At the Bedside

I. New Neighbors

There’s the guy that stole a stack of prescriptions and wrote “Mofeend. One pound.” Classic. Pharmacist wanted to fill it but got confused by the “one pound.” Called me, said the max she could dispense was a gram. That’s what I’m talking about: every day something new, something funny. Not forward-round-the-office funny. So funny you have to hold it in, at the bedside. Best feeling in medicine, when you’re holding it in and the patient laughs with you. After telling you something awful. How her teeth have grown apart. How veins bulge from her chest. You know what it means. What little time. Still, you can’t help but laugh. Because symptoms are funny. First time feels a bit faux pas. You can’t apologize. All it does is make them feel worse. Work here enough, the humor overwhelms. Has to do with class, especially the whites. They’re my favorite. I’m talking true white people: not homeless, not drunks, not anyone you’d see in a nursing home. People you take one look at and wonder why they’re here. Why didn’t you go to Saint Whatever? Not so many neighbors here? Like 21a. You see her? Tortoise-rimmed glasses, looking at us? Know why she’s here? Walks into walls. First thing out of her mouth was, “You really should know, I’m a control freak.” That’s just it, you say one word to them, they’re thunderstruck somebody else has an education down here. Talk to you like they would their wedding planner. She started trembling at work the other day. Called the therapist, had her Xanax upped. Tremors worsened. To the point she can’t walk. Completely ataxic . . . by report. But not. Just do a neuro exam—finger-nose-finger, RAMs, Babinksi—you’ll find it’s all in her head. Know why? I walked her. From her stretcher to the bathroom. Whole body shaking like a Pentecostal. Whole team following her with outstretched arms, like movers. Never fell. Got close. Did that whole number where she gyrates on one toe and keeps balance with her hands, high-wire–style, which requires an incredible amount of functioning cerebellum. Said she was embarrassed. Embarrassed! Who’s embarrassed here? Bawled when I told her it’s the processor, not the wiring (i.e., psychological, not neurological). You’re a control freak that’s lost control of your body, don’t you see? “Well, when you put it that way.” In the abstract, she means. The white vernacular. Gave her a wet paper towel and examined one of the many neighbors. Took a full history of another guy within earshot, arm’s length rather. Guy with liver disease. That’s what I love about this place. The anonymity. Streets of Manhattan on stretchers. She eavesdrops. Whites can’t help it. Hears how he drinks a fifth each day to go along with twelve beers, no food. That’s the biggest thing you gotta decipher with these guys: have you switched fuels? I do a neuro exam. Girl watches. I test cerebellum and liver guy’s hands flap, flap, flap. All right, stop, I tell him, while giving her a look that says, Where’re your tremors now? About to discharge her when security hands out the sandwiches. Liver guy’s in the bathroom. Liver guys. Now here’s the part that makes you love your job. Not because you can do anything—because how do you repair a tangled knot?—but rather because you see it, you’re here, real shit’s happening and you’re privy. Girl saves him a sandwich. Places the white paper sack on his stretcher. Other neighbor makes like he’s gonna steal it. Girl stops him, guards that sandwich like it’s her child. Liver guy comes back and tears in. Gives no thanks. Eats so much, the girl starts eating her own. I come over to discharge her and she offers me half. No thanks, I tell her. Wouldn’t eat one crumb down here. Normally it’s Hasta...