Earlier this week, I spoke of the lavish residency-applicant lunches of which hungry and tired psychiatric residents partook, myself included. As alluded in that piece, however, dining options as a intern or junior resident were not always so ‘five star.’
After that post, my former RN girlfriend dropped me an email and reminded me of how she kept me alive while I was carrying the code beeper as an intern, and asked why I had not blogged on that topic?
Maria, you’re right. That was an oversight. Allow me to expand and correct the record.
As an intern at UVa in the late 1980s, I rotated between services every 4-6 weeks. At that time, the only two inpatient services that were not located within the medical center proper were the psychiatric wards – ensconced at a former TB sanatorium several miles away – and what we called the Towers. Though the Towers unit was just up the street from the main medical complex, it wasn’t physically connected, and therefore if a patient had to be transferred from the Towers to the ER or OR, for example, they had to be taken outside by ambulance.
The Towers was a combination geriatric and general internal medicine service. It is probably best described as an overflow unit for those two disciplines. There were a number of patients there who were elderly and DNR status (Do Not Resuscitate), hanging out in God’s Waiting Room. But there were also younger patients with curable conditions who came and went (and were to be fully coded should something happen unexpectedly). And because of the full-code status of that segment of the patient roster, the lowest ranking resident – in this case the intern (i.e., me) – had to carry the code beeper.
Those with code beepers – the designated first responders to a code – were required to remain on the floor until relieved; naturally, if a patient were to stop breathing or beating, the code resident couldn’t be somewhere else… like getting dinner.
Back then, the hospital cafeteria was in the main complex, and getting to it required crossing two busy streets and walking two blocks. There was no fast-food located adjacent, and I don’t recall that any of the sandwich shops or pizza places delivered to the Towers. In short, unless you had possessed the foresight to pack your own meals – not a high likelihood for a young bachelor resident who was massively sleep deprived – or were lucky enough to know a higher-level resident who was leaving the building and going to get food, you were going to starve as long as you were wearing that code beeper.
Computers were rare back then, and dietary orders were written on old fashioned paper and sent over to the food service department (which was up the street in the main complex). Meals for the Towers were then delivered three times a day by van. If a Towers patient was made NPO (Nothing By Mouth) pre-surgery, or had expired altogether, their designated meals continued to arrive, name taped to the tray, until and unless the nurses on the ward sent the necessary paperwork to the food service saying to stop.
Maria knew this and regularly ‘forget’ to stop patients’ meals. And guess who got to eat them when on-call and starving?
I must confess that it never bothered me to sup on the trays of those recently departed. Poor Mrs X would have enjoyed this grilled cheese sandwich I’m certain. But where those erstwhile meal recipients had gone, they wouldn’t be needing the beef stew any longer. And I didn’t then want to expire from famine and join them.
Thanks again, Maria! xoxo!
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