Agraphia Medical Tragicomedy


A Tightly Coiled Spring

Walking out of the MICU today, I had an overwhelming sense of accomplishment.  In the last couple days I've placed 5 central venous catheters and intubated 2 people - one of whom looked to be a few minutes away from dying when I walked in the room.  I've started to really hit my stride.

I swung by Trader Joe's after work in my scrub bottoms and t-shirt. I used to keep an extra pair of clothes in the car so I didn't have to walk around in scrubs, but at some point I got too tired to make the effort.  I figure taking off the scrub top is a good compromise.

As I was checking out, the cashier struck up a conversation.

"Just going on, or coming off?" she asked, brightly, "You look a bit tired, so I'm assuming coming off."

I smiled, "What gave me away?"

"Well, the scrubs, for starters.  You haven't shaved in about 4 days.  And you've just got that... look about you."

"What look?"  I asked.

"You look like a tightly coiled spring.  Calm at the surface but ready to act in a heartbeat.  I'll bet you know exactly where the AED is in the store."

I chuckled.  I had noticed the AED.  Back corner, newer model.  It's become unconscious, that quick assessment.  It has served me well in the ICU and the ER so far.  A year ago I doubt I would have been able to make that snap decision to intubate just by looking at someone.

I finished bagging my groceries and thanked the cashier.  As I walked out an elderly gentleman walked in, breathing hard and barrel chested, nicotine stains on his fingers.  "COPD," I thought to myself, as I strode to my car.

Like a tightly coiled spring.

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  1. Zac,

    I’ve spent the past week reading as much as I can of your blog; how far you’ve come and what you’ve been through. As a recent graduate still struggling to get into med school, what you’ve detailed scares the hell out of me.
    But I wanted to thank you for giving me the opportunity for personal reflection and affirmation that this is what I want. I want this commitment now more than ever, so please keep up the good work and I will continue to read regularly. Good luck in everything you do.


  2. After my peds rotation, all I saw were dysmorphic children. One of the coolest things about medicine is that it changes the way you look at the world. Still, it’s nice during those times when you are able to remove your doctor hat and stop noticing that your real estate agent has a left facial droop.

  3. I’m impressed by the highly observant cashier! I have a hard time suppressing my medicine lens outside of work. I recently saw a 45ish year old woman struggling on a hiking trail. Despite her normal weight, everything else I saw screamed heart disease. I desperately wanted to suggest a cardiac work-up but I managed to stop myself from giving unsolicited advice.

  4. …and if I’m right I hope her doctor gets her that work-up sooner than later.

  5. I was impressed by the cashier too! Kudos to people who recognize how much work you do.

  6. Where have you been? Please keep writing. I really enjoy your blog.

  7. Yes, you’re not an intern anymore, so there’s no excuse!

  8. OK, ok, ok, I apologize! Promise I’ll try to write more now that I’ve made the big transition :)

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