Friday, February 02, 2007

The Indoctrination

It was a cold day, many, many years ago. A young, impressionable medical student entered the VA hospital on his first day of his medicine rotation. Never before had he seen so many patients, nurses, doctors, family members hurrying to get to their destinations. No one was smiling.

The hospital was of the 1950’s genre: tall, foreboding and quite intimidating for the young medical intern. The layout of the building was idiotic, with two large elevators centrally located that carried the patients between their rooms and testing facilities. Like a 90-percent stenosis of the left anterior descending artery, all patient traffic flowed through these elevators and the traffic in turn, moved slowly. Hoards of patients, nurses, doctors and family members waited for the elevator and would enter whether it went up or down, because to get on the elevator meant at least you were sure to get to your destination, eventually.

No one knew this better than the seasoned patient transport personnel. Their days were made or broken by the ability to move patients from one point to another. The impressionable medical student spied one of these transporters as he entered the main corridor of the hospital. There she was, Ms. B., pushing a thin, confused man in his 80’s covered with four hospital gowns left untied from his recent testing, his foley catheter draped from the side-arm of the chair, his IV draped over Ms. B’s shoulder.

“Alright, Mr. J, we’ve gotta get yous on one of these elevators to get you back to yo’ room.”

She stood before the bank of elevators, waiting restlessly.

“Damn, you think they’re ever gonna come?”

“Hopefully soon, ma’am,” said the medical student.

They waited and waited. Finally an elevator door opened. No one got out. They waited, and the door closed and the elevator returned to the upper floors.

“Shheeeeaaatttt,” said Ms. B. “You hang on Mr. J. I’m gonna get you on that next elevator if it kills me!”

Again she and Mr. J waited. The medical student looked on, realizing he’d better not take any space on the elevator before Ms. B and Mr. J.

Finally, the other elevator door opened packed with people. Four people left, three more got on before Ms. B. She knew this was her chance.

She swiveled Mr. J around and backed her generous derrière back into the packed elevator, towing Mr. J’s wheelchair, too. The door began to close and hit the side rail of Mr. J’s wheelchair as she struggled to compress the impeding crowd of people on the elevator and negotiate the wheelchair into the elevator car.

“Com’on ya’ll, let us sick folks in!” she shouted as she shoved.

“Bang,” went the elevator door. She shoved harder. “Bang,” the door tried to shut again. She made a few more inches. “Bang,” the door hit the foot rests of Mr. J’s wheelchair. She gave one final shove and cleared the door. The elevator door closed.

But unbeknownst to Ms. B and Mr. J, Mr. J’s foley bag had fallen to the floor and had not cleared the door.

A bewildered medical student looked on as the foley bag flew up from the ground. It struck the ceiling of the elevator door with such force that the foley bag disconnected from the tubing. Urine splashed all over the ground. Patients, nurses and physicians near the door scattered.

Finally, a seasoned attending physician munching on a bag of chips smiled. He leaned over to the bewildered intern and whispered:

“Welcome to Medicine.”


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