On Rotation(22)

Anger spiked through me. Nia, with all her wisdom, had predicted this reaction almost verbatim.

“Momma, Daddy, rounds are coming up, and I have to see my patients,” I said. “Can we please do this later?”

“Fine,” Momma huffed. “But we will discuss this. Call us when you are done.”

“Sure,” I said, knowing that I would be doing no such thing. Then I hung up. My heart galloped in my chest and my eyes stung with tears. You care too much about what Mom and Dad think of you, Tabatha had said once. You just have to tune them out. But Tabatha could tune them out. She was their precious, pretty baby girl, deemed too sensitive for the form of “correction” they liked to dole out on me. If she ignored them for a few weeks, they would accept her back with open arms. I, on the other hand, would have to return on my hands and knees.

“Breathe,” I muttered to myself. I glanced down at my patient list. A week into pediatrics, and I’d already crossed it off my list of possible professions. Hospitalized kids were depressing, but they definitely helped put things into perspective; my parents could be insufferable, but some parents were worse than that. Besides, I hadn’t been lying when I told my parents that I had to pre-round. The first step to proving myself worthy to future residency program directors was to ace my clerkships, and I was not about to let my parents’ pearl-clutching sabotage that.

I stepped out of my alcove, adjusted my stethoscope around my neck, and continued to my next patient.

*

“Angela,” my attending, Dr. Berber, said. “What are the adverse effects of Depakote* in pregnancy?”

An hour after my phone call with my parents, I stood outside my patient’s room, clutching a wrinkled wad of paper—my note, written carefully in the wee hours of the morning before my pre-rounds. My patient was a two-year-old who had come in with a febrile seizure. I knew it was a febrile seizure. My resident, who stood, hip cocked, behind me, knew it was a febrile seizure. Even my attending, who had taken a look at the patient’s chart and history—thirty-month-old with an uneventful birth history and no known medical problems coming in with two days of upper respiratory symptoms and a fever to 101.4—had deduced that it was a febrile seizure. The kid was already bouncing around his room comfortably, and his dad, who’d come into the Emergency Department practically foaming at the mouth in distress, had finally been assuaged. Most importantly, my patient was a kid, not a pregnant woman on Depakote.

And yet here I was.

“Umm,” I said, my heart jumping in my throat, “what’s the generic form of that again?”

My resident gave me an encouraging smile.

“Valproic acid?”

“Oh. Neural tube defects.”

“Correct,” my attending said. “So. Why aren’t we starting Timothy on any anticonvulsants then?”

“Um. Because he had a recent upper respiratory illness, and a high fever. So it’s a febrile seizure, and we don’t treat that with anticonvulsants.” I paused, aware that my answer was insufficient but not sure why. I looked to my resident in panic. She was looking at her iPad and typing away, no longer interested in watching me flounder through this pimp session.* I was on my own.

“Did you ask what the seizure was like?”

“Um. Yeah. His dad said he found him shaking in bed, and then he went limp.”

“Okay, but how long was the seizure? Did he have another one after that? Was he confused or listless for some time afterward? Did he wet himself during it?”

Heat rose to my cheeks.

“Um . . . I . . .”

My attending looked over his glasses at me with bleary eyes. I could feel myself being measured and found wanting.

“All right, Angela,” he said, in the slow, deliberate tone you’d use on someone who was just learning English, “I have an assignment for you. Go read about seizures in pediatric patients and teach us about it tomorrow after rounds.”

Behind me, my resident let out a huff of impatience. It’s just the first block, I tried to remind myself. I don’t have to know everything—

But, clearly, I should have known that. So much for acing my clerkships. My residency application was going to be a disaster. A face came to my mind, of a fourth-year I didn’t know, his voice echoing disdainfully across the empty auditorium: Maybe the white kids always get AOA* because we work harder.

For the rest of rounds, I kept my mouth shut. Questions I wanted to ask were scrawled messily in the corners of my notes. They were too stupid. They were things I should’ve known. If I had known them, I would have done better on Step 1. I would look them up on UpToDate* later.

A few doors away, I heard the strumming of a guitar, the sharp lilt of childlike laughter, and clapping hands, and my heart rate spiked. Child Life, helping one of the other teams’ patients deal with their illness through play. It was an honorable job, done by the kindest, most open specialists and their devoted crew of volunteers, and I avoided them like the plague. Because Child Life could mean Ricky, and I did not need boy-related anxiety on top of my regular school-related anxiety compromising my clerkship performance.

Thankfully, Ricky hadn’t tried to reach out since the Sanity Circle brunch. Maybe getting so summarily ignored had given him a hint. Still, every time I walked into a patient room, I peered through the window in the door first, checking to ensure that he wasn’t sitting there, speckled with finger paint and smiling hopefully up at me.