Two days later and back in the hospital, I received a page from Dave, the chief resident who’d given the phlebotomy tutorial at intern report. I wasn’t sure what it was about—the message only asked, YOU FREE?—and I quickly tried to recall if I’d said or done anything that would warrant a face-to-face discussion with an administrator.
My mind immediately leapt back to the Palisades retreat, which had ended up being a cathartic bonding experience with the other interns. The realization that I wasn’t alone gave me the courage to really unburden myself; I’d ultimately described in detail what I’d gone through with Gladstone, with Peter and Denise, and with Dre, though I’d skipped the part about the needle stick. Over the course of the retreat, only a few people had refused to speak candidly. Many of my colleagues had opened up about what the daily traumas of medicine had done to their fragile psyches. The surprising part was how, despite all the vicissitudes of the recent months, I was not the most exhausted or damaged intern. During a group hike several of my fellow interns confided that they intended to leave the program before the end of the year. I felt better having heard their stories, but now I wondered if I’d said too much; if, despite the retreat having been a safe space, something had made its way back to Dave.
I tucked my pager back into its holster and headed toward the chief residents’ office. There were four of them, and each chief resident had just completed the Columbia internal medicine residency program and was now spending the year arranging conferences, teaching medical students, and keeping tabs on the mental health of the residents. They were liaisons between residents and the hospital’s administration, often serving as the bearers of bad news when a new regulation or oversight committee was foisted upon us. It was a great honor to be selected as a chief resident, and the position was frequently a pit stop for physicians applying for the ultracompetitive cardiology fellowships. (Diego had once been a chief resident.) I tried to imagine what the meeting was about as I hopped down three flights of stairs.
“What’s up, guy?” Dave said as I entered the tiny, windowless room. On his desk were four pictures of an attractive woman doing yoga. “Take a seat.”
“Hi, Dave.” We had spoken a handful of times, mostly before and after educational conferences. He liked to put a hand on my shoulder when we talked, and he evoked the image of an assistant coach—someone who was there to advise and guide me, but lacking the gravitas of a senior physician. There was an off-the-record feel to our interactions; he knew what interns were going through because he’d been one just three years ago.
I sat down and crossed my legs. “How are you?” he asked eagerly.
I smiled. “You know…hanging in there.”
He nodded vigorously and readjusted himself in his chair. “How do you feel?”
“I’m good.”
I found myself staring at the yoga lady. Dave took off his glasses and we sat in silence. “I’m going to get right to the point,” he said, clasping his hands together. “We’re worried about you.”
We locked eyes momentarily. “What?” I said.
“Five interns are leaving the program. That’s unheard of.”
It was true. I hadn’t been aware of the deep discontent among my peers until the Palisades retreat. “Well,” I said, with as much enthusiasm as I could muster, “I’m not going anywhere.” I wondered why the departing doctors were all men. No answer sprang to mind.
Dave put his glasses back on. “I heard about the error. The thing with the pupils.”
I flinched and looked away. It had taken place more than four months ago; why was he bringing it up now? Word must’ve trickled out from the retreat. “I thought that was confidential.”
“I also know about the needle stick.”
I felt a knot in my stomach; I wanted to know who else had spoken with him. I wondered if Dr. Phillips had told him about our conversation. Dave leaned back, pulled a handkerchief from his breast pocket, and blew his damp nostrils. I briefly closed my eyes and again felt the urge to disappear. “Look, people talk. What can I say?”
“You could say that stuff at the retreat isn’t actually confidential.”
His eyes scanned back and forth across my face. “Matt, this isn’t meant to be an inquisition. I’m just checking in to see how you’re doing.”
That wasn’t what it felt like. I was sick of the hot seat. “I’m…fine.”
“You’ve been through a lot.”
Ashley had once told me she didn’t want to hear that I was struggling. The whole complex hierarchy made it impossible to figure out when it was safe to vent and when not. But I was running out of patience. “Okay, Dave, I’m not fine.” I leaned back in my chair. “I’m not fine at all. Is that what you want to hear? I made mistakes, people are leaving the program, and…” The corner of his lip curled upward as he nodded. “And I might have AIDS.”
“You don’t have AIDS, Matt. But talking about this stuff is a good thing.”
It was making me feel worse. I had to take the HIV pills for ten more days, and then it was time for the blood test. Then I would know if I’d contracted the virus. Why did Dave want to talk about this stuff now? As I thought about what to say next, my pager went off. Perfect. I was getting the hell out of there. “I need to respond to this,” I said, without reading the message.
“Oh sure, sure,” Dave said, pushing the phone in my direction.
“No, it’s something on the floor,” I said. “I have to go see a patient.”
I extended my hand, and he smiled. “Good talk, Matt,” he said. “Let’s keep the lines of communication open.”
I had no intention of doing so. I felt my nostrils flare; I wanted to hit something. “Sure thing.”
I caught another glimpse of the downward-facing dog and walked to the stairwell.