No Apparent Distress by Rachel Pearson

Author:Rachel Pearson
Language: eng
Format: epub
Publisher: W. W. Norton & Company

I ENDED UP TALKING with Damien a lot. I guess it was because I felt guilty for being part of the team that was operating on his foot. Maybe I was just trying to comfort myself, but I thought he might feel better if he had someone to talk to. So I’d drop into his room after rounds, and we’d talk. I don’t think it actually made much of a difference to him. In the end, he lost the foot, and that was what he cared about—not connecting with some random, guilty-feeling medical student. When I tried to talk with him about learning to walk again and everything he could still do, he shut me down: “I ain’t going to have no kind of life,” he said, “with half a foot.”

He did tell me a lot about himself, though. He told me how much he loved his mother and how hard she fought for him, hauling him into clinics month after month and getting his paperwork in so he held on to medical coverage, even when they were homeless. He blamed his illness on himself, on running away and getting in trouble, on doing bad things. Teenagers, I told him, always screw up on their diabetic care. When you’re that age, it’s impossible to know how bad the complications will be. Damien was angry, but mostly at himself.

Things become so immediate in medicine. I was an MD/PhD student, and I could easily find myself zooming out into thoughts about the research on race and bias, and everything that we as a profession could do to change things. But when you’re actually doing medicine, you always return to the particular body; every afternoon, I returned to Damien’s room. You can say that the medical system has problems, but then there is the actual pus oozing out of the bottom of this particular wound. And this particular young man, whom I found myself caring about, was actually losing his foot.

We did the surgery late that first night. I brought my size-six nonlatex surgical gloves to the scrub tech, then washed my hands and scrubbed under my nails. I got to the operating room before the rest of the team, and talked with Damien while the anesthesiologists put him under. There was a black line marked on his foot where we were going to cut. “This drug is for pain. This one’s going to make you sleepy. Are you ready? Okay, count backward from ten . . .”

Once he was asleep, we swung into action. We painted his foot with dark-red Betadine and got the overhead lights shining right on it. The senior resident began to cut, while the attending physician observed and I ran a little tube sucking up blood and stray bits of bone. It went quickly. The sick bone crumbled, and we cut away infected tissue until all we could see was healthy looking. We managed to leave his two smallest toes and most of the foot, rinsing the wound thoroughly with sterile water.

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