Back when I was doing my clinical rotations, I would dread waking up and going into the hospital. I simply did not like to see patients. There’s something about the early morning that makes me not really want to have contact with too many people. It’s just the way I am.
I’m not anti-people. In fact, I enjoy working with people. I feel that I communicate well, and I don’t stumble when meeting somebody new. It’s just the intimacy that’s involved with patient care that really turned me off.
Hospitals and Elevators
Upon arriving at the hospital, I would take the elevator to one of the high floors where my team’s “office” was located. I quote the word “office” because it’s actually a very small room with a table. If you’re lucky, they’ll be a computer in there for looking up information or killing some time on the net.
It never failed, but somebody would always say “good morning” to me in the elevator. Yes, I realize that they are just being polite, but since I knew I was in for yet another day of dealing with patients, there was nothing “good” about it. I’d prefer they not say anything at all.
Pre-rounds. Just another word for why you, the medical student, has to come in (along with the residents) a couple of hours before anybody else. I don’t even have time to finish my coffee before I need to start waking up patients.
I don’t know, but there’s just something about dealing with people after they have just awakened that’s kind of creepy to me. And when you’re waking people up at 5:30 am, there’s nothing you can do about it.
Pre-rounding always involves questions. Questions about bowel habits, stool consistency, and wound discharge. Information including urine output, and if the patient has vomited since I last saw him. Why did I ever think that I would be interested in finding out this information from a complete stranger? Answer: I was never fully informed.
I Feel Dirty
The physical exam on hospital inpatients is one that I have learned to hate. I just arrived to work in a nice shirt and tie, and now I have to poke and prod some poor guy in a hospital gown who hasn’t bathed properly in days. I feel dirty. The sights. The sounds. The smells. Even the sterility of the hospital makes me feel unclean. The scent of breakfast trays mixed with the smell of sterility, and the patient in room 902 who needs his diaper changed all remind me not to eat.
All Hands On Deck!
The attending arrives, just as we’re finishing up with pre-rounds. It is now time for “attending rounds.” It’s just more of the same, this time with pimping and humiliation involved. Same sights, same sounds, same smells. My day doesn’t get better. I’m more awake now, but I feel like a walking zombie.
“The patient in room 904 needs a disimpaction.” I know who will do it. Nobody else wants to, and I’m the low man on the totem pole. The medical student. Should I refuse? Is it a learning experience? Maybe, but it isn’t for me. Anyone can disimpact.
I gather the needed equipment, which is simply some type of covering to catch the shit that’s about to fall out of this poor guy’s rectum. He’s a big guy, so I make sure it’s an extra large.
He hasn’t passed stool in some time now, and the rectal exam reveals that he is, indeed, stopped up. Why can’t they get nurses to do this type of work? Because I’m there and will do it for free. Actually, I’m paying for the privilege.
I always double glove, and this is certainly no exception. I manage to roll 350 pounds of human on top of the covering, and reach in with one finger and start to scoop.
Stool comes out, but it’s slow. I scoop some more.
A minute or so passes, and I begin to dry heave. Here I am scooping feces out of a complete and total stranger’s rectum, and I heave some more.
I step out of the room for a breath of fresh air and sit down. I knew this patient care business was never for me, but the experience has just solidified my thinking.