Surgery calls…

And so we enter into the Q3 (every third night) 30-hour call of the surgical ICU. The most intense of the ICU rotations, not only because of the call frequency but also because of the patient volume. By far the saddest stories in the hospital. Young trauma victims, healthy before their tragedies, now completely incapacitated – and many with little hope for recovery. As December snow falls gently outside the windows, I slide into my Q3 schedule with ease. The hospital has become home for now – uncomfortable call beds, cafeteria food, monitors – they are almost comforting in their familiarity and hardly bother me anymore. And as busy as things are, it is still a nice reprieve from the chaos of the emergency department.

I am almost at the pinnacle of my second year now, with only 7 more overnight shifts left after today in a long stretch of 30-hour calls. As I trudge upwards towards the finish line, I take in the view from the windows at the top of the hospital. It is a place I will not return to for a long time after this. My retreat to the windowless basement of the emergency room is imminent, and I reflect on it all with mixed feelings.

Now I understand the origin of the word resident, a term coined when residents truly did live in the hospital. There is a learning process, through absorption over time, that takes place during an intense month like this that cannot be replaced by shifts broken up into 12 or 16 hours. But this is only the beginning and already I am growing exhausted, day after day. And so the count down begins.

Thanksgiving in the Hospital

I press on the gas, lean back against the head rest, rest one elbow on the consul, and glide along vacant lanes of highway. Speed, and the absence of traffic, is almost exhilarating at 6AM in the morning, as gold rays pierce through a lattice of cloud cover. One more day in the hospital, in this long string of days. As I walk through the tunnels to the entrance, weary faces pass in the other direction – worn but polished with morning light. Ready to leave. Comforted to be going home, even if only to crash on a pillow. I have a fleeting wish to turn in the other direction, but I suppress it, keep walking, pretend I don’t notice the lump building in my throat. Just another day.

A boy playing in a marketplace with a strutting old gobbler entertains Chichicastenango visitors by doing the son, a dance popular throughout Guatemala. Luis Marden, National Geographic.

Inside the hospital, it is not Thanksgiving. Small, lonely reminders of what is missing – a turkey poster on a wall, the festive sweater of a passerby,  a holiday song playing faintly in the cafeteria – make for a somber backdrop to the day. It would almost be better if there were nothing at all. It is not Thanksgiving inside these walls. It is on the calendar, if one were to look, but in here it is only a shadow, an echo, a memory reverberating through the sterility and the sadness. It is a day to remember – even to long for – all of the better, healthier Thanksgivings before this one. The ones to be thankful for.

The families in the hospital are quiet. Sadder today, if that is possible. One father, rubbing his eyes and rising from a hospital cot as I enter the room, says to me, “I’m with my little girl today. That’s all that matters. That is Thanksgiving.” Another anxious mother raises her eyebrows, “Do you think my son will be able to go home today? It is Thanksgiving, after all.” A grandmother greets me with her new plan, “We are going to reschedule Thanksgiving this year. Thanksgiving will be when my baby comes home. Then we will have a turkey to celebrate. Yes, Lord, we will.” A five-year-old boy begins the day by singing in his room. He ends the day in tears – no one in his family came to visit like they promised.

Holidays in the hospital are some of the saddest times I have experienced. Families, patients, and even nurses and physicians – their yearning for home becomes more poignant. An anxious longing to be elsewhere pervades the building. But we are all resigned. We imagine Thanksgiving beyond the windows. The empty roads are the only sign that something else, something better than this, might be happening in other places. But try not to think of this. Instead, think of it as just another Thursday. Another day in a string of days. The time to celebrate will come, but not today.