Page 36 of Dr. Intern

I was only just paged to OR3 and had to scrub properly before entering the room, but I don’t say that. He’s just trying to be a dick.

“What do we have?” I ask, turning to allow the nurse to put my gown on.

Normally there’s a little bit of time to prep before a case and I don’t have to walk in completely blind. As someone who’s used to planning out everything I do, it makes me uncomfortable feeling unprepared, but sometimes that’s the nature of the job.

“Thirty-year-old male,” the scrub nurse reads from a clipboard with practiced calm. “Paraplegic for five years. Cut his right foot on a rock at the lake this weekend, and presented to the ED with a t-max of 104 this morning. Bacterial swab positive for necrotizing fasciitis.”

“Hell yeah,” I mutter as I position myself across the table from my chief resident.

Necrotizing fasciitis, also known as flesh-eating bacteria, is incredibly rare to see, especially in a city hospital. If it’s not detected and treated quickly, it can cause significantly high mortality rates in patients.

Looking down at the limb, I note how swelling and redness have taken over the whole foot. The chance that our patient keeps anything below the knee is probably pretty slim, but we won’t know how extensive the damage is until we get in there. Sometimes we have to take more than necessary to ensure the infection is gone and we don’t have to do a repeat surgery.

“What’s the plan, Dr. Chastain?” I ask, feeling my heart start to race with excitement. I likely won’t see this again in my surgical career, and I feel grateful that he brought me in on this case rather than another intern.

“I was going to ask you that,” Walker says, watching me carefully.

Okay, remain calm. You know this shit.

I take a deep breath and spout out my plan.

“It’s systemic at this point, so we can’t just debride the wound. We need to remove the limb above the ankle, and then assess the area of involvement once it’s open to determine if we got enough. Post-op we’ll consult infectious disease to manage antibiotic therapy.”

“Bingo,” Walker nods with approval. “Let’s get it done, Buffington. You’re running the show today.”

Though the mask hides it, my grin is huge as the scrub tech hands me the blade to make the first incision.

Other specialties always rag on orthopedic surgeons for being idiots with power tools, and I totally get it—it’s easy to make fun of something from the outside without knowing what it takes to do our job. From their perspective, they see a male-dominated field, filled with bros who like to listen to heavy metal while sawing off necrotic toes.

And yeah, orthopedic surgery can be all of those things. There are days when it’s fun as hell, and we pound our hammers into hips until the sun goes down, but it’s also incredibly complex and challenging.

Orthopedics requires you to think mechanically about each patient’s life outside of the hospital. I have to consider how they go about their days, what’s important to them, and how I can minimize the impact of their injury. If I compromise even a few degrees of motion to someone’s shoulder, they might not ever be able to comfortably dress themselves again.

Our patients put a lot of trust in us. Sometimes, it’s scary as fuck because I still feel like a kid most of the time, and one minor mistake has bigger implications than just a bad grade in med school.

But it’s also exhilarating.

There’s no other high like it.

By the time the case finishes and we speak to the family, it’s well into the afternoon. I was going to scrub in on a septic joint washout with Dr. Franklin, but Walker suggested I catch up on charting before heading out. I’ve got ten open notes that need to be completed from follow-up visits and procedures today. It might not sound like a lot of work, but when your chief resident starts breathing down your neck about the formatting of a current medication list, it’s better to do things right the first time.

As I walk into the empty ortho lounge, I pull out my phone to check my blood sugar, feeling thankful that my numbers have recovered. That case was longer than I anticipated and toward the end, I started feeling a little shaky and lightheaded. Fortunately, I tossed back a few handfuls of Skittles after we closed up and immediately started feeling better. I can handle the shakes as long as I don’t pass out on the operating table.

Sinking into the uncomfortable desk chair, I pop on some tunes and give in to the tedious task ahead of me. Truthfully, charting has got to be the worst part of a physician’s job—it’s repetitive and mind-numbing. I understand why we have to do it, but squinting at a computer screen for hours on end was never high on the list of reasons I wanted to become a doctor. Nor was the daily dose of getting chewed out, but that’s beside the point. At least the berating will taper off after five years. These notes, however, will haunt me for my entire career.

The door opens just as I’m finishing up, the raspy voice of Hinder’s “Lips of an Angel” echoing through the cramped room.

I know—I’m a walking, talking stereotype.

“Hey,” Walker greets me as he falls on top of the bed in the corner of the room.

His massive feet hang off the edge of the frame, and he makes no effort to move them as he drapes his tattoo-covered arm over his eyes. The man has a couple of inches on me and a much leaner build, almost like a swimmer. Honestly, at one point I think he told me he did swim in college, but everything in the past few months has been a blur, so it’s hard to keep non-medical details straight.

I pause the song. “How’s it going?”

He grunts, not opening his eyes. “Horrible.”

Walker is the most literal person I’ve ever met. He’s not one to beat around the bush or make a play on words. He says what he means, and he means what he says. And I love him for that.

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