It always started with a bloody racket.
From the moment the ambulance driver took the turn, at the bottom of the narrow road, the wailing crept closer, tearing the night apart. Up, up toward the hospital, the much-abused VW-van labored. The hedges, lining the winding strip of road, absorbed very little of the noise. The traffic authorities thought it wise to install speed humps every fifteen meters. It is still a mystery how the excursion affected the patients inside this speeding van—it would slow down, bump across the hump, then speed up again, bump across the next and continue bouncing its way to the emergency room entrance.
A nine-inch brick wall separated my doctor’s apartment’s bedroom from that road, which was the only vehicular access to the ER. Ripped from sleep’s embrace, I would listen, in the now quiet night, to the drivers offloading their human cargo. They took their time with this endeavor, sufficient for me, to slumber in again. The saving grace of their return-journey down the speed-hump-rich road was: the siren was muted. But now, the driver vented his frustration, for being on duty at that unchristian time of the night, on each and every swell in his path.
I resided in that apartment the entire twelve months of my intern year. Thus was born my ability of selective hearing.
It was a small provincial hospital: the medical staff consisted of us six interns, three medical officers and the superintendent, with access to private practice specialists.
From day one, it became like long-distance open-water swimming. Exciting. Challenging. Intimidating. Exhausting. We had to learn to swim, to tread water, to float, to not drown. The six of us would rotate, on a two-monthly basis, through the main disciplines. One of which was, running the emergency room as a solo-physician. Indeed, as interns. The belief was it gave us hair on our chests.
Knowing the theory of the signs and symptoms of a stab-wound in the heart is one thing. It is an entirely different narrative to encounter one in real-life for the very first time. Once I realized that the young adolescent, with the tiny puncture holes in his chest, wasn’t being obnoxious, but fighting for breath and for his life, the surgeon was alerted and the injured rushed to the operating room—in time to save his life.
As the year progressed and the strain of being on call 6 night out of seven, for 8 months straight, took its toll on us. The other 4 months we did one night on, one night off. The ER call remained the most dreaded of all. What pulled us through, though, was the camaraderie. It became the unwritten rule, especially over weekend evenings, when we had a social gathering, that everyone would chip in, and quickly go and clear the ER from patients, see everybody, treat them and return to the barbecue, only to repeat it two hours later.
There was often so much blood and mayhem in the ER, that we, after time, got rid of our pristine white coats—usually during after-hours and on weekends. It was impossible to keep them white for more than an hour. And, it being in South Africa, made it unbearably hot to wear long-sleeve overcoats.
I would be busy treating a person with a severe asthma attack, putting up an intravenous and nebulizing medication to break the cycle of the bronchospasm, when the next moment, our friendly ambulance-team dropped off a mother with an eleven-month old with bacterial meningitis. The baby, having fever-induced seizures, required immediate attention.
That did not include the fifteen patients already waiting to see me, who kept being bumped to the back of the line. And, then, while I was busy performing the lumbar puncture on the infant, the ER outer-doors swung open again, like the bar-doors of an old Wild West saloon. In barged the ambulance-team with their next catch of the day: a bleeding patient. One of them would announce triumphantly, “Doctor, this man was stabbed in the stomach!”
Hallelujah! We had just received our guarantee: that day too, would not be boring.
I would finish up with the baby, wash hands and go drag the stabbed victim from the clutches of death. My clothes, soon enough, was smeared with fresh blood. The single ceiling-fan lost the battle against the humid air hours ago. The white coats simply had to go.
If things really became chaotic at night, we had the candidness to phone one of our colleagues to come and assist us for a short while, to perform some emotional life-support.
As we became more seasoned, especially if we were called back to the ER in the early morning hours, after things had quieted down, we would return with only a short-sleeve shirt, running shorts, sandals and our stethoscope around the neck.
One such night—it had been a particularly rough stretch—one of the family-members of a wounded patient, both partially inebriated, stood watching my antics. I carried a patient from one stretcher to another, because the orderly didn’t show up in time to assist me with the transfer.
The man threw his head back, and with hands on his hips, said, “But you don’t look like a doctor, man!”
Too exhausted to say anything, I simply rolled my eyes at him, continuing with positioning the patient.
He wasn’t done and stumbled closer, breathing his wine-vapor over me. He gestured up and down my person, pushing the air in front of him.
“Those are not doctor’s clothes you’re wearing!”
I found my voice. “Oh, yeah?”
He spun around and mumbled, “Yes … You look like shit, man!”
He passed out and fell headlong, onto the wooden bench among his buddies. They laughed at the public display of their friend’s bravery.
Only then did I realize, I felt exactly the way he said I looked like, and I had long lost sight of the white coat’s magic.