EIGHT
Antibiotics
Amputating a man’s arm is a gut-wrenching and shocking act. Regardless
of the clinical justification and no matter the years of practice, severing a
limb from a body requires stubborn resolve and intense personal
subordination. Perhaps some surgeons grow callous to cutting off a limb—
I never have.
I am a surgical intern at Pennsylvania State University and all I want is
a couple hours sleep. I figure, if I can lie down now, I’ll instantly fall
asleep, and will get enough shut-eye before 4:00 A.M. to last me through
another day of grunt work. But on this winter night, just as my body
twitches and shocks itself to slumber, my pager vibrates me to reality. Like
all surgical interns, I am taking call while “in-house,” staying in the
hospital all night fielding phone calls from the Emergency Room, the
hospital floor nurses, and outside patients.
In the darkness, I fumble for my little black Motorola pager on the
nightstand next to my head. Checking the four-number code, I dazedly
recognize “6550” as one of the extension numbers to the Medical
Intermediate Care Unit. We don’t get many calls to that number, and I hope
that I have been paged incorrectly. Without turning on the lights, I prop up
on my left elbow and punch the number on the institutional green AT&T
office phone.
A nurse answers my call, informing me of an urgent surgical consult on
a seventy-eight-year-old man with elbow pain. She explains that he had
been admitted hours before with heart attack–like symptoms, but that all
preliminary tests were ruling out an MI (myocardial infarction, or heart
attack). Oftentimes an MI patient complains of crushing chest pain, with
associated left arm or jaw pain; alert ER personnel hear these complaints
and immediately begin testing the patient for a “cardiac event.” Although