Ninety-two hundred

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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.

***

It was never about education. It was about getting the job done.

Interns and residents were the gears, medical students the grease. A huge amount of work needed doing, a superhuman amount of work, so much work that docs taking sick leave were looked upon with intense suspicion. “You’re either in this hospital working,” we’d say, “or you’re here as a patient. Either way, you had damn well better be here.” In my five years at County, I missed one day — for food poisoning.

As interns, we took call two days a week. One day would be ward call, and one, admitting call. Ward call could be sleepless but it was rarely evil. Admitting call only came in different shades of cruel.

9200 was our General Surgery admitting ward.

It looked something like this. No joke. Imagine that big ward chopped up into three smaller wards and you’ll have an even better picture of 9200. At the center of it all lay the charge nurse’s desk, where three or four nurses ate, drank, read magazines, did anything but help us. I never figured out what they did. Took vitals. Criticized us. As a rule I love nurses — God knows they’ve saved my ass plenty of times — but 9200 nurses? Useless.

Residents manned the Emergency Room or scrubbed in surgery. Med students helped out on 9200 when they could, but more often than not they held retractors in surgery. Interns, that’s me and my pals, ran 9200. Friday through Sunday, two interns ran the show. On weeknights, we went solo.

Every patient needed the same stuff: IV, EKG (for patients over 35), urinalysis, chest X-ray, abdominal films, Foley catheter, blood tests, plus ‘specials’ specific to each patient (consults, CT scans, other radiologic studies). We kept track of everything on a grid: studies and tasks on the X-axis, patient names on the Y-axis. And we did everything. We placed the IVs, went back and forth to Radiology to retrieve X-rays, did our own manual urinalyses, placed the Foleys, drew the bloods.

Oh. We were supposed to be paying attention to our patients’ rapidly changing conditions, too. Yeah. Right.

In fairness to the residents, they never expected more of us interns than the successful completion of the grid. The charts had to be well organized and all X-rays had to be in their appropriate place by morning attending rounds. And God help you if you, the lowly intern, made your resident look bad on attending rounds.

Resident: “. . . is a 24-year-old Hispanic female who presented with a rigid abdomen, febrile to 104, four-hour history of shaking chills and sweats, abdominal air on her KUB –“

Intern: “No there wasn’t.”

Resident: “WHAT?”

The attending physician looks from the resident to the intern, then back again, smelling blood.

Intern: “You’re confusing Miss Torres with Mrs. Alvarez. She’s the one with the belly air.”

This would never happen.

***

Post-call on a weekday, my work lasted until 6 PM. On a weekend, yippee! Out by noon, if I was lucky. Thus I would have to work for six to twelve hours post-24 hour call. I discovered I could do quite well (i.e., not commit any serious atrocities) with two hours of sleep. One hour of sleep was far worse than no sleep at all. With one hour of sleep, I would spend my day with molasses-clogged synapses, one small step away from a crying jag.

Funny thing, I never minded post-call work. I was too relieved at having survived another haul on 9200. I felt no small amount of pride, too: we had the second busiest ER in Los Angeles County (Martin Luther King usually ranked first), which probably made us one of the busiest surgical admitting services in the country.

Remember the old Shake’N’Bake commercial? And I helped. You could even say we interns were the keystones of the whole affair.

And now I can hear my favorite surgical chief resident, a Texan who was hell on phones*, saying, “Don’t press yer luck, Doogie.”

To be continued.

D.

*Better to destroy a phone than punch out the dumbass on the other end of said phone.