I have spent the better part of an hour making patient call-backs. What this means is I call a phone number of a patient that has been treated, and the phone rings until I get an answering machine. Then I leave a message and hang up the phone. I repeat this probably about twenty or thirty times within an hour or two every night, when the shift begins to slow down. While the phone rings, I sit on my stool alone in lab and listen to the hum of the printer at the front desk. Almost invariably, no one's home.
As I leave a message on a patient's voice mail, the doctor orders a lab test requiring a blood draw for a patient in room 2. I check the name, Nashiely, and wonder how I would go about saying this correctly. I gather the phlebotomy kit and leave.
When I walk into room 2, there aren't any lights. But I hear a voice and someone stirring. I turn the lights on, and I see that she is in what appears to be pajamas, and that she is caramel and dark and beautiful. She is curled up on the bed, watching Garfield on tv.
I ask her name as a question, but I already know I haven't pronounced it correctly. She answers regardless.
"Hi, my name's Brent," I tell her. "I'll be drawing some blood for another test the doctor wants to take." I am unnerved by her full lips, luscious black hair, and unblemished complexion, but it is easy to appear to be in control when you have the entire interaction broken down into a step-by-step process.
"OK." She stays snuggled and relaxed on the bed. I wonder if this is how she spends a typical Saturday evening, lounging on the couch watching animated movies.
While I assemble what I need from the phlebotomy kit, I ask her, "How do you pronounce your name?"
She answers, "Na-SHEE-leh."
I still can't pronounce it correctly. "Do you mind me asking what country it's from?"
"Mexico," she says. She's probably been through this a hundred times. "A little part of Mexico, they have their own dialect. It means, 'I love you.'" I think she rolls her eyes a little when she tells me the last part, but I feel that the name is appropriate.
"Your name means 'I love you?'"
"I think that's a really cool name," I tell her. I like the idea of pronouncing your love for a lady every time you utter her name.
"Thank you." She is laughing at me, and I briefly consider the possibility she knows what I'm thinking.
I ask to examine her arms to determine which one I'll draw blood from. She still doesn't move from a position that she obviously finds comfortable. I like this lady's style. She is warm, even through the gloves. There's a scar on her right arm, which I ask her about.
She tells me. I listen more to the sound of her voice than her words. She has an accent, and she speaks softly.
When performing venipuncture, you use your sense of touch. After you've applied the tourniquet, you use a fingertip and press gently against the skin, feeling for the spongy spring of a non-arterial blood vessel. Then you palpate up and down the length of the blood vessel, mapping what direction it runs in order to determine which direction you align the needle, and identifying anatomical landmarks on the patient's arm so that when you look away to assemble and uncap the needle, you can find your way back. Sometimes the veins you can see in a person's arm aren't appropriate for venipuncture. Sometimes the antecubital vein, which is usually the most desirable vessel to draw blood from, can only be detected by touch.
I pull a stool close to her, and trace a map along her arm with my finger tips.
When I've made the puncture, one quick and smooth motion, and have already engaged the tube into the vacutainer to draw blood, she looks down at her arm, surprised that she did not and continues to not feel pain.
"Wow," she breathes in relief. "You're great."
"I've got a steady hand," I tell her. I don't like to brag, but I actually get this a lot. I do it for a living.
"You're really good."
I am happy she is impressed with my phlebotomy skills. Her smile is tired, but it is for me. This will affect me profoundly for the rest of my night at the clinic.
It's cold in the city. I find my intimacy where I can.