Medical fiction book review 8/31/25-Hospital Sketches

I have been a huge reader ALL of my life. The first book I ever read to myself was Ferdinand the Bull about the bull who would rather smell flowers under his favorite cock tree than fight in the arena. The first book I ever stayed up all night to read was Magic’s Pawn by Mercedes Lackey when I was a sophomore in high school (shhh, don’t tell my parents). The first chapter book that I ever read by myself was Little Women by Louisa May Alcott.

We’ve all seen the various movie adaptations where various actresses spanning generations played Jo, the headstrong March daughter. These actresses vary from Katharine Hepburn to Saoirse Ronan, seven in all from 1918-2019. Her story remains the same. So does the story of the doomed March sister, Beth March, the gentle soul that contracted scarlet fever while providing care for a poor family in their town.

But as a child and teenager I read all the Louisa May Alcott books I could get my hands on. Little Women, Good Wives, Little Men, Jo’s Boys. I own a very old copy of Aunt Jo’s Scrap Bag that I got in an antique store in Wyoming. These are the books that dealt with the March sisters. There are also more like the Eight Cousins or the Aunt-Hill, Rose in Bloom, Under the Lilacs and Jack & Jill. This last book was written in 1880 and the Jill of the title was a poor girl who had a friendship with Jack of the title while they were young. Through childhood misadventures she tumbled down and broke her back, like the nursery rhyme while Jack got a bump on the noggin.

Louisa May Alcott desperately wanted to go to war and wanted to enlist but she was denied because she was a woman. She volunteered as a nurse during the Civil War in 1962 and was confronted by the dirty, nasty, medical mess that accompanies war. She served only 6 weeks of her 3 month assignment, becoming seriously ill herself. She sent home stories that were compiled into Hospital Sketches in 1863.

I had no idea this novella existed until I heard about it on an NPR program about Louisa May Alcott. The library didn’t have it but Amazon did and I purchased it immediately. It is a little book, only 99 pages. I am glad that I didn’t read this book until I was an adult and a working nurse. Because my 24 years in the hospital trenches allowed me to understand Tribulation and to empathize with her.

It is about a woman in the 1862 who is bored. This is Tribulation Periwinkle. She doesn’t want to teach, or write, or get married, or act. Her little brother suggests that she go to war. And she does.

Although not without difficulties or barriers in her way. The battlefields were a long way from New York.

While nursing the desperately wounded, Tribulation has conversations with the dying soldiers. One dismisses his injury as just being shot in the stomach and wishes for a drink of water. But there was no water to be had as the water pails were being filled. Tribulation took the first mug and hurried back to her patient patient, who was dead. There is something about the description of the patient patient who is patiently waiting for water that never comes.

Louisa May Alcott touches on the senselessness of war and the unceasing dying of the soldiers. She writes of families that are holding vigil at bedside for those who were dying. She writes of sitting vigil herself and the conversations that she had with the wounded.

Tribulation Periwinkle goes home and writes about the surgeons and the patients and the other nurses. The last paragraph in the book is about her wish to volunteer at a hospital for “colored regiments” because she knows that society owes them a great debt.

A little book, yes, and a bit disjointed, but it really gives a snapshot of what it was like serving in the Civil War battlefield hospitals. Some good, a lot of bad.

Rather like today. Even with all of our pharmacological advancements and surgical advancements and technological advancements we sometimes don’t in. And Louisa May Alcott knew that.

Call Secrets of the OR #5- Designated Call Room

This is it. The big call secret.

It’s not about how to make friends with people you wouldn’t talk to at a party. It isn’t about making nice with others of the opposite political divide. It isn’t about sleep deprivation or a cool, dark place to sleep. It isn’t about keeping all the procedures in your head so that you can pull out the appropriate one and get to work. It isn’t even about being on call.

It is about having a designated call room.

No, I don’t mean a room in the bowels of the hospital to chill in if your call is a twenty-four hour deal.

It is about having a designated operating room for call.

We like to think that all operating rooms are the same. We like to think that all operating rooms are a blank slate, just waiting for us to walk into and start the surgery.

We like to think about the call shifters as being separated from the rest of the OR crew. After all, we are a small cohesive unit. We work well together because we know the mission is to get in, do the case, and get out. No breaks, no water cooler moments, just case and be done.

In our perfect little world, every operating room would be the same. Each room would have exactly what it needs for the most common call cases. It would have a video tower, it would have an auxiliary monitor that shadow casts from the video tower. And it would be hooked up. It would have a full tank of carbon dioxide so that you can inflate the abdomen. It would have an irrigation module so that irrigation can be run into the abdomen. It would have a functional suction tree, with every “branch” that has a suction cannister. It would have the powered coagulator that you need to create access in the abdomen. It might have a tourniquet. The dilation and curettage machine would be in the designated spot. It would also be fully stocked. The irrigation would be warmed to the correct temperature of 104 degrees Fahrenheit and in the anteroom. The warmed blankets would be in the same warmer as the irrigation, steps away from the action.

The perfect little world call room is also close to help if you or the patient needs it.

But we don’t live in a perfect little world.

These operating rooms are workhorses. In the course of a day they can go from an OB-GYN case, to an orthopedic case, to a podiatry case, to a general case, and back again.

You will never be able to enact your will on every operating rooms. Don’t even try.

Because there are humans who inhabit the rooms during the other shifts. And their idea of a perfect operating room will differ from yours. The orthopedic rooms will have a tourniquet but will not have the power coagulator. The OB-GYN room will have most of what you need for a perfect little world call room, plus stirrups. The podiatry room will have a tourniquet and a bump for under the hip.

However, what is possible, is to have a dedicated call operating room that has all the equipment that the perfect little world operating room does. But you know that the dilation and curettage machine is fully stocked and where it should be.

This is imminently possible to have a conversation with your boss, or the boss before that one, or the boss before that one, about why having a dedicated call operating room is important.

Ideally invoking the wrath of a code blue in a surgery is not necessary. Remember what I said about close to help. Having a dedicated operating room allows those who would show descend on you if there was an actual code know where they are going.

I’ve done a code in the far flung cysto room. Now, do you understand why there are directional signs to that cysto room?

Having a dedicated call operating room will make your life so, so, so, much easier.

You won’t have to run around like a chicken, cursing day shift out loud as you search for the irrigation module, or the cord that connects the video tower to the auxiliary tower, or a video tower in the altogether. Or frantically searching operating room by operating room, in every store room, in the other store room, maybe it’s in the cysto room, looking for the dilation and curettage machine.

And that?

Is priceless.

And well worth the brow-beating you have to do to accomplish having a perfect dedicated call operating room.

What’s in my bag?

I have a confession to make. Not something deep and dark but something a little more fun than that.

<deep breath>

I do not carry a purse. I never ever ever have. Don’t get me wrong, a purse is a useful thing. To some people.

I am not that kind of people. I just never got into the habit of carrying anything other than my backpack when I was high school or college. Any of the colleges.

I just done see why I should carry a school bag and a purse. This seems counterintuitive to me. Why carry 2 things when one would do?

To carry the thought further, why carry 1 thing when nothing will work as well.

What about your wallet? I carry it.

What about your phone. I carry it.

What about your keys? I tuck them into the back of the pants/shorts/skirts that I am wearing. The larger key fob keys has made this possible.

There is also this new-fangled thing that men have enjoyed for centuries. It is a small pouch that is sewn into the seam of the pants they are wearing.

I think they call them pockets.

There are a couple of reasons why pockets for women disappeared.

Fashion is one of them. Of course it is. Dresses were cut closer to the body and there was no room for pockets. It would spoil the line, you see.

Apparently there wasn’t any call for women to carry money or to have access to money. After all, the men had pockets. It is the attitude akin to the why teach women to read. Reading and thinking is suspicious.

Eye roll.

Another more sinister reason is that women with pockets were suddenly especially suspicious.

Who knew what she was harboring in her skirts!

A puppy or kitten. Money she had saved from the shopping in order to run away from her abusive husband. Or political tracts/articles that she had no reason to read because she wouldn’t understand them anyway.

This is sarcasm. But what isn’t sarcasm is that it was yet another way to financially control women. Why would a woman need to have money if she could charge anything at the shop with the bills to be sent to her husband. Or her father. Or her brother.

Ahem.

Pockets and access to pockets is not the reason that I’ve never carried anything but a backpack for school or a work bag for the hospital. I have just never cared to.

It just always seemed like something to lose. Not to mention that you have to have one for day and one for going out. You have to match the purse of the day to your outfit.

Frankly, no thank you. I’m a simple soul and I don’t need a purse. But I would like pockets.

To that end all the clothes that I have bought in the last several years must have pockets. Yes, even pajamas. And dresses. And skirts.

The overall secret to this freedom?

Small wallet and minimal keychains. Too many keychains is bad on your ignition anyway.

But what if you need X, Y, Z?

We’ll look at what’s in the wallet next time. But it isn’t much. Simplicity is the keyword, after all.