Chapter 21

21

"How much Lasix is Mr. Sanchez getting?" Dr. Westin asks me.

It's the twenty-eighth hour. I'm sitting at the nurse's station with Alyssa and Dr. Westin, near Mr. Sanchez's room. Mr. Sanchez, the pregnant man, has now reduced his gestation to about four or five months. We're going to send him home. I'm all set to send him home, and have been surreptitiously writing his discharge summary during every free moment. I've gotten to be really good at writing while walking up and down stairs.

"Uh," I say. I start shuffling through the stack of papers I'm holding.

"Jane," Alyssa says, "you have to be ready to answer when the attending asks you a question."

Good advice. Except it doesn't make me find Mr. Sanchez's med list any faster .

"I'll go check the nurse's med book," Dr. Westin says, leaping to his feet.

Alyssa watches Dr. Westin run off. As soon as he's out of sight, she leans in so close to me that I can feel her hot breath on my neck: "The attending does not stand."

I stare at her. "What?"

"If the attending asks you a question," Alyssa says, "you get up and find out the answer. You do not let the attending stand. Ever ."

Hey, maybe I should just carry the attending on my shoulders during rounds. Would that be okay, Alyssa ? And if you're so gung-ho on never letting the attending stand, why didn't you go look up the medications?

I've composed about ten angry replies to Alyssa in my head, none of which I have the courage to say, when Dr. Westin returns. "He's on 40 mg twice a day!"

And of course, at that moment, I discover the paper with Mr. Sanchez's meds on it. But it's probably good I didn't find it earlier, since I had the dose wrong.

"Jane," Alyssa says in an inquiring tone, and I wince inwardly. No more questions, please! I am way too tired for this. "How long did you spend yesterday waiting on the phone for the translator for Mr. Sanchez?"

I don't really understand the point of Alyssa's question. I've been awake for a long time, and it's not clear why it matters how much of my life I wasted on hold for the translator. It's over. Why waste more time on it?

"I don't know," I finally say. "Ten minutes?"

"Mr. Sanchez speaks English ," Alyssa says triumphantly.

I don't know what she expects me to make of this revelation. All I can say is, "He does?"

Dr. Westin chuckles, "Gina, you didn't know your patient speaks English?"

"Did you even try to talk to him?" Alyssa asks me, shaking her head at disgust at my lack of effort.

I tried. He doesn't freaking speak English! "I did."

"We had a great talk this morning," Alyssa says pointedly. "I was telling him about the diet he needs to keep due to his cirrhosis and he asked me all sorts of really intelligent questions. Jane, you really have to make more of an effort to communicate with your patients."

I swear, Mr. Sanchez did not speak English when I met him yesterday. The only solution I can think of is that the man somehow learned to speak it within the last 24 hours. It's a miracle.

The three of us march into Mr. Sanchez's room together. He's showered this morning, his face is scrubbed clean, and his black hair is brushed and slicked back. It's amazing how so many of my patients look like they just spent a night at a fancy resort.

"Hello, Mr. Sanchez," Alyssa says cheerfully .

"Hello," he replies. I swear, if he starts speaking fluent English, I'll cry.

"Mr. Sanchez," she says. "I was just telling the team about our talk this morning. About all the foods you said you're going to avoid."

He nods and a pleasant smile appears on his face. "Ah. Yes."

She folds her arms across her chest, getting ready to show off. "Tell the team what you're going to avoid eating."

I hold my breath. Mr. Sanchez looks between the three of us. Finally, he says, " Qué ?"

Alyssa's eyes widen. "Mr. Sanchez, don't you remember? You're not going to eat…?"

He keeps the pleasant smile plastered on his lips. " Qué ?"

"Salt!" Alyssa blurts out. "Salt. You're not going to eat salt, right?"

" Sal ?" Mr. Sanchez raises his eyebrows. I look over at Dr. Westin, who is trying not to laugh. Alyssa's face is a shade of bright pink.

I love you, Mr. Sanchez. Just for that, I'm giving you a few tablets of Percocet to go.

Hours awake: 29

Chance of quitting: 19%