This is the story of how I grew up to become an orthopedic surgeon. This is also the story of things I wish every doctor would keep in mind, including myself, as well as the lessons I’ve learned along the way.
— Laura Krivicich, University of Illinois College of Medicine Chicago, Class of 2022
Part 1: The Yellow Monster
My mother was hit by a car five days before my fifth birthday. I was young, but I remember a few things clearly.
I remember my dad telling me he did not know if she would be coming home. I remember tears running down the cheeks of one of my big brothers, and knew this meant I should be sad, too.
I remember being scared of the yellow monster I met the first time we went to visit her in the hospital; I did not believe that the iodine paint-covered, plaster-wrapped thing that could not say my name was my mom. I remember backing out of the room, crying, breaking her heart.
I remember jumping on my parents’ bed, in my favorite white turtleneck, dotted with tiny, multi-colored stars in perfect diagonal rows, when my Aunt came in to give me the birthday presents my mom had left for me. I remember not understanding why she wasn’t there herself.
I remember our priest hoisting me up into her bed; he handed me the remote, and I felt powerful. I was distracted enough by this new-found control — something so rarely endowed upon a youngest child with two older brothers — that I thought only briefly about the bed pan, and how funny a place to live this hospital was.
I remember not understanding why she had to use a wheelchair, but bypassing this confusion in favor of fascination over the indoor playground full of colorful balls and bands that was inpatient physical therapy. I remember the man with no legs, who saw me stare, smiled at me, and told me that he, too, would be learning to walk again.
I remember when she came home after more than a month away, the hospital bed setup in our living room, the wheelchair that my brothers and I dubbed our personal entertainment system. I remember pulling her socks off for her in the evenings, and putting our mother to bed each night.
What I remember most — when my mom could not run alongside me or get down on the floor to play with me in the years that followed because, she said, all the metal in her bones made those things hard for her — was being angry that the doctors didn’t do a good enough job putting my mama back together.
Part 2: The Cardinal
My mother hated the residents.
They ordered the wrong films, so
she endured twice the pain
of moving onto the film board,
and moving off.
An order re-entry, a smack of the hand,
a moment of embarrassment for the resident.
An hour of agony, for mom.
Once, they forgot to renew her pain medication orders.
The attending told her one thing on rounds,
the resident said another.
So overnight, she was left to suffer.
In a perfect storm, her nurse was floating –
knew nothing of orthopedic patients —
knew not how to turn them,
knew not what their pain looked like.
Knew nothing of her.
So, when my mother screamed,
and begged for her medications,
the nurse waited, and waited.
drug-seeking, she thought.
The residents, too, knew nothing of her.
Knew not of her goals,
knew not of her pain,
knew not to consider
the accident was the worst day of her life.
We were told she had a good outcome.
Months of physical therapy to climb a stair.
A good outcome.
Could get down on the ground, but couldn’t get up again. A good outcome.
Twenty years later, can walk at a brisk pace, but never run. A good outcome.
Never a single mention,
of someone telling her
I’m sorry this happened to you.
My mother was right to hate the residents.
Part 3: White Coat
“Trauma is nice because the patient already has a terrible outcome, so if you make it any better, you’ve done a good job.”
Two decades of being frustrated by a ‘good outcome’ was not enough to soften the blow.
Who works so hard, trains for years, to set the bar so low.
Is this what it means to have a good outcome?
Is a medical student naïve to think a patient should hope for more?
To demand more?
Twenty consults a night, multiple polytraumas.
Screaming comes from every direction.
‘Internal amputation’ added to the vocabulary.
Every time a resident walks in the room,
they plan to make the pain worse, first.
One resident runs around.
Two hands, no more, responsible for
every broken bone in the hospital.
Drugs, and more drugs,
An airway team on standby.
All the drugs in the world are not enough.
The screaming hardly dulls.
The comforting words go unheard.
The resident will always be the bad guy.
Part 4: Pressed Suit
Say it first, before it gets worse:
I’m sorry to meet you like this.
I realize this is too much to take in.
Please, tell me what happened.
The privilege of growing old,
with adventures yet untold,
is much preferred to the alternative.
What are your goals? Where are the holes?
Let’s come up with a plan together.
Take my hand.
I’ll do what I can,
and always push for better.