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Day of the undead: The zombie intern
By James S. Newman, FACP
“Let me get one thing straight. I don't eat human flesh, so don't get stressed. It's tough and salty and just not that appetizing.” I found myself saying this at least 15 times on my first day of internship. It's not like I was a vampire or anything; they tend to stick to pathology.
I didn't think my fellow first-years were really worried about my consuming them, but you never know about the strange prejudices of the living. As the only zombie intern in my internal medicine residency group, I was mostly prepared for the nervous looks and discomfort. There were four zombies in my medical school graduating class of 220, so at least I had not been totally isolated then, though I rarely hung out with them. They were too busy studying and worrying about their image, while I am more of a fun-loving type. Nonetheless, it was good to have fellow undead creatures to discuss things with.
I'd been a zombie for almost six years, after driving a snowmobile across a frozen lake while in college. I'd been looking for a friend's ice-fishing house and gotten lost in a drunken haze. They say you should not head into the light, but I distinctly remember that as I was drifting down into the frigid water, the only light was the hole in the ice above me, and it was getting further away. I woke up in the resuscitation center, getting the full zombification treatment. My parents couldn't let me go and they had the funds. Having frozen quickly with no trauma, I was a fairly decent-looking corpse, if I do say so myself.
The zombification procedure has been well described, so I won't bore you with it. For a 20-year-old dead guy, the enemas, body fluid replacement and intensive irradiation is no picnic. The upsides are that I can't catch any infectious disease; I need only 30 minutes of “downtime” a night; and I can run a marathon without getting tired. The downsides are that I have to eat living things occasionally; my teeth are prone to cavities; and it's hard to get a living date sometimes. Food-wise, I actually prefer the aquatic life force, so a sushi bar with really fresh fish usually takes care of things. But if I have been partying, don't let me near your aquarium.
To return to my residency: I was working at the county hospital and was assigned to the ICU for my first rotation. It would be a trial by fire. There was a martial consultant, a distracted fellow, a resident with senioritis and a second intern. The other intern kept staring at me. Was there some tuna on my lab coat? No, just a typical “lifer”sometimes they can't take their eyes off you. I hoped she'd settle down or we would have to rumble.
There were 16 patients on the unit, each sicker then the next. We dove into the fray. The next 12 hours were a blur of central lines, cardiac arrests and complex differentials. Of course they put me on call the first night. Typical. My co-intern checked her patients out to me, saying with a smile that I'd be up all night with her patients, and not to expect any sleep. Was this some kind of anti-zombie slur? I was used to it, but hoped for more from a colleague. How depressing.
At around 2 a.m., I was admitting my fifth patient of the night. It had been a long hard day, but I felt like I was doing well. The patient was septic, with a failed cadaveric renal transplant on hemodialysis and neutropenic fever post-chemotherapy for lymphoma, plus the usual assortment of hyperlipidemia, coronary artery disease, diabetes, hypertension and other syndromes the living are prone towards.
As I entered the room, the patient turned and stared at me. He noticed my bluish-tinged skin; I apologized for my cold hands. He flinched when I touched him. He called the nurse and demanded a living doctor. I will never forget that fine nurse. She looked hard at the patient, and told him he better cut it out. I was the doctor, and a good one, and if he didn't like being taken care of by my “type” he could take his septic butt elsewhere.
The nurse and I walked out of the room and she laid her hand on my shoulder. She told me I was really doing a fine job, and there was no place for prejudice on her ward. We both looked up as the next patient rolled in. It was a polytrauma case, fresh from the OR, and it was a zombie.
Zombies rarely get admitted to the hospital. We don't get infections. We don't have heart attacks or cancer or diabetes. We do get depression, but the main thing is trauma. Most zombies are quite conservative; having died once already makes you not want to take too many chances. But a few of us are just thrill-seekers. I entered the room expecting a warm greeting, but this was one nasty zombie. He tried to bite a nurse and had an evil attitude. He ordered me to give him pain medication. His teeth were ragged, his corpse maggot-ridden. This was the kind of guy that gave zombies a bad name.
He cursed at me when I refused to load him up with excessive narcotics. He called me every name in the book, said that I was a traitor to my own kind. Was he my kind? Was this how people saw me? It took everything I had not to lose my temper. I treated him respectfully but firmly, as I would any other abusive patient. His zombie status did not come into my decision making, other than in the doses of medications and avoiding antihistamines. You never want to see a zombie hopped up on diphenhydramine!
The sun came up. I had missed my usual 30 minutes of shuteye, but I was functioning pretty well. I had learned a lot of medicine and a little about myself, and that was plenty for my first night on call. I walked out into the bright sunshine. It felt good to be undead.
Dr. Newman is a hospitalist at the Mayo Clinic, and editorial advisor to ACP Hospitalist.
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From the March 25, 2015 edition
- EGDT provided no benefit compared to usual septic shock care
- Using a threshold of 2 SIRS criteria to define severe sepsis may not be adequate, study finds
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