by Atul Kumar
“You poor thing,” Peters was a genuinely caring individual and now hugging Juanita. “Then what happened?”
“I fell after he hit me, but then I got up and came out of the shower and told him to call 911. I changed real quick and by then the ambulance was there … you know the rest.”
“Juanita,” Peters looked her straight in the eyes for a few seconds before continuing, “now you have to be honest with me here.” She nodded that she would be. “When was the last time you actually saw or held your baby before today?”
She looked away as she tried to count the time, “Over three weeks. Like I said, John became scary possessive of her. He never ever let me see or hold her. When I’d try is when he’d hit me.”
“Okay, dear, I believe you. I’m going to go outside for a while and make sure the ER is under control. I’ll have a nurse bring you some food and juice. Would you like that?”
She perked up at the mention of food.
~~~~
We reconvened outside. Higgs was the first to speak, “You thinking what I am, Doc?”
“Yeah, John’s got some serious problems. He’ll need a psych eval, might even get away with everything.”
“That’s what I’m thinking. I’ve seen this before, but it’s been the woman who gets attached to the child. I’ve never seen it happen with a guy before. Role reversal or something?”
I knew if I didn’t ask now things were going to happen fast and I’d never get a chance, so I interrupted and asked them both what was going on. I thought I might get in trouble, but instead they were quite happy to bring me up to speed.
“I’ll start,” said Higgs. “See, John fell in love with Juanita. But nobody is so stupid that they can’t figure out there’s no way in bloody hell a normal healthy term child can be born within six months of meeting somebody. That explains his bullshit excuses about the child growing fast. But deep down inside, he’s pissed that the kid isn’t his, so in his head he blames Juanita for being unfaithful to him. He’s angry at the child because he knows it’s not his. Problem is he can’t fully come to terms with the fact it ain’t his kid.”
Peters continued, “Over time he becomes more attached to the child. But then anger replaces the bond and he starts to abuse the child; hence the cigarette burns and broken bones. He doesn’t want to kill the child, but when rage takes over he takes it out on both the baby and Juanita. As the beatings got more intense, he didn’t want Juanita seeing the baby, else she might report him; thus, he prohibited her from interacting with the child.”
I started to understand what Higgs and Peters figured out several minutes ago. “This should be a straightforward case. Just take John to jail, right?”
Laughter greeted my comment, followed by a whopping pat on the back from Higgs. “They’re so innocent at this stage, aren’t they?” he said to Peters.
“Unfortunately no, Raj.” Huh, she remembered my name! “There’ll be several lawyers involved. John will likely be determined insane; he’s clearly got psychological and anger problems. Of course the police will need his side of the story. There will be a long investigation and he’ll likely get acquitted due to insanity or some other psychological bullshit. Juanita will definitely get some time for being an accessory to something short of manslaughter, but given she didn’t participate, and is a minor at 17 years old, she might get some sort of leniency.”
Higgs summarized, “In a nutshell, it’s a huge clusterfuck. This is going to cost big bucks before it’s all sorted out. I just hope J get his just deserts because I don’t think we’re going to be able to locate him without more information”
“That’s for sure,” added Peters. “It’s people like John I worry about, I hope he never picks up one of those serial killer novels, he’s the type that’d try to re-create Dante’s Hell, except on earth when he’s older.”
“What about the baby?” I asked.
Peters answered, “I think its best we don’t come up with a name for her. I’d wager she’ll make it out of surgery but likely won’t survive more than a couple weeks given the extent of her injuries.”
Higgs and Peters split up, Higgs to talk to his partner and Peters to see what she’d missed in the rest of the ER while she was dealing with this fiasco.
Higgs and his partner decided that they’d be taking both John and Juanita to the station for further questioning and procedures. Peters was quickly busy with another emergent case, an acute MI from what I could tell.
Again, I was left standing alone and confused. There was nobody to whom I had to report or check out with, and my shift had ended over an hour ago. With nothing else to do, I started on the walk home. Not exactly what I’d expected to experience my first day of entering into clinical medicine. But as the year would prove, this was far from the most interesting or tragic case to which I’d be exposed.
Chapter Two: Two Enter, One Leaves
“The worst thing isn’t that you saw your mom in the shower, or even that you took a photo of her, but that you’re stupid enough to tell us about it!!”
“You make me sound like a pervert; it wasn’t like that at all. Dude, digital cameras had just come out and all my friends thought my mom was hot,” explained Adam.
“You mean a MILF.”
“I didn’t know what a fucking MILF was when I was 14. My biggest stressor was the SAT … something I doubt stressed you out, or else you wouldn’t have been stuck going to Brown.”
“Yeah yeah, not all of us can be Harvard alums like you. But we still ended up at the same med school either way.”
“Anyway … I only took the photo ‘cause my friends kept saying my mom was super hot. That, and they double dared me to do it, plus offered me a hundred bucks. And don’t forget, that was like a zillion dollars back then.”
Another med student joined in the conversation, this one clearly a jock type with a fit physique. He was what one of my former residents dubbed an ‘orthomorph’; a med student with the trim and athletic body of someone who was likely to enter into orthopedic surgery. An orthomorph was the dumb jock of medical school. “It’s ok as long as you didn’t think your Mom was hot. If you know what I mean,” he winked.
“Yeah!” piped in another student. Now everybody was engrossed in the conversation; with four guys and two girls, only I stood in the corner observing—clearly the outcast. Though I must admit I was mildly amused; this is not what I envisioned future physicians to be discussing in the 10 minutes before morning rounds began.
“Wasn’t your mom a Yoga instructor or something?”
“Yeah, but she mostly just managed a few studios that she owned. It kept her busy ‘cause my dad was always working long hours and pretty busy with trauma surgery call when I was younger.”
The jock spoke up again, “Dude, if she was a Yoga instructor, I bet she was a MILF. Hey, you still got that photo? Maybe on your phone or something?”
On cue, both girls gasped and shouted, “GROSS!!! How could you ask that?”
“Actually, it’s not that big of a deal … the other reason my friends wanted me to take that picture was because my mom was in Playboy two years before I was born and they wanted to compare her photos from then to after my being born.”
The three other guys all high-fived each other; I’m sure Adam would have too. Why, I still to this day don’t know, but I guess it’s why I never really fit into medical school. I didn’t come from the world of Playboy mothers and private schools, which was the norm for a significant portion of our class. Particularly on this rotation in internal medicine, I found myself surrounded by students from a pedigree of successful high income households and top tiered educational institutions.
“What I wanna know is how’d your dad hook up with a Playmate?”
The girls attempted to act repulsed, but you could see they were just as intrigued with the question. While their arms were crossed trying to seem disinterested, they were leaning into the circle and eagerly waiting for Adam to answer.
“My
dad was into the Hollywood scene. He was somewhat of a celebrity after CNN did a few interviews with him describing some new surgical techniques he innovated. From that interview, he became the go to surgeon for the VIP crowd around here. He met my Mom at some party a couple months after her centerfold issue came out.”
“How is it you have a MILF mom and a rock-star dad, yet you look like ‘Where’s Waldo’?” contributed Jocko the Orthomorph to the conversation, and then playfully hit Adam’s shoulder. They all shared in the amusement as though this were a perfectly normal conversation.
I’d heard enough and bee-lined to the door in an attempt to exit the small conference room. Just as I grabbed the doorknob, Jocko hollered in my direction, “Hey Rajeen, how come you don’t sit with us before rounds?” Nobody ever gets my name right; I think it’s on purpose, but I’m not sure.
Fuck, I almost escaped, and now I was dragged into the morning summit of meaningless pretentious drivel.
The summit leaders are Jocko the former Princeton lacrosse player who’s name I’ve never bothered to commit to memory, Adam the playmate offspring, and his other Harvard colleague Chris. All three come from families that are highly successful and rooted in social circles frequented by such captivating sources as the illustrious Enquirer.
Then there’s Donovan from Yale; he’s the mousey one who never quite fits in, but is always included because his net worth alone is a sum so high I cannot even fathom. Let’s just say when visiting home he travels via private jet, his own private jet.
The group is rounded out by Crystal and Paige, BFFs from Columbia who both managed to get into the same top medical school almost immediately after applying. How exactly they pulled that off is anyone’s guess. But it clearly wasn’t due to the fact that all of their parents and step-parents are successful physicians with a great deal of pull in the medical community. Nor did the Bel Air addresses, fund raising events, and deep donations made to the campus have anything to do with their acceptance letters. I’m sure it was a complete meritocracy.
Don’t get me wrong, all six here are brilliant individuals, always in the top 1% of whatever they do despite external factors. But they are so detached from reality it’s amusing. They come from a world of nannies, au pairs, chauffeurs, gated mansions, private schools, privilege, power, and, well, you get the idea.
Fortunately not the entire medical school is filled with such creatures. I’d say only about 50% of our 150 person class is of their ilk; the rest actually worked hard to get here. Unfortunately I happen to be on a seven student rotation in which I’m the sole outcast.
I eventually responded, “No reason other than in my culture, discussing the nudity of one’s mother is considered disrespectful.” My condescension was lost on them.
“You just don’t want to sit with us ‘cause you think you’re so much smarter than us.”
And on the first day of the rotation … it starts.
I hate conversations like this; unfortunately they occur far too often. In medical school there aren’t so many physical fights, mostly due to the zero tolerance for violence and instantaneous suspension bestowed upon all involved should it occur. Thus, everybody is judged by their academic performance; it serves to stratify the entire class. And in this morass of high achievers, where egos are more delicate than a Fabergé egg, academic prowess and achievements become all encompassing and essentially the entire world view of a medical student, far more so than other frivolous traits such as kindness, humor, empathy, interpersonal and other social skills the rest of the world perceives as important.
Medical students want nothing else than to ace every test, make it known to everybody else that they aced the test, impress all their superiors, publish a few scientific articles, get great letters of recommendation, and then move on to a prestigious residency in which the cycle repeats in an effort to obtain a top notch fellowship after which the cycle again repeats in an effort to obtain one of a handful of sought after jobs in desirable locations. Those of us that don’t fit into this paradigm are often the butt of most med student ridicule.
“That has nothing to do with it,” I try to reply, but before I can finish the door bursts open and a dozen residents pour in.
Instantly the summit ends and all six toadies are standing raptly at attention, ready to please their teams in an effort to do well on this critical inpatient internal medicine rotation. This is one of the core rotations in which a stellar letter of recommendation is crucial to secure, regardless of which field a student ultimately decides to apply.
And thus, begins day one of a six week audition, the goal of which is to obtain the best letter of recommendation possible.
There will certainly be lying, cheating, and stealing involved. The only caveat is you can’t get caught, or else you can forget the letter and likely face suspension. And I’m stuck with six of the most cunning sycophants in our class. They’ll stop at nothing to prove they are the best—this rotation’s going to suck.
I was right about the sucking, just wrong about the why.
The room instantly began to reek of shit, and not from somebody’s flatulence or bowel dysfunction, but from all the brown nosing that’d already started. The six immediately had their noses so far up the chief resident’s ass that they might as well have biopsied any polyps they found.
Instead of mingling I occupied a now vacant seat and dedicated my undivided attention to devouring my bagel. It may well be my only caloric intake until dinner if I got stuck being on call tonight.
“Attention everyone,” the chief resident announces, instantly commanding attention and complete silence from the 20 or so bodies in the cramped lounge.
“I’d like to welcome our new third year medical students to their inpatient internal medicine rotation. This will be a very rigorous six weeks, and I’d like to set some ground rules. First, there are four teams and seven students. One team will have only one student, that’s team Red. The medical students will be on overnight call with their respective teams and be expected to be fully involved in all patient care activities. I will personally meet all students from 7 to 8 a.m. every morning for lecture; thus, all pre-rounding patient care should be taken care of before then …”
I’m sure he droned on further, but I lost interest after the 7 a.m. lecture notice. A quick mental calculation taught me all I needed to know, namely, that I’d have to show up at 5:30 a.m. to be able to see my patients before being rewarded by a lecture, which was to be immediately followed by more work. Doable? Sure. Great learning opportunity? Check. Fun? Negative.
“And finally Rajen will be assigned to team Blue.” I startled to attention only to notice everybody was exiting the room. Shit, I already started off on a bad foot. Luckily I saw Adam being handed some blue cards, so I figured I was on his team and joined the group of five in the hallway.
“Hi, Raj, is it? I’m Duke, the senior resident; this is Kelly the second year resident, and Amy and Jason, the interns of the team. I’m guessing you already know Adam, your co-med student. I think we have a couple pharmacy students, but they’ll join us later and only sporadically.”
“Pleasure to meet you all?” I wasn’t sure myself if I was asking or stating. It’s intimidating when the whole team is sizing you up on the first day of a critical rotation.
“Hey, are you the one everybody talks about who crushed the board examination this year?” Amy instantly asks me. Clearly, she’s the overachiever of the group, and judging by her Fendi pumps and Versace bag, also comes from a life of privilege and status. I’m hoping she works with Adam.
I notice Adam frown. While a genius and accustomed to being the smartest kid around, he full well knows that I hold the title of virtuoso test taker in our class. This was a title that I did my best to conceal, but rumors in med school are like fleas in a kennel, ubiquitous, annoying, and unrelenting.
There was always one outlier in most of our tests, a single individual known to mess up most of our grading curves and who reportedly got o
ne of the highest scores on our board exams in the history of the school. While many people took credit for all the high scores, I was the only one who knew the true answer, but I had no desire to claim credit. Eventually rumors spread that I was this individual. To this day I vehemently deny it, but most are certain it’s me.
“Rumors will be rumors.” I reply and leave it at that.
Amy winks in that all knowing style girls have, indicating that this wouldn’t be the end of the topic.
“So Raj, hopefully we can make good use of your brain power to take excellent care of our patients. You’ll be working mostly with Jason,” instructed Duke.
I looked over to Jason; he was in scrubs, bad sign. He nodded, knowing I wouldn’t like what came next.
“Thus, you’ll be on call overnight today. Hopefully you brought some scrubs to change into.”
Damn it, I knew this was going to happen. That meant that Adam would be on call as well, and everybody knows that misery loves company. His company would lead to my misery.
Duke pulled us all in close for a team huddle and continued, “Our attending is Dr. Miley. She’s brilliant, and more importantly she’s no nonsense and incredibly fast. Her goal is to get out of here as soon as she can. The best part though is that her husband is Dr. Manis, the CEO of the hospital. Thus, anything we want, we get, and fast, so our lives should be quite good in regards to minimizing red tape.”
Just then the infamous chirp of a pager went off. All six of us instantly checked the beepers on our waists. Like gunslingers in a duel, Duke is the first to remove his from the little plastic holder and quickly reads the message, announcing, “It’s the ER—looks like we got our first hit (a resident’s way of describing a patient admission, or basically work to do). Jason, you wanna take this with Raj?”
Jason nods and pats me on the back indicating I should follow. Great, just minutes into the first day of the rotation and I’ve already been antagonized by my classmates, told I’m on call, and received the first patient. Could be worse, at least I didn’t have a kidney stone.
