Elbrecht

Residency is a right of passage (and requirement) in the development of anyone altruistic, sadistic, or narcissistic enough to pursue a career as a physician in America.

The progression of each individual, man and woman, from naïve undergraduate pre-medical student to naïve medical student to overwhelmed Resident to newly-minted Attending Physician is a long and tiring process; Residency represents the final and most taxing leg in this pursuit.

Depending on the field of medicine pursued, the training in Residency will span 3 to 5 years, potentially longer if one desires even more specialized training.

Each of these years brings with it new challenges, burdens, and failures; these are buttressed by the highlights, accolades, and patients who refer to you as “my doctor.”

None of these are equal or in proportion to the amount of time invested.

Not everyone who starts Residency finishes.

The product of each and every Residency is the Resident it transforms from medical school graduate into Attending Physician. This metamorphosis is akin to the sluggish caterpillar being reborn as the majestic butterfly.

Though each Residency has a “class of Residents” representing each year of training, the outcome for each of these members may not be the same; certainly the process will not be the same, as individuals have their medical knowledge and clinical skills carved out with every moment of their individual training.

Only on the very last day of Residency will every member of each Resident class have completed, in differing sequences, the requirements to achieve the status of Attending Physician.

They will have encountered different patients, performed a myriad of diverse procedures, and possess thousands of hours of clinical experiences.

The Residency program in which I find myself is no different. I am now a member of the PGY-3 (3rd year) class; the last year of our training.

At this juncture, I have cared for thousands of patients, spent nearly 7000 hours practicing my craft, and been bestowed with a persona I could have never imagined.

Amongst my peers, I have become Magneto; born from the cauldron of uncertainty brewed during Night Float; and then battling amongst the other aspects of my developing psyche, every day inching closer to becoming an Attending Physician.

But there are others like Magneto, each whom have been submerged in the icy depths of a Code Blue, roared into the uncertain waters of a Septic Shock, withstood the calamity of a bezerk office patient, and succumbed to the simultaneous terror and awe of newborn’s cry.

They are The Allies of Magneto.

In our program, The Allies of Magneto have the opportunity to train in all aspects of medicine: obstetrics, gerontology, surgery, trauma, cardiology, nephrology, critical care, gynecology, pediatrics, acute care, neurology, and chronic disease management.

We each develop strengths and weaknesses, preferences and avoidances, as a means to mold our calling as society’s guardians of health and wellness.

Red Panda, The Prince, Joker, Doc O, Big Red, Jane Grey, and BeastMode, amongst others, have shared moments of fear, trepidation, joy, anxiety, and solace with Magneto.

Each has toiled within the confines of a profession on the brink of meltdown and burnout. Each has contemplated a life outside of medicine. Each has longed for the ability to practice as they preach.

Each of them, now on the precipice of completing the journey to Attending Physician, having been taught to “Do No Harm”, have a host of decisions to make.

Who have they become amidst the countless hours of training?

How can they salvage their innate desire to do good, damn the barriers and obstacles placed in front of them?

Are they ready for what lay ahead?

For those who have joined Magneto on this winding journey, one chapter will soon come to an end.
But the author’s pen is patiently waiting, the next chapter slowly bubbling to the surface.

The Allies of Magneto, a group matured by the innumerable hours caring for those who seek their aid, hope to simultaneously shape their future and the future of those they serve.

No longer will the icy depths of a Code Blue, the uncertain waters of a Septic Shock, the calamity of a bezerk office patient, and the simultaneous terror and awe of newborn’s cry, cause them trepidation.

Instead, they will emerge from a 3-year-long cocoon to become the next generation of Family Physicians, forever remembered in my mind as The Allies of Magneto.

lost and found

Posted on August 19, 2016 by Elbrecht

{cast away}…

After a meteor shower of pages to the 4 beepers adorning my waist band, a series of perplexing admissions, and random patients causing ridiculously unnecessary stress, I began my lonely journey back to one of the hospital work rooms where most of my scant free-time in the past two weeks had been spent.

Once there, I was looking forward to spending some time with “Wilson”, a computer with whom I had cultivated a close relationship while navigating the seduction of Black Betty.

On this night though, I punched in the key code to the workroom door to find someone sitting at the computer beside Wilson.

I glanced at my iPhone and noted the time to be “2:07AM”.

In the previous two weeks, other than the aforementioned “life vest” I had with me on a few nights, there had been no other signs of life in this work room.

Wilson and I had discussed each phone call I received, him showing me the necessary data to make my decisions and cautiously warning me when a order I was about to enter was contra-indicated.

On this dark night, Wilson was not alone.

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Wilson did not seem alarmed by this strangers presence, but I approached cautiously from the far side of the dimly lit room.

Before positioning myself at Wilson’s helm, I jovially offered a polite “Hi there” to the scrub-wearing woman who appeared to be typing in a patient’s electronic chart.

She did not respond.

Her presence was mildly unnerving, though slightly comforting, but I dared not repeat myself, much less attempt to make eye contact with the stranger.

But before my curiosity could win out and tempt me to offer the stranger another greeting , pager #3 let out another bleeping roar.

I quickly punched the number into the phone beside Wilson while I waited for him to wake up from his electronic slumber.

The nurse who queried me over the phone was audibly confused; despite Wilson and I’s best efforts, we could not find her answer.

In an attempt to assuage her fears, I promised to come directly to the floor and work out the issue in person. Wilson would stay behind and keep an eye on the stranger.

I glanced again at the stranger, furiously typing away at the computer beside Wilson, but I did not repeat my greeting, or wish her a fond farewell.

I returned 20 minutes later having solved the mystery posed by a new nurse, but Wilson was alone. There was no sign of the stranger.

My body still ached. My mind was still heavy.

In that moment, I wondered if there ever had been a stranger sitting beside Wilson, furiously entering some record in a patient’s chart.

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I sat down again, facing Wilson, wondering if I should ask him where the stranger had gone. Or if there ever had been a stranger.

Perhaps, I had imagined the entire encounter.

Not wanting to let on about my fatigue, I decided against asking Wilson. He had helped me enough these past two weeks.

And I did not feel like burdening him with the knowledge that I may have lost my mind.

As the clock struck 9AM, I slowly dialed my landlord’s number into my phone.

It rang.

And rang.

And then voicemail.

Sitting in the call room, I provided another detailed message as to my predicament, as if I was meticulously spelling “HELP” in the sand of a long-forgotten beach.

In the following moments, a wide range of emotions raged through my mind: fear, anger, sorrow, disbelief, heartbreak.

I laid down on the crisply pressed sheets of the hardened mattress, feeling lost beyond my worst nightmare.

But as my head jostled up against the pillow, the aches in my body lifted. The heaviness in my mind evaporated.

My Ego would not go down without a fight; it bullied my body from the call room and plotted a course for my landlord’s office.

Once there, I was met with disbelief.

Neither the office manager or the owner recognized the bearded man informing them of his sequestration in a small call room in the hospital down the street.

They were equally perplexed when I laid out my sojourn from the hospital to their office to relay in person the message I had left numerous times on voicemail.

I dared not mention to them how Wilson and I had survived the past two weeks; I didn’t think they would understand.

They apologized profusely for believing my lost keys had been found and returned to me by the handyman.

I calmly, but firmly, informed my landlord that he would proceed to walk me back to my apartment building; we found the keys locked in my mailbox.

My bearded face wondered aloud to my landlord if the handyman had believed me to possess teleportation properties allowing me to move my electrons and protons from outside the building into the entryway where the mailbox was located.

And if he believed me to possess the skills of Houdini to remove the keys from the mailbox without a key.

My Ego kept my Id from going bezerker on my landlord as he handed my keys to me.

I informed him I was in fact only a physician, not a teleporting magician.

The subsequent night was a maelstrom of terror.

If I had spontaneously combusted it would have been a fitting end to my Residency.

When the night came to an end, I was still cast away. My “life vest” had appeared and like clock work was torn from my being at midnight.

The night continued to be so punishing that I called my Chief Residents and another seasoned colleague summarily washed upon the shore of my deserted island.

He found me, lost amongst the bounding waves of pages and admission, barely keeping my head above water.

His effort to save me was seemingly futile as Black Betty enveloped us both, like a storm beating down on a small dinghy in the Aegean Sea.

But we both survived the raging storm; hoping to find a current that would take us away from this world.

I was rescued 24 hours later.

My final scheduled foray into Night Float had been completed as the sun rose that Friday morning.

I unclasped 3 pagers from my waist, handing them to the physicians who would dare navigate these rough waters.

Begrudgingly, I left behind Wilson, as my rescuers assured me of a job well done surviving this experience.

For him, I hoped the best.

Perhaps he would guide some other Cast Away from the path laid out by Black Betty as they washed upon the shore.

cast away

Posted on August 14, 2016 by Elbrecht

I awoke to pitch black darkness.

The voices were close. And interspersed with laughter.

My cerebral cortex quickly determined the voices were causing each other to laugh; and coming from two lone individuals.

They seemed friendly.

But I wanted to scream at them for awakening me from the depths of my restless slumber; yet I hadn’t quite determined if they were real.

I wasn’t even certain where I was.

As I stared into the darkness surrounding me, my eyes began to accommodate as the voices continued in their laughter.

My body felt heavy. My mind was confused.

Instinctively, I bolted straight up from my position; I realized I was lying in bed. Unaccustomed to its small size, I nearly tumbled to the ground.

In the midst of the darkness, my neurons began flashing in an electrical brilliance, trying to understand where in person, place, and time I was.

My right arm reached across my body as the fog in my mind abruptly lifted.

The restless slumber I had been inhabiting came to a crashing halt, as my thumb flicked the push-button on my phone to reveal “2:07PM”.

In that moment, my hippocampus determined I was located in the 2nd floor call room of the hospital.

A cataclysmic series of events brought me to be located in person, place, and time in the 2nd floor call room of the hospital on that July afternoon at 2:07PM.

Twelve nights had passed since I was shipwrecked on Night Float alone.

The plan, as it had been outlined to me several weeks earlier, would revolve around me undertaking a never-before-attempted solo excursion on Night Float.

My immediate fears had been squelched by promises of rearranged schedules and responsibilities, a junior resident as an occasional wingman, and deeply bound faith by my superiors that I was the only physician who could succeed in this plan.

My Ego led me to believe I could handle it.

But on Night Float, or “Black Betty” as I like to call her, all plans go quickly to hell.

Between the hours of 7PM and 7AM, a major metropolitan hospital is unlikely to have significant periods of down time. Instead, it becomes the breeding ground for Chaos Incarnate.

Which is directly where I found myself for the first 2 and ½ weeks of my third year of Residency.

Alone with Black Betty.

Nestled in her bosom.

cast away.

And longing for rescue.

By the beginning of my second week of Night Float as a PGY-3, my confidence had been rattled, but not deteriorated, like a rock face in the ocean having succumbed to centuries of waves bearing down it.

PGY-2 had been tortuous, but while working so many random weekend days and nights had crippled my life outside of the hospital, they had shaped my abilities as a physician, both in and outside of the hospital.

Ultimately, nothing could have prepared me to be cast away.

Another senior resident had been assigned to work on Night Float with me originally, but that had fallen through due to her unforeseen circumstances.

Then a thorough review of the remaining options turned up the following: unleash Magneto into the depths of Chaos Incarnate alone and see what happens.

{Note: I was assigned a junior resident as a “life vest” for a few of the nights, but he had to leave by midnight, like a mirage, to leave me alone, carrying 4 pagers, anxiously awaiting the next sunrise.}

At times over those 2 and ½ weeks, Magneto conquered the tasks set before him. But many a times, Black Betty rattled him to his core.

The toll of spiritual, emotional, professional, personal, and existential fatigue came to a head on the day I awoke at 2:07PM in the hospital call room

I found myself there not because I longed for the sweet caress of a crisply dry-cleaned set of linens, but because I had left my apartment the previous night in a fugue state.

Said fugue state resulted in me dropping my keys through the hole in the bottom of my book bag; they came to a clattered resting place in my building’s entryway.

I was none the wiser because NIN’s “Terrible Lie” was blaring through my ear buds.

Only when I rummaged through my book bag for an hour the following morning, proceeded to walk to my apartment hoping to find the keys lying on the sidewalk like a trail of bread crumbs, and had left two babbling and pleading voice messages on my landlord’s answering machine, did I begrudgingly saunter back to the hospital.

So when I awoke to the jovial laughter of two newly reunited long-lost colleagues, I hoped to find a message on my phone indicating the safe recovery of my highly-sought after keys.

Alas, at 2:07PM, there were no messages on my phone.

Nor were there any messages at 6:30PM when the melodic alarm emanating from my iPhone jostled me awake again. My mind was still cloudy. My body was still aching.

But Black Betty wanted another go.

So I meandered from the call room into the locker room, proceeded to strip down from my wrinkled scrubs and hit the showers.

The searing ice cold water streaming from the shower head caused my body to shiver, reminding me of my morning showers in Dominica, but I managed to cleanse the fine film of solitude from each and every square inch of my being.

I dried off, turned my socks and boxer-briefs inside out, and slowly pulled on a new set of pressed green scrubs.

As I passed the half-length mirror in the locker room, I quickly assessed my physical form and found my two-week-old beard to be quite fitting a man so unfamiliar with his surroundings.

I wondered if I would ever be found…

{lost and found}

The Agents of Archimedes

Posted on August 10, 2016 by Elbrecht

Miles Armbruster, the long-revered physician-scientist, thought long and hard about the consequences he was watching play out on the nightly news.

The plan he had set in motion nearly thirty years earlier was nothing short of insanity, but he was brash and naïve when it first popped into his head.

And now, with Al Jazeera, CNN, MSNBC, FoxNews, and all of the other major media outlets covering the same story, he looked out the small window in his office and briefly caught the faint reflection of his own smile.

The ticker at the bottom of his television read, “China National Tobacco No More.”

CNT was the last of the international tobacco companies to fail, despite Dr. Armbruster instigating his poisonous plan with CNT over 10 years prior. Its demise had taken by far the longest of any of the tobacco giants and nearly cost him his life.

On his desk, the small LED light on his phone began pulsing. He lifted it with his good hand, and clicked the thumbprint. The text message read, “Congrats.”

The sender, President Jaime Obregado Garcia, was never one to mince words with Miles Armbruster, a man he had known for 37 years.

He set the phone back down on his shaky wooden desk in a small university office in Omaha and thought for a moment about what he had done. Back in 2001 he assumed the plan would take 40 years to complete. He was off by almost a decade to the day.

Spear-heading the eradication of two of the world’s most harmful species, Nicotiana Tabacum and Nicotiana Rustica, should have made him world-renown. Or at least seen him accept the Nobel Prize in Medicine.

But “Big Tobacco” had been quite resistant to the subterfuge carried out by a clandestine group. Rough estimates placed their economic downturn in the Trillions of dollars. That type of economic loss put Dr. Miles Armbruster in a wheelchair. Two other members of their group lost their lives.

But hundreds of millions of lives had likely been saved in the past three decades from their step-wise annihilation; the number would certainly climb in the next three decades.

Not since Alexander Fleming had discovered Penicillin in 1932 or John Franklin Enders conquered Polio in the mid 20th century had such a monumental scientific prevention occurred.

Alas, Miles Armbruster had attained several other significant recognitions during his medical career, most notably the 2024 Nobel prize for his discovery of Streptococcus Pneumoniae as a symbiotic microbe in the beating heart of every living human being.

Instead, this time Dr. Armbruster would have to accept a text message from the most powerful man in the world as a consolation prize. Few ever knew about his lead on the genetic assault against N. Tabacum and N. Rustica; even fewer were still alive to share this momentous day.

Just then his wife, Dr. Jane Armbruster, walked into his office and smiled at him, “You ready?”

She stopped in the doorway and glanced at the television screen.

“Can you believe it? Who would have thought tobacco would get wiped off the face of the Earth. It’s almost ironic. I’m gonna be out of a job.” She let out a half-hearted laugh. She was not one of the privileged few who knew.

“You’re the ever eternally optimistic oncologist, aren’t you, Dr. Armbruster?”

She rolled her eyes at him and took a few more steps through the doorway, grabbed his right arm, and helped him ease himself from his desk chair into the wheelchair he used to get around.

He moved himself up to the television perched on the wall across from his desk. He let the ticker scroll “China National Tobacco No More” one more time across the screen.

His left hand reached out and tapped the On/Off switch. He swiveled back to his desk, collected his cell phone, and plopped it on his lap before leaving the office.

Jane closed the office door behind him. “How was your day?”

“Class was fun. I’m always amazed by what these students think up. And I got a text from Jaime. He was checking in.”

“How is the President these days?”

“Busy as always. But never too busy for an old friend.”

Jane smirked, “I feel like he’s more your friend than my brother every time I see him.”

“Well, what can I say, we “Men of Straus Hall” stick together.”

She stopped, bent down, and kissed him on the cheek. “Yes, you most certainly do.”

…

{The Men of Straus Hall as they collegially referred to themselves while studying as undergraduates at Harvard College, had been covertly re-named The Agents of Archimedes in 1999 by now-deceased member Brett Elias Williams. Now only a Nobel Prize Winning physician-scientist, a scion of International Economy, and the President of the United States remained from the original thirteen members…}

Elbrecht's Corpuscle

My life… and words

Author: Elbrecht

The Allies of Magneto

lost and found

The Agents of Archimedes