustrated enough to rip your head off of your shoulders and not even remember your name two seconds later.

I feel closer to a lot of the residents and interns. Feeling my way along. Waiting to learn something new. Quick to ask questions, but quick to listen, open to new information. When an attending rounds with his group of students, it's quite an entourage. Two, three, sometimes four students. When an attending rounds on my patients, I'm quick to be at the bedside with a chart and answers. It's a serious time.

Such was the setting when a neurologist, an attending, came to the ICU the other day. We had a fascinating case, and he was called in to evaluate the patient. Here he came... with four students in tow. One grey coat, four white coats, and me. We drew the curtain around the patient's bed and the doctor sat in front of her, conducting a thorough evaluation. He was a kind man, seemingly gentle. All nerves assessed, a detailed history, test after test... after 20 minutes the entourage had barely made a sound, watching his every move, listening to each question and answer. Then it happened. I broke the unwritten rule. I felt something softly drop on my foot, and looked down to see a tiny white sock laying on top of my shoe. It must have shaken out of my scrubs where it was stuck after a washing. Without thinking, I leaned over and grabbed it, held it up in the air and yelled, "Alright! I found it! And I know exactly where the other one is!" I almost launched into my victory dance, when I became painfully aware that the entourage, the patient, and the neurologist were all staring at me. I bit my lip and stuffed the sock in the pocket of my shirt. But the best part was that they all broke out into laughter... including the attending.

Thursday, December 14, 2006