Archives of The Cheerful Oncologist, Volume 2

As we pick up our story, our narrator wanders over to the hospital for the first time as an attending…

Those of you who have started a new job after receiving only a cursory tour of the building where you will work can appreciate the strange look I had pasted on my face as I loped down one hospital hall and back up the other on my first official trip to the sanctum sanctorum of healing. I was searching for the ward where my first consult awaited me and every corner I turned revealed the same anonymous blend of clutter and emptiness that defines most hospital units. Unlike the men’s clothing stores I frequent, where one can barely get the trailing mocassin across the doorway before being assaulted by sales clerks sporting enviable pompadours, the nurses’ stations I crawled up to were either as empty as Grant’s Tomb prior to his demise, or teeming with personnel all presenting their backs to me for inspection. In my paw I held a slip of paper with the name and room number of a patient who, as my secretary breathlessly related to me, lay desperately ill with a seemingly inscrutable cluster of symptoms. With a whisper she described how the finest specialists in the city stood in a solemn circle around this poor fellow’s bed, all hemming and hawing with indecision, as groups tend to do when asked to make a group decision. Not until one of the more vocal members of the clan cried out “Let’s get that celebrated new oncologist to consult on the case!” did anyone give this pitiful sufferer more than one chance in ten to live long enough to pay his bill. A dozen bearded faces turned toward this wildcatter and, after the obligatory pause of disdain, launched a dozen slow nods of approval. A hushed call was placed and Bob’s your uncle - there I was at the desk holding my first official chart in trembling hands. I lifted the plastic cover as if the map to El Dorado rested within and took a peek. Gasp! That hissing sound emanating from deep within was my ego deflating quicker than the merger of a balloon and a well-aimed dart.

“Consult Hematology for anemia” was scribbled on the order sheet. I suddenly entertained thoughts about my secretary that were undoubtedly a breach of decorum, even after omitting the part where she gets a quick demonstration of how to use a coconut cream pie as makeup. To put this into translation, an oncologist who gets an anemia consult is like a costermonger at the intersection of 44th and Broadway who receives a request to wipe the mustard off of a customer’s mustache. It is a humiliating consult for the simple fact that any doctor with a standard medical education can solve the mystery (if any) of anemia with deductive reasoning. The problem is, no one cherishes the joy of deductive reasoning any more (unless they happen to reside at 221B Baker Street).

“What a revoltin’ development this is!” died on my lips as I entered the room.

In interest of patient privacy I shall not describe my brief encounter with this gentleman except to say that he was ancient, and had apparently assumed the left lateral decubitus position for the remainder of his existence, and had a beard that mirrored his hair style (or was it vice-versa?), and was as taciturn as an owl on sentry duty challenging an approaching shadow. Despite the lack of bonhomie in the room I was able to plunge ahead and, deerstalker cap or not, find the cause of his anemia in due course. It seemed that he was losing blood through the upper G.I. tract due to the fact that his daily dose of 2400 mg of ibuprofen had been inadvertantly continued by the admitting physician, and no one had yet been able to decipher the connection between the decrease in hemoglobin and the increase in dark, tarry stools. All I had to do was pen a couple of quick orders and Bob’s your uncle once more - the end of the beginning had begun, and now I could skip back to the office, (perhaps humming “Begin the Beguine“).

Again, those of you who remember that first day on the job and how you felt when the lunch whistle blew, announcing that the day was half over - didn’t you get a giddy quiver in the heart when you realized that you were going to survive without committing some faux pas that would be retold at the company picnic for years to come? I had a similar feeling as I headed back for a well-deserved lunch, courtesy of the delightful hospital cafeteria. I gave an oleaginous greeting to my secretary and told her I had finished the consult. She gave me a smile that even dear, sweet Alice herself would find suspicious and reminded me that I had office hours beginning at 1:00. I salaamed to her and, grateful for the chance to catch my breath, eat and make a couple of half-time adjustments in the game plan, walked to my office. Even before I neared the doorway I could detect a repugnant odor wafting from within.

Sitting in my chair, leaning against my microwave oven, were a couple of employees on their lunch hour, each with a fashionable ladies’ cigarette clamped on their mouths like a lamprey on a juicy lake trout. The atmosphere, which was already cloudy to begin with, turned threatening.

It seemed that my first day on the job was going to rival one of Job’s typical afternoons with the wife and kids. I drove the sinners from the room, turned on a fan and raised my voice to heavens, thusly:

“My sighing comes before my food; and my groanings are poured out like the waters!”

A knock at the door shattered the silence and I heard the unmistakable voice of my secretary warble “Your first patient is here.” As I arose from the kneeling position, I knocked my sandwich off the desk. I stared at it for two or three seconds longer than required, then walked out.

Next - Private Practice: The First Day, Conclusion: Now I Lay Me Down to Sleep…