Chicago, Illinois
July 2019
Omar
First day of intern year was here. A new beginning was upon me. An opportunity to start over, do better, go further.
It should have been a good day too. I was living in one of the most exciting cities in the world, and about to start work at one of the best hospitals in the country, even if it wasn't my first choice of residency program. It was a means to a goal - a top tier surgery residency program.
One year, in and out. Easy peasy. I kept reminding myself that I planned to only stay at the institution my ex-fiancé worked at for only a year before applying to surgery and hopefully getting the hell out of here.
But as I stepped out of my apartment, my breath was still stuck in my throat and my clammy palms betrayed the sunny outlook I was trying to portray. My mind was still stuck on the possibility of facing her again. And worse, on facing him - the complicated man who took everything from me.
That day I met neither. Yet, somehow my day just went from bad to worse.
It was my rotten kismet at work, I swear!
*******
My phone rang just a few steps into my walk to work that day. Ami's picture was flashing on the screen like it had so many times in the last few days. Some of those calls I had ignored, others I had to cut short since I was in the middle of a move. But neither had discouraged her, so I gave in and accepted her call. Knowing full well that I had really just opened the gates to my own personal abyss of hellish misery.
"Omar, did you look at the pictures I sent to you?" A shrill voice pierced my early morning peace.
"Salaam Ami. Are you not even going to greet your only son properly?" I laughed, but only half-jokingly.
"Wasalaam. Now answer my question!" she insisted.
"I did look at the pictures but I don't know what you want me to do with them. They all look fine."
What I had really wanted to say was, stop sending me pictures of random young women. I refuse to find a wife this way. But I was the perfect, polite son. So I kept quiet, only silently sighing.
"I am getting so sick and tired of your delaying tactics. What kind of a girl do you even want? And don't say an independent career-minded girl, you've seen what such girls do" Ami's voice dripped with hostility.
She had never been a fan of Noor, even when growing up. She was too out-going for her to be a good bahu, and too career-minded to be a good wife. There was no hiding that hostility now either when she painted every working woman with the same broad strokes.
But I was in no mood to get sucked into an argument with her so I simply replied, "All I want is someone who is nice and easy to talk to. I honestly don't have any requirements per se."
"Fine", she huffed, "I am going to go talk to your dad and we and we are going to go meet some of these girls and their families and let you know who we like."
"Ami wait, you're going now? I am not ready" I all but panicked. My plea went unanswered because she had already hung up and I was left staring at my phone screen in the middle of the sidewalk as people all around me rushed to their destinations.
Oh great! I resisted the urge to call back. It wasn't going to change anything anyway. Nothing ever worked out in my life, so perhaps it was time to leave the reigns to someone else.
Besides, it's not like I would ever find anyone on my own anyway.
*******
Of course, my awful kismet meant that I would draw the shortest straw even when the intern schedules were being made. There was no other explanation as to why only I out of my entire intern class found myself on one the toughest rotation in residency: the ER rotation, on day 1.
Chicago, a city of almost 2.7 million people, had its fair share of accidents, violence related injuries as well as the never ending heart attacks, strokes etc. And since we were the biggest hospital in the area, our ER was always full.
It didn't help that because of the poor state of primary health care (similar to general practitioners in other countries) and the even poorer health insurance system in the country, the majority of people tended to use the ER as their primary care facility (instead of going to a general practitioner). So along with the real emergencies, we also saw many people who visited the ER only because they had run out of their diabetes or blood pressure medicine.
Our ER shifts in general lasted for 8 hours, which may seem like an improvement over the 36 hours surgery shifts that I had done as a medical student in Pakistan, but no one had mentioned how much heart stopping medical drama went on in this particular ER.
By the 7th hour of my 8 hour long shift, I knew I had done a decent job with patient care, but I was completely exhausted and hungry and I couldn't even remember the last time I had drank any liquid. But I was a new intern hellbent on doing a kickass job this year to get kickass letters of recommendation for my dream surgery program application next year.
First impressions were key. So when a new patient rolled into the ER, and the head nurse called out, "50 year old male with intense abdominal pain that started 3 hours ago. Who can see him?" I summoned every last ounce of strength and jumped up to volunteer even before she finished her sentence.
"Me"
The nurse shook her head and smirked, muttering "interns" under her breath before she handed me some of the paperwork that paramedics had bought in with him. I pursed my lips, but ignored her rolling eyes and instead my gaze averted to the suturing kit she held in her hand.
The contents of the kit could be seen through the clear plastic cover, but I could have told anyone what it contained; a scalpel, a hemostat to clamp blood vessels, forceps, scissors, needle with the attached dissolvable thread also know as the suture. Just as I could have told anyone the name of the company that produced it: Surgilab - a proudly Pakistani company that supplied surgical instruments to many countries around the world.
As much as that company was the bane of my existence, it was also the reason I dreamt of becoming a surgeon - or maybe that too was just my father's dream that I was trying to fulfil.
I looked down at the paperwork in my hand. Either ways, I was stuck doing a non-surgical residency for one year.
Might as well make the best of it, I told myself, not for the first time.
*******
"Hello Mr. Jacob, I am Dr Khan. What brings you in today?"
"Don't know what happened doc, but I was at my job, and sitting at my desk as usual and all of a sudden I started to get this really bad pain in my stomach," the man said, placing his hand on the left lower side of his abdomen.
I couldn't help envisioning the man's anatomy under the spot that he was pointing towards, and remembering that the only anatomical structure in the left lower part of the abdomen was the large intestine.
"Mr. Jacob tell me a bit more about the kind of diet you have and what you do for a living"
The patient described details of his diet, which mostly included fast food and quick-fix dinners and hardly any fiber or fruits and vegetables. He was a night-time security guard at one of the nearby high-rise buildings and his job basically included sitting and monitoring the feed from the security cameras installed around the building.
After examining him quickly, I explained to him what I thought was going on, "So Mr. Jacob I think you have diverticulitis."
"I have what-the-itis?" he interrupted me, looking very concerned.
"Diverticul-itis - which is basically inflammation of the diverticulum. A diverticulum is a small pocket that forms at the end of the large intestine when the muscle of the large intestine starts to become weak with age. A low fiber diet can make things worse by causing constipation, because pieces of stool can get stuck in the pocket and cause infection of that area...", I tried to explain.
"Wait, so I have pockets in my stomach and there is poop stuck in it?" he seemed even more aghast than before.
"Essentially, yes. And usually surgery cures it so you don't have to worry about anything..." I tried to start again but his eyes bulged out of their sockets.
"Surgery? Wait. What? No one said anything about cutting me up", he sat up in the bed, his mouth wide open, "What the hell doc? NURSE...GET ME OUT OF HERE" he yelled and frantically pushed the nurse call button.
Now I was panicking as much as he was. In a flustered moment I mumbled, "No no, wait. Maybe surgery won't be necessary. Why don't we just admit you overnight and monitor you for now", and then quickly stumbled out of that room surprised that I had made it out alive.
But as I said my ridiculous kismet only made matters worse.
The ER attending was still busy in the trauma room, the ER's senior resident was tied up in a complex patient's room and with the patient conjuring up a storm in his room I did the only thing I could think of. Which was go with my plan to admit and observe the patient.
So I looked up the senior resident on-call for the in-patient medical team. The call listed an M. Ahmed as on-call today. Nice, finally a desi guy, I almost managed to smile at myself.
I paged the listed number, ordered some pain medications for the patient and then started working on the patient note.
Twenty minutes later I still hadn't heard from the senior resident and was contemplating paging him again when I noticed a woman, with striking features and jet black hair pulled back in a neat ponytail, coming out of my patient's room. She was wearing scrubs without a white coat on.
So of course my stupid kismet kicked in with full force, and I made an assumption I really shouldn't have.
"Nurse, how is Mr Jacob doing? Did you give him the pain medication I ordered?"
Without looking at me she walked over to a nearby workstation and started typing in her login information. She had been standing close enough to me that I was sure she had heard me, yet had chosen to ignore what I said.
What's with all the nurses here? I was too tired to deal with people's attitude problem right now, so I strode over to her and raised my voice, just slightly.
"Excuse me, nurse!"
The woman looked up at me with a confused expression on her face, "Are you talking to me?"
"Who else could I be talking to?", my voice came out more curt than I had intended it to be, and I was about to immediately apologize when her eyes darkened and a frown instantly appeared on her forehead.
"Are you blind? Or just stupid enough to assume that every female here is a nurse and could not possibly be a doctor?", she said, pointing to her badge where it said in relatively large letters that I should not have missed, Dr Madiha Ahmed.
Oh, my mouth went dry, she is the senior resident? The one I thought would be a male.
Oh crap.
"Uhh...I am so sorry Madiha...I am Omar Khan...umm, the new intern", I stuttered an introduction even though I could feel my face flush with embarrassment.
"That would be Doctor Ahmed", she glared at me.
"Yes, Dr Ahmed...I am really sorry about that...but umm...thank you for coming to see this patient", my stuttering did not stop.
I was not one to be easily intimidated, but the way that this woman was scowling at me made me take a couple of steps backward, and forget how to form complete sentences. She got up from her seat, and took a couple of steps towards me. I was about 6 ft tall, and she must have been 5-6 inches shorter than me, but she looked up at me with such intensity that I felt like a dwarf in front of her.
"Did you just tell the nice man in there that he would need surgery for a simple stomach ache?", she gritted her teeth, anger pouring out of her dark brown eyes that were framed by thick, long eyelashes.
Why am I looking at her eyelashes?
I shook my head and focused back on her scowling face, "Umm...yes", I reluctantly admitted. I really did think that he had diverticulitis because I had seen at least 3 such cases being taken to the OR during my surgery rotation.
She wasn't impressed.
"He is freaking out because he doesn't have insurance, and he could never afford a surgery. Why would you say that without first asking any senior resident or your attending?"
Now that she mentioned it, I probably should have waited and run this case by someone with more experience than me. It was, after all, my very first day as an intern. And I had been doing research for the last 6 years. So perhaps my medical knowledge was not as good as it used to be.
"I am sorry, Dr Ahmed. I really should have waited. It's just that during my medical school surgery rotation I saw a number of these cases in the operating room"
She raised an eyebrow at me, but her tone softened just a tiny bit, "News flash Doctor, you are doing an internal medicine residency, not a surgery residency. We can treat a lot of diseases with medications alone. So maybe learn to do things the right way, instead of being overconfident in your ability to recommend surgery"
I nodded to her, feeling instantly humbled by her words, but also slightly amused by the fervor with which she had reprimanded me. Clearly, she was the type of person to always speak her mind, and have no qualms about standing up for herself.
The complete opposite of me, I also reluctantly admitted.
Quietly, I followed her into the patient's room and she got some more details about his illness. It turned out, and I had completely missed this, that he attended a family BBQ recently and several of his family members also had the same symptoms as him.
"Mr Jacob you probably just have food poisoning of some sort. So let's give you some fluids, and observe you in the ER for a little while. If you are feeling better, we can probably just discharge you from here"
The relief on the patient's face was very obvious. "Oh thank you so much doc. Your friend here scared the shit out of me...no pun intended!"
Dr Ahmed smiled, and her face lit up briefly when she looked over at me, "You are very welcome! It is my colleague's first day on the job, so you'll have to excuse him for his over enthusiasm at making a diagnosis"
By the time we stepped out of the patient's room, the ER attending had come out of the trauma room so we updated him on the patient and our plan, which was really Dr Ahmed's plan, and he completely agreed.
"Thanks for coming by Madi! Really appreciate it. That trauma case took forever", he said to her.
Madi? Huh.
No its Dr Ahmed, I quickly reminded myself.
"Oh no worries at all", she smiled warmly at the attending, and then turning towards me added, "Keep your head in the game. Trying to send your patient to surgery without them needing it, is not a good way to make a first impression"
She swung around and walked away, her ponytail swishing against her back, before I could say anything.
"Madi is one of our best senior residents. You'll be lucky if you get a chance to rotate with her", the attending said just before he got back to work as well, leaving me standing alone in the middle of the bustling ER.
And thus ended my very first day of Internal Medicine intern year. As I walked out of the ER shortly afterwards, I realized something that made me smile a real, wide toothy smile.
I had not thought about Noor even once during that 8 hr shift.
Maybe being at this institution is exactly what I needed to finally get over her. As long as my stupid kismet doesn't interfere.
Kismet did interfere, just not in the way I was dreading it would.
*******
Dr Madiha Ahmed! Yup...she is the female protagonist! Read the next chapter to find out more about her.
Also, the nursing profession is a backbone of any health system, so no slight intended at all. But it is a fact that male physicians are never mistaken for anyone but a physician 🙄
Thanks for reading! Don't forget to vote and let me know your thoughts 🙂