The art of self-diagnosis

For the first two or three years of residency, I knew I had a “nervous cough.” Every morning hack hack hack, this dry retching thing that would only subside by 10 or 11. Why a “nervous cough”? Because (A) I obviously wasn’t sick sick, and (B) morning rounds made me irritable as hell. You could cut the stress with a scalpel. A dull one.

By my third year, however, I should have known something was up. The stress level dips in your third and fourth years (only to jump to celestial levels in your chief year) and, for a brief time, life is good. You have medical students, an intern, and a second year resident buffering you from all the Bad Stuff. Sure, in the middle of a call night you’re technically in charge (since your chief really doesn’t want to hear from you), but that kind of anxiety passes after two or three times at bat.

Yes, third year, and I’m still coughing. Should have been a clue.

One evening, we got together with the urology team in our call room for an evening of rented movies (Robocop, IIRC) and atrocious (but cheap) Thai food. It was early enough in the evening that our chief was still hanging around. So there we were, three ENTs, two urology residents, two interns, and one or two med students, watching viddies, ready to chow down.

I took a big mouthful of white rice, dry-swallowed, and the bolus lodged somewhere below the level of my thyroid and wouldn’t moved. I felt like I was being deep-throated by a rogue elephant. No problem — I could wash it down with a swig of Diet Coke, right?

Wrong. The Coke bounced off the rice and splashed onto my vocal cords, which promptly went into spasm. Laryngospasm in this context is an emergency measure designed to prevent aspiration. In other words, my body was none too keen to see my lungs bathed in caramel syrup and carbolic acid, or whatever the hell Coke’s secret ingredient is.

In the long run, laryngospasm is incompatible with life, but in practice, folks either manage to break the spasm or pass out (whereupon the spasm breaks spontaneously — you hope). Meanwhile, however, the air ain’t going in, the air ain’t coming out.

Oh, how I wish I knew how to record and upload a wav file, because I can imitate the noise to this day. Imagine if someone were to strangle a seal. Something like that.

Picture it. I’m standing now, hands at my throat, making funny noises in a room with two other ENTs, two urology residents, two interns, and an irrelevant number of almost-doctors. And what are they doing?

Karen, what was that expression again?

(more…)

How’s work? Let me tell you about work.

A typical doctor-patient interaction.

More later, after I pick up the pieces and sew shit up.

***

Okay, I’m back. A little bloody around the clavicles, I can’t find most of my left ear, and it’s a good thing I got that buzz-cut last week because blood in longish hair? Oy. You don’t want to know. Hydrogen peroxide doesn’t even to begin to cut it.

I’m thinking this mood has little to do with patients and everything to do with life in general. Now, if I gave you the nitty gritty details of my life, 49/50 of you would pull out the violin and say (as we did in school), “Ooooooh, poor baaaybeee!” I have a nice house, stable self-employed job, good health, and no major money problems.

But lately I’m feeling like a walking video of Remain in Light. Remember Remain in Light?

So maybe it’s a Houses in Motion kinda feeling . . .

I’m walking a line – I hate to be dreaming in motion
I’m walking a line – just barely enough to be living

Or maybe a Once in a Lifetime kinda feeling . . .

And you may find yourself living in a shotgun shack
And you may find yourself in another part of the world
And you may find yourself behind the wheel of a large automobile
And you may find yourself in a beautiful house, with a beautiful
Wife
And you may ask yourself-well…how did I get here?

I’ve never approved of folks who dodge responsibility for their lives. And yet, I can’t help but feel a little bewildered at my place in the world. One thing followed another with seeming inevitability. You chose A instead of B, C, or D because A was clearly the right thing to do. You would choose A again, given the opportunity. And yet, here you are.

And this goes all the way back to high school.

I think the solution to the puzzle is that I limited my choices from the beginning, putting myself in a position where there really was only one correct choice. We create our choices, those of us who can.

When I was in junior high, I aced some sort of State-mandated aptitude test. My counsellor told my parents, “He can be anything he wants to be.” How lucky I was to have someone there in my life, at that young age, telling me that. How unfortunate that I didn’t believe him.

None of this is new; I’ve been out of sorts for several years now. In 2001, nearing my 40th birthday, I decided to create a new choice and reinvent myself as a writer (and, hopefully someday, author). But as y’all know, it’s a long haul between making that choice and quitting the day job. I suspect many authors never have the ability to quit their day jobs.

I’m hoping it’s not too late to try.

D.

Ninety-two hundred, part two

Remember when you were a kid and you complained to your parents, you would get the When I Was A Kid speech? The other day, I decided to do that to myself by remembering the most difficult bits of surgical internship. Kind of like Monty Python’s Four Yorkshiremen, only it’s me yammering at myself:

Get yer head out o’ yer arse, Doogal, and quit yer whinin’! You call that a tough week? When you were 29, you were putting in 100 hour weeks, you snivellin’ excuse for a doctor!

Without further ado, here’s more pain.

(more…)

Ninety-two hundred

click to see big mofo hospital

We used to imagine the demolition of Los Angeles County Hospital. Would the city allow spectators? Would they charge for front row seats? How many former residents and interns would return to Big County for the privilege of seeing her leveled?

We eat Dodger Dogs and drink Coke. Or, in a fit of sentiment, perhaps we eat carne asada soft tacos and drink horchata or tamarindo. Someone passes me the pad thai. “Hey, Doogie, choke on this!” Another story for another day.

Someone mentions the Northridge earthquake of 1994. It did $389 million in damage to our auxiliary hospitals (Peds Pavilion, Women’s, and Psych), but Big County hunkered down and rode the shaker like a proud old whore.

The first explosives blow. Dust rises and the wings fall, then the main building, with its central hall so wide you could drive an old Buick through it. “Two,” someone says. “Two Buicks.”

The building crumbles. Big County. Mother County. “Ride this one,” I say.

(more…)