The oversized bed shook in the trauma bay as Sheila continued to chatter about the circumstances that brought her to the emergency department. The gynecology resident’s legs trembled as his gloved hands held back layers of adipose tissue in an attempt to place the speculum. As a good medical student, I stood behind him ready to anticipate his needs. The mounds of fat formed a layered barrier that multiplied with each new excavation.
After two more students were summoned to help retract, the resident was able to complete the vaginal exam. He probed the outer wall and stumbled upon a large bulbourethral gland abscess. Pus extruded as he palpated the abscess with his fingers. The putrid stench of infection hit us all at the same time. Our heads turned in unison, our eyes squinted, and our mouths grimaced. Another resident watched from the doorway and snickered at our discomfort.
Within minutes, news of Sheila had spread among the other physicians and students in the hospital. As I walked to the operating room, a few classmates passed and giggled as they shot mock high fives in my direction. Others scattered, hoping they wouldn’t be asked to assist with the ensuing incision-and-drainage procedure.
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A few minutes later, I was gowned and gloved. The scrub nurse waited at the door and placed a drop of oil of wintergreen on my mask to overpower the smells coming from Sheila. The surgical procedure lasted less than 30 minutes; the abscess was lanced and packed.
By the time I sat down to write the operative note, it was well past midnight. I halted at the nursing station, trying to recall the appropriate nomenclature. A nurse interrupted my efforts and reported that Sheila had spiked a fever and the phlebotomy team was unable to draw blood for cultures. I looked around the corner and saw that all of the residents were either in the operating room or had gone to sleep. I slowly sauntered over to the supply closet and withdrew the necessary supplies.
I worked on Sheila for almost an hour. Every time a good vein appeared, it would roll under my fingers and collapse before the precious flash of blood could appear. At first Sheila was patient, but eventually the pokes elicited screams and finally prayers.
Oh Jesus, help me!
The sweat rolled down my forehead and dropped onto her gown. I was finally successful after using a large-gauge needle on both femoral veins. Sheila was exhausted. I left the room, exhausted but triumphant. I had secured the precious samples for culture. I placed the bottles on a table and reached over on my left side for the labels resting on the counter. Overworked and horribly fatigued, I lost my balance and crashed onto the table. The culture bottles bounced off my side and smashed into pieces on the ground. I dropped to my knees and watched helplessly as the blood splashed onto the floor.
When I walked back to the room with a new tourniquet and syringe, Sheila almost jumped out of the bed and ran for the door. I kept my eyes averted while I explained what happened. My usually confident voice sounded childlike, distant, and apologetic.
Sheila lifted her hand from under the covers and unexpectedly grabbed mine.
Humility is a two-way street, isn’t it?
Like Dorothy finding out the truth about the wizard, I suddenly saw the situation clearly. Sheila knew about the snickers and the oil of wintergreen. She knew what people were thinking about her. But this was her reality, and she needed our help. She released my hand, and I drew her blood once again. This time I was successful with the first stick.
I have thought of Sheila many times since that day. Every time I get angry, disgusted, or annoyed by my patients, I see her smiling face.
And I realize that sometimes they feel the same way about me.
