Her pager beeped. Softly first and then got stronger. Shrill and nerve-wracking. She moaned in her sleep, trying to reach it. She finally woke up with a jolt. Her clothes were drenched. It was her alarm. She lazily turned off the alarm and ignoring her racing heart, headed to the shower.
“Why are these conversations always so difficult? Why can’t people make them easy for me? Spelling out everything so unfeelingly is not my thing. Why am I the bearer of bad news always?”
She fell in her chair. The sandwich that she had carefully microwaved and had looked forward to eating before her patient’s CAT scan results suddenly looked ripe with maggots. It smelled of rotting corpses. She pushed it away.
“Mommy!” She heard her toddler running towards her, hands streaked with Nutella. She picked him up and swung him around. She smelled into his hair. She saw her daughter, walking towards her purposefully. She hugged them both, knowing that the hazelnut spread was now staining her new clothes and that she should’ve showered before hugging them. Throwing caution to the wind, she kissed them.
She sat at the family meeting. She had sat at many family meetings before. It never made them easy. Usually family meetings were held for elaborate plans of clinical care and surveillance. She looked at her patient. Today the family meeting was for goals of care.
She looked at his wife. The woman couldn’t be more than 40 and yet she was here to navigate her husband’s diagnosis of cancer and options for palliative care. His tumor had spread and he didn’t have any curative options. He had been on aggressive chemotherapy for years. His body hadn’t responded as they had hoped.
He looked stoic. She tried to smile at him to offer some strength but her mouth assumed a rigidly somber expression. She couldn’t smile. She couldn’t cry either. Sometimes she hung between professional and indifferent. That was the safest place for her. She dared not get too close to her emotions in moments like these. They betrayed her almost always. He was signing his “do not resuscitate” order and was going home. She handed him her pen, her hand steady. She wasn’t surprised to see the steadiness of his hand. He had come to terms with it a lot faster than her or his family. He signed the papers. His wife wailed in agony.
The car behind her honked loudly. She realized she had been sitting in her car for many minutes since coming home. Her husband of six years came around and excitedly told her of a potluck at his office next week. She smiled to humor him. She will grieve later. She couldn’t shake the image of her patient’s family sobbing.
Her pager was beeping. She sat up. She called the number,
“What’s going on?”
“Doctor! He’s gasping for air”.
“I’ll be right over”.
Her patient did fine eventually. He had congestive heart failure and needed an additional intravenous dose of a diuretic, a mediation that gets rid of excessive fluid in the lungs.
He had visibly improved about fifteen minutes from when the medicine was injected. He looked at her with gratitude.
“I couldn’t breathe. I thought I’d die. Thank you”.
Her smile lit up the room.
She stooped over to pick a bread crumb from the floor. She heard her husband call her name,
“I’ll be over soon”, she called back.
By the time she had completed her charts and made it to bed, he was fast asleep.
“Do you know what you’re doing? You look awfully young to be treating patients. When did you graduate from medical school?”
“A long time ago”, she said patiently.
“So you had better fix me or my ghost will haunt you forever”, he joked.
She looked at his EKG. She looked at him turning pale.
A minute later they were performing CPR on her 80 year old patient. Ten minutes later, he had return of spontaneous circulation.
Five days later she signed his discharge papers.
“Guess you did know what you we’re doing after all “, he said begrudgingly. He had never chosen a woman physician in his life but had insisted on being under only her care while in the hospital.
She laughed. His eyes twinkled. He lived on to be 90 and sent her a card every year on the day when they had called the code team for him.
“We have drifted so apart, I don’t even know you”, she heard her husband complain.
“May be”, she mused.
“Listen”, he took her face in his hands, ” we need counseling. We need to reconnect. We need to go away for many days and try to build it all back together”.
She tried to validate him. She was looking for words that would take the edge off. She finally moved closer to kiss him.
Her pager went off.
They divorced a year later.
Her pager beeped. It was the one constant in her life. She called back the number on the pager,
“What’s going on?”
“She looks like she is in shock. I think we have to call the rapid response team”.
“Call them and I’ll be right over”.
As she started walking down the hallway she felt a shadow next to her. The same familiar shadow that had accompanied her to many of her patients. It had waited in the wings. It had been disappointed usually. It still followed her everywhere she went in the hospital. It had a cold, cruel feeling to it. It smelled of putrid fury and infested eagerness.
“I’ll come with you too,” Death said.
“I don’t think there’s anything for you where I’m going”, she said politely.
“Are you sure?” He smiled darkly, a sinister smile that she had come to see play in his face more when she challenged him.
She considered her relationship with him. He had always been where there was disease. He feasted on misery and scarcity. He loved the fear in her patients’ eyes. In the initial days of their illness, Death always stood next to them and leered at her, trying to scare her into wrong decisions and fatal mistakes. She never took his bait.
As her patients recovered, he inched slowly away and sniffed the air for a weaker victim. Her triumph over Death in her career was a medal that she wore with pride. She also respected him as a worthy opponent and had never prepared for a fight as she always did when it was against him.
As always she ignored him and turned around.
She reached out her hand to the silent figure standing behind her. Where Death was a tall and dark shadow with an aura that caused doom, Hope was a ray of light. It was tall and bright. It sparkled and glittered. It made her want to look at it for however long she could.
As in all the years past, Hope took her hand and glided towards her.
“Yes”, Hope beamed.
Slipping her hand in Hope’s , with Death in her wake, she made it to her patient who was doing well by the time they got to her room.