It has been so long, very long ago that it happened. The Wracks remembers and the image floods into memory and the realization that hindsight is 20-20 but the lessons learned in a brief moment last for a lifetime, even if unused.
The Wracks is glad to get out of surgery. The pace and work are demanding, call it every third day and people cry out for sedatives in the middle of the night. Anesthesiologists ask the surgical residents to not administer neuroactive sedatives to their patients before surgery because they might stop breathing during the procedure. The patients cry out in the middle of the night, they know they might die and they want to be sedated while it happens. In Ob-Gyn, women go into labor at inopportune times as dictated by the maker so the staff must always be there and awake to bring new life to the earth
I am glad I am out of surgery says Dr. Wracks. I cannot take the stress. All I wanted to do was hand out antibiotics and treat venereal infections in a beach consultation, but I ended up removing organs, doing cancer ablation techniques, and putting people back together who had been broken in car accidents.
You are in internal Medicine now says Dr. Q. Remember to keep your mouth shut.
The people in the ward in medicine are mostly well-to-do elderly gentlemen who have stressful high-power existences and have high blood pressure and or a stroke. They lay in beds, propped up, with the TV on and an I.V. bag drips a clear solution of heparin into their arms around the clock. Heparin is an ideal anticoagulant because overdosage is nearly impossible. Coumarin causes severe bleeding and none of the patients like it. Dr. Wracks sits in the nurse’s unit with a warm cup of tea, a teaspoon of sugar, and a smile on his face. His real education will soon begin
The Italian is a small man about five feet six inches tall who dresses impeccably. His grey suits must cost at least five hundred dollars apiece and everyone knows he is the best at what he does. These intangibles make him famous. His eyes are like laser beams and they burn through your very soul and he decided to keep Dr. Wracks alive.
Look at the charts he says as Dr. Wracks sits in white, hygienic luxury, in a chair, somewhere, in a nurse’s station. His right hand pulls a three-by-five flash card from his coat pocket and it says stenciled in black Sharpie marker
Atropine.
This is a busy man, a rich man, and he is gone. He has better things to do than nurse Dr. Wracks.
Another day in internal medicine and he is there again and he points to Dr. Wracks, and puts a patient chart on the desk and points to it and his left hand pulls a flash card from his wallet pocket in his coat and it says:
Strychnine
A hand flashes up into the air, and he makes one gesture with his index finger, turns, and is gone. All the patients on heparin smile, and Dr. Wracks has another day in Medicine, taking blood pressures and looking at coagulation parameters.
About a week elapses and he strides into Medicine in a new expensive pinstripe suit like Don Corleone used to wear in the Movie, “The Godfather.” A chart in his hand, he sets it in front of Dr. Wracks, taps it and his right hand pulls a three-by-five flashcard from his lapel pocket and in black stenciled sharpie letters it says:
Arsenic
After looking at all his patients he vanishes again like a whirlwind and Dr. Wracks never saw him again. Dr. Wracks sees an elderly man with white hair looking at him in the distance it is Harvard, and he doesn’t realize what is happening now, then, or in the future. Most acute hospital admissions are poisonings. Dr. Clancy finds him.
We need you back in surgery. You are on the board.
Surgery is too much for me says Dr. Wracks, I can’t take the pace.
You either come back to surgery or we are sending you back to Mexico. Do you understand me, says Dr. Clancy.
Yes, I do says Dr. Wracks
I will see you tomorrow at seven AM for rounds on surg floor., He strides away
Internal medicine is a vacation, the ICU is a vacation, taking blood gases and watching the heart monitors around the clock. If you are in the ICU the attending watches the heart monitor., Heart drugs are toxic and a physician watch for dropped p waves, QRS asynchrony, and inverted T waves.
Dr. Wracks is not a doctor anymore like he was in New York State. The brain needs time to process the information and data fed to it and it wasn’t for a while that the Wracks understood. He finally understood. The world is a world of people and people do crazy things all for the smell of olfactory money. The only thing the devil can’t give you is love. Love is all-powerful and a gift of God and the Wracks hope he gets a second chance. He goes to church now, sits in the back, and prays for better things. The Italian had a son and I hear he is good, hopefully as good as his dad. Summer is in bloom everything is green and the cycle renews, and the tomatoes are growing well. All in all, in the twenty-first century.