The Devil Wears Scrubs (Dr. Jane McGill, #1)

by Freida McFadden

Most of what I’ve got in my room is books. Like, a million of them. I’m not a hoarder, but it would be accurate to say I’ve saved pretty much every medical book I’ve ever bought. Even the ones in fields I didn’t go into like OB/GYN or Surgery. Because they’re books. How can you get rid of a book? That’s like throwing away knowledge.

Connie is what they call a preliminary intern, which means that, unlike me, she’ll only be doing a year of internal medicine. After that, she’s going to do a residency in dermatology, which is one of the most competitive residencies in the country. For the moment, I’ll withhold my opinion of interns who are planning to do dermatology. You know how they say if you can’t say something positive, don’t say it at all? Yeah.

My first patient is a 63-year-old woman named Mary Coughlin. Mrs. Coughlin was admitted to the hospital with a kidney infection, but in the course of her work-up, we have discovered a mass in her pancreas. The mass could be benign—meaning, completely harmless. Or it could be pancreatic cancer, which is Really Bad. Mrs. Coughlin is supposed to be very nice. So it’s probably cancer.

“I’m Dr. McGill,” I say. It’s the very first time I’ve referred to myself as a doctor. It feels so weird. My tongue can’t seem to wrap itself around the words. I almost expect everyone to start snickering at me behind their hands that I just pretended I was really a doctor.

It is now creeping past 1:30 p.m. There are two things I have not done since I arrived at the hospital this morning: Eaten Used the bathroom Alyssa and I are seeing a new hospital admission and I’m beginning to lose hope that I will ever escape from her long enough to perform either of these bodily functions.

Does becoming a doctor mean I’ve given up my right to pee? I’m scared it has. Note to self: Drink less coffee tomorrow morning. My stomach lets out this super-human growl while I’m bending over my new patient to examine his abdomen. Super embarrassing. The patient raises his eyebrows at me. “Was that you?” “Just a little hungry,” I say with a strangled laugh.

“Never tell a patient that you’re hungry,” she says. “Why not?” I can’t help but ask. Alyssa blinks at me, as if stunned I had the nerve to question her words of wisdom. “It’s unprofessional. Even a medical student should know that.”

I race down to the second floor to the cafeteria, making a brief pit stop to relieve my bladder. (Which feels glorious, by the way.) Then I head down to the cafeteria to eat the fastest lunch in the history of the world.

Hospital cafeterias are divided into two categories: Awful and Not-That-Awful. I have a bad feeling ours falls into the former category.

I strongly suspect that these sandwiches are older than my medical school diploma, but I’m too hungry to care. I grab a random sandwich without even looking to see what’s in it (chicken, I think) and a bottle of soda. I get in line, cursing the old man ahead of me, who is one of those guys who has to have a big conversation with the cashier. Something about his granddaughter and/or his prostate.

He opens up the package of beef jerky he’d purchased and sticks one in his mouth. “Is that your lunch?” I ask, incredulous. “Oh, I don’t eat lunch,” he says, as if I’d suggested something crazy. “Surgeons are the camels of the hospital. I’m fine with one meal per day.”

I hate tofu—really hate it. There’s nothing intrinsically bad about it, but I just feel like I’ve been fooled by it too many times. There’s nothing worse than thinking you’re eating a piece of chicken and mid-chew realizing that it’s actually tofu.

I laugh with Kali and it’s the first time I’ve laughed all day. It feels nice, actually. I have a feeling it might be the last.

Dr. Westin is the attending physician in charge of our team. In teaching hospitals, the hierarchy is that the senior residents are responsible for interns, and the attending is the old guy in charge of the whole team.

The attending is a little like God: He knows all. He is never wrong. There’s only one of him. When he says to do something, it is done. If you screw up, he will unleash his wrath.

In normal human society, a man might have offered to give up his seat for one of three young ladies. But not an attending. I mean, you can’t expect God to stand up and give you his seat, can you? That would be crazy. If there’s ever a seat available, there exists a very clear hierarchy of who may sit.

First, the attending gets to sit. Then if there’s another seat, the senior resident can sit. Then if there’s another seat, someone can put their purse there. Then if there’s another seat, a homeless drug addict who wandered into the building can sit there. But after the attending, the resident, the purse, and the homeless guy are all settled, any available seats are all mine.

Mr. Garrison is on a jillion medications. I realize that a jillion isn’t a real number, but I really think a new number needs to be created to express the sheer number of medications this man is taking. I copied over the list in my pristine handwriting this morning and it covers two pages, which I hand over to Dr. Westin.

I am on call tonight. Call is this horrible thing that happens to you when you’re a doctor. It essentially means that if there’s an issue with one of the patients, the nurses can “call” you. All night long, baby. In my residency program, interns are on call q4. What does that mean? Well, in medicine, “q” means “every” (it’s probably a Latin thing) and “4” means “4”.

Put it all together and this means that I’m on call every four nights. Every four nights, I get to spend the entire night at the hospital answering questions about patients and admitting sick people.

Overnight calls in our hospital last 30 hours. Alyssa has told me to come no earlier than 7:30 a.m., so that I can stay until 1:30 p.m. tomorrow. County Hospital is very strict about us sticking to the 30-hour rule, because the hospital could get slapped with a big fine if we stay in the hospital longer than 30 hours. Along the line, someone discovered that tired residents perform at roughly the same level of competency as drunk people, so now there’s something called the Bell Commission, which ensures there aren’t a bunch of drunk people caring for patients.

In case you’re interested in the history of the Bell Commission, it all dates back to the olden days of medicine. Back then, residents would go for weeks at a time without sleeping, eating, or using the bathroom. Sometimes months at a time. Truly, it was a golden age.

No wonder Alyssa and Connie act like they’re BFFs. They’re both engaged. They can bond by talking about the fabulous weddings they’re planning. Chicken or fish. Color schemes. Flowers. DJ vs. live band. The conversation topics are probably endless.

On my way to the lounge, I get a page and my stomach sinks. As part of my overnight call, I’m cross-covering the whole hospital. That means that if there’s any problem with any patient in the hospital, I’m the gal who’s supposed to solve it. It’s kind of cool. And by “cool,” I obviously mean it’s completely terrifying and I want to curl up in a corner and hide under a big pile of coats.

The computer is taking forever to log me in. This is truly the slowest, oldest computer in the history of the world. Before our modern-day computers, people used calculators, and before that they used slide rules, and before that they used the abacus, and before that, they probably used this computer right here.

I’m not sure I’ve ever been so tired in my whole life. I would pay a thousand dollars if I could go to sleep right now. Well, actually I wouldn’t, since I don’t have a thousand dollars. How about this—I’d give up a kidney if I could go to sleep right now.

She collapses into a chair, cuddling against the armrest. “I would give anything if I could just not have to get out of this chair. I’d even give up, like, my spleen.” Pssh, just a spleen? Kidneys are way more important than spleens. She’s clearly not as tired as I am. But I say, “I know what you mean.”

I brainstorm what I can do to make myself feel more like a human being. I readjust my ponytail, which helps very slightly. There’s a travel-sized tube of toothpaste on the sink. I squeeze about half an inch of toothpaste onto my finger and start massaging my teeth. Funny how I feel more like I’m about to do the Walk of Shame after a sexy hook-up than finish my first shift as a doctor.

I quickly pre-round on my patients, which means I essentially look into their rooms to make sure they are still alive. Everyone is still alive. We’ve all somehow survived my first shift as an intern. Apparently, people are harder to kill than I thought.

“You need to speak with him before you leave.” It’s official. I will be spending the rest of my life in this hospital on this call. After we pop in on my patients and Alyssa gives me a mile-long list of things to do, I slink away as quickly as I can. When I finish my to-do list, I can leave.

Yet I don’t know how I can possibly get through this nearly infinite list. I feel like Cinderella, when she was given that huge list of chores before the ball. I will never get to the ball at this rate.

I feel like at this point, I should just write the word “SORRY” in big block letters on my scrubs. I can point to it and save my scratchy voice. Or I could write it on a sticky note, except I don’t have any of those.

“I suppose you can go sign out now.” Believe me, she doesn’t have to tell me twice. I race out of there like I’ve got ten minutes before I turn back into a pumpkin. Hours awake: A jillion Chance of quitting: 91%

“So you survived your first night of call, huh?” he says. “Barely.” “It will get easier,” he says, as he casually sidesteps the legs of a bum that are jutting out onto the sidewalk. “Then it will get harder again. Then you get your own minions to yell at, and that, let me tell you, is awesome.”

I’m starving. But at least I’m not tired and I don’t have to pee. I figure I’m always going to be ignoring at least one of my body’s needs.

By some miracle, I get everything done and arrive at Dr. Westin’s office only a few minutes late. Naturally, everyone is already there, and Alyssa is looking at her watch with an annoyed expression on her face. I want to take her watch and flush it down the toilet. But I can’t because I don’t have time to go to the bathroom anymore.

“I’m calling to give you an update on your wife Marquette.” Although what I really want to say is: Your name is Thomas Jefferson! How did your parents give you that name? Are you aware of how funny this is? I mean, I feel like he should at least acknowledge that, yes, he has the same name as our third president, and yes, it’s weird. He should volunteer that information upon meeting any new person. Because obviously it’s all we’re going to be able to think about.

“Oh, thank you, Dr. McGill,” Thomas Jefferson says. Then he writes the Declaration of Independence. (No, not really.) “She’s doing okay,” I say. “She was having a little trouble breathing last night because of heart failure but we took off some fluid so she’s doing better.”

I can’t remember a time in my childhood when my mother wasn’t working at least two minimum-wage jobs. She was always shuttling me off to my grandparents for free babysitting because paying for a sitter was just out of the question. But when she took me to my pediatrician for my annual visits, she saw a woman who made a great living, was well respected, and in no position to have her entire life wrecked by a deadbeat husband.

And that’s my secret. I didn’t become a doctor because of some great love of medicine and healing. I did it mostly because my mother convinced me that it would be a secure, stable career. Don’t tell the admissions committee at my med school.

Mom and I had always been super close, which makes it hard to conceal from her my growing dissatisfaction with my career. That is, with the career she picked for me. I don’t feel like an independent, intelligent, respected career woman. I feel exhausted, dumb, and mistreated. And what really sucks is that while no man is in any position to destroy me financially, I’ve done a pretty good job of that myself.

Thanks to college and med school, I am now a quarter of a million dollars in debt. Whenever I start to think about it, I feel a crushing weight on my chest. That’s a lot of debt. It’s going to dictate everything I do in life. I can never stay home with my kids because I’ve got to be working to pay back my debt. (Lucky for me, children are nowhere on my horizon right now.) Sometimes I think I’ve made a huge mistake with my career and it’s all her fault.

“You’re going to have such a great life, sweetie. You’ll see. You made the right decision going to med school.” Right now, I’m just having a lot of trouble believing that something making me so suffocatingly miserable was really the right decision.

Pancreatic cancer is Bad Cancer. Not that any kind of cancer is good cancer, but pancreatic cancer has an especially poor prognosis. Dr. Westin broke the news to her, and I hid, because I was too scared to see her reaction.

She spent $89.34 on bathroom cleaning supplies. Why do we need “bleach foamer”? And why are all our cleaning supplies “organic”? It’s not like we’re going to eat them.

On the Medicine service, we’re not supposed to admit pregnant patients. They’re supposed to go to OB/GYN. But this one is okay. Mostly because it’s a man. And he’s pregnant not with a fetus but with a lot of fluid that can’t get through his liver because his liver is hard as a rock thanks to years of drinking. He really looks pregnant though.

This is one of those moments where you can do one of two things: Burst into tears, shaking fist at the heavens, and yell out, “Nooooooo!!!!!!!” Laugh. Somehow, against all odds, I start to laugh. I cover my mouth with my hand so that Mr. Sanchez doesn’t see and I attempt to stifle my snickers. It’s not funny. But I guess it sort of is. In a really horrible kind of way.