The one who was preoccupied about her toothpain at 4 a.m..

Accidents and Emergencies - Short-term care - Any hospital
Any training year

"- Good evening !
Er, Good morning !
Er, Good night !
Anyway, excuse me for that, what can i do for you ?"
"- Good Night. I am here because I have this horrible toothpain. Here."
"- Here ?"
"- Here."
"- Since... ?"
"- Since yesterday night. The problem was that it was saturday, so no dentist could have me in. So, i took painkillers.
And... Well, it doesn't work, i am in pain. So, here i am."
"- Mm."
"- Mm ?"
"- Mm.
Well, we are going to give you some painkillers.
And then, since it is sunday, monday actually, and it is four in the morning, well, i guess you won't immediately find some dentist to take care of you. Even here, in the university hospital.
Because, you see, i am not a training dentist.
The guy there, i mean my boss, i mean my senior, well, he isn't a dentist either.
In fact, the problem is that hospitals and emergency departements are unfortunately full of physicians but not of dentists."
"- And so, about my tooth ?"
"- And so, about your tooth, here is your prescribtion.
I wish you good luck for the rest of the treatment. With the dentist.
Normally, there are a lot of them available on mondays. Dentists, i mean.
Did i use too much the "dentist" word ? What time is it, already ?"
"- Four a.m. . Goodbye, Doc."
"- Actually, i am only a medstudent, as far as i am concerned. Only a medstudent. Under the resident stage, so not really important. But it is me who's pernickety.
M'am ? Hello ?"

Because i believe that everyone has already met The Ethereal Toothpain of the middle of night.

Like a scottish ghost never at peace, it goes from any University Hospital to any University Hospital, from any big hospital to any tiny hospital, from any "developed" country to any other "not-so-lucky" nation.
It cracks preferentially after the twilight, most oftenly in the last hours before dawn. Those exact long hours during when all the senses are shaken and the tiredeness is everywhere under the strained white coat.

Nobody have found a remedy to cure that Pain yet.

Legend has it that it will last until a dentist will be on call as well as a brave orthopaedic surgeon for the whole night.
Waiting for that we, unfortunate members of the medic-corp, are doomed to meet them wandering about in the Emergency departements in the middle of the night. Only equiped with our poor WHO grades of painkillers to fight back.

Oh, High Priests of the Health Board, do hear our humble prayer.

The One who swallowed clocks.

Visceral Surgery, 4th year.

"- So ?"
"- Easy one : clock !"
"- Right !"
"- What was his excuse ?"
"- Oh, this one doesn't really theorize things. It's not the first time, actually. He is coming from Saint
Gargoyle* (* Psychiatric Hospital of the area).
"- Oh, I see."
"- Yes. We're waiting for the clock to pass through the pylorus and then the cecal defile and he'll
be free to go on swallowing whatever he likes."

That awkward moment when you understand that it is the item more than the human being or the
reason he swallow strange things which matters to you.

That terrible moment when the simple sentence "He is coming from Saint Gargoyle" suits to undoubtedly justify nearly everything.

The one who drank caustic soda in order to forget.

Visceral Surgery rotation, 4th year.
Digestive surgery patient hosted in the high located E.N.T. service.

I quietly stare at her, waiting for any kind of answer.
It won't come.
Her blurred look insists on ignoring me, heading towards the window. We can't see anything else than the summer sky through this one. From her eighty-five years and her erratic medical follow-up, i am not convinced that she actually sees that sky.

I hold on to her file.
According to the nurses, the first thing she said to the psychiatrist was "I failed, but i'll do it again.".

I inform her that i am going to check up her scar.
She starts holding her lips and blouse tightly. With that strenght that can only be shown by the elderly while defending themselves against the White Coat Confraternity.
I instantly start reciting an endless flow of words in order to establish some kind of non-agression pact. Doing that, i brought back her record in my mind.

Eighty-five years old, social isolation, domestic violence lasting for more than half a century, eighth suicidal attempt recovered at the hospital.
Phlebotomy and defenestration didn't work out, neither the absorption of caustics. Unlike some others doing it again and again, it is not due to a lack of will.
This time, she drank two bowls of Destop(R).
As our Psychiatry professors say "When an elderly does a suicidal attempt, he or she usually succeeds."
She, indeed, stood close to self-dissolution.

She reluctantly accepts to show me her abdomen, rightfully hoping that it would make me leave quicker.
The scar is smaller than what I had expected. There is a  nearly clean draining pocket and a gastric tube for enteral nutrition. I follow the tube with my finger.
Indeed, compared to the other clinical cases I studied before entering her room, she "was lucky". I mean that the soda didn't have the time to nibble her stomach as it did for her now removed oesophagus.
The firemen, called by the family, came up pretty fast, which is of prime importance in the cases of chemical burning by strong bases.
She won't be able to swallow her saliva anymore. A little pocket on her neck is here to collect the limpid liquid.

I can't help thinking that she might be planning another suicidal scenario right now.

I step aside and let her button herself, ending the contact which was obviously painful for her.
I reach the door of the room and try a last glance. She is still huddled on her armchair, staring at the window.
"- The one who is always there to call the firemen, don't you think that he could prevent her from being beaten ?" would eventually spat my senior surgeon.

The occasional impotence of our caring system and the morbid grotesque of her situation still freeze me to the bones.

The one whose life was saved by a mushroom.

Summer in the Visceral Surgery Service. Operating room.

I attend a diverticulitis surgery. It is a complicated inflammation of a part of the intestine which is called the colon.

A patient is there, lying down somewhere under the surgical drape.
I've never met him because he came in by the ER. I will never see his face because he won't be in my area of the service.
As usual, i am holding the operating tools to remove the tissues and the little device to draw of the body fluids. I am quite good at it actually, drawing of. It is tidy, it is meticulous and it doesn't need you to overthink at all. The main difficulty being the task of keeping the operating field clear for the surgeon and the resident, i think i can handle that without any overwhelming difficulties.

This patient is kind of a riddle.
The CT scan tells us that he is suffering from a perforation of the digestive tract leading to a start of peritonitis, an inflammation spreading in the abdomen, but the clinical aspect of this man is actually quite good.
Several minutes and a incision running from the sternum to the ombilic later, here we are, in front of the trouble-making gut.
"- Er, it's..."
"- Do you believe... It seems... I think..."
"- Nurse, take my iphone !"

The beaming surgeon smiles at me over his procedure mask. He cuts the gut and put it on the operating field so that we can examine it.
There, forming what is litteraly called in french a "perforated-then-patched-diverticulitis", is a... Mushroom.
A real one, a button mushroom, full piece, with its stem and its little cap. Cutted in half in the lenght side, it blocks the hole, preventing the intestinal content from pouring itself where it shouldn't.

I don't look at the mushrooms the same way anymore.
First, because i know the fungus' secret : the fact that we can't process them at all.
And secondly because they remind me the fact that, sometimes, you just need to be the right one in the right place to make the difference, no matter what brought you there.

The one who taught french with half a stomach less.

First clinical year. Summer. Visceral surgery rotation. Understaffed.

I walk in the bedroom of one of my new incoming patients of the day.
A lady who had walked into the hospital by herself. Not so recurrent in visceral surgery, it needs to be said.
A woman undoubtedly overweighted and really nice. I am holding her file and it says that all the requirements needed for a bariatric surgery are completed. This sweet lady is here to let half of her stomach be amputated. The "last call for obesity" i've heard.

I sit down, i have all the time i need.
The arfternoons when we weren't supposed to be in the operating room, we could organise our days as we wanted. We could manage the patients of the district on our little level
Incoming patients, calves, abdominal scars.
No superior to solicit us permanently or to show us a whole bunch of CT scans with unidentified (not-so-)swallowed objects within.
No time running, no emergencies. Only us : young white jackets, nurses and parameds.

"- Hello. I am a medstudent, i am here to chat a little bit.
- Yes, i know. I know you."

Caught in the middle of the monologue i was about to output, productivity over and over, i try an uneasy eye over my file.
The patient has a polite, prepossessing smile. Maybe a little bit disappointed.
As far as i am concerned, i don't know her.
I try again.

"- Yes.. This is the game of the University Hospitals. Students everywhere, plus the residents, plus..."
She stops me nicely. She shakes her hand in the air as if i was a little girl who, one day, would stop stealing candies.
"- No, no. I know you. Pneumology, at the beginning of the year. You took care of me."

I frown. Pneumo. Ten months earlier. Week-care hospital. I mostly remember my cancerous patients. And surely this lady doesn't have any general alteration at all. She doesn't smoke. She tried everything to lose weight. Really, everything. She is  discrete. She..... Has sleep apnea.
I suddendly remember.

I think I have been nice, the first time, because she puts my awkward face aside and waits. She is indulgent.
Her look blames me to think of people as numbers, i feel it, i know it. But she doesn't say anything, she stays polite and smiling.
"- We were saying ?
-  Yes, so, i am going to ask you a few questions...
- Yes, like the last time."
She is testing me, i know it.
I smile. She is a clever one.
She smiles, again.
I continue with something i would try not to do too quickly in the future. Quickly gathering the antecedents. Personal ones.

"- Your job ?" "French teacher." "Do you smoke ?" "No." "Already smoked ?" "Never smoked." "Are you married ?" "No." "Ménopausal ?" "No." "Kids ?" "No." "Pregnancies ?" "Yes."
She breaks into tears.

Well done. Great. Congrats, Polly. Less than ten minutes, rhino-nasal catarrh and really bad score.
Don't you want to ask her for how long she has been obese and her life has been ruined by it ?

I stayed in this sunny bedroom with my little patient. I amended myself, i think so, and we talked.
I had plenty of time, she still had her stomach, everything was fine.

I got out of the hospital that evening with the feeling that one day, i wouldn't be going to be the"student number thirty six" anymore. Some fleeting white shadow. That serial blunderer here to remind the older ones how much they have achieved or are supposed to.
No. One day, i would have a name. As i already apparently had a face which had not been wiped off by my white coat.
One day, i would have to assume every little blade that would come out of my mouth right in the face of the patients I will be responsible for.
Yet, I had the luck to be able to train myself and count for nothing, to try things. But I also had to remember that i still counted for some people, as i already had the power to hurt them for real.
At that time, i had two years to learn how to cope with it, and so i had to get to work as soon as possible.