Monday, May 21, 2018

vintage scutmonkey: doctor id

This is a rare bird indeed, in that it is the one Scutmonkey comic that I never disseminated widely. I in fact never completed this strip. This string of panels originally ran with the tag line, "To Be Continued..." but I never followed it up, because...I don't know. I think it just never felt very funny to me. Don't get me wrong, for someone who has worked in the Peds ER, there is a decent dose of acerbic humor in there, but on the whole, when taken with the other comics I wrote, it felt...kind of darkly bitter. A little too much dark, and a little too much bitter.

In retrospect--and I don't think I needed that much distance from that time to realize this, I think I even realized it at the time--there was a point in my first year of Peds residency when I was likely borderline clinically depressed. It was circumstantial depression, certainly--I think many of us were at the time--but nonetheless it was a period of my life that both imprinted deeply and which I don't remember well. Day blended into night, one rotation blended into the next, there was very little time, very little spontaneity, very few genuine sparks of joy that I can recall. This had very little to do with my residency program per se (to this day I have nothing but good things to say about my Pediatrics residency, which turned out some of the finest doctors I know), but had everything to do with the nature of residency itself, which somehow, despite all best intentions, tends to bleed the humanity out of the young people training to take care of human beings at their most needy and vulnerable. It's quite a paradox, when you think about it.

So despite the fact that I cringe a bit reading this now, remember the place I was in when I wrote this, I'll republish this nubbin of a comic from the archives anyway. But I will also link these two things.

One is this older blog entry I wrote seven years ago, entitled, "It Gets Better."

The lowest point in my residency was in January of my intern year. I was a Pediatrics resident back then, doing a month-long rotation on "Team 2," which is what we called the general inpatient pediatric team, with a focus on the patients on our liver transplant service. 
It was a very long month.

I'd get to work at around 5:45 every morning to pre-round, and invariably leave after dark every night--not difficult, considering that, in January, it seemed like it started to get dark around 3:30pm every day. I was there much later than that, of course--most nights I'd leave around 7:00pm, unless I was on call, in which case I'd leave at around 10:00am the following morning. We'd have pre-rounds and then rounds, then attending rounds and work rounds, followed by teaching rounds and radiology rounds, with time at the end of the day for sign-out rounds. Twice a week we'd have Grand Rounds and Chief of Service Rounds. How we ever got anything done with all this rounding, I'll never know. How I ever got to spend time with any patients in between all these rounds is even more of a mystery. It just felt like a day of endless, endless scut. Losing the forest for the trees. It would be a day full of writing down numbers and pagers beeping and phone calls and faxes and entering computer orders, and not nearly enough time practicing medicine or spending time with patients. And then I'd go home and collapse and wake up at 4:15 the next morning to go in and do it all again... 
And let's get this straight. I liked residency. Really, I did. Yes, it was hard, and yes, I was tired basically all the time, but I expected that, and now that it's over, most of my memories are affectionate. Residency, like medical school, was full of stories, and many of them, in retrospect, are funny--not at the expense of patients, but at my own expense, because Lord, how serious and inexperienced and bumblingly well-intentioned I was! But that first January of my intern year, I was very close to being clinically depressed. It just all felt so grim and featureless and endless, and I felt more and more like I was just some kind of task-programmed automaton, not like the doctor that I thought I was supposed to be at this point.

I wanted to quit. Not just quit being a Pediatrics resident, but quit medicine altogether. I was unhappy. I didn't like my life. I wanted to be done. I know that this comic was intended to be a joke, but there were time, real times, when I passed by a Gap or a Starbucks or whatever, saw that they were hiring, and seriously considered stopping by to fill out an application. At least they don't make you take call at The Gap, folding chambray button-down shirts at 2:00am. 
Now I'm going to tell you a secret. Everyone who has been through a residency has felt this way at some point. Everyone
Maybe you're feeling this way right now. So here's another secret. There's more to life than this. Even though it feels like residency is your life, it's not. There's more to life. There's more to you. And it gets better.

It gets better.

The second thing I would like to say is this. I am not a great person, and I know this. The people who work in the Peds ER are...incredible. Phenomenal. Superhuman. It is one of the rotations during my residency--both residencies--where I learned the most, and one of the rotations from which I have retained the most indelible memories. There's a chapter from my book, and though this is one of the less sensational excerpts (you would have never centered an episode of ER around it, for example), it's still the one that sticks with me the most.

...[T]here are some subtle changes of the twenty-four hour cycle that, to the experienced eye, can give some clue as to what time of day it is, but otherwise, days and nights in the ER are all pretty much the same, a constant stream of low-grade urgencies punctuated by the occasional heart-stopping emergency. 
In fact, the only event that allows me to reliably tell time in the ER is the 3:00 a.m. sandwich drop, wherein a cafĂ© across the street, just prior to receiving their bakery-fresh goods for the morning, drops off heaping mounds of day-olds for the patients and staff of the Peds ER to pick through. Walk through the Peds ER at three thirty in the morning and you will find leftover yogurt cups lined with soggy scrims of granola, see patient attacking chicken salad wraps, and watch ward clerks turn away from their work stations to deal with a mouthful of cheese danish. "Try the turkey sandwich," the attending urges a floridly tattooed teenager with the air of insider knowledge, "the bread is really good." 
At these times, the ER feels like it could be anyplace where unlikely company is trapped together for an interminable wait. The DMV, the passport office, an airport terminal after all outgoing flights have been canceled due to a storm.

Anyway. Dr. Id. We don't often immortalize the worse of ourselves in amber, but it's still important to remember that there was a time when that person was there. Is still there at times. And to remember the small moments of happiness and good humor, no matter how inconsequential. And to know that it gets better. To know that you get better too.

It gets better, and you get better too.

Tuesday, May 15, 2018

vintage scutmonkey: OB-Gyn

Belatedly in honor of Mother's Day and peri-maternal services (cervixes?), another visit in the wayback machine. Happy Tuesday, and may all your splash-proof booties be knee-high.

Saturday, May 12, 2018

vintage scutmonkey: surgery

So starting in 2000, and for more than a decade thereafter, I used to have part of my blog hosted on a platform called Homestead. (The fuck, you say? Shut up, it was the early 2000s, we didn't have nice things back then.) Homestead was clunky and hard to navigate and ugly as sin, and they also charged me upwards of $400 a year in annual hosting fees. As a resident I paid this. I mean, my God. Every July they would extort me remind me to cough up this renewal fee, and every July I would put off the payment as late as possible until they threatened to wipe all my data, at which point I'd pay and they'd keep my files online for another year. Anyway, one summer, many years ago, I just decided not to renew, they made good with their promise, and anyway, that's why the oldest strata of archives on this seventeen year-old blog have been fittingly lost in the ether. (That's an anesthesia joke for you. Not a good one, I admit, but...there really aren't that many great anesthesia jokes.)

Anyway, I do mourn the loss of those first three years of archives (as much for their Web 1.0-tackiness as for the content itself), but one thing that I didn't count on happening was that I would lose the scans of the first three long-form Scutmonkey comics I ever made, about three third-year clinical rotations I did in medical school: Psych, OB-Gyn, and Surgery. I am certain that the original hard copies remain somewhere in my possession, but I've moved 5 different times since then, and whatever logical location they once were stored is unclear. (I had also scanned them at some point, but, again, that was five hard drives and fifteen years ago--not every file has migrated intact.) So while I somewhat regret the archival loss of proto-me in medical school (only somewhat because let's be real--between the ages of 21 and 24, I was even stupider than I am now), what I really regret is the loss of the cached images of those first three long-form Scutmonkey comics.

I'm going to continue to look for the original hard copies, as I'm certain that they are merely displaced, though hopefully not irrevocably. But in my search, I did find something close--the two remaining copies of the handmade booklets I made and sold of the Scutmonkey comics, optimistically named "Issue #1" of the series. In truth it was the only issue I ever made. I wrote a dozen more comics in various forms for Scutmonkey, but that scan and Xerox, cardstock and staple zine-form of publication was on its way out, if it hadn't already become well extinct even before I cranked out "Issue #1." But in this form, the three original long-form Scutmonkey comics still exist.

Here's the last one of those, entitled (rather straightforwardly): Surgery. The images below are janky, because they are very "your mom texting you a photo of a photo," but I'm doing this quick and dirty, and it gets the point across. Forgive the slight image bleed-through, it was printed on cheap paper, both because I myself was cheap, but because the booklet had to be thin enough to be stapled through. (#thepast)

Mack, looking through this comic book earlier today, asked, a little puzzled: "Is this, like, supposed to be...for humor?" I don't know, son. I really don't know.

May all your dressings remain clean, dry, and intact. I'll post the Ob-Gyn comic once I summon the will to rotate and crop all those photos of photos too.

EDITED TO ADD: Thanks to Daisy Porter in the comments, I have found cached copies of the super old archives and extracted clean images from the Wayback Machine, thus enabling me to un-jank these images. Thanks, Daisy!