"It just got a bit hurt when I was in the hospital. It's nothing."

5 a.m. The pump beeped. The digital display blinked "distal occlusion." In the dark, I felt the tubing and searched for kinks. I turned on the light above the bed and looked for air bubbles. The IV was brand new, not 8 hours old. It couldn't be infiltrated. It just couldn't be. I rang for the nurse.

"My pump is beeping."

She came in and tried to fix it; there were no kinks, no air bubbles. She tried to flush it.

"Ouch-that hurts." Diagnosis: infiltrated IV.

"Do you need it? Do you know what you are getting in it?"

"I'm getting steroids and I'm going for colonoscopy in the morning. I need it."

She called the IV team and she said she'd be back. I turned off the light and waited.

9 a.m. I rang again. The ward clerk answered. "Can I help you?"

"I have no IV and I'm due for my meds-can you check on this for me?"

I was terrified of missing my steroid dose. At home, I was meticulous about my medications. I kept them in pillboxes arranged by the time of day. It was the only way I could keep track of them. Once, only once, had I missed my morning meds. It had been the day before Thanksgiving. We had been busy cooking and preparing for the holiday, so I had rushed off to work. By 11 a.m. I could feel strong cramps in my abdomen. It felt rough and raw, like it had felt as a child to fall off your bicycle onto the gravel-rough road and scrape off a whole layer of skin. The difference had been, this was inside. It was like falling off from the inside out. As soon as I felt the cramps, I knew what had happened. I called home. "Paul, check my box. Are the pills still in there?" They were. I had forgotten to take them and my colon was angry. No, I didn't want to miss any meds.

9:15 a.m. There was a knock at the door and a woman entered. "Hi! I'm from the IV team. I hear you need an IV."

A moment later, my morning nurse joined her and they chattered with each other as they searched for a new site. The tourniquet cut tightly into my arm.

"Open and close for me, honey. Open and close. We need to find a spot. Good job. Okay, now big stick-"

It hurt. Every part of me tightened up.

"Now, relax-don't squeeze tight." She angled the point up and back, in and out. I breathed up and back, in and out, and tried to stay still.

"Nope. No good. I wonder why. The vein looked so good, but I just couldn't thread it." She spoke to herself as she intently searched for veins. "Have you been sick for a while? What are you getting in your IV?"

I thought back over the past year and a half, remembering doctors, nurses, labs, biopsies, admissions. It felt as if I had been sick for a long, long time. Before I had the chance to respond, my nurse answered for me.

"She was admitted yesterday and she's getting steroids IV. You know how steroids make these veins so fragile."

The IV technician slapped rhythmically on the top of my hand. "Okay, we'll get one, honey. Don't worry. I wanted to avoid your hand because I think that it hurts more, but we need to try here." She pointed to a spot that was next to the original IV site. They pulled off the tape to expose my whole hand, and the old site started to bleed.

"You hold here, while I try this one." Together they twisted my hand to press and to pull-to stop and to start an old and a new place to enter my veins. "Okay, honey, big stick."

"Ow!" It hurt so much that I could not lie still. I tried to let go of that hand, to let them have it to work on, but it hurt so much. They pulled on my arm to hold it still.

"No! Honey, you're tensing up. I can't get it like this. Now just breathe, just breathe for me slow." I'm breathing, honey, I'm breathing.

"Nope. No good. No good." I closed my eyes tightly and let them work. They moved to the other side-one more try. No. No good. My nurse held my hand, but I couldn't feel it anymore. At this point, I did not want a friend. I wanted an IV.

"Poor dear. She's so scared. She's been sick-it's those steroids that ruin your veins." They spoke about me as if I were not there, and in a sense I was not. Slowly, as I lie on the bed, I closed my eyes and turned in to myself. I took myself out of their space to let them alone. "Poor sweet thing. Oh, here's one. It's small, but I think it will do-if she can only stay still."

I thought to myself, "I can. I will. I am stronger than this-I can do it. I know."

I relaxed my left hand and did not let it move. Tears streamed down from my loosely closed eyes as they worked. Salty, wet tears ran down my cheeks. I heard them exclaim, "Yes, we got it-we got it." My nurse continued, "I have your medications right here. We'll do them right now."

I did not open my eyes. I did not stop the tears. They held the tubing tight while they taped it in place.

"Thank you," I whispered. "Thank you."

I did not see them leave but I heard the door close behind them. A note would be written in my chart, "IV placed after four attempts." There would be no record of my vulnerability, no note of my contribution, no feature to distinguish this piece of assigned work from a million others. From day to day, room to room, task to task, the potency of the practice of medicine is hidden in the humdrum to those who are too intent on the task to see.