don't want no sugar in my coffee

In any modern city, you're liable to get patients who speak a multitude of languages. Fortunately, probably the most multicultural group of people in said city will be its doctors, so you're probably going to have a colleague who speaks whatever language your patient does.

Take last week; I admitted a guy whose primary language was Cantonese. He spoke a very tiny amount of English, but somewhat more than I speak Cantonese. My senior resident that night, by luck, grew up speaking Cantonese and English, so I watched as she got a much more complete history than I could have.

Now, being the culturally sensitive guy I am, I tried to pick up a couple of words. The most important word in any language for me is "pain," (and how fucked up of a statement is that, eh?) and "pain" in Cantonese sounds something like "tong" or "tung"; it's hard to tell exactly because it's an inflective language which all sounds the same to my white-guy ears.

So three days later the guy, who's had a catheter stuck in his penis for a few days (long story), pulls it out. This is more difficult to imagine than you might think, as there's an inflated balloon inside keeping it in place, so it's impossible to pull out a Foley catheter without some bleeding and, er, tearing.

I go up to his room and try to ascertain how much damage there is. I ask him, "where does it hurt?" and he looks confused. I point at his penis (which is only bleeding slightly) and ask him if it hurts, and he looks confused. I dimly remember from when I admitted him that Cantonese for pain is "tong," so I point at his penis and say "tong?" At this point he looks unbelievably befuddled and a little insulted.

After about five minutes of sign language and screaming "tong" he seems to realize what I'm getting at and says, "no, no pain." Whew! I go out and relate this story to my (also Cantonese-speaking) med student, and she starts laughing uncontrollably.

"No, no," she says. "'Tung' is pain. 'Tong' is sugar."

That's right, I spent five minutes pointing at an old guy's wang and yelling "sugar! sugar!" I can't imagine what he thinks of the health care system now.

Happy hospital thanksgiving

Today, if you live north of the border, was Canadian Thanksgiving. Most people have their turkey on Sunday night, though, and leave Monday free for digestion and hockey games.

I missed my family Thanksgiving for the third time in as many years; it seems I’m always on hospital call on that holiday. This year I’d arranged my schedule so I could travel to my cousin’s wedding the previous weekend, meaning I had to make up the call on Thanksgiving weekend.

I’m not going to lie, it had been a rough few days. Friday I admitted something like ten patients to the hospital, which doesn’t sound so bad until you realize that each internal medicine consult takes like two hours if you do it right, or if you have to do any on-the-spot reading. So either you half-ass your job, or you don’t sleep. I’m not jaded enough to half-ass it yet.

Saturday, I slept.

Sunday, I was on ward call. Now, for ward call at this particular hospital there’s one resident on for all the internal medicine patients. That’s about 300 patients, several of whom are actively dying at any one time. Ward call, as one of my colleagues put it, “is like going to hell.”

Around dinnertime I was up on the fifth floor, trying to figure out what antibiotics to give to an alcoholic who’d inhaled his own secretions. This 70-something woman came up to the desk, asking if anyone would like a plate of dinner. I took a glance at the plate, and realized it looked a damn sight better than any hospital food I’ve ever seen before. Turkey, mashed potatoes, stuffing, carrots, and cranberry sauce. And gravy.

I asked if she’d brought this from home, and she confirmed that impression. Her husband wasn’t going to eat his home-cooked dinner today, and she wondered if the nice young doctor would like to have it instead? Considering I hadn’t eaten anything but coffee and vending machine Mars bars all day, I gladly accepted. I did have to ask, however, why her husband wasn’t going to finish it, and if he was OK if I had it.

“Oh,” she said, “I’d brought this turkey to give to him, but they put a tube down his throat to help him breathe today, so he can’t eat. We didn’t want it to go to waste.” I’m still amazed she said this without tears in her eyes. She assured me it was all right, and walked back to her husband’s room, leaving me standing there flabbergasted with a plate of delicious turkey in my hands.

It amazes me sometimes how well people are able to maintain their humanity in the face of the indignities perpetuated by old age, infirmity, and the health care system. And if I’m thankful for anything today, it’s that. Happy Thanksgiving.

Medicine ate my life

So. Sorry about the downtime, folks, but it's been kind of... hellish lately.

I've been doing internal medicine the past month and a half. It wasn't so bad at the University; I usually would get home by 7 o'clock or so and have a little time to pretend to set up my new condo. By the way, I moved into a new condo about four weeks ago. Haven't done shit to get it set up, mind you.

But now I'm at the Alex (another big hospital). I am the sole resident in charge of my team, which currently has about 10 patients but will likely have about 40 after a couple of nights of admissions. My staff doctor is essentially absent. I am NOT FUCKING READY FOR THIS.

Also the power company shut off my juice and it took a week to come back on. I forgot to set it up in the first place, you see; I think a sign of how much this job drains you is when you forget to do very obvious and simple tasks in the rest of your life.

I'll see you all in a few weeks. Life will get better some day soon, this I promise myself.