Internship Begins

Never far from consciousness, Anne reached for the telephone on the first ring,

"Anne Marriott speaking."

"Good morning Dr. Marriott. Gert Ogilvie here, night nurse on Medicine. Just got a call from Dr. Hill to say he has a case coming in through ER…a new diabetic in renal failure. The boss says he wants the intern on-call to do the assessment."

Gert paused. "Are you awake?"

"Sure, just listening. I assume the ER will page me when the patient arrives. Anne yawned and stretched “Anything else going on?"

"The patient in 502 needs her IV restarted. Her veins are miserable, as is she, to tell the truth. Her next dose of antibiotic is due in two hours.” The nurse answered. “And there are charts here for you to sign off."

"Any coffee on?"

"An hour ago, but it is still hot. Got to go. Call bell buzzing."

Anne leaned over to drop the receiver in its cradle on the nightstand. She rolled over to stare at shadows dancing on the ceiling, and then

glanced at her watch. Four am… she had been in bed for an hour. Moonlight flooded the call room. The predawn sounds of the city whispered

through the open window in concert with the slap of the cracked vinyl blind as the breeze sucked air from the intern's room. She swung her legs over the side of the cot. Her feet slid instantly into her comfortable loafers. She forced herself upright then tucked the green OR top into the drawstring pants she'd worn for eighteen hours. Four more hours to go. Anne lifted her white coat, pockets heavy with "On Call" books, her stethoscope and the cherished stash of 22 gauge iv catheters. She balanced the contents while poking her arms into the rolled up sleeves.

House staff on call were housed in small rooms on the hospital’s sixth floor. The aging structure’s corridor was ominously dark, the red exit sign

above the stairwell door being the only available light. Overhead hot water pipes creaked. The absent presence of previous interns on the same

journey filled the silence. Tonight she was alone on the sixth floor. Pushing open the half glass door to the stairwell and forcing a deep breath, a

memory flashed through her mind.

Anne was not new to the hospital world. Graduating from High School at seventeen she spent two years training as a laboratory technologist and

worked in several hospital labs. Intrigued by the hospital culture she explored the realm of administration. While she was on duty as the night

administrator in another hospital, an eighty-year-old woman had slipped the watchful eyes of the night nurses and wandered into a stairwell maze.

Missing for just one hour when Anne found her, the woman was curled up on a stairwell landing. The coroner ruled the cause of death to be cerebral

haemorrhage secondary to a fall. The incident launched an extensive internal investigation. As a result alarms were installed on the stairwells and

cameras focused on the entrance to each. But for Anne the vision still haunted stairwells.

Palms gliding down the rail Anne flew down the three flights of stairs to the Medical wards. The fifth floor ward was quiet. The nurses' desk was piled

high with patient charts. Anne picked up the blue binder marked 502 and read the Admission Note. Eighty-two year old Jean LeBlanc had been

admitted through the ER two nights ago with abdominal pain and fever. Tests demonstrated pyelonephritis, an infection in her kidneys. She had

responded well to the IV antibiotics. Her vital signs were now normal. Flipping to the Progress Notes she read that the previous intern's plan had

been to discontinue the IV antibiotics the following day. Tucking the chart under her arm she made her way down the dim lit corridor. A soft glow of

light oozed from beneath the door marked 502. As Anne approached she could hear the muffled voices of Gert and Mrs. LeBlanc. Pausing for a

moment at the door she collected her thoughts. Often the elderly were the most difficult of patients and at the same time the most appreciative.

Stripped of their dignity in a world of illness, they fought for control by striking out. Anne knocked softly before she entered.