Oh how I miss the feel of your thick spine, so wide I could barely grasp you with my oddly small hands. Wrist cocked, an awkward drag ensued from rack to desk, your heft landing with a thump under fluorescent lights on the laminate desk. I scooted into the low chair and dove in with aplomb. I was ready.
I started just beneath your mauve plastic cover. There, just under the hood, curious items lived in plastic baggies that I associated with peanut butter sandwiches in rusty-hinged elementary school lunch boxes. Wrist bands, lab slips, and personal belongings within, the packets were pierced onto large metal rings, awkwardly bulky atop the flat paper chart. I gently pushed them aside and moved on with my task.
Weighed down by my white coat — its heavy pockets bursting with implements and primers, I hovered with aching shoulders hoping to gather, from you, a more fulsome picture of what was happening inside my new patient. I sifted through page after silky page, starting with the section bearing pale pink progress notes. There I found the impeccably square font of infectious disease, the chicken scratch of nephrology, and the Greek stylings of surgery. I shifted, I squinted, I sounded out letters until I finally asked the nurse — the only one who could translate the language it had taken years to master. I moved on to results.
“But where are today’s labs? The ones I need — like right now?” I asked to no one in particular, knowing the answer. They weren’t back yet, the ones that I needed. The critical ones: the troponin, the creatinine, the urine culture, the potassium. “How can I write any orders without the key facts?” I went on to myself.
(The imaging section was similarly bare.)
Now sweaty and swearing, I went to see my patient with no answers to the questions she’d most certainly have. After an examination, sitting next to her with you on my lap, I listened and apologized and promised to return with more to offer.
Back in my spot by the nursing station, I had no choice but to flip to orders and place skeletal requests. A diet, an activity. Is and Os. Allergies. An insulin sliding scale. A fingerstick glucose I had!
But I had to move on. I pulled out my crumpled white-paper list of patients and put four empty squares next to the results I’d need to find later to check off those boxes.
But it wasn’t your fault.
You bore the burden of our human imperfections. You didn’t scrawl the scribbles and weren’t too busy to call the lab. You were merely a receptacle for all of our foibles. You revealed our vulnerability, overload, and fatigue on those blush-colored sheets and still-empty sections.
And you reminded us that no matter what mindset our training had instilled, no one is perfect. And that is why I miss you most.
Eve Makoff, MD, is an internal medicine physician.
This post appeared on KevinMD.