The White Coat Diaries

The White Coat Diaries

by Madi Sinha

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Overview

Grey’s Anatomy meets Scrubs in this brilliant debut novel about a young doctor’s struggle to survive residency, love, and life. 

Having spent the last twenty-something years with her nose in a textbook, brilliant and driven Norah Kapadia has just landed the medical residency of her dreams. But after a disastrous first day, she's ready to quit. Disgruntled patients, sleep deprivation, and her duty to be the "perfect Indian daughter" have her questioning her future as a doctor.

Enter chief resident Ethan Cantor. He's everything Norah aspires to be: respected by the attending physicians, calm during emergencies, and charismatic with his patients. And as he morphs from Norah’s mentor to something more, it seems her luck is finally changing.

But when a fatal medical mistake is made, pulling Norah into a cover-up, she must decide how far she’s willing to go to protect the secret. What if “doing no harm” means putting herself at risk?

Product Details

ISBN-13: 9780593098196
Publisher: Penguin Publishing Group
Publication date: 09/15/2020
Pages: 368
Sales rank: 94,370
Product dimensions: 5.46(w) x 8.18(h) x 0.94(d)

About the Author

Madi Sinha is a physician, and THE WHITE COAT DIARIES is her debut novel. She lives in New Jersey with her family. You can find her at madisinha.com.

Read an Excerpt

Chapter One
   
    I just want to help people, I just want to help people, I just want to
    help people. . . .
   
    I crouch on the floor in an Emergency Department supply closet, wedged
    in between boxes of adult diapers and pregnancy tests. The door swings
    open, and a nurse pokes her head in.
   
    “Are there any linens left in here?” she asks.
   
    “I’m not sure.” I stare into my lap, letting my hair fall across my face
    like a curtain. Hopefully she doesn’t notice my puffy eyes.
   
    “Are you the intern that just stuck herself?”
   
    “Yes.” I discreetly wipe my nose with the back of my hand. I try to
    sound less panicked than I feel. “Yup, that was me. I just took the
    needle out of the patient and accidentally stuck myself in the hand with
    it. Like an idiot.” I attempt to laugh ironically, but it comes out
    sounding more like a desperate whimper.
   
    “Well, when you’re done doing whatever it is you’re doing, you need to
    report to Employee Health. They’ll test you and give you medication.”
    She peers down at me through her tiny bifocals. Her voice sympathetic,
    she asks, “Have you ever had a needle stick before?”
   
    My chest is so tight I can barely get the word out. “No.”
   
    “Well, I’ve had four in my career, and it’s not that big a deal.”
   
    “Really?” I’m buoyed by a surge of hope. “Did you—”
   
    “Make sure to get yourself together before coming back out here. It’s
    unprofessional to cry in front of the patients.” She closes the door
    abruptly.
   
    The motion-­sensor light goes off, and I am left in near–­pitch darkness.
   
    I just want to help peo— Oh fuck everyone!
   
    I spend probably fifteen minutes sitting in the dark supply closet, too
    exhausted and depleted to move. I’ve been awake for over twenty-­four
    hours. During that time, I’ve peed twice, eaten once, and asked myself,
    How did it come to this? eighteen times. I thought I’d be good at this.
    Why am I not good at this? I reach into the pocket of my white coat for
    my inhaler, and the lights flick back on. From the corner of my eye, I
    see something tiny and brown scurry across the floor and dive behind a
    box of gauze pads. I spring to my feet, and my head strikes the shelf
    above me. Pain sears through the back of my skull. I yelp, and as my
    hand flies up to my scalp to check for bleeding, I knock over a box,
    causing a million little Band-­Aids to come fluttering down all around
    me like ticker tape, as if to say, Congratulations! You’re a
    twenty-­six-­year-­old loser hiding in a closet.
   
    It wasn’t supposed to be like this. I graduated at the top of my
    class—Alpha Omega Alpha honor society, in fact—from medical school. I
    beat out hundreds of other applicants for a coveted internal medicine
    residency spot at Philadelphia General Hospital. The Philadelphia
    General, my first choice. I could have easily gone to the Cleveland
    Clinic or Mass General or Mayo, but I chose to go where I knew the
    training was rigorous and unmatched because I was certain, beyond a
    doubt, that I could handle it, probably with one arm tied behind my back.
   
    I can recite the name of every bone, muscle, and nerve in the adult
    human body the way other people can recite song lyrics (and, just for
    reference, there are 206 bones in the human body). I can diagram, from
    memory, the biochemical pathway by which the liver converts squalene
    into cholesterol. I can list the top twenty medications for hypertension
    and the side effects of each, without using a mnemonic device. I’ve
    studied. My God, have I studied. I’ve studied to the point of
    self-­imposed social isolation. To the point of obsession. I’ve prepared
    for this for years, decades, my whole life. I wrote an essay in third
    grade titled “Why Tendons Are Awesome!” that not only earned me an A,
    but was prominently displayed for months on the classroom bulletin
    board. I mean, I was meant for this.
   
    I’ve been an intern for twenty-­four hours, and that arm that’s tied
    behind my back? I’m ready to rip it off this instant.
   
    Sighing, I crouch down, pick up all the Band-­Aids, and cram them back
    into their box. Then I emerge from the closet sheepishly, expecting to
    find at least one of the several ED nurses waiting for me, ready to
    comfort me in that stern-­but-­understanding, maternal way of theirs.
    The only person at the nurses’ station is a disinterested janitor on his
    cell phone.
   
    A balding man wearing large, square wire-­rimmed glasses and an angry
    expression barks at me from the hallway. “Excuse me! Miss, do you work
    here?”
   
    I nod, and he approaches. “My wife is still waiting for a bed.” He
    indicates a woman in a hospital gown lying on a stretcher that’s been
    pushed to one side of the bustling ED hallway. “When is she going to be
    moved to her room?”
   
    “I’m not sure . . . ,” I say, uncertain if I can help him but
    desperately wanting to do something, anything, right. “Has she been
    admitted?”
   
    “Obviously, yes. She’s being admitted for observation for pneumonia. Her
    name is Tally. Lenore Tally. Do you have any information on her?”
   
    The name means nothing to me. “I’m sorry, she’s not one of my patients,
    but I can try to find her nurse for you,” I offer. The few nurses in
    sight look busy, drawing blood and taking vital signs. “It might take a
    few minutes, but—”
   
    The man throws up his hands in frustration. “None of you people have any
    answers! Oh, for God’s sake, I’ll find her nurse myself!” He storms off,
    and I can hear his voice echoing down the hall: “Excuse me? Do you work
    here?”
   
    My shoulders sag. So much for doing something right. At this point, it’s
    clear: the gaping black hole of despair that has consumed my being can
    be filled by only one thing. I need baked goods, and I need them stat. I
    hurry to the vending machine in the ED waiting room, eat two and a half
    bags of mini chocolate chip cookies while waiting for the elevator, and
    find, to my great disappointment, that my mood is only marginally
    brightened.
   
    It had never occurred to me—until the moment I drew the needle out of
    my patient’s vein, popped off the test tube full of his blood, crossed
    my hands to reach for the gauze pad, and jabbed the end of the needle
    into the back of my hand—that I might be putting myself at risk by
    spending my days and nights tending to sick people. Well, then again,
    that’s not true. It had occurred to me, but before it became an actual
    possibility, the idea of contracting a potentially lethal disease from a
    patient had a noble, romantic, Victorian sort of feel to it: the
    selfless, waistcoated doctor carrying a leather satchel and a jar full
    of leeches, sacrificing herself at the bedside of her patient—that sort
    of thing.
   
    I know the chances of actually getting sick are extremely slim,
    especially if I take prophylactic antiviral medication, but I worry
    nonetheless. I worry with a fervor that I both recognize as irrational
    and embrace as inevitable. Worry out of proportion with reality is kind
    of my thing.
   
    “Is this your first needle stick?” The nurse at the tiny Employee Health
    office next to the hospital pharmacy—her name tag identifies her as
    “Rhonda”—looks irked and preoccupied. When I walked in a moment ago,
    she was engaged in a heated phone conversation with someone named Hank
    about getting his lazy ass off the couch and maybe, for once in his
    worthless life, cleaning up the cat’s vomit. It was quite a few minutes
    of this sort of thing before she turned around and realized I was
    sitting right in front of her desk, awkwardly trying to decide whether
    to wait for her to notice me or just interrupt her. When she hung up the
    phone, it was with one eye fixed suspiciously on me. “Can I help you?”
   
    I told her what had happened and, in doing so, triggered another bout of
    panicky tears. Rhonda kindly, if impatiently, handed me a box of
    Kleenex. Then she proceeded to fish out from a filing cabinet no less
    than eight different questionnaires, each of which she now seems
    determined to methodically complete in its entirety.
   
    “No. This is my first needle stick,” I answer, twisting the damp Kleenex
    around my fingers.
   
    “Do you have any risk factors for HIV or hepatitis C?” Rhonda asks.
   
    “No.”
   
    “Have you ever been tested for either?”
   
    “No.”
   
    “Are you currently sexually active?”
   
    “Nope.”
   
    “When was the last time you were sexually active without barrier
    protection?”
   
    “Um . . . never.”
   
    “As in you’ve never had unprotected intercourse?”
   
    “As in . . . I’ve never had intercourse.”
   
    Rhonda pauses, her pen hovering above the paper.
   
    “It’s cultural,” I add quickly. “I’m Indian. Premarital sex is frowned
    upon. Like, a lot. You’ve seen Bend It Like Beckham, right?”
   
    “That’s . . . fine,” Rhonda says, scratching one raised eyebrow.
   
    I sigh inwardly. Whatever, Rhonda.
   
    She asks me for my medical history (None, except a mild case of asthma),
    list of allergies (None, except cats), and social history (Do I smoke?
    No. Drink? No. Do I use illicit drugs? Obviously not.). Then she asks me
    to put my arm on her desk, ties a tourniquet around my biceps, and draws
    four vials of blood.
   
    As she tapes a wad of gauze over my skin, she says, “You’ll need to come
    in for another blood test in six weeks and again in three months.” She
    hands me a slip of paper. “And this is for the antiviral tablets. Pick
    them up at the pharmacy next door. You’ll take them three times a day
    for the next six weeks.”
   
    I look at the prescription. “Lamivudine? A nucleoside reverse
    transcriptase inhibitor?” I say, aghast.
   
    Rhonda stares at me. “That’s the protocol.”
   
    “But the potential side effects of this are nausea, diarrhea, abdominal
    pain, headaches, pancreatitis, and liver failure.”
   
    She regards me skeptically. “If you say so.”
   
    “Isn’t there anything else I could take instead?” I plead. “I’m an
    intern. I can’t afford to have headaches and go into liver failure. I
    have patients to round on. I have a lot to do.”
   
    “That’s the protocol.” She enunciates each word in a way that indicates
    that she has fulfilled the duties laid out in her job description and,
    therefore, our interaction must come to an immediate close.
   
    I turn toward the door. “You don’t think didanosine or even efavirenz
    would be a better—”
   
    Rhonda puts her phone to her ear. “Have a nice day, Doctor!”
   
    I’m sitting at one of a cluster of long tables near a picture window. A
    curt little sign in a metal stand nearby reads: Reserved for PGH Doctors
    and Staff. It’s early, a half-­moon still visible in the dawn sky, and
    the only other patron in the cafeteria dining room is an elderly man
    connected to an oxygen tank that he carries in a cloth duffel bag. He
    shuffles in my direction, notices the sign, then shuffles away. A
    plastic tray appears across the table from me, and a slender young man
    with round glasses says, “Hi. Stuart Ness, Harvard Med.” He begins to
    vigorously dissect a grapefruit.
   
    “Yes, I remember. We met at orientation.” Where you introduced yourself
    as Stuart Ness from Harvard Med. Twice.
   
    “Being on call is great!” he enthuses without prompting. “I admitted
    eleven patients, started fourteen IV lines, and still had time to watch
    a movie. I’m not even tired. I think I’ll go for a run when our shift is
    over.”
   
    I wonder if it’s possible that I’m so fatigued I’m hallucinating this
    entire interaction with this gratingly peppy Harry Potter look-­alike.
    “That’s dynamite,” I say.
   
    “I’m so psyched to finally be here. I can’t wait to meet Dr. Portnoy.
    The man, the legend, am I right?”
   
    “Yup.”
   
    “And the Dr. V. Did you hear that we get to work with him? Like,
    actually round with him and everything?” His eyes gleam. “So awesome!”
   
    “It’s pretty awesome.” I manage a thin smile.
   
    “What was your name again?”
   
    “Norah Kapadia.”
   
    “Hey, any relation to Dr. Kapadia, the head of Pediatrics at UPenn? The
    one that came up with the Kapadia criteria for Kawasaki disease? I mean,
    I don’t know how common a last name of Kapadia is, but—”
   
    I blow a puff of air through my pursed lips. I’ve lost track of how many
    times I’ve answered this question over the years, but it always comes
    from someone eager to show off that they’re well-­versed in rare
    pediatric disorders. “That’s my father.”

Reading Group Guide

Readers Guide
The White Coat Diaries by Madi Sinha
Questions for Discussion

1. Impostor syndrome is when an individual suffers from self-doubt and feelings of fraudulence, in spite of being qualified to handle the situation. Discuss Norah’s experience with impostor syndrome and whether you have ever felt similarly.

2. Norah struggles to balance her career expectations with her family’s expectations. When do these expectations clash? Does she handle the situations the right way? Have you had to balance conflicting expectations in your own life?

3. Recurring emotional stress can lead to “compassion fatigue,” the experience of becoming emotionally numb and disconnected from the suffering of others. In the medical field, compassion fatigue is recognized as a factor in burnout. Discuss which characters show signs of compassion fatigue and what factors you think contribute to its development.

4. Norah and her sister-in-law, Reena, have a rocky relationship. Why do you think that is? How is this relationship different from Norah’s friendship with Meryl? Reena is Indian American and Meryl is not—do cultural factors play a role in how Norah relates to both women?

5. The White Coat Diaries is written by a doctor and shows what it’s like to work in a hospital. Does it match your expectations of how a hospital is run? Why or why not? Did this novel change the way you think about the medical system?

6. Where do you think Norah will be five years after the end of the novel? Will she be practicing medicine? Why or why not?

7. At the beginning of The White Coat Diaries, Norah reflects that she’s spent so much time caring for Ma and studying to become a doctor that “for a person in my midtwenties, there are a lot of things I’ve never done.” Discuss how this relative inexperience shapes her decisions. How does Norah change over the course of the novel as she experiences various firsts (first night on call, first real kiss, first group of friends, first sexual experience, etc.)?

8. Norah tries to adopt a “confident and breezy” persona around Ethan, essentially trying to remake herself into someone she thinks he’d find attractive. Have you ever tried to change yourself for someone? Looking back, do you wish you’d made a different decision?

9. At the end of The White Coat Diaries, Gabe remarks on how different Norah seems compared to when he first met her, and Norah replies that “We all evolve.” How does Norah’s personality change from the beginning of the novel to the end? How has your own personality changed over the course of your life? Are our personalities ever fixed, or do we keep evolving? In what ways do you think you will be different ten years from now? In what ways will you be the same?

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