Archives of The Cheerful Oncologist, Volume 2

June 1, 2005

The Graveyard Shift, Part 2: Be There Method in This Madness?

Filed under: The C. O.

There are oodles of synonyms for the word “naive”, each contributing in its own colorful way to paint a portrait of an individual unencumbered by sophisticated attitudes such as wariness, cynicism, perspicacity, or weltschmerz. Think of these few descriptive terms: gullible, ingenuous, childlike, unseasoned, simple-minded, wide-eyed, patsy. The words conjure up a vision of one who is friendly and honest, but unlikely to be given any position of weighty responsibility like sentry, or head of security in a nuclear power plant.

I know, because like many cherubs who flitted about the heavens during the pastoral days of youth I was somewhat of a rube. The transition from Little Jack Horner to the hard-boiled medical gumshoe (complete with stubble and trench coat) I am now began when I worked the graveyard shift. It wasn’t just the wrenching disruption of the sleep schedule that did it, though that alone is enough to turn any soi-disant “model citizen” into a mattress-label-tearing grizzly bear. It was the responsibilities of the job description that tended to stress me out. I earned a paycheck for doing one thing and doing it promptly, with a smile on my face. My job was to serve others - patients, nurses, interns, visiting dignitaries, even wandering minstrels could have asked anything of me. Hearing a request for a drink, I was expected to dash to the Nile for a refreshing pitcher. With such conditioning I soon became a skilled automaton, much to the delight of the nurses who began to look at me like a hungry Greek ogling the cornucopia. I didn’t seem to mind the workload - because I was (ahem) still somewhat naive.

It was with this valet-like servitude that I answered a call light at around one-o’clock in the morning and found within the darkness of room 214 a young man lying stiffly on his back. He registered his awareness of my presence by snapping his head toward me like a flag in a stiff wind. Before I could ask the question, he sat upright and began to criticize his accommodations vigorously.

“Listen - I want out of here! I want you to get the doctor to let me go!” His unwashed hair lay smashed against his right ear, defying gravity. I was shocked - he was the youngest patient I had encountered in my brief period of employment. Although paler than me, he reminded me of myself, and I thought of that short story by Poe that had unnerved me last semester. Trying to recall how to address someone not a septuagenarian, I issued some standard there-there-everything’s-all-right blabber. He suddenly rolled over onto his stomach and showed off what turned out to be a textbook display of catatonia. It appeared that a friendly game of gin rummy was not in the offing, and I crept out of the room. The charge nurse gave me the details of his admission - PCP overdose from the E.R., no immediate family available, attending physician left few orders. She floated off down the hall, and I slowly turned toward the new sounds of moaning and laughing…coming from room 214.

What else but innocence could make me believe that I could reason with a lunatic? I went into his room again and again and tried to calm him down, only to break out in a sweat each time he confronted me. He had the glare of the striking cobra and the laugh of the mythical Yeti. After presenting my case for sending in the Marines, the nurse made a guest appearance in his room and tried to give him an injection. Our patient looked as if he had the jawbone of an ass hidden in his gown, and since I knew the outcome of the old Bible story I high-tailed it out of there, followed by the sister of mercy herself. I half expected the patient to come storming out into the hallway crying Though ye have done this, yet I will be avenged of you!” - real fire-and-brimstone rhetoric.

The night dragged on. It seemed that rosy-fingered Dawn was out night-clubbing somewhere, for I thought my shift would never end. I pleaded with my compatriot to remain calm, but he wouldn’t listen. Just when I had finished making the morning pot of coffee I heard a hugh crash inside his room. Although I ran to the door, a sixth sense told me to open it with the same caution one sees being taken in those slasher movies - just before an unsuspecting head is lopped off. I peered into his chamber - and my skin crawled.

He was sitting at the foot of the bed holding a light bulb in a bloody hand. His lamp lay in pieces on the floor, and he chanted something like “it’s-time-it’s-time” or some other phrase designed to work as a laxative on authority figures like me. Now back in those days the rules for restraining patients were about as strict as the rules against enjoying a Lucky Strike at the nurse’s station - there weren’t any. This fact was not lost on me as we circled round his bed like two cowboys confronting a rattler. Why the heck didn’t we have him in a Posey vest if we knew he was unstable? How were we going to get that weapon out of his hand? Who’s running this insane asylum anyway?

The most pertinent questions always get asked at the most inopportune times, and as I tried to disarm him I kicked myself for not predicting this outcome - leaving a deranged drug addict to his own devices in a room laden with objet pointu. Necessity being the mother of improvisation, I decided to fight him on his own terms, and within the minute he was sans lightbulb and back in bed - soon to be enjoying the comfy-cozy feeling of four-point leather restraints. How did I do it? Easy - I started jabbering, Hamlet-like, in gibberish to him, calling him “fishmonger” and accusing him of breeding maggots. When he heard the same nonsense he was spewing coming from his fellow man he seemed to realize even in the throes of an angel-dust delerium he was acting ridiculously. Chalk one up to fast thinking and belief in the power of human understanding.

My experience working the night shift was invaluable as medical school began. I no longer feared sleep deprivation or strange patients. Soon I was crossing the stage of a large auditorium, mortarboard and hood in proper place, receiving the diploma that gave me the opportunity of a lifetime to work with cancer patients. I had only one hurdle to jump before I could hang out my sign and load up the closet with long white lab coats - the residency and fellowship. As I stood on the hill overlooking the school, the red sun setting behind me, I felt as if the world was mine to command. My internship in St. Louis started in ten days, and I was ready.

Somewhere in the far reaches of the galaxy my name was being called, followed by the sound of uncontrollable laughter. Not only did I still have a debt to pay to the graveyard shift, it had saved its biggest surprises for the upcoming years. My nighttime duties were about to take a leap forward - into the abyss.

Next: The Graveyard Shift, Part 3: Night of the Living Dead






















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