My eyes have adjusted. Faint streaks of light from the edges of my window illuminate the darkness of my room. I toss onto my side and my gaze drifts to the shadows on the wall. I make shapes out of them, like making shapes out of passing clouds. Like how I would try and fail to count sheep to fall asleep as a little girl. Like I am failing now.
My legs ache faintly as I lay there. They ache from the icy wind through my scrubs on the walk to the hospital in the darkness. From bouncing nervously under the conference table during rounds. From the weight of wondering if I am doing enough. My legs ache from walking each day through a museum of human suffering. The attending draws back a papery blue curtain, and on come the green fluorescent lights. “See here?” he points out for the huddle of craned necks around him. “See here, the waves in her abdomen, her dandelion skin.” We examine and inspect and poke and prod and palpate and thank our patient. The curtain shrieks shut and we file out, moving to the next exhibit.
I close my eyes, trying to shut out the light. Instead, their faces float through my mind. I think of him first. My first patient. I had met him confused and afraid in the emergency department, not knowing where he was. Not knowing who he was. With each day on our service, his condition waxed and waned. Where we solved one problem, two more cropped up. His personality returned slowly, as his body withered in his bed. I would visit him each morning, opening the blinds so that the sunrise would paint his room golden. “Do you remember me?” I would ask him. It was the same question I had started to ask my grandfather when I visited home in those last few months, afraid of the answer. He would nod and smile weakly, shifting his skin and bones so I could listen to his heart and lungs. One day, as I was about to leave his room, I asked, “Anything else you need, anything I can do for you?” He took my hand and his piercing, hollowed gaze fell on me. I had to look away.
“Please,” he whispered. I lifted my eyes to meet his and saw them filled with tears. “Pray for me? I miss my wife… I want to get better… I want to go home.” I nodded, biting my tongue. I squeezed his hand and wiped the tears from his face. Two days later, after a much needed day off, I returned to the hospital and scanned the list for his name, as had become my morning ritual. It was gone. He had been discharged.
Another face floats past, a sunshine smile on the dim wards. My patient who had lost both her home and her health in the span of a day. I would apologize for interrupting her rest as I entered her room and turned on the lights. I would apologize for my cold stethoscope, my cold gloved hands. She would shake her head and thank me, like she thanked every member of the team. “People keep telling me I’m so nice,” she would say. “Why?” I thought about what it must have been like for her, to lie in that small curtained room and think about the uncertainty of her future. I think about what happened to her after she left the hospital, if she beat the cancer we had found. If she was able to find a home for her children. I think about what kind of person it takes to accept life’s cruel hand, smile and say thank you.
The scene fades, then another. My Epic search history, as I try to find one of my new patients. Then I see it. Her name. Parentheses. Deceased. I had met her only once before we sent her home. I had stood at the edge of her bed as she told me how she knew she needed to make some changes, for her health, for her family, for herself. We spoke at length about baby steps, about how hard it can be to make the changes we know we need. Reason cautioned me, but I allowed myself to hope that her present did not cement her future. I always wondered what experiences, what losses had hardened the residents and physicians I worked with. Why they held themselves back from hoping. I stared blankly at the ceiling. Maybe this was why. Maybe she had not tried. Maybe she had. Maybe it was not enough.
It is not long now until the streetlights seeping through the edges of my window will be replaced by the light creeping over the horizon. I will be in the hospital by then, perhaps opening up the blinds in my patient’s room, so a golden glimpse of sun might illuminate the standard issue gray. I will drift through the halls from room to room, from exhibit to exhibit. I will drift through my patient’s lives, hoping that they will not become the ones that keep me up at night.