The Last Job in Medicine

The last job in medicine

Overview– This blog will give you a deeper outlook about jobs dealing with emergency medicine and other medical career paths

My grandfather was a doctor; he was amongst the last generation of human physicians. He was an anesthesiologist, but spent most of his time in the intensive care unit. He would tell me of the daily struggle to save lives with an antiquated arsenal of medical tools. Back then, physicians would place a pipe called an endotracheal tube into the patient’s trachea, and that pipe would connect to the mechanical ventilator – a machine that delivered air into the patient’s lungs. He told me of patients who accumulated pus in their pleural cavity, and had to have a large tube inserted between the ribs, through the muscle and into the pleural space. He told me about the cardiothoracic surgeries, where the patient’s sternum would be opened with a serrated saw to access the heart – medicine in that age was full of barbaric practices. People would die early; the average life expectancy was only 82 years. My grandfather would get to the hospital every morning before dawn and leave after sunset, but I could tell from the way he recounted his stories that he loved every minute of his work.

Work was a common thing back in his day. People did all sorts of work: some would cook or serve food, others would drive cars, others would make or enforce laws, invent things, run companies, anything to keep society progressing. Now with the Helpers, there was little work left for humans.

My grandfather once took me to visit the hospital where he used to work. I remember walking the dark, dusty, linoleum tiled halls. My grandfather showed me the old computers on wheels that they would drag around the wards, the vacuous and insentient ancestors of Helpers. I saw the patient beds, burgundy mattresses lined with thin, once-upon-a-time white bedsheets. I even saw one of the mechanical ventilators, a bulky arcane machine with more knobs than function.

I have only been admitted to a hospital once. I was twenty-five years old and had fractured my arm after a fall. The hospital was teeming with Helpers. Helpers checked me in and dropped me off at my room, they took a three-dimensional scan of my arm and then interpreted the imaging findings, they moved me from the hospital bed to the operating room, they administered the anesthesia and performed the surgery, and they checked in on me afterwards and delivered medications to control my pain. I did not see a single human being in the hospital. As a Helper was leading me out of the hospital, I noticed a job posting – the last job in medicine for humans. Since that day, I wanted that job. I had been applying to every hospital in every nearby city. After years of trying, my application was finally accepted. I interviewed with a Helper and got the job in a city three hundred miles north – I was ecstatic! Helpers came the next day and moved me to the new city.

Which brings me to today – my first day of work. A Helper drives me to the hospital, and then another Helper ushers me in, scans my retina, creates an identification badge, changes me into standard hospital attire and gives me a ride up to the fourteenth floor. The Helper drops me off outside of a patient’s room and leaves me with the patient’s medical chart, distilled and summarized, a vast multitude of data curated for my unsophisticated human eyes. Franklin Jay, only 77 years of age, had alcoholic liver cirrhosis and had had an artificial liver implanted three times, and each time he had developed cirrhosis from continued alcohol abuse; he developed hepatocellular cancer detected on a monthly molecular body scan, and was treated with targeted ablative nanorobots; the present hospitalization was for bacterial peritonitis, for which he received antibiotics specifically designed based on the pathogen’s genetic profile; Franklin then suffered a cardiac arrest, and his cardiopulmonary system was replaced with artificial heart and lungs. Today, he developed an infection in his artificial heart. At this point, the Helpers declared futility. The treatments were discontinued. Franklin’s artificial heart and lungs were powered off. This is not my grandfather’s hospital, there isn’t much for me to do. Maybe there was never much humans could do.

I walk into Franklin’s room and introduce myself to his wife, Jill. Her weary, drooping eyes are encircled by dark craters that were dug over the decades of caring for Franklin. Jill’s purse string sutured lips are scrunched and twisted shut, a sealed off wound beyond which her pain hides. I walk over to Franklin’s lifeless jaundiced body. I gently open Franklin’s icteric eyes and shine a light – fixed, dilated pupils bilaterally. I lightly touch his cornea and note no response. I pinch the bed of his fingernails, and he lays still. I feel for his carotid and radial pulses; both are absent. I place my stethoscope between the protruding ribs of his skeletal chest and listen for heart and lung sounds. The Helpers with their near omniscient technology have already evaluated every cell in Franklin’s body, so perhaps my auscultation with this primitive instrument appears a trivial ritual. But the Helpers know that Jill needs this ritual, a mystical service beyond the scope of the Helpers’ mechanistic universe. Jill needs me to listen to Franklin’s empty chest. Jill needs me to hear the silence. So I auscultate, I listen, I wait, and I hear the silence that confirms the painful truth of our shared ephemeral natures.

I place the covers back over Franklin’s cold, cachectic corpse. I take a seat next to Jill. She breaks into a heavy sob punctuated by a haunting diaphragmatic wail, a sound that can only surface when confronted with permanent loss. I hold her trembling hands in mine. I look into her shattered weeping eyes. I say the only words I have for a fate that none amongst us is prepared for, yet a fate that awaits us all. Delicate words that can only be delivered by an equally fragile fellow human being. “I’m sorry for your loss.”

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