The conversation with Sothscott left me hollow, paralyzed. I closed my eyes, tracing and retracing the creases in my palms as I tried to make sense of it. I had just told Carl Gladstone’s wife that he was going to be okay, that he’d get through this, all as I had almost single-handedly assured that this would not be the case. I dug my fingernails deep into my hands, creating a physical discomfort that served as a blissful, vivifying moment of distraction from the perverse mixture of worry, fear, and anxiety. I opened my eyes and again examined the creases. They almost formed letters—an A in my left palm and an M in my right. I searched for significance but drew a blank. Then I felt a tap on the shoulder.
“What is this?” Baio asked. “What’s happening?” Trying to compose myself, I looked up. Did Baio already know about the error? Did Dr. Badass? “Are some amazing things happening here?”
“Well.” Part of me wanted to blurt out the entire conversation with Sothscott. But a bigger part didn’t. Baio wasn’t responsible for leaving notes on patients; that was the intern’s job. There was no documentation of his faulty reasoning, only my own. I felt like I was going to throw up.
“Are you okay?” he asked.
“Not really.”
“You look terrible.”
“I’m not feeling well.” I didn’t know where to begin. “I’ll be back in a minute,” I murmured.
I went to the only place of refuge I could think of—the call room, with its lilac walls, buzzing fluorescent lights, and flimsy bunk beds. It would almost certainly be deserted at this time of day. I punched in the three-digit code and headed for the bathroom. Catching a brief image of my face in the mirror—I looked like wet shit—I bit my bottom lip and dry-heaved over the toilet bowl.
My arms went limp as my face turned into a damp mess. But I had to get back to the CCU. In the room next to Benny’s, there was a young woman in need of the large-bore IV. I threw cold water on my face and tried to focus on her story so I could momentarily forget about my own. Her name was Denise Lundquist, and she had just been transferred to us from a hospital in New Jersey. Baio had obtained her medical records and explained to me that a few days earlier, she had come home from work to find her husband, Peter, in the kitchen, holding his head in his hands. Peter informed Denise that her brother had been killed in a traffic accident. Upon hearing this, Denise collapsed; minutes later an ambulance arrived and took her to a local hospital, where it was revealed that she, like Gladstone, had suffered a massive heart attack.
It was a terrible story, but the details were a welcome distraction. After a seemingly successful catheterization, Denise’s heart had continued to deteriorate as her lungs filled with fluid. Doctors ultimately placed her on a respirator, at which point they also made the decision to transfer her to our CCU, which was better equipped to deal with such critically ill, unstable patients.
I grabbed a paper towel and dabbed my face. I had to get back to work. Denise needed the large IV to receive a cocktail of potentially lifesaving medications, and every second I spent in the call room delayed her treatment. When I reentered the CCU a minute later, Baio had already started the procedure. By the time I had put on my gloves and disposable gown, the IV had been inserted.
“Go home, dude,” Baio said as he walked out of the room. “Come back when you’re ready to work.”
I shook my head, remembering some of the first words he ever said to me: We have to work as a team. Everything is teamwork.
“Seriously,” he said, glancing around the unit. “Go. There’s not much left to do today. Go.”
After a weak protest, I was on the southbound 1 train to my apartment, wondering how my absence might affect the others. What would they think? Exiting at Seventy-Ninth Street, I blew past my large Eastern Bloc doorman with a small wave before he could get a word out. Heather was still at work, seeing patients in her primary care clinic. I had the apartment to myself. I dropped my shoulder bag and spilled its contents—stethoscope, white coat, and a small bible called Pocket Medicine—on my living room floor, collapsed on the couch, and slept soundly through the night.
I woke the next morning to the caterwauls of small children outside my window, and immediately my anxiety came flooding back. How was I going to face the day? I had no emotional frame of reference for something like this. Something so grave, so awful. A swirl of questions bombarded my conscience. What had happened to Carl Gladstone after he left the unit? What would I say to Baio? Should I just keep the phone call to myself and move on? And was that even possible? If someone found out, were we in danger of being sued? I imagined for a moment having to tell people that I’d been a doctor for two days but then I accidentally killed someone. The thought made me almost throw up again.
I pulled an outfit out of my closet and took a deep breath as I recalled a small silver lining: my schedule today would take me out of the cardiac care unit in the afternoon, down to the other end of 168th Street to begin work in a primary care clinic. As part of my medical training, I also had to learn how to treat everyday complaints like back pain or the sniffles. Many residents found the transition to a slower pace more difficult; they included Baio, who warned that primary care would be the most painful part of my medical education. Other residents loved it, considering it a much-needed change from the frantic pace of the hospital. Given what I’d just been through in the CCU, an afternoon spent in an office chatting with patients who were in no immediate danger of dying seemed like a godsend.
As the subway lurched northward into the dewy morning, I overheard two young men considering Barack Obama’s chances in the upcoming election—both agreed he had promise but was ultimately too inexperienced—and my thoughts turned inward to my own inexperience. My medical school diploma hadn’t yet been framed and already I found myself racked with guilt.
On the other hand, it seemed impossible that this was all my fault. I had told Baio my differential diagnosis on the anisocoria, but he didn’t have to listen to me. He could make his own clinical decisions. His job was to show me the ropes. What the hell did I know? One might say this was really a case of faulty oversight. Still, I felt like shit trying to blame Baio, and either way it didn’t change what happened to Carl Gladstone. Or maybe Baio hadn’t listened to me; maybe he’d called my sedative suggestion “reasonable” but ultimately ignored it. What if I wrote a note that didn’t reflect what actually happened to my patient? I was very confused.
My mind continued to wander, as it often did on the subway. Were these first few days in the hospital a sign of things to come or just a bump in the road? People enter medical school with the belief that they’re on the path to becoming revered, trustworthy physicians, but what if I was destined to become the one colleagues whispered about? Maybe it would be safer to have me tucked away in a laboratory, tinkering with those imaginary numbers and—
“Excuse me, ladies and gentlemen!” a man in the center of the subway shouted. “It is your lucky day!”
I looked up to see a black man a few steps away dressed in a purple bathrobe and sandals.
“My name is Ali and I am an internationally renowned spiritual healer.”
I pulled out Heart Disease for Dummies.
“I have been blessed with the clairvoyant powers of my ancestral spirit and I am here to help you!”
Ali looked up and down the aisle, largely ignored, and raised his tawny arms. His facial hair had been fashioned into a Vandyke beard, and I guessed he was originally from West Africa. “My powers include, but are not limited to: bringing back loved ones, depression, substance abuse, debt, and impotence!”
The woman next to me put down her New York Times and looked up at him.
“I can also help with court cases, immigration status, breaking black magic, breaking curses, breaking jinxes, and all general demonic forces that may cause you trouble!”
He paced the length of the subway car, tying and untying the bathrobe. “Your pain is my responsibility,” he continued. “I can also help with success in business, success in sports, and SAT prep!”
He produced a stack of cream-colored business cards from the bathrobe pockets and handed one to me. It read:
ALI
YOU KNOW I CAN HELP
YOU KNOW WHERE TO FIND ME
I put down the book and stared at the card. I wasn’t a superstitious person, but at the moment I was willing to indulge almost any fantasy that my life could be improved instantly. Was this some sort of sign? After all, I did need help. I was unprepared for the extremes of emotion that medicine provided and found myself in search of something—a moral compass, a mood stabilizer—anything to get me through the ups and downs of hospital life. What if Ali was actually some font of wisdom who could provide sage if unexpected advice to guide me through my career?
As I rubbed the business card between my thumb and forefinger, wondering how Heather would react if I asked if Ali could move in with us, the neighboring passenger tapped my knee with her newspaper. “Last week,” she whispered, “this guy was selling candy for youth basketball.”