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My Metamorphosis

My God I've gotten fat.


I untucked my scrub shirt to try and cover my belly, but that made things even worse. Now I looked even wider.


Oh c'mon it can't be that bad, I thought as I threw on my white coat and tried to disregard the image in the mirror. But when I bent over to pull on my sneakers, my scrub pants untied themselves and a fat roll activated the pager on my hip.


Shit.


It had to be the food. There's an awful lot of free food in the Doctor's Lounge - a luxury that I have obviously taken advantage of over the years. I hate to admit that we physicians eat for free in the hospital, but it wasn't always that way. (Also...screw you, we work hard).


When I was a medical student many (MANY) years ago, we were offered a nominal discount in the hospital cafeteria. It seemed like a great deal at the time, although the quality was in line with the offerings at my high school cafeteria.


That reminds me of the time the lunch lady (yes, I realize that term is no longer PC) threw gravy at me when I asked her if she could tell me what the "hot shit" and the "cold piss" of the day was. Thankfully it was turkey gravy and I was able to hide the stains from the priests and brothers that afternoon and avoid having to explain myself to the Principal.


Things didn't get much better after medical school. Yes, I was in New York City where the food choices were fantastic. But I was a medical resident in New York City on resident's pay in the 90s. So most of the time, I ate in the cafeteria. When I didn't, it was burgers, fries, pizza and the occasional foray into Chinese, Italian or Indian cuisine. But even that was limited to whatever I could occasionally afford on a resident's pay. And residents could generally afford whatever was fried. Or leftover. (Or stolen off a patient's tray. Oh yes I did).


My diet was so crappy my fellow residents made fun of my perpetual bowel distress and my resulting bland food selections whenever we went out.


"Dude, you're having broth again?!"


Things were more difficult than usual during the first six months of my internship as I was experimenting with vegetarianism. It wasn't because I was interested in the health benefits of a plant-based diet. It was because I was sleeping with a vegetarian.


On her birthday several months into our relationship I splurged and took her to the Quilted Giraffe, a nouvelle cuisine fine dining establishment in the City. I almost threw up that night - not because my stomach hurt, but because it cost $400 for dinner, dessert, and a bottle of wine. The food was delicious, but delicate and minimal, and we left hungry. On the way home I bought and ate a hot dog, ending my dabble in vegetarianism.


That vegetarian is now my wife. Last night we had turkey burgers. I win.


Back in medical school, my gut was so distressed I often had to stop whatever I was doing (a physical exam, a patient interview, presenting on rounds, etc) and excuse myself to fart in the hallway or run down the hall to try and poop in a public restroom. And if anyone knows anything about me - they know how much I hate using a public restroom.


I hate that SO much.


My kids have this ability to poop whenever they want wherever they are. They didn't get that genetic freakishness from me. They got it from my wife who can go to the bathroom anywhere without even bothering to close the door. I don't know how we live in the same house.


Anyway, in medical school my apartment mate would roll his eyes whenever I would run past him to the bathroom and slam the door. This was so routine he would slip a magazine under the door for me to read and then he would go for a run. He knew it was going to be a while.


"You need to see somebody about that," he would say. I knew he was right. And I have since then. And really, it just boiled down to my food choices.


One night I was on call at County Hospital...state of the art now, a veritable shit hole then. I woke up in the middle of the night with stomach cramps and sweats (not unusual) and shot out of bed. There was one shared bathroom with the other residents and there was no way I was going to use that one. I needed privacy. So I made my way to the Ambulatory Surgery unit which kept bankers hours and was closed at that time of night.


I headed towards a single occupancy bathroom at one end of the recovery room -thinking that the cafeteria-grade spicy Jamaican beef patty was a poor dinner choice - and settled in for some relief.


I find that there are few times more serene and meditative than sitting in a dark, quiet bathroom sans distraction and stress, free to proceed with my inner cleansing ritual.


There are also few times more vulnerable.


It was dark in there. Not pitch black dark, but dark enough that I wasn't sure what I saw. And I thought I saw something fall. Confused, I looked up and flashed my penlight on the ceiling. Nothing. Then I looked on the floor around me. Nothing.


I shrugged and thought my eyes were playing tricks on me. But before I put away my penlight, I saw an enormous cockroach running up my thigh.


I'm not sure how I got to standing up on the toilet seat, but there I was screaming in a pitch I have never been able to duplicate. In between screams and cries for help (I was in a closed part of the hospital and nobody was coming to save me) I was taking things out of my pocket and hurling them at the roach as it frantically ran around on the floor.


I finally hit it with my beeper and after waiting way too long to ensure that it was indeed dead, I ran from the bathroom, never having completed my transaction. Did that moment somehow change me? I suppose so. To this day I still check the ceiling before I poop.


Later that year I was working in the outpatient unit at County Hospital (equivalent to today's Urgent Care) when an obese African American woman came in wailing and screaming loudly. She was flailing her arms and throwing her head back and forth violently, crying out "MY EARS!" in Haitian. When we were able to get her seated in a chair and settled down enough for us to examine her, my attending physician thrust an otoscope in my hands and said, "You go left, I'll check her right."


A nurse held the trembling woman's head still as I gently inserted the lighted instrument in her ear and peered inside.


I squinted and wrinkled my nose, unsure of what I was seeing. I leaned in close and mumbled "Is that?..."


Just then an enormous cockroach ran out of her ear canal and up my arm.


I'm not sure how I got to standing on the wheeled exam room stool, but there I was screaming and swiping at my arm as the stool slowly rolled across the floor. The roach, having escaped from its ear burrow and jumping from my arm, scampered away and disappeared under the exam room door.


And after my scream dwindled into a whimper, the sound of the stool coming to rest against the steel exam table echoed in the silence.


To this day I wear a mask and gloves and stand back a foot or two whenever I look in a patient's ears. If I look in them at all.


One month later I was working in the nursery and was entranced by this one infant who wouldn't stop smiling. I gently picked him up and made cooing noises but dropped him abruptly when an enormous cockroach scampered across his smiling face.


I don't know how I got to standing up on the garbage can, but there I was screaming and pointing at the fleeing insect, as if the infants had any idea what I was trying to tell them.


To this day I am not a pediatrician.


But I am bothered that my go-to move in the face of fear is to imitate a cartoon elephant terrified of a mouse.


I haven't seen a cockroach in years. My last run in was in Dayton OH where - for some reason - the military gave us an introductory class to hissing cockroaches. After gaining enough courage to put one on my palm it scuttled up my arm, sending me sprinting out of the lecture hall in uniform.


Cockroaches were a way of life in New York, particularly NYC. It is not an exaggeration to say I grew up with them and was accustomed to them in the typical places - the closet, the kitchen, even at the dinner table.


One time I was eating a romantic dinner with my vegetarian fiancé in a quaint little Italian place in the City. The food was delicious, the atmosphere was fun, and most importantly it was CHEAP. We were about to dig into our favorite appetizers - stuffed mushrooms - when we noticed a set of cockroach legs sticking out from the stuffing it was baked into.


In true poor New Yorker style, I brushed that particular mushroom aside and ate the one next to it before subtlety sending the plate back to the kitchen.


At an Indian restaurant on 6th street in Manhattan, my kind-of vegetarian wife (she was now eating chicken and fish) and I sat down to dinner when something fell from the ceiling on top of our rice. Yes, another cockroach. This one was not alone, as there were other roaches crawling all over our food. I motioned to the waiter and whispered to him as he bent down "there are bugs on our rice." He grabbed the plate and yelled "NOOOOOOOO! ROACHES!!" as he ran back to kitchen, weaving between other restaurant patrons who continued to eat as if nothing was happening. He came back a disarmingly short time later with another plate of food which made us wonder if he just dusted off the bugs and brought back the same plate. It was delightful.


It has been difficult for us to find Indian food of the same quality and caliber as we were accustomed to eating in New York City. A couple of years ago a new Indian restaurant opened near our house and ignoring our skepticism we decided to try it. It is now a staple at our household. The owners are friendly, the food is fantastic (the best we've had), and the place is CLEAN.


The concept of culinary diversity has made its way to the Doctor's Lounge and the hospital began to serve "Ethnic Delights." This would have raised eyebrows years ago but now we all look forward to it.


Last week they announced that they would be serving Indian food. Before heading down to the cleanliness of the well-lit lounge, I untucked my scrub shirt and made my way downstairs.




















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