Just Like Someone Without Mental Illness Only More So_ A Memoir - Mark Vonnegut [28]
Every morning the whole team watched as the resident listened to the heart and lungs of each of our patients. Usually he said nothing because there was nothing to say. One morning while examining Richard he stopped and had each of us listen to a spot he had located on the patient’s back.
“Those are rales and rhonchi,” he stated flatly. “Richard is coming down with pneumonia.”
He had one of us write orders for a chest X-ray and massive doses of IV ampicillin. Four hours later Richard was short of breath, running a 105-degree fever, sick as a dog. The chest X-ray hadn’t been done and the antibiotics hadn’t been given. The one time we had a physical finding that might have made a difference on the closest thing we had to a salvageable patient, the damn orders were written but never taken off. Our resident was closer to tears than mad. Richard did well. If he had been eighty-five, he probably would have died.
My father asked me what I was learning from all this. I told him that needing a doctor was a bad sign.
It continues to amaze me how easily doctors can walk away from their mistakes. A patient would be sent to the ICU with horrendous complications and zero prognosis, and the surgeons who botched the case could be toweling off in the locker room and chatting about how to bill for the various procedures involved and the upcoming Pats game.
The month before I finished medical school one of my sisters had a psychotic break right after she quit drinking. I went down to New York and was a model of tough-minded efficiency, hiring an ambulance and getting her transferred to a better hospital and better care after it was carefully explained to me why such a thing was not possible. That evening I had two Heinekens, a dozen oysters, a big steak, a double of Jack Daniel’s, and called it a day. A job well done. The best proof I had that I didn’t have a problem with alcohol was that I drank at least a little every day for many years and didn’t have any trouble.
By the end of medical school, I could walk through an emergency room or an ICU and feel comfortable and know how to act. I owned a solid Victorian house where my mother and siblings came for holidays. I was the only person in my medical school class graduating with a two-year-old on his lap. Right before the ceremony, my cousin Steve taught Zachary how to say, “Pop’s a doctor.”
“Half of what we’ve told you is untrue. Unfortunately we don’t know which half, and it will be up to you to figure that out,” said the commencement speaker.
It was a clever and wise thing to say, but nowhere near half of what we were taught was true except in a very conditional and relative way. We also lacked the support to make use of what we knew, but besides that.…
Later, when I interviewed applicants for Harvard Medical School, they were all bright and earnest and planning to help people. I hurried them through all that because I couldn’t tell one from the other.
“Yes, yes, yes … but what exactly is being a doctor going to do for you?”
I wanted life and being a doctor to be like getting on a bike, pedaling hard, and generating good. By going into medicine—working against suffering, disease, and disability—I was set for life with good thing to do after good thing to do and I would be able to make a living at it. To put myself even more firmly into positive territory, I went into pediatrics. If you were going to change the world, it was a good idea to start with people. And if you were going to change people, it was a good idea to start early.
“Sorry I’m late, dear. I was snatching babies and children from the jaws of death.”
I thought that as a pediatrician I would be taken care of and protected, that if people knew I was a pediatrician they wouldn’t break into my house or mug me, that I wouldn’t have to stop and chat after minor car accidents, that my way would be smoothed. I wanted to be someone no one could take exception to.
When