June, 2003, and I am 18 years old, just a few days from graduating from high school. In his home in Bridgehampton, Kurt Vonnegut is sitting at his kitchen table railing against the injustices of the American health care system. When he finishes, he takes my hand and says, “Don’t worry, you’re going to make a fine doctor.”
November, 2015, and my feet are blocks of cement as I slowly make my way to yet another shift.
June 2010, and I am an eager medical student trying to keep my head above water, to appear interested and engaged, prepared without being obtrusive, finding ways to fill those gaps in patient care that only a person with no real responsibilities can do. My internal medicine rotation includes one month on the oncology floor caring for a man newly diagnosed with leukemia/lymphoma whose one request is to make it out in time for his daughter’s high school graduation. With every episode of neutropenic fever, this becomes less and less likely, and all I can offer is company and the FIFA World Cup as I draw yet another set of blood cultures.
July 2011, and I’ve moved back to New York to start my residency. I’m excited to be near my family again. My best friend, Sonia, comes with me to Ikea to buy new furniture and assemble my space. She’s getting ready to take the MCAT herself, and over practical Swedish design, we trade stories about we what we want to be when we grow up.
Two weeks later, Sonia has been diagnosed with a malignancy. She is 24 years old. At first, they thought it was breast cancer, but she has tumors in her thorax, in her abdomen, and on her spine. Eventually, she is told that she has a rare sarcoma, but her oncologists sound prepared. We continue planning for her MCAT, and we continue trading stories.
August, 2011, and I start my residency in earnest as a rotator on the medicine service. Our team exists primarily as a step-down for the ICU. I pronounce my very first patient dead one afternoon after my attending has left the floor for the day, and my senior resident is still in clinic. His family had just decided to turn off his pacemaker/defibrillator that morning, knowing this meant he would die soon, but not anticipating it would happen that very day. Five years later, and I am still sitting in that private room, offering his daughter a box of tissues.
Later that month, I am rotating through the ICU, where people transform into a tangle of wires, tubes, and drips. I come home every day to a roommate who writes about pop-culture for a blog, and I am reminded what it means to be human. After finishing my week of night float, I travel across the city to the oncology floor where Sonia sits, hooked up to three different drips, receiving her first round of chemotherapy. I have been an intern for exactly two months, and everyone in the room is looking to me for answers and reassurance. Instead, I have coloring books and stickers.
She is dead by January, and every young person I see in the ER has her face.
There are myths about ER doctors, myths we’ve all bought into at some point in our careers. ER doctors are adventurous, we travel to obscure places, and we have actual hobbies. In fact, we justify this specialty as way of maintaining our hobbies. We have trouble focusing on any one thing at a time, and we choose this life that leaves us half a step out of time with everyone else, because it means that we don’t bring our work home with us at the end of the day. Each day is one step forwards; each shift is a blank slate and an opportunity.
Today, I’m on my third overnight in a row. I have class in the morning, and I’m just going through the motions. My next patient is a new mom without any real medical problems. Tonight, she had a seizure for the first time. The CT scan comes back showing an intracranial mass with midline shift, and at that moment, I am on the oncology floor in 2010 watching soccer with a man who wanted desperately to attend his daughter’s high school graduation. I am on K5 in 2011 with a family that thought it had more time. I am pacing the floor of the ICU at 3 a.m., working up the nerve to keep talking about what I want to be when I grow up.
Anjoli Anand is an emergency physician.