Clash Of Cultures

7. Toxic Families

Noor

Three weeks of Gen Peds had passed. Its often said that interns have a very steep learning curve in the their first few months of residency. Mine was a literal vertical line at this point. My greatest struggle had been the American healthcare system's obsession with abbreviations. Every condition, test and treatment protocol seemed to have an acronym.

Thank God for smart phones and easy access to Google!

Scott and I had become good friends by now. We bonded over being away from our families. Like me, he was raised by a village. We missed not being able to walk over to our grandparents' house for sugary treats that were forbidden by our own parents. Or hang out with our cousins at family picnics. It made me realize that families, even on opposite ends of the world, are so important in shaping us who we are as adults.

I tried not to think too much about my own family, because every time I did, it left a gaping hole in me. The time difference between Chicago and Pakistan and my crazy schedule made it hard to connect with them at reasonable hours of the day. At least for this month, I had resigned myself to leaving them voice messages so at least I would have some communication with them.

Sal and my relationship (maybe acquaintance was a better word) hadn't had the fireworks it did on my first day of the rotation. But he was still so unpredictable. I would sometime catch him looking at me, as if he was interested in my conversation with Scott or the other interns, only to then grill me on the most trivial of medical facts in front of our whole team. Often leaving me red-faced and embarrassed.

And then there were times when he would randomly do things that would leave me speechless. Like the time when he left a slice of cheesecake on my desk with a note that said 'good job today'. Or the time I was late for noon conference and all the veggie pizza was gone. But when I took a seat in the last row, someone handed me a plate with an uneaten slice of veggie pizza and a hand scribbled note saying 'Saved the last one for you. Sal'. He himself was sitting two rows ahead with his back towards me. And when I tried to thank him after conference, he shrugged and walked off without even looking at me.

There was no doubt that I had learned a lot from him, but I never knew which of his personalities I would be dealing with at any given time. And for my type A personality that needed to control everything, it was a very frustrating position to be in.

Today, was on overnight call with him. My last few calls had been insanely busy. The hospital had been at 95% capacity with a surge in summer respiratory illnesses, and the many elective procedures being done before children headed back to school in just a few weeks. I had barely gotten 5-6 hours of sleep per night over the last 3 weeks.

Recently I came across the cliche 'running on fumes'. And that is exactly what I felt like today. Even the four cups of coffee were not enough.

You're almost there!

6 more days and 1 more night call and you'll be on to your 9-5 outpatient rotation.

Sal's deep voice cut across the haze, "Newbie, we have a 14 month old new admit. Finish your coffee and let's go see him"

I gulped the last few sips, my brain could use every last drop of caffeine today.

According to the ER sign-out the toddler was being admitted for a malfunction of his ventricular-peritoneal shunt. He was born with an abnormally large head because of fluid build-up in his brain when he was still a fetus. After birth the neurosurgeons had inserted a shunt in his head that connected to the abdominal cavity. As long as this shunt was draining the excess brain fluid, his head remained a normal size. Today though his Pediatrician had noted that he seemed to be in pain and his head circumference had increased in size. So he was being admitted for possible neurosurgery tomorrow.