Curtain Call

After five years as a resident and fellow at Stanford, I turned in my badge and left for the last time. I get nostalgic about these moments. There is poignancy and longing and reminiscence and triumph and wondering. Here are a few memories that flashed through my head this last day.

-Sneaking out of noon conference as an intern to wander the Rodin sculpture garden and see the Gates of Hell with the woman I would eventually marry.

-Watching the construction of the new hospital from all angles. I remember noticing trucks ceaselessly carrying out dirt at 2AM, being awed by the magnificent crane raising girders, and seeing the hospital take form as I crossed the skybridge to the ambulatory surgery center.

-Picking up my locked box of controlled drugs at the operating room pharmacy each morning and carefully counting the number of vials of fentanyl, lest I get in trouble for not returning them all. This went away when each operating room got an electronic dispensing machine.

-As an intern, before I got a bike, walking about half an hour from Menlo Park to the hospital. On my way in, I knew all the short cuts to shave off precious seconds getting to the hospital and memorized the traffic light pattern at Pasteur; on my way home, the walk was cathartic: all the tenseness and emotions released before I got home.

-That weird feeling after spending a year in the ICU where I could look at each room and picture a patient or a major clinical event that happened there. Corner pocket code blue, the room where I placed a dialysis catheter in a patient with an INR of 10, the isolation with the young man we desperately tried to save over months, the room where we did an emergency cricothyrotomy. E221-E264, I can picture something in every room.

-Even seeing an elevator triggered the memory of resuscitating a patient by squeezing in blood while we were trying to get them from the emergency department up to the operating room.

-Grabbing a handful of candy...from the consultant bribe box in the emergency department, the pre-op clinic as I passed through to the ICU, the ASC nursing administration office (who I'm pretty sure never knew I stole candy), the GME office. Sometimes you just need a little sugar.

-Medical student saying I was "amaaaaazing."

-Those bitterly cold mornings as I rushed to anesthesia grand rounds.

-Half-way through a pediatric anesthesia case in the basement of the children's hospital when I get a call that my house had been burglarized - not all memories were good.

-Going home post-call with the airway pager and fuming as I had to run back to the hospital and hand it off.

-Taking computers-on-wheels with a co-intern (who, again, I eventually married) to an empty waiting room outside the coronary care unit so we could write our notes while listening to live music in the atrium.

-The look of relief both I and my critical care crisis nurse would get when we arrived at a rapid response call and saw each other.

-When I was on medicine, that outdoor space outside of B3/C3 where I escaped for respite. I ate lunch there, I cried there when patients died, I talked to my parents there when I was unexpectedly stuck at work, I napped there in the sun, exhausted.

-Getting my exercise as I ran to codes in the ambulatory surgery center, about four flights of stairs away.

-After five years, finally figuring out the traffic patterns to avoid getting stuck in a stretch of red trying to get onto Sand Hill and 280.

-Watching my world get bigger. As an intern, I lived on B3/C3 and it felt overwhelming. A year later, on the acute pain service, I ran from managing catheters on D ground to epidurals on F3. As a fellow, being expected to put out fires everywhere, simultaneously.

-Ethics meeting in the boardroom where there are screens everywhere; we had a powerpoint projected on at least six locations around the room.

-The pre-op area where half way through residency, they switched from pre-spiked IV bags to having us prepare them ourselves. The first few days, there was a puddle of saline on the ground as we all struggled to figure it out.

-One of my favorite north ICU nurses mentioning that she reads this blog. Boy, was I embarrassed.

-About to leave the ICU on my last day when nurses and respiratory therapists surprise me with celebratory cake.

I know there are dozens more memories to share (and I decided not to mention the VA and Valley). I am most fond of those short, fleeting, and wonderful moments spent with patients, colleagues, medical students, residents, attendings, nurses, respiratory therapists, anesthesia techs, and others who made my life so rich, my work so easy. Not only did I work with them, but I got to know them as people, understand their stories, learn about their passions. There was this point of realization during my fellow year that I knew a huge number of people in the hospital: co-interns who are now attendings, medicine residents who rotated through the ICU, surgery chiefs who I worked with in the OR, consultants who knew me by name. Through the last five years, I made so many friends, and for that, I am grateful. Thank you.

Image shown under Creative Commons Attribution Share-Alike License, from Wikipedia.