Monday, August 29, 2011


I'm not sure if it's true in other parts of the country, but New York loves to hype up natural disasters.  This past winter, the various dumpings of snow led newscasters to label the winter storms with such monikers as "Snowgate" and "SNOWMAGEDDON!!!"  It led a lot of people to stop taking weather reports seriously, as well as the Fox News team in general.

Somehow, the dude upstairs had something else in mind this week, though.  Post-call last week, I woke up sometime in the afternoon to feel a rumbling.  I assumed it was the local freight train that comes through once or twice a day and gives my apartment a mild vibration, but when it intensified and became more irregular, I briefly woke up and thought to myself "Hmm, must be an earthquake.  Okay." and went back to sleep.  My first earthquake ever, and I missed it!!  It wasn't until a few hours later when I hit Facebook that I realized that the earth had moved from virginia to connecticut, with everyone else super-excited for The Great Quake of 2011.  (A guy in Brooklyn even had it tattooed on his arm.)  Of course, there was much mocking to be had - a number of pictures circulating "documenting" the destruction, which depicted a lawn patio table set with one plastic chair mildly knocked over.  Still, it was exciting.

That is, until the news team seized on Hurricane Irene, steaming up the Eastern Seaboard.  It was apparently the first hurricane to directly hit the NYC area in several decades, although I remember many summers of very intense thunderstorming and flooding because of the residual tropical storms coming from the Caribbean.  I've seen NYC panic before, but people began to act like the end of the world was approaching.  My friends all posted pictures of people lined outside the Trader Joe's, beating each other down for the last biodegradable container of wasabi peas, while my parents brought in the goldfish from the pond and stocked up on sandbags from Home Depot.  My own home base became a part of the mandatory evacuation zone, and so all 40 patients had to be removed from the facility, as well as a number of my co-residents who lived in the area as well.

But for me, it became an exciting chance to hole up and go back to basics.  My new boyfriend Z asked me to spend the weekend safely ensconced together, so I "evacuated" him from the Upper East Side and we drove together to Brooklyn, to spend it with his friends J&J, a fabulous couple about whom enough sweet things cannot be said, as well as his close friend S.  We hung out, ate pizza, watched Star Trek, played Settlers and Starcraft (I took a nap for that last part) and just had a million laughs.  Around 3 am, we went up to the roof to watch the hurricane kick into action, and as the wind blew the trees over and the rain poured sideways, I started to feel infused with an incredible awareness and connection to the force we were witnessing together, something I rarely feel since leaving the windy streets of Chicago.  We woke up the next morning to eat bagels, lazy around, and take bets on who would be able to escape their Monday morning responsibilities.  (I wasn't.)

Like the storm, I came into the weekend with an intense fever pitch and left in a calm, deeply contented state.  My neighborhood had a downed tree or two which smushed a few cars, but we were otherwise well for the wear.  The home base hospital still hadn't opened, but maintenance crewed and residents began trickling in.  Everyone showed up to work more or less in one piece, and we resumed the work of the day without a backwards thought.  Except for the occasional twig out of place, we had all moved on.      But in my head, I treasured having two whole days to feel gratefulness and even joy.

Wednesday, August 10, 2011

Death and Birth

It's been about a week and and a half, and my return to Shmeens has started a bit smoother than I expected.  Considering how tense and nasty everyone was acting the last time I was there, I clamped down and tried extra hard to be sweet to everyone I spoke to.  I encountered a nurse or two who I had gotten into throwdowns with, and thankfully they didn't remember me, so I was able to start over with them and act extra grateful (even if all they were doing was a basic task).  I would have tried to do this anyway, since I was scheduled to spend a lot of time at Shmeens, but I had a separate reason for doing so.

Without revealing too many details, it is looking a bit likely that my home base hospital may close.  Sadly, this is the story not just for our facility but for many many others in the metropolitan area.  It seems to be a clusterfuck of a situation, for lack of a better word, because all of the hospitals' debt is being called out at the same time that corruption in the governing hospital systems is being called out, at the same time that the state is unable to provide funding despite acknowledging a need for hospitals in underserved areas like ours.  There has been a lot of rallying on the part of the community and doctors and nurses to save our facility from a terrible fate, but I fear that it's just too late for what seems to be a done deal.

The kind of pall this sort of event throws on everyone, it's hard to describe.  When we first heard news (which wasn't even news), the nurses went into a super-chicken mode in which they basically screeched and clucked the news to anyone and everyone who would hear, even if there wasn't anything definitive to report.  There is so much sadness that everyone feels for the community residents, many of whom cannot seek medical help elsewhere because of economics and geography.  The attendings have all gallantly tried to roll up their sleeves to help, but of course must think of their families and so are quietly exploring jobs elsewhere.  Everyone agrees that it's a tragedy of Greek proportions.

This, of course, puts the residents in an uncomfortable position.  Because of the nature of residency programs and spots nationwide, when a program shuts down, residents don't lose their positions - they are typically redistributed to other programs (who happily take on the $150,000 value + resident labor) and the spot is later lost after the resident graduates.  In other words, while the hospital closing creates drama as far as where we will all go, we are not in the same boat as everyone else in terms of job security, and it's hard to look everyone in the eye when they're struggling and we aren't.  This is especially true of the surgical program, because our director is working hard to preserve the program itself as a living structure - to do this, we are trying to shift our home base to Shmeens.

We are very fortunate because we already were spending so much time at Shmeens, running their service and staffing their OR, that the program disseminating would be a massive blow to them.  Additionally, Shmeens once had a residency many years ago and lost it, and there has always been an interest to re-acquire one if possible.  All of our attendings there have been exceptionally supportive of the plan to relocate permanently, and seem excited to have us.  The chairman in particular has shown a lot of enthusiasm to further develop our program and utilize affiliations to create new outside rotations that we can add to our roster and boost our academic strength.  And fortunately, we already share one attending with the home base, to help ease the transition.

I'm not really sure of how I feel about it.  Or rather, I know how I feel, but then I'm overwhelmed by guilt about it.  Our program will have an easier transition by far than the other residencies at the home base, and they are still fighting to stay open.  One in particular will likely be split into two programs, a travesty because that program is quite coveted in the area because of the specialty it trains for.  On my part, I almost wish closure would happen as soon as possible so that we could all move on with Shmeens, but the reality of that would mean expediting the loss of nearly a thousand jobs in a relatively poor area.  Being at Shmeens where it feels safe, I'm taken away from the tragedy and heartbreak.  I don't want to go back.