Colors

My sneakers squeaked as I hurried down the hospital’s hallway. A fresh coat of wax had just been applied and I could see my distorted reflection in the shiny, off-white tiles. For a minute, I thought that I looked good in my green scrubs and long, white jacket. I must have walked down that same corridor at least twenty times that day and I knew all the pictures on the wall by heart. The flowers and seascapes in the prints were all faded and I figured that the original painters would be sad to see what had happened to all the vibrant colors they had chosen for their artwork. It made me a little sad too. I passed by the nurses’ station on that floor, waving and smiling at the ladies behind the desk. They were busy writing in their patients’ charts and measuring medications as the sound of heart monitors droned in the background. I stopped by a window near the elevator. The sun was beginning to set and I spotted an architecturally beautiful church nestled in the distant hills. I had seen it many times before. It looked so inviting to me and I often contemplated running there to seek refuge, but then the elevator came and I went inside.

It was my first year of general surgery and I was on night call at one of the hospitals outside of NYC. I was both exhausted and lonely all at the same time. I missed my bed and the softness of my girlfriend’s skin. My days were spent scrubbing into as many surgeries as possible. In between, I would run around the floors performing consults and taking care of the many needs of our floor patients. Yes, it was pretty much like Grey’s Anatomy, but without the sex and commercials. In any given hour, I would unclog a feeding tube, change an abdominal wound dressing, insert an intravenous catheter into someone’s internal jugular vein, deliver blood samples to the lab and write orders for a battery of x-rays and medications.

I tried to be as efficient as possible, but it seemed that every place I had to go was at the opposite end of the Medical Center. To make matters worse, the hospital was a Level 1 Trauma Center, which meant that it accepted the worst accidents. Just when I was getting caught up on my “scut” (that stood for some common, unpleasant task), I might be called to the ER to handle a multivehicle accident with half a dozen casualties. Suddenly, I’d be up to my elbows in blood trying to put a chest tube in and re-inflate a collapsed lung. There were days when I barely had time to change gloves before the next trauma rolled in, and all the while I would be thinking about how behind I was getting on my other work and how my prospects of sleeping that night were dwindling.

During the evening, the hospital transformed from a chaotic madhouse into a quiet, eerie place. The lights became dimmer and all the pain and suffering that was taking place behind each curtain and door took on a more silent character. That night, I was so tired from a sleepless night before that I felt bugs crawling under my skin. My hair was oily and I wasn’t sure when I had last brushed my teeth. I suddenly realized that the gnawing feeling in my stomach was hunger, so I found my favorite vending machine and made a selection. I made sure to vary my diet, so I chose something from a different row than before. I was just about to sneak off to the call room for a nap, when I heard the announcement from overhead, “Surgical Resident to the Medical ICU, STAT!”

I listened to it for a second, and then looked around me. A calm voice inside my head broke the confusion. “Yes, that’s you.” I looked down at my candy bar, stuffed it in my pocket and ran to the MICU which was, yes, at the other end of the medical center. When I arrived there, one room full of light and bustling activity stood out amongst all the others. A nurse ran out of the room and looked at me. She was out of breath as she adjusted her glasses, checked her watch and screamed back into the room, “He’s here!” Walking towards the room, I felt like Alice floating down the hole into Wonderland, but I had no idea where this rabbit was leading me.

I walked into the room and stared at the unconscious man on the bed in front of me. The anesthesiologist was at the head of the bed trying to put a tube down his windpipe to help him breathe. “I can’t get it in, he’s too swollen. He needs a trach!” Somehow, I found myself right beside the bed. My white jacket had been taken from me and in its place was a surgical gown. It all happened in a matter of seconds. Betadine, a skin cleanser, was placed in my right hand and a scalpel was placed in my left. A tracheotomy is a surgical procedure to place a tube through the skin into the windpipe an inch below the voicebox. I had learned about it, and even saw a few done, but I had never done one myself. I knew that if I succeeded, he might live, but if I failed, he would surely die.

My eyes remained fixed on the patient in front of me. I coated his neck in betadine and felt for the location of the incision. I brought the scalpel closer to my patient, but just as the edge of the blade indented his skin, the anesthesiologist screamed, “I got it, the tube is in!” I looked over and saw that air was entering the man’s lungs from a tube in his mouth, called an endotracheal tube. The scalpel made a clanking noise as I dropped in back onto the instrument stand next to me. Part of me was relieved that he was going to be OK, but another part of me was disappointed that this pivotal moment was swept out from under me. “Thanks for coming”, the anesthesiologist said with a smile and patted me on the back. Walking back to my call room, I felt empty and confused. The adrenaline was still pumping through my veins. Consuming the rest of my half-eaten candy bar was my only consolation.

That was one of the toughest rotations of my two years in General Surgery. Before heading home the following morning, I actually had the opportunity to perform an emergent tracheotomy in the ER with my Senior Resident leading me through it. These days, as an ENT, I get to perform these procedures rather frequently, but I always think about the one that got away that night. Walking through the hospital’s parking lot, the sun was shining and I enjoyed the feeling of warmth on my face. The faded paintings in my mind were now replaced by a vibrant, blue sky and the sweet, warm breeze coming off the hills. For now, I was free, but I knew that my escape would be short-lived. As I drove out of town, I passed the church that I saw the night before. The doors in the front were opened wide, as if they were saying, “I’m here when you need me”.