Postoperative Day Three

         Dalia, completely ignored by the nurse sitting at the computer outside of room 314, knocked inaudibly before easing the door open. The sky outside of Mr. Leary’s room was completely black, and the flickering lights of the city only barely visible through the fog.  Eyes shifting from the window to the bed, she wrinkled her forehead in confusion upon seeing it empty. She would never admit it to the resident team, but she had been guilty of silently checking the drainage tubes and incisions of her patients while letting them sleep and prying a general report out of the night nurse. It was cruel enough that she had to be awake before 5am to be here, the patients recovering from major cancer surgeries deserved to sleep in. In the last two weeks of her early morning rounds though she had never found a patient bed empty. Dumbly, she looked around the room as if he might jump out of a corner, before hearing water running through the closed bathroom door. If it had been the docile elderly lady she was checking on, she might have knocked on the door and asked if she could come in to check her abdomen, but Mr. Leary was quite gruff. She would have to settle for talking to the nurse and trying to circle back before she had to meet the residents in the workroom.

              Thirty minutes later, after Dalia had presented each resident with a printed copy of a meticulously updated chart of patient information (a report that surely could be generated by the electronic medical record but mysteriously remained the responsibility of the medical student, the group stood outside of room 314. Dalia summarized the vital signs and drain outputs and summarized Mr. Leary’s progress in recovering from the removal of part of his pancreas and small intestine three days prior, despite the fact that all of the residents knew vastly more about every patient than she did without ever seeming to look at the patient charts. She then stammered her confession, “Um, I didn’t see him this morning though, I mean I did, I tried, but he was in the bathroom.”

              Dr. Catherine Trammel, the chief resident (always Dr. Trammel, never Catherine), glared at her, before snapping “I guess we’ll see him now then.”

              Dalia cowered in the back of the group, slightly comforted by Kevin the intern rolling his eyes behind Dr. Trammel’s back on the way into the room.

              Mr. Leary was still not in his bed, although the sky outside of his room had started turning purple. Dr. Trammel knocked on the bathroom door with her right hand while turning the knob with her left, far to impatient for politeness. “Mr. Leary, how are-“ She stopped abruptly at the sight of the empty bathroom, the first time Dalia had seen her hesitate about anything.

              “Oh.” Dr. Trammel said. “Med student!” Dalia slid around Kevin and the third year resident into Dr. Trammel’s line of sight. “Go find him.”

              “Um…” Dalia was about the ask where to look for him before thinking better of it. 

              Narrowing her eyes, Dr. Trammel said, “I don’t want to see you before you find him.  I am not telling Dr. Thibideaux we LOST his patient.” Conversation evidently over, she turned on her clogged heel and left the room.

              Dalia trailed the group, unclear if she was supposed to start looking for him now or continue on rounds to present her other patient. Savior and protector of the medical students, Kevin lagged behind with her for a moment to whisper, “Check the cafeteria first, obviously. Then the smoking shack, then outside. He seems like he kind of guy who would just go sit outside.”

              Nodding, Dalia broke off from the group. As a third-year medical student on surgical oncology at the VA hospital she was used to being given assorted random courier, retriever, and information gathering tasks.  It was nice to be useful and out of Dr. Trammel’s intimidating orbit.  She felt hopeful that Mr. Leary was simply getting some fresh air, not eating something that was not part of his clear liquid diet and would put her in an awkward position of trying to take food away from him. On her way down to the cafeteria, she texted her friend Maureen, who was on her pediatrics rotation and probably not even at work yet, to complain about having to go to the cafeteria but not being able to get food (Dalia knew that if she bought herself second breakfast she would inevitably run into her residents, who would think she wasn’t even looking for Mr Leary, when in fact she very much wanted to find him).

              Wait you’re looking for a post op patient? Maureen’s reply came immediately.

              Yeah, have you seen him lol Dalia typed while walking down the stairs.

              Actually, maybe… was just driving up the hill and saw a middle aged guy with a hospital gown flapping under his jacket walking down Terwilliger. Maureen replied.

              You’re kidding me. Dalia wondered if it could really be Mr. Leary. Maureen knew that Dalia wanted to do general surgery, maybe even surgical oncology, and was exhausting herself trying to impress everyone on this rotation so she wouldn’t be playing a joke on her. But Mr. Leary walking away from the hospital? It seemed implausible.  Dalia continued towards the cafeteria while typing Middle aged dude with brown hair, kind of long in back but not a mullet? Big belly?

              I mean I was driving but yeah sounds like the guy I saw. Maureen replied. Hey I gotta go see the kiddos, but good luck finding your patient!

              Stopping in the hallway, Dalia paused for a moment to make up her mind then turned towards the front entrance of the hospital. Never mind that it was 50 and drizzling and she was in scrubs with the insulation of a medium weight sheet of paper, she speed-walked through the doors, darted in front on an ambulance, and broke into a jog on the sidewalk heading downhill. Surely she could catch up to someone who had just undergone major abdominal surgery and was requiring intravenous pain medication when she last saw him at 7pm the night before. Clogs thumping on the sidewalk, she marveled at the absurdity of her situation. Two and a half years of her life and $250,000 in debt so far, and after the last two weeks she wasn’t even sure she wanted to be a surgeon anymore, but remained sure she didn’t want to be any other kind of doctor. Could she really survive a five year residence full of the attitudes of Dr. Trammels and the condescension of Dt. Tibideauxes?  Or on a more basic level, five years of predawn alarm clocks, zero to two meals her day, and one to two bathroom breaks?

              The flutter of the pale green, geometrically patterned hospital gown ahead of her brought her back to the current issue.

              “Mr. Leary!” she yelled before considering that protection of patient privacy probably precluded screaming a patient’s name in public. To her complete and total shock, the man stopped and turned around. It was Mr. Leary.

              Closing the distance between them, she panted, “What are you doing? Are you ok?”

              Mr. Leary chuckled, the first time she had seen him smile. “Aw damn, you caught me.”

              “What are you doing?” she said again, incredulous that she had found him while her mind raced about how to sneak him back to his room in time to catch Dr. Trammel before she started her eight hour surgery.

              “I couldn’t stay in there,” he said matter-of-factly.  “Y’all were starving me. Plus my grandbaby was just born.”

              “But you just had surgery,” Dalia replied dumbly. “You still have drains! Aren’t you in pain?”

              “Oh I watched the nurses empty the drains, I can do that. But yeah now that I’m stopped for a minute my belly does hurt pretty bad,” he replied, easing himself down on the nearby bench.

              Dalia had thought that maybe she could walk with him back to his room, as if nothing had happened, but was surprised to see how far down the hill they had made it. Plus what if something happened to him on the way back up? She would be responsible. 

              Hesitantly sitting down next to him, she said “Mr. Leary, I have to get you back to the hospital. I’m going to call an ambulance.”

              “I really wish you wouldn’t,” he replied as she dialed. “I just don’t know if I can do it, or if I want to. After everything I went through with chemotherapy, and I hadn’t even recovered from that before you cut me open.  There might even still be cancer in there. I just want to go see my grandbaby one last time and have it be over.” 

              Holding up one finger, hating herself for shushing his confession, Dalia said into her phone, “Um yes hi I’m down the hill from the VA, about three quarters of the way to Naito, and I have a patient here with me who needs to get back to the hospital and we need an ambulance. I’m a med student. He’s awake and talking, but he, um, can’t walk back up, he just had surgery.” The operator confirmed they would send an ambulance and she hung up.

              “Mr. Leary, you’re looking at it wrong. If you go see your grandbaby now and then give up, he won’t even remember you. Don’t you want to teach him to play catch? And take him out to that cabin you were telling me about, out in the coast range? You’re through the hardest part, you just need a little more time to recover,” Dalia pleaded as she saw an ambulance approaching. They must have been just idling outside of the emergency room.

              Her patient didn’t say anything in response, but he didn’t object as he sat down on a stretcher and allowed himself to be loaded into the back. The EMT, noting her damp scrubs and goosebumps, encouraged Dalia to jump into the cab and she did, texting Kevin that the patient had been found.

              The next morning, Dalia was surprised to find Mr. Leary wide awake in the dark when she slipped into his room at 5:30am. He blurted, “Thank you for chasing me down yesterday. I don’t know what I was thinking, I just got so angry about everything, I didn’t even think about you guys caring that I left. And when you mentioned the cabin you made me realize that’s what I want – not to be gone but just for this to be in my past, just another story for the grandkids about how I beat that cancer that tried to kill me. I’m so grateful to you.” He smiled sheepishly before continuing, “ok now you can poke my belly and ask if I’ve pooped. I haven’t, but I’m still really goddamn hungry.

              Dalia brushed it off, “Oh I’m just glad you’re feeling better about things,” then turned to check his drain so he couldn’t see the tears that were threatening to break free down her cheeks. He had no way of knowing his words were exactly what she had needed to hear to continue through another year of school, five years of residency, two years of fellowship, and a career of reminding patients they were fighting cancer together.