I knew a wonderful surgeon who packed his own lunches: a bowl of instant ramen, a jar of salsa, and a package of pre-shredded Cheddar cheese. After mixing and microwaving these components, he’d enjoy his meal with a can of diet soda. But not everyone has the time or the disposition to bring in food. As a medical student rotating through various hospitals, I saw only newbies snack on those packaged crackers ubiquitously available to patients as a poor man’s Dramamine, and I definitely never saw anyone eat the Jell-O.
And so to the cafeterias. Two hospitals I rotated through had outsourced their cafeterias to McDonald’s. Other canteens featured the ersatz blooms of cellophane-wrapped apples nestled among breaded chicken patties and lasagna. Even the basically fine cafeterias were mysteriously terrible. Once, for a month, I decided to consistently order the soup of the day along with its accompanying whole-wheat-appearing roll. After putting on more weight than I ever had before, I returned to my old lunchtime regimen: stepping outside to the food carts for a milky tea and a chocolate-frosted doughnut. I rapidly slimmed down. This made no sense, but I had been taught to respect evidence-based medicine.
“Every rotation changes my body,” Mike, the resident I was assigned to as a student for my first month of surgical training, said to me over Asian noodles left from a grand-rounds meeting. “On neurology, I was a peach. On surgery, I just get pale and fat.”
“But you never even have time to eat lunch,” I said. Later, we had fortune cookies.
The unit Mike and I had been assigned to mostly did bariatric procedures—weight-reduction surgeries. Mike explained that the procedures were repetitive and therefore I would learn very little; furthermore, he would likely not have a chance to perform the core competencies that he needed to do a number of times before he could finish his training year. Mike was an Army veteran, recently returned from Afghanistan, and had a baby at home.
“Yeah, I’m so glad I’m on this incredibly valuable rotation instead of at home,” he said. When we were called on to drain the armpit abscess of a patient suffering from a virulent strain of tuberculosis, Mike again said, as he put on his blue mask, “I’m so glad I’m here. . . . ” Also, one of the senior surgeons had a reputation for yelling at the residents and for never knowing their names—the rumor about him was that he had lost his license in Canada, after performing a gallbladder surgery for a supermodel in some idiosyncratic and medically inadvisable way, because he had been asked to avoid giving her an abdominal scar—and, when Mike was scheduled to assist this surgeon all day, he again declared himself very happy. Mike, who was at the hospital ninety hours a week, was so unfailingly thorough, caring, and funny with patients that it became clear that these traits were the metabolic by-products of a constantly replenished rage.
And the poor patients! They weighed three hundred, four hundred, five hundred pounds—sometimes more. They were there for relatively risky procedures that diminished their stomachs or rerouted their intestines, or both. A young man of about nineteen told me, “I used to eat a whole pizza as a snack. It just calmed me down.” I wanted to say that I, too, had eaten a whole pizza, but I knew that it was wrong to ignore the differences between us.
Yet I do remember a certain reliable happiness during that rotation, even for Mike. Occasionally, a window of time would open, late at night, when Mike’s baby was probably sleeping anyway, or not sleeping, and his beeper wasn’t beeping, and exhaustion itself seemed like some curse that had miraculously been lifted from us alone. “Let’s go get a treat,” Mike would say.
The cafeteria would be closed, leaving only a corridor of six or seven vending machines. On illuminated display were pretzels, and chocolate bars, and potato chips that were baked, and potato chips that were made from superior root vegetables, and potato chips that were actually corn chips coated with a supernatural orange powder. There were bright-colored drinks full of “essential electrolytes,” which medical professionals knew basically just meant sugar and salt, but still. One machine was different. It hid its wares. Nothing was on display but a closed freezer unit and artistic renderings of ice-cream bars. The drawings recalled ice-cream trucks from a childhood before mine, with almond-like objects matted onto a chocolate-like substance, with a vanilla-like substance inside. The bars were a dollar and twenty-five cents, I believe, payable in quarters. Mike and I would listen to each coin fall. Then came a whirring sound as the freezer chest opened slowly, like a vampire’s coffin. A robot arm descended, suctioned up glycerides on a wooden stick, then released the treasure into the dispensing slot of the machine. “I’m so glad I’m here,” Mike would say. ♦
