A STORY ABOUT VIRGINIA

This is a story about one of the craziest, weirdest, and most amazing things that happened to me in the first grueling year of residency. Warning: Descriptions are graphic. Patient's name changed for privacy.
  1. Do you ever have days where you really ask yourself, "Did I make a mistake by choosing this ________"
    Career, life, partner, place - whatever?
  2. It was August of my intern year (first year of residency after graduating medical school), the worst year of my life. I was on my surgery rotation and I asked myself that about my career more days than not. I was worried that med school was a giant mistake. Maybe I should've pursued that writing job four years ago.
  3. It was torture living in Hawaii and knowing how much better life was outside the walls of the Pink Palace of Pain (I quickly learned why the hospital was given this nickname by residents of years past).
  4. You basically live at the hospital.
  5. You sometimes don't see daylight for weeks at a time.
  6. You routinely hold your pee for 12 hours.
    I don't know how I never got a urinary tract infection or a kidney stone.
  7. You get four days off a month, and you work 80 hours a week (or more).
  8. You eat all your meals there, if you manage to eat what qualifies as a meal.
    Peanut butter and graham crackers from the nurses' station saved my life that year.
  9. You hardly talk to anyone other than the people there. You miss your loved ones, if you can catch a mental break long enough to remember them. My husband was deployed, so I came home to an empty apartment every night.
  10. Life was so different two months ago, but it was starting to feel like a distant memory.
  11. Nights in NYC. Catching all the latest shows on and off Broadway. Discussing good books. Reading the NYTimes. Good food. The Met. The Blue Note. Concerts at MSG.
  12. Life on the island was lonely and monotonous.
  13. I was starved for good conversation. I wanted to talk to someone about something non-medical for once. So I talked to Virginia.
  14. Virginia was in a coma.
  15. One day, she was eating dinner, and then next thing you know, she was in the ER with severe abdominal pain.
  16. The X-rays in the ER showed air in her belly. This is a true emergency, so she got whisked off to the OR, where they made an incision from just below her sternum all the way down to her bikini line and tried to find the problem.
  17. Her chart said she had felt a tearing sensation in her belly.
  18. It turned out she had a stomach ulcer she didn't know about. She had chalked up her previously mild belly pain to heartburn.
  19. Well, her stomach ulcer ruptured, and floating in her belly, along with all of her organs, was the saimin and SPAM Musubi she had eaten for dinner that night.
  20. After 8 hours of surgery, the surgeons had fished out all the noodles (my chief resident talked about the damn noodles every day on rounds, and how they kept falling apart when they tried to grasp them), and patched up her stomach. And off she went to the ICU.
  21. She was really sick. The ICU physician remarked how he had only seen a few patients needing as much medication as she did to keep her blood pressure up to keep her alive.
  22. You see, her case was so complicated that multiple factors prevented them from fully closing her back up.
  23. I didn't even know that was a thing until I met Virginia.
  24. Everyone taking care of her was honestly just waiting for her to die. She was my mom's age. I remember this striking a nerve. Her family wanted to keep her on life support, though, so everyone carried out their wishes. I remember one of the residents calling it cruel.
  25. I didn't have an opinion. As an intern, your job isn't to think. It's to do whatever your resident tells you to do. You are a workhorse. You do all the scut work your resident gives you. You never complain. Complaining is a sign of weakness.
  26. My resident loved to give me scut work, especially wound care for Virginia. She once mentioned that she hated doing dressing changes on her because she swore she could smell the noodles that were once floating in her belly.
    I should mention that despite the scut, my resident was really a great physician and we got along pretty well.
  27. So there I was, on a lonely night shift, with a bucket full of supplies. Just me and Virginia.
  28. I was certain Virginia had no idea what was going on. But I did what they teach you in medical school, and I introduced myself to her every time I went into her room.
    It's really awkward to walk into the dark room of a comatose patient and say, "Hi, I'm Dr. Moghul, I'm here to do your wound change."
  29. I worried inside that I was violating Virginia's possible wishes to not be touched. I worried that she dreaded me coming into her room. I worried that she could feel me removing dead pieces of tissue from her gaping, open wound and couldn't scream. I never mentioned any of this to my resident, though, for fear of being seen as weak.
  30. I'm pretty sure the nurses thought I was a naive idiot. Most of the ICU nurses hated interns, especially in July and August when they're brand new and clueless, like the dumb one who talks to the almost-dead patient. I sighed and got all the supplies ready and snapped my gloves on.
  31. "I'm going to peel off the old dressing now."
    I always dreaded this part because it smelled terrible. By the end of the first week doing this, and with no end in sight, I started smearing Vicks VapoRub under my nose to keep me from gagging.
  32. Occasionally I had to do more than just change a dressing. I would have to debride her wound. "There is some dead tissue I have to cut away, Virginia."
  33. I always braced myself before the first touch of scalpel to tissue. You know those stories about people who say they felt everything during a surgery but couldn't scream or move? I was always worried she would feel it and flinch, even though she was on heavy pain meds and hadn't shown anyone any signs of consciousness since before her surgery.
  34. But she never flinched. So I would stand there for about 15-20 minutes and tell Virginia about my old life while removing the necrotic, black bits dotting her yellow fat. I remember thinking of my cadaver in med school ("Daisy") and how her dead belly looked healthier than Virginia's.
  35. I told Virginia so much random shit. It was more for me than for her.
  36. I talked about how my parents emigrated to the US. How I screamed when I saw the 2nd plane hit the towers while daydreaming and looking out the window of my high school classroom. How I missed my husband and this wasn't how I imagined our first year married. How I hoped she would make it. How I was sorry if she could feel what I was doing to her.
  37. Night after night, I rambled about all kinds of stuff. I actually started looking forward to time in her room because it meant I could whine without abandon to someone who wouldn't care.
  38. By some miracle, Virginia didn't die by the end of my month on the surgery team. I went off to my other intern rotations. Medicine wards. Pediatric wards. Newborn nursery. Medicine wards again. Pediatrics clinic. Labor and delivery. Medicine wards again. Obstetrics clinic. And then ICU.
  39. It has been eight months since I set foot there. Virginia wasn't there, and I didn't expect her to be. I had assumed she had died. Half the patients in the ICU don't make it, and she was one of the sickest the ICU attending had seen. But I thought of her every time I walked past room 3.
  40. And eventually that rotation ended, too. I went on to my Emergency Room rotation. Then Family Medicine.
  41. I was set to graduate my internship at the end of that month. One of my fellow interns and I decided to celebrate surviving that terrible year by getting donuts at the snack shop. We had both lost about 15 pounds that year from missing so many meals, so we justified eating them.
  42. On the way to the snack shop, someone yelled "Dr. Moghul!" I looked to my right and saw someone rushing towards me. It was Virginia's daughter. She seemed really excited to see me. I was stunned to see her and immediately started dreading talking to her because the conversation would surely turn to her mother's death.
  43. She hugged me and started crying. She was mumbling incoherently. I patted her back and felt my eyes and nose start to sting.
    I always cry when other people are crying. I hate that.
  44. Suddenly she let go and yelled, "Mom! This is Dr. Moghul!" I opened my eyes and saw a friendly looking older lady, who then suddenly grabbed and engulfed me in another hug. She let go and looked me in the eyes. I didn't recognize her. I was so confused.
  45. "It's me, Virginia," she said. She started crying. I was even more confused. Was I hearing them correctly?
  46. "I remember you. You talked to me. You saved me," she said through sobs.
  47. And suddenly, I was crying too. I knew I didn't make a mistake. And I knew, in a way, that Virginia saved me, too.