It is an early July morning at the start of my very first clinical rotation as a third-year medical student. Few people are roaming the halls of the suburban community hospital at 6 a.m. Nurses carrying tiny paper cups filled with colorful pills periodically appear and disappear into patient rooms. Except for the faint hum of a motor at the opposite end of the hall from where I am meeting with my surgery rotation teammates, all is quiet.
We huddle for a few minutes, creating a game plan for the day, then begin shuffling down the hall toward our first patient. I instinctively clutch my left hip pocket as our formation tightens to steer clear of the "caution: wet floor" signs. Like most medical students, I learned to fold my papers lengthwise to fit inside the hip pocket of my white coat, causing the tops of the pages to flap with each step. I don't know when I learned or who taught me. So much of medical knowledge is acquired through silent observation.
We carefully avoid the drying puddles of the newly cleaned floors as we make our way to see Avery, a middle-aged man who was hospitalized after passing out while carrying a tray of barbeque across his lawn.
****
“He thinks he was just dehydrated," Caroline, our senior resident, offers before entering the room. "He's in for a terrible surprise." Caroline was on call overnight and assisted with the procedure Avery underwent. He has yet to learn the results. Our attending, Dr. Getty, is here to tell him.
Our troop of white coats appears like stark icebergs in the sea of red and grey jerseys Avery’s family sports in honor of the baseball game they are heading to that afternoon. The festive mood quickly cools with our presence.
"Good morning, Mr. Dodson," Dr. Getty begins. "How are you feeling?"
"Just fine, thank you," Avery smiles. "Perhaps a little sore from lying flat on my back all night with this sandbag on my groin but happy to be alive."
Dr. Getty nods with a smile before saying, "You'll be allowed to get up after we have a quick look at your incision site. But before we do that, I'd like to tell you the results of the procedure."
Avery looks to his family and then back at Dr. Getty, saying, "Yes, please doctor."
"It turns out the major blood vessels in your heart are severely clogged," Dr. Getty says. She proceeds without pause, "They have likely been that way for some time now, as it appears your body has created an entirely new maze of blood vessels that resemble, oh, something like a freeway spaghetti junction, as they have tried to build a sort of overpass to compensate."
Avery slowly nods his head. His family mirrors his movement. The temperature in the room continues to drop.
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