Now ICU, Now I Don’t

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This topic contains 12 replies, has 8 voices, and was last updated by  Dee-Marie 9 years, 11 months ago.

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  • #488569


    This is a true story that blogged out of me when I first started writing a few years ago. I’m not wild about the way I wrote the ending. Suggestions welcome for any of it!


    Now ICU, Now I Don’t

    When you’re an intern, everything that happens seems momentous. Every patient is unique, every experience is new, every sensation is intense. The learning curve is so steep it feels like it’s carving a permanent groove in your brain. You’re always in high gear, rarely sleeping, alternating between panic and exhilaration. You know you’ll never forget a single moment of this.

    Of course, you do forget. I’ve forgotten. I’ve forgotten a lot of it.

    But there are those experiences, those patients, that are truly unforgettable. Impossible to erase from your memory, even if you wanted to. This was one of them.

    The guy seemed a little wacky from the get go. We should have known better.

    Oops. I mean, “47 year old married male presented to the emergency room, accompanied by his wife, who expressed concern that her husband might have consumed an excessive amount of aspirin in a state of despondency.”

    The guy is denying ingesting anything, although he admits that he’s been depressed, and refuses to tell his wife or the ER staff where he went that afternoon when he was gone from home a few hours. (This is the time during which his wife suspects he overdosed.) His behavior is strange enough, however, to put up a red flag for the ER doc. They go round and round a while, and finally it’s decided that he’ll check in for the night for lab tests and observation.

    They send him up to the ICU, since there’s at least a possibility that he ate a bunch of aspirin, which could throw his body chemistry into deadly disarray. This is where I come in. Those of you in medicine know that the first doctor a patient sees in his hospital room is the intern. Wet behind the ears, eager and sleep-deprived, assigned to do the dreaded “H and P”. History and physical. Getting the basic info about the patient. That was me, on my medicine rotation at –we’ll call it General Hospital (names have been changed to protect the guilty).

    So I trot into the room in my white coat, loaded with pocket-sized reference books and tools of the trade, clipboard and pen at the ready.

    The guy is sitting on the bed, fully dressed in his street clothes. I think, “That’s odd; usually they come up from the ER in a gown, with their stuff in a bag. Oh well, I heard this guy was a little wacky. Maybe they cut him some slack.”

    Out loud I say, “Hello, Mr. X, I’m Dr. Spencer. I’m here to do your history and physical.”

    “Well, I’m leaving.” grunts Mr. X.

    “Sir, I’m afraid I can’t let you do that.” The brave little intern, asserting her authority as The Doctor Who Knows Best.

    “You gonna stop me?” He stands up, pulling his hand out of his coat pocket to reveal a very small, shiny, grey —good Lord, it’s a gun!

    About face. Change in attitude. From brave little intern to backing-out-of-the-room-with-hands-surrendering-in-the-air intern. Hey, you wanna leave? Be my guest. Me, stand in your way? No sir! I’ll just skedaddle on outta here. You do whatever you please. I’m no hero. Not stupid, either.

    Once out of immediate danger, I hustle over to my chief. “He’s got a gun!”

    “What? No way! He couldn’t get up here with a…” he bit it off and ducked behind the desk as Mr. X emerged from his room, gun in hand, and hit the nearest stair exit, banging through it before anyone could speak or move. “Shit!”

    He grabbed up the phone and called security while the nurse called the ER and warned them Mr. X was on his way down and out with a gun. Then we all held our breaths. One minute….two….five….no word. Then the phone rang. It was the ER. “We haven’t seen him. Are you sure he came down?”

    Oh no. No. Shit, no!

    Yes. He went up. Up, into the hospital. A crazy trapped animal with a gun, loose in the hospital.

    ……… be continued………….

    I’m just teasing you. That, believe it or not, was pretty much the end of the story. After an extremely nerve-wracking half hour, we got word that the police had picked him up across the street from the hospital at a fast food place. He didn’t go on a shooting spree in the wards, in fact he never showed his face up there that anyone could recall. How he got out of the hospital, nobody ever saw. The police came back over to interview me and show me the gun for confirmation. Mr. X traded his comfy ICU bed for a jail cell. I never heard what happened to the ER staff that let him out of there without going through the usual routine. I never saw Mr. X again. And I never forgot him.


  • #326067

  • #488570


    I enjoyed the read until the …to be continued… part. I think you should just write is as it happened. Take us through the nerve-wracking half hour, the accusations of who’s to blame and the end with the police bringing him back for id ect.

    I like your style:)

  • #488571


    Same as Elibet here. Great read till “To be continued.” Everything after that could have been summed up in one sentence.

    I wanted the ending to take me back to YOU. e.g. how you were affected by all this, what your state of mind was after going from brave intern to wise skeedaddler. After all from the “get go” this story is about you, and should stay that way till the end.


  • #488572

    I agree with everyone above 🙂 You should continue with the thoughts going through your head, did they start a random search? Were fingers pointed? Where was the wife? Finish through to the part that the cops showed you the gun for verification.


  • #488573


    I hate to just say I agree with everyone else (in fact, I think you agreed with everyone else in your second sentence) but I just wanted you to know that I read it, I didn’t come up with any other critiques. I basically agree with the others that you went from story mode into narrative mode, and you might consider leaving it in story mode throughout. Did you ever find out why he wasn’t in a gown? Did it change the way you approached any of your other patients?
    Overall, I thought your writing was good, didn’t have anything to add in that aspect.

  • #488574


    Elibet, Paul, Kimeez, Dan,

    Thank you all so much for your feedback! Dan, I don’t care if you all say the same thing if it’s what I need to hear. The more the better! Maybe eventually it’ll get through my thick skull! Just kidding. You all gave me great ideas about the ending. Very helpful! I’m psyched to get back on it and rewrite it.

    Muchas gracias!


  • #488575


    Now, this is the kind of stuff I need to get myself into the middle of. My life just doesn’t have real drama to it. Oh sure, I have the existential dilemma of “to be, or am I at all”, but even then, there’s no real option A or option B involved. No real dilemma.

    I need to rent a life somewhere. You’re fortunate to have things like this wander in off the street. I’m jealous. :~D

  • #488576


    Noreaster – take EMT training and work on an ambulance for a while. Or volunteer in the emergency room. You’ll get enough drama quickly there!

  • #488577


    Oh Pegs, how scary for you! And how brave of you to continue your training.  I wonder how many would’ve just said “All right, that’s it, I’m outta here!”? 

    As far as critique, I’m with everyone else.  I’d like to know how it affected your life from that point on.  Great style!

  • #488578


    NorEaster – 2008-11-24 7:58 AM  I need to rent a life somewhere. You’re fortunate to have things like this wander in off the street. I’m jealous. :~D

    Have a child. 🙂

  • #488579


    Thrilling story.  That would definitely be on my list of top ten patients to never forget.

    Beyond the last paragraph, which everyone has already commented on, I did have a suggestion for you.  I think you need to work on what tense you want the story to be in.  You start off in past tense, then do a good job transitioning over to present tense… except then in a couple of spots you use past tense again. 

    If you want to tell the story in past tense, then the only part I would leave in present tense is when you quote the wording from the hospital report. 

  • #488580


    Great comment, hematite! The tense thing happens to be one of my pet peeves. And here I am, doing it myself! I’ll definitely fix that. Thanks.

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