Doing Harm Read Online Free Page A

I’m not ashamed to admit, I never have. It’s what got me here.
    Luis, the junior resident I’m currently working with, slouches into the seat across from me with a tray of food and grunts good morning, running his hand across his bald head, over his bloodshot eyes, and down his olive-colored face toward the rough, salt-and-pepper stubble dotting his chin. It’s a striking, if not particularly handsome, face—thin and long, almost gaunt, and all sharp angles, with thick cords of muscle extending from his chin down his neck. He was on call working in the hospital for most of the weekend, and this morning he’s been in the hospital since well before 6:00 A.M. , checking on our patients.
    I sip my coffee, considering my breakfast companion as he scratches some notes on a piece of paper he’s laid out on the table in front of him. Luis Martínez is a few years behind me in our training program, but this is the first time I’ve worked with him closely on a daily basis. His smoothly shaved head, by the looks of it a defiant stand against a markedly receding hairline, looks good on him; the prominent rise of his naked skull somehow makes him appear more commanding and belies the lower rung on the professional food chain he currently occupies in University Hospital. Even now, clearly exhausted, with another full day of work looming ahead of him, his squared shoulders and prominent jawlines betray not a hint of weakness or capitulation. He oozes self-confidence and radiates unassailable authority, even around me, and even though I’m his direct supervisor. But not in a bad way. He’s not arrogant, or egotistical. Just self-assured. It doesn’t bother me.
    As a junior resident, Luis’s job is to handle the myriad practical issues involved in taking care of hospitalized patients: medication orders, nursing questions, diet changes, initial assessment of problems, discharge paperwork—all of the minute-to-minute, hour-to-hour details and minutiae that constantly arise when patients are staying in the hospital. It’s essential stuff. But it’s also a lot of grunt work. In medical parlance, we refer to it as scut, and to the interns and junior residents who take care of it as scut monkeys. Surgeons hate scut. But scut pretty much sucks no matter what kind of medicine you practice.
    I don’t have to do scut anymore. I did my time in the trenches, when I was a junior resident like Luis. Now my job is to oversee Luis, teach him what I know, and pretty much make sure he doesn’t do anything stupid. I’ve worked with him for only about a week now. He seems like an okay guy. Taciturn and gruff, he runs a tight ship and, for the most part, keeps his thoughts to himself. We don’t talk very much beyond work-type stuff. He’s older than I am, several years at least. I heard he did some time in the military before he went to med school. Beyond that, I realize, I really don’t know anything about him—where he’s originally from, or where he went to school. I make a mental note to find out more.
    But he definitely gets the job done, and gets it done well. Quite well. I don’t worry about his doing anything stupid with the patients. He’s also unfailingly polite and attentive to my directions; although I suspect that he secretly considers himself to be a much better doctor than I am, despite my greater experience. But that’s no big deal. Supreme self-confidence isn’t necessarily an unusual, or even unhealthy, attitude to have in medicine. A lot of doctors, at all levels of training and in all specialties, think they’re better than the next guy. It gives you the confidence you need to get up in the morning and go to work. Besides, in the end, the most important thing is that Luis always follows the chain of command and does exactly what I tell him to do.
    Most weekday mornings, Luis and I meet here in the cafeteria to discuss our patients and plan their treatments for the day. This morning, as with every morning, I listen