Friday, July 08, 2005

12:54 PM

Sitting in the caf, tucked in a booth with Huey, Louie, and Dewey. Lunch is over and they're yacking about something; Foreman's doing most of the yacking. Me, I'm fiddling with my straw. If anyone asks, I'm doing an experiment in fluid mechanics.

I didn't go up to my mother's over the Fourth of July, and as it turned out, I never needed to come up with an excuse -- when Mark emailed me back, he said he hadn't mentioned it to her.

So that took care of that. If I had needed an excuse, though, I would have said something about busy at work, all the new residents starting July 1, bad time to get away. Which would have been a crock, as Diagnostics takes no residents and took no new fellows this summer. But you never know -- James might have needed someone to call and complain to. (He didn't, but give him time.)

We're actually pretty disconnected from the new crowd. New faces at M&M on Wednesday, new people holding up the line in the cafeteria as they squint at the menu, but otherwise it hasn't affected us too much.

There's a meet-and-greet this afternoon for the new house staff. I plan to skip it. The food's not worth the trip, and I don't see any point to meeting the residents: I try to avoid them, and they'll be trying to avoid me soon enough. My minions are going, though, and they're gossiping about fellows and residents they already know. Foreman has managed to, once again, wedge in the fact that he was a Chief Resident. Cameron and Chase don't look any more interested in this piece of his life story than they looked the last time he dragged this credential out. Does he talk about his MCAT scores when he's trying to meet girls? No wonder he dates drug reps. He must have been insufferable when he was a resident. Did Cameron have a crush on her R-3 ? Did she cry? What was Chase like? I hear they start them off young over there; were his patients afraid they'd drawn some teenage prodigy, some limey Doogie Howser?

Now they're gathering their things and standing up. "Are you sure you don't want to come?" Cameron asks. "It'd be a good chance to..."

"Sorry, can't do it. Actually, Cuddy asked me not to come. I went last year and all the new residents wanted to leave their rotation and start off in Diagnostics, and they weren't taking no for an answer. Some of the fellows were trying to get transfers as well, and it was just a huge mess, hurt feelings and everything. So Cuddy asked me to stay away this year." Chase looked down at the table, half-smiling; Cameron got her little overcompensating "got-the-joke-thirty-seconds-after-everyone-else" look. Foreman just rolled his eyes and headed for the door.

I watched them go and turned my attention back to my straw. Residency.... it was so long ago, but sometimes it's so vivid in my mind....

Thank you for your interest in the Nephrology Fellowship Program at St Raphael Hospital. Our program integrates research, education, and clinical practice in a state-of-the-art facility serving a wide patient population….

And so on, and so forth. It was a grey, chilly November afternoon and I was spending it in a booth in the hospital cafeteria, eating a very late lunch. It was also application season: the med students were applying for residencies, and we senior residents were applying for the fellowships where we would start to learn our specialties.

A few of the senior residents would be invited to stay on, of course, as Chief Residents. It was an honor to be named a Chief Resident, to be tapped to help oversee the residents and take a hand in their training. It was an honor I was confident I would not be receiving.

I pushed my empty plate aside, took a sip of my Coke, and picked up my stack of fellowship applications. I had the rest of the day off, but before I headed for home I wanted to finish my lunch and read over my applications one more time, check and see if I needed to bring anything home with me. Our location offers an excellent quality of life….

You must have a medical school transcript sent to GME…. Your curriculum vitae… A dean’s letter… two letters of recommendation….

Letters of recommendation. I stared at the form.

In July the new residents had started and I’d acceded to the lofty rank of third year resident. I’d had a pretty good summer, including a great rotation with Jennings in Nephrology, but I’d also gotten in trouble a few times. To be more precise, my mouth had gotten me into trouble a few times.

Well, more than a few times. That was nothing new, but I was still regretting an especially bad scene in September, when I was on Doyle’s GI service. Doyle was pretty okay, so getting the summons to his office for the chat had been bad enough, but reaching his office and finding Dr Ball getting up to leave…. I’d forgotten that they were pals. No doubt Doyle had just finished telling Dr Ball about the whole thing. Dr Ball just nodded, but I couldn’t meet his eyes. I heard the door close as he left, and I sat down to let Doyle have at it….

I hadn’t seen Dr Ball after that, so I was nervous when I approached him in October to ask for a letter. I waited for his reply. I’d mentally prepared myself for Unfortunately, Dr House, I doubt I could assist you; or Dr House, surely you know that I am aware of your…unsatisfactory conduct on Dr Doyle’s service....

But instead, without hesitation, he said, “Why, of course, Dr House. I’d be delighted.” He reached out, took the papers, and slipped them into a manila envelope. He wrote my name on it and straightened up. “It’s been too long. Please, sit down. Tell me how you’re doing.”

I said something evasive about my current rotation. He asked about my future plans and I babbled something about fellowship applications.

He took out my applications and leafed through them. “Ah, nephrology. Dr Jennings told me that he’d been very pleased with your performance on his service.”

He put the forms back in the envelope. “What about your being here next July? Have you considered staying?”

I looked away. “Even if… someone… nominated me, I doubt G-Med would offer me a Chief Resident’s spot.”

“Do you think you’d be an effective Chief Resident?”

I didn’t look up.

Dr Ball steepled his fingers and looked thoughtfully at the ceiling. “The problem with mere ambition is that it can be very… limiting. It’s an honor to be named Chief Resident, of course, but what if one simply doesn’t want that honor? What if one’s talents and inclinations lead one elsewhere?

“What about staying here as a fellow? Nephrology is certainly an interesting field, but surely you’re not married to it. Have you ever considered hepatology?”

I looked up.

“It would be a GI-Hepatology fellowship, of course,” Dr Ball continued, “a three-year program. Our department’s going through some changes, and I’ll be taking on other responsibilities, including working with the fellows instead of the residents come July. It would be nice to see a familiar face.” He selected a large envelope from a file rack and leaned across the desk to hand it to me. I took the envelope and sat back down.

“I’ll be directing the hepatology side of the fellowship, and I’ve asked Dr Doyle to head up the GI side.”

“Dr Doyle,” I repeated dully.

“Yes, Dr Doyle. Perhaps you didn’t know – I’ve known Dr Doyle since he was one of my residents. He was very impressed with your clinical skills this autumn, and he’s going to be very disappointed that I beat him to offering you this envelope. Anyway, I’m also planning to develop an optional fourth year for fellows who wish to further specialize in hepatology.

“But that’s still in the future. We have a good group here now, and I’m looking forward to being able to truly mentor a few fellows instead of managing a constantly changing herd of residents. It will be a pleasant change of pace. And I won’t have to wait as long for a table at the pancake restaurant.”

He glanced toward the envelope in my hand. “I do hope you’ll consider applying for a fellowship with us. We would be very pleased to have you. Meanwhile, I’d be happy to write a letter for your other applications.”

“Thanks, Dr Ball,” I said.

That had been a month ago. I was almost finished with my applications, mostly for nephro fellowships, but I had filled out the application for Dr Ball’s fellowship as well. I still wasn’t sure what I was going to do with it. Livers were okay, but I wasn’t interested in GI at all (too many butts.) The idea of working for three or even four years with Dr Ball, though, and the idea that Doyle wanted me…the idea of being wanted at all….

I looked up from my table. There was an heated conversation going on somewhere in the half-empty cafeteria, and it was getting loud. The raised voices – a man and a woman’s -- were approaching the flash point. I narrowed my eyes –- stupid idiots, distracting me – and turned back to obsessively re-reading my applications.

Please include your personal statement….

I looked up again. The voices were really getting into it. Why couldn't they take it outside? I gave the universe an annoyed look and turned back to my papers.

Suddenly the argument stopped. I looked up, and saw that others in the caf were looking up too, at someone frantically threading her way between the tables. Someone was starting after her, the guy in the argument, calling “Eileen!

I stared in amazement. Sure enough, the fleeing girl was Eileen Abney. Eileen Abney! I hadn't seen her since that softball game, months and months ago.

She found a clear path and rushed past me in her flight towards the dining room door. She was crying; she didn’t notice me. David Kopp was still clumsily picking his way out between the tables. I looked quickly over my shoulder – Eileen was too fast for him, she vanished out the door.

I slumped into my booth and hid behind my papers as Kopp ran by. As soon as he’d passed, I turned around to watch. He stopped at the door, searching, paused as if he were thinking, and then hurried off to the left.

He was headed for the shuttle bus stop. I stood up and gathered my things as I took a long look around. The other diners were already turning back to their own business. It helped to be tall; I was able to see where Kopp and Eileen had been sitting before she ran out. Kopp, you idiot, I thought, she didn’t go to the bus stop; her coat and backpack are still at your table.

So where did she go? I didn’t have much experience with girls in general, particularly crying ones – they made me nervous – but I’d noticed crying girls tended to head for ladies’ rooms. And I knew there was a ladies’ room near the cafeteria, close to one of the side doors to the dining room.

I went over to the abandoned table. Nobody was watching. I casually scooped up Eileen’s coat and bag (resisting the urge to snoop at Kopp’s papers) and strolled over to a seat by the side door, one that also gave me a good view of the main door.

I only had to wait three or four minutes before I heard a sniffle from the side door, and then a little gasp of horror as Eileen peeked into the dining room and saw her coat and bag missing.

“Hey. Abney,” I said quietly.

She turned, and started a little as she recognized me. I patted her stuff. She just kept staring, her mouth open a little. "Hi," she finally said. "I'm sorry -- oh, I'm so embarrassed...."

She put her hand over her mouth. I started getting a little uncomfortable myself – her eyes were filling up again and she was blushing -- I hadn’t thought about this part, sitting there in the caf with a crying girl.

I stood up and held out her things. “Kopp is looking for you, probably around the bus stop. Do you want to see him?”

No." She took her coat and bag and looked around frantically. “Thanks, I –” she looked toward the ladies’ room – oh, great, she was starting to blubber again –

The thought of her crying alone in the bathroom -- no. No, I couldn't just leave her . But even if I could get her out a side door and sneak her past Kopp, I couldn’t put her on the shuttle bus like this. Some plan this was turning out to be. Great. I never should have done this. But now what?

I glanced toward the main door again and shoved her backpack at her. “Come on,” I said.

She stared at me.

"Look. You can stand here and wait for him to find you. Or you can come with me and give him the slip. It's your call." I took a step towards the side door and looked back at Eileen.

She looked back to the main door, hesitated, and turned back to me. "Okay."

I led her out the side door and down the short hallway. As we hurried along, I scanned ahead, watching for Kopp (or anyone else.) We were growing close to where our corridor fed into one of the crowded main halls. I stopped, let her catch up, and opened a door into the stairwell.

We went down the flight of stairs to the basement. “Look, you’re getting a tour,” I said. “I’ll make sure to take you by the leech tanks and bleeding parlour. We can get to the shuttle stop from here; we’ll just pop out close to the exit and skip the main hallways upstairs….”

My shoulders sagged. Eileen was trying to keep it together, but the tears were rolling down her face again. “I’m sorry,” she choked.

I sighed. “Do you need to be back right away?”

She shook her head no.

“Come on, then.”

I led her past Sterile Processing and Central Supply to a little side corridor with two vending machines and a door at the end. “I should make you close your eyes for this part,” I said.


“’Cause I’m probably not supposed to know about this.” I tried the door: unlocked, just as I was hoping.

We stepped into the dark room. I cut on a light and locked the door behind us.

We were in the dusty wing of a shabby lecture hall. It was the stepchild classroom, one of the only rooms in the original section of the hospital that hadn’t been renovated since the Coolidge administration, too tiny for any but the smallest gatherings and hated by presenters for its poor acoustics and lack of such amenities as lights and places to plug in projectors. It was a great hiding place, though; I’d been coming here since I was a first-year resident.

I led Eileen out into the front of the hall. “We can hang out here for a while.”

“We? You don’t have to – “

I shrugged. “I’ve got a pager and stuff to do. The techs from Sterile Processing like to hide here too, but if they see me they’ll leave you alone.”

She looked dubious. I started getting frustrated – indecisive crying female -- why had I stuck my nose into this anyway?

“All right. I’m getting a drink. Tell me when you’re ready to go to the bus stop.”

She nodded.

“You want anything?”

“No thanks,” she whispered.

I dropped my stuff on a desk, checked my pocket for coins, and headed back out to the hallway. I dropped the money into the soda machine. My Coke thudded down to the tray.

I popped the tab, leaned back against the wall, and stared at the machine. What had I gotten myself into? Why was I spending my afternoon off dragging some punk med student’s crying girl all over the hospital, even bringing her to one of my favorite secret hiding places? Why wasn’t I just pointing her in the direction of the bus stop, giving her a gentle push, and going about my business?

Well, she was here now, and I still had no plan. Maybe when I got back in there, she’d have gotten herself back together and I could put her on the bus. I fed five dimes into the slot, tried to remember what she drank, and realized I had no idea. Didn’t girls drink diet? That didn’t seem right, though. I remembered her ordering decaf coffee, back at the pancake restaurant, and hit the button for a Sprite. I bought some candy at the other machine and went back into the lecture hall.

I passed through the wing and stepped out onto the stage. I looked, and looked again.

Eileen was gone.



I look up. Stacey's standing next to my booth. She lifts her eyebrows.

"Oh. Hi, Stacey."

She smirks a little. "I'd ask what has you so lost in thought, but I doubt I'd want to know."

"Probably not." I sigh in frustration. "It's that Angelina Jolie chick again. She just won't leave me alone. I don't know what to do."

"Maybe you should just obey the restraining order?"

I shrug -- what are you gonna do? -- and go back to staring at my empty cup. Stacey takes the hint and moves on; I watch her walk towards the front door of the cafeteria. Once she turns the corner and leaves, I turn back to the cup. I stare at it a while longer, tap it a few times on the tabletop, and crush it in my hand. I toss it on the table, extricate myself from the booth, pick up the crumpled cup, and stomp off to the side exit. I spike the cup into the garbage can as I leave.


Blogger Jen said...

I love this blog.

And more back story! I do really enjoy back story, especially digging back into the residency days.

July 23, 2005 8:23 PM  
Anonymous Auditrix said...

Thanks, Jen, glad you're enjoying it :)

July 24, 2005 5:48 PM  
Anonymous Benj said...

Love the backstory and the Stacy pullback to the present. The fluid way you write House and Eileen is really interesting.

Much love for the ref- "while I looked around for my possibilities" - Hazy Shade of Winter is one of my favourite S&G tracks and a perfect fit for this entry- will have to listen to it now- shame.



July 26, 2005 6:39 PM  
Anonymous Auditrix said...

Thanks, Benj. Much love for your picking up the ref :)

July 27, 2005 11:46 AM  

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