The Good Kind Of Nerves

It was so terribly cold. Snow was falling, and it was almost dark. My eyes were heavy and I could hardly see my way to the Red parking garage. The one that was in the back of the hospital. The one for guests and residents. As if we as residents, weren’t staff. As if we as residents, weren’t real physicians.

Dear God, what did my car even look like? It was a rental. I had been rear-ended the week before on my way to antepartum rounds. It was five in the morning and the Virginia roads in the dead of winter had been covered with ice. The car tailing me skid into mine and shattered my bumper. I braced myself on the steering wheel jamming my left hand on impact. I quickly exchanged info with the other driver, a Spanish speaking man who like me, wanted to expedite the exchange without involving the police. I had nothing to hide, but I couldn’t risk being late to rounds and being berated by the attending, Dr. Samra, a Lebanese man with a cutting accent and an even sharper tone. To give him credit, he was highly accomplished and a dedicated physician. A superb person to learn from. He simply had high expectations. “Ones that we should all live up to,” I repeated to myself in his voice as I sped off from the scene of the collision, ignoring the pain in my hand.

My car ended up in the shop, but I have yet to get my hand examined. Maybe I will do that on Monday. I have the day off. That is if I wake up before four pm.

My days off had transformed since I was an exuberant intern. When I arrived to DC via Texas, I was exploring Georgetown in the afternoon and dancing in DuPont at night. It seemed like the next four years was going to be amazing. I was finally a doctor, a dream of mine since I was two years-old. At least that is what my parents tell me. One cannot recall events from the age of two, but I had been told this enough that it felt like the dream was mine. In the weeks before I started residency, I had found a great place to live, made friends with my classmates, and more than anything had been filled with enthusiasm and nerves. The good kind of nerves. The feeling that envelopes you when you have arrived at the moment you have been waiting for, and therefore, cannot predict any moment after.

See one, do one, teach one. That is the motto in medicine and I did all three. And I loved it. Until I didn’t. The change in feelings didn’t happen one day. It wasn’t because of a tragic case or one bad attending relationship like one may see in a TV medical drama. It was slower than that. Much more insidious. The months not seeing any daylight, the browbeating, the belittling from Chief Residents, the rapid turnover of patients, the loss of life outside of the hospital, all together picked away at me, until nothing was left. After three years with one to go, I was now a shell of the bright-eyed, fun-loving, motivated, young woman I had been.

I remember the day I interviewed for my residency position. The Program Director, a tiny woman in her forties, with a prematurely-grey bob greeted us. She could have dyed her hair to better match her youthful skin, but she left it, wanting to appear more experienced than her years. She was fond of disguise.

On introduction, she boasted about the number of vaginal deliveries the residents completed, the state-of-the-art laparoscopy equipment available to train on, and the heads of academia we may research under. In her speech about the accolades of previous graduates, she failed to mention the unspoken slave labor culture of the program. She didn’t explain that residents make far less than minimum wage or that although we were required to work no more than eighty hours a week, they would make sure they skirted the rule by making that an average. Some weeks we would be on duty a hundred and twenty hours followed by a lighter week to make the math add up.

She didn’t disclose that we would forgo all personal time. She didn’t tell me that during my second year when my grandfather dies and I am also scheduled to be on shift, that I will not be allowed to go to the funeral. I didn’t hear her say that when my co-resident has a miscarriage after doing weeks of night shift that she will be expected to be at work the next day and I definitely didn’t leave the meet-and-greet knowing that by the end of the next three years, eight out of ten of my co-residents will be on an anti-depressant.

I pushed my key with my good hand to alert the alarm and locate the car. The snow was falling harder and I was beyond exhausted. Headlights flashed. There it was, backed into a corner, hard to find, and even harder to recognize. I walked up to it. How did I get here? My bad hand starts throbbing as the cold air continues to settle in.

I get in the car, start it and decide it is best to take a small nap before driving home. I awake to a knock on the window. I waved my badge at the hospital security guard and looked down at my watch.

This isn’t my dream.

I was supposed to start my next shift in five hours and it was going to be my first day as the Chief Resident. Tomorrow was the start of my fourth and final year. I took a swig off the can of sugar-free Red Bull that I had left in the cup holder, slapped my cheeks, started the car and put it in reverse. I drove out of the garage and away from the hospital. I looked up at the massive institution’s reflection in my rear-view mirror and watched it appear smaller and smaller as I drove ahead. As it disappeared from my sight, a tingle started in my toes and crept up the back of my calves, through my pelvis and into the lower part of my stomach, filling it with a sense of heaviness. There it was again, the good kind of nerves. The feeling that envelopes you when you have arrived at the moment you have been waiting for, and therefore, cannot predict any moment after.