My Career As A Hospitalist

George's mind was spinning. The surgeon described how he would make a hole in his wife's skull. The procedure was called a "hemicraniotomy" but to George the words made little sense. All he knew was that his wife had been dancing in his arms two hours before.

At first, when she collapsed, he thought she was pretending. But then she didn't get up. He saw her chest moving up and down. But she wouldn't respond.

The ambulance came quickly. The paramedics gathered up his wife and placed a breathing tube down her throat. They whisked her off to the hospital.

Two hours later, George sat in a conference room with the neurosurgeon. His wife suffered a devastating stroke. The swelling had already caused sgnificant damage to her thirty five year old brain.

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I shifted uncomfortably in my seat as I listened to the neurosurgeon. He would offer George's wife a procedure. It would release the pressure on her brain. But there was no mincing words. She was unlikely to recover fully.

After the surgeon left the room, George and I talked for a few moments. I gently pushed him to consider what his wife would say if she could speak for herself.

He rocked back and forth in his chair. In the main ER the PA system called a doctor overhead. The monotone voice of the page operator broke the silence.

She would want to be there to see her kids grow up.

There was little certainty in his statement. It was more a question than a declaration.

I reached out to put my hand on George's shoulder but was surprised to see him pull away. I was neither a trusted advisor nor a long time friend. I was a stranger newly assigned to the case.

It was precisely at that moment that my thoughts began to crystallize.

My career as a hospitalist would be short lived.