Telegram from Another Planet

Dear Mom and Dad,

I'm sorry it's taken me so long to answer your last letter. I am in survival mode. I work from 6 a.m. until 7 p.m. every day of the week except Sunday, and I have all-night call every third night. If I sleep on call nights, it is for two hours on the floor of the surgery floor conference room. If call night falls on a Sunday, I work all of Sunday, too. I am on the Trauma Team, and I have lost count of the number of young men I have watched die in the last three weeks. At first I kept track of them: the seventeen year old who jumped off a cliff, the drug dealer shot through the heart, the twenty-three year old who wrapped his sports car around a tree and had a love letter on a wrinkled piece of notebook paper in his pocket, the unhelmeted motorcyclist who left his brain on the sidewalk. Now they are starting to blend into one archetypal young man with a handsome face and beautiful broken body; a crushed skull and an opened chest; tubes in his mouth, nose, groin, arms, and sides; and a bracelet around his ankle that reads, “Unidentified Black Male/ 900 27 48.”

In the operating room, I see the face of God. The opalescent lights, the beeping of all the monitors, and the glint of the instruments put me into a trance. The glory of creation in the pulsing of blood vessels and the pattern of sinews brings on a feeling like ecstasy. I run home and scrawl with lipstick on my bathroom mirror: “I LOVE SURGERY!!!!” My closest friend on the service will barely speak to me anymore because, he says, I act like a jock. “I like the other Jan,” he says. There is no other Jan. This is just Jan adapting to the current situation. I feel as though I am being flayed alive of all the soft appurtenances of civilized humanity, and what is left is lean and strong and hard with a dull shine like gun-metal. This is Jan who rowed lightweight for Radcliffe crew and trained cross-country so hard she stress-fractured her fibula at seventeen. This is Jan who rode a motorcycle in the Peace Corps, carried dead babies back to their mothers, knelt in pools of blood on the highway, went without food for three days, and swam to the island in the bay. I laugh loudly at coarse jokes about the two suicide attempts we operated on earlier this week. One guy washed down twenty-five Demerol with a cup each of Clorox and ammonia; when this modern version of a hemlock cocktail failed to kill him, he stabbed himself several times in the chest, then slashed his throat. My chief resident ligated his jugular veins and let me staple his neck back together. His head is held on with staples; he looks like an inner-city Frankenstein. The other guy stabbed himself in the belly. He refused to cooperate with anyone in the ER and was generally such a pain that, though his peritoneal lavage was equivocally normal, the residents did an exploratory laparotomy on him just to shut him up and teach him a lesson. We put the would-be suicides in the same room on the surgery floor so they could compare notes about methods for next time.

I have reverted to a creature of the jungle. I forage among the trays of food left by patients for cellophane-wrapped slices of bread, pints of milk and orange juice, Graham crackers, packets of saltines, and little trays of peanut butter and jelly. I eat at 3 a.m. on the elevator from the sixth floor to the emergency room if it's a modified trauma; if it's a major trauma I run down the stairs while gulping down a carton of milk. In this way I keep all of my 125 pounds on my frame, while my friend on the service has lost weight standing through eight-hour surgeries and missing meals. I find corners in which to sleep between emergencies and surgeries; ten minutes, twenty minutes, an hour, before my beeper or my watch goes off. I steal pillows from empty patient rooms to make my bed on the floor; I lift blankets from laundry carts and pinch tiny toothpaste tubes from supply cabinets. I have labs to look up and patients to examine and charts to write in before 7 a.m. rounds. I ignore the man on the stretcher behind me addressing me as “Nurse” and asking for a cup of water. In hell, I would dip my finger in the water to wet the lips of Lazarus in torment, but in the hospital I am much too busy.

The other day I fainted in the OR. I've never fainted before in my life. It was quite an experience. It was not from being grossed out by anything…I have an unbelievably high gross-out threshold. In fact, the only thing I can think of that grossed me out in recent memory is when a guy I knew named Peter had a girlfriend who had his baby, and afterward Peter fried up the placenta with onions and tried to get his girlfriend to eat it with him: “For the vitamins.” The morning I fainted I was merely watching a routine hernia repair, of which I'd already seen several. It was not disgust, but exhaustion and terror that caused me to go pale and clammy. The surgeon was an extremely talented teacher who strove mightily to overcome his natural antipathy toward women. That day he was failing. He was “pimping” me, asking me questions, and I didn't seem to have any of the right answers. Everything I did was wrong, and he was calling me “Sister” in that special tone that men like him reserve for people without Y chromosomes, when I just said, “Doctor M., I feel ill,” handed him my retractor, stepped back against the wall, and slid gently to the floor. I never actually lost consciousness, but let us say that consciousness was briefly and radically altered. I couldn't keep my eyes open, and though I could hear the voices of the surgeons and nurses, it was like listening from the bottom of a well. I knew that the “she” they were mentioning must be me, but I didn't quite identify with whomever they were talking about. I was loaded onto a stretcher by the anesthesiologists and wheeled down the hall to a holding area, where I took advantage of my first opportunity to lie still with my eyes closed in something like thirty hours. Fifteen minutes later I was back in the OR, but I wasn't allowed to scrub in…“Why don't you just watch for a while….” Guess I'm just not The Right Stuff.

This is why I have not had time to write. This is why, when I tell you that I miss you, that I send you my love, that I am happy for Johnny and Heidi expecting their baby, and that I am glad for David and Maggie and congratulate them on their engagement, I feel as though I am sending you a telegram from another planet.

Love,

Jan

Jan Steckel

Yale University

School of Medicine

Class of 1994