Surviving with Sisyphus

The patient in room 214 asks me and my attending if we can sit him up in a chair and bring him a Bible. He has a non-survival injury; wires and tubes tether him immovably to the bed. Even so, we tell him yes and leave the room. A medical student on a mission, I go in search of a chair.

Two doors down, the patient with no hands—they were amputated several days ago—yells out to the hallway:

“Hey! Hey! Is that Black man still out there?”

He’s referring to an exhausted-looking Burn ICU nurse who sits tucked into an alcove outside the patient’s room, typing on a computer. The nurse catches my eye as I walk past. I’m sure my attempt at a smile looks more like a wince: Besides me, he’s the only person of color working on this floor. 

The white patient’s call rings in my head like an annoying monitor alarm as I drift down the hall.

Black, Black, Black, beep, beep, beep.

Next, there is a child. A victim of survivable burns, he has survived, is surviving. Days ago, I left his OR in a cold sweat, leaning my head against the scrub sink and willing myself not to vomit after two hours of watching the surgeons graft his scorched skin—piecing him back together like a puzzle that lacked its reference picture.

A lanky, grey-haired surgeon found me this way outside the OR and laid a hand gently on my sweaty back.

“It’s okay to need help,” he said, then walked away as I repeated, “I’m fine, I’m fine, I’m fine. It was just the heat. I’m fine.”

A scrub tech brought me a cup of apple juice.

Did you know that you’re twenty-seven times more likely to become a doctor if you have a parent in the profession? I think about this fact as I look back on the successive two-week services on my surgical rotation—my first clinical rotation in medical school. First, on Vascular, there was a nine-hour aorta replacement; then, on Transplant, a five-hour liver surgery; and finally, on Burn, that young boy’s two-hour skin graft.

I often blunder. I don’t know an artery when asked about it under the too-bright OR lights. I don’t know the difference between “screen left” and “patient left” when a resident shoves a probe with a camera into my hand and asks me to “drive” it. I don’t know how to answer when an attending asks if a chest tube is set to “water seal,” and I struggle, always, to satisfactorily answer questions about the “ins and outs” (the patient’s intake or excretion of fluids). I worry that my failures not only reflect my shortcomings as a medical student but also declare me an alien in the world of medicine—a worry that, as a minority, I always carry with me.

Every day, like the mythical Sisyphus rolling his boulder up the mountainside, only to have it roll back before reaching the top, I push through the unfamiliar, untaught and unrelenting hidden curriculum of surgery, attempting to assimilate my identity—a Brown woman wearing the hijab—with the stark white sterility of the space.

At the end of each day, I take a moment to appreciate the view from whatever vantage point I’ve achieved—a scrub tech’s approving nod when I get my hand into the stiff, starched sterile glove on the first try, or success at rounds when I don’t mispronounce every surgical procedure. This appreciation is fleeting, though, as I brace myself for the rock to crash back on me and the vista to disappear. Every day, it seems, I start out again from exactly where I first began.

My parents are not medical professionals, but I do know what it feels like to push against an unwavering force designed to bring you down. My dad used to come home exhausted and angry after ten-hour days of being yelled at because the pizza took too long or the salad had the wrong dressing. I would sit quietly with my mother at the local food pantry, snug against her warm body as volunteers flurried around us, calling out numbers and shoving boxes of mismatched foods into wanting hands.

“Do you think your brothers would care if we don’t get snacks this time?” she’d ask. “We can only request ten items.”

“Why’s Dad always so mad?” I’d respond, not yet understanding the exhaustion of a long day spent serving others. Years later, my siblings and I still ask each other that question, and I still don’t quite know the answer.

My earliest memories of my paternal grandfather were that he was mean. My middle name is the first initial of his first name—just the letter “M” and nothing else. My dad didn’t want to give us names that sounded too foreign, and “Mohammed” wasn’t a suitable middle name for a girl in America. When he moved here, he went so far as to change his own name, making our last name the same as his first name. Our real surname was lost somewhere between Egypt and the United States Immigration Office.

I still don’t know his birth name, which makes me feel closer to him, because no one really knows mine.

“Nora…am I saying that correctly?” I’ve heard this countless times from attendings and residents alike as I come onto new rotations.

Phonetics seem to not apply when you reach a particular threshold of not-white. My name is Noora, a long o, like that of “moon.” It’s an Arabic name that means “light,” which is ironic because my skin is not, nor is the black hijab that I don daily.

Boys in middle school used to make fun of my brown eyes, calling them “mud-piles,” but even they had the sensitivity not to compare my skin color to the ground they walk on. I think about this as I learn about donor grafts and repress a shudder at the thought of stapling white skin to Black and Brown bodies. It strikes me that this clinical jigsawing is symbolic of what the medicine asks of us as providers: To heal unrelentingly, even at the expense of identity.

On my worst days in medicine, I find comfort in imagining myself at the foot of the mountain, alongside Sisyphus. I like to imagine him the way the philosopher Albert Camus did—as happy in his struggle.

Standing beside one another, Sisyphus and I grin in commiseration as we grasp the stone together, never mind that we’re already deeply exhausted and covered in sweat. Trembling, tentative but willing, we push the boulder uphill over the unrelenting earth. This time, we are so happy—the happiest we have ever been, because we’ve already beaten the odds twenty-seven times, and the young burn victim is surviving.

We push because maybe at the top we’ll be untethered, and someone will offer us a chair and a Bible.

And we’ll get to try again tomorrow, because we can.