Monday, November 22, 2010

Ode to Intern Year

My last several posts have been like deep fried Crisco -- really really heavy! But today I find myself with just a few minutes and I reckon it's high time I write something that isn't quite so dense and unreadable! For inspiration I turn to my experience working as a first year medical resident.

I find that when I meet someone new and we are trying to be polite while at the same time not really knowing what to say to each other, the small talk generally includes (but is not limited to) our names, the weather, President Obama, why Texas is the greatest nation…errr…state on earth, and what we do for work (all of this, of course, assumes that we both speak English…I really should have tried to learn Spanish before moving to south Texas!) What is interesting to me is how people react when they find out that I am a medical resident! Almost without exception, people think that residency is this glamorous thing filled with perplexing diseases, brilliant diagnosis and of course, a little lovin' in the call rooms (I blame "House" and "Grey's Anatomy")! The truth, I'm afraid to say, is a little less flashy. A much more accurate picture of what being a first year resident is often like can be gleaned from watching that scene from Forrest Gump where the Drill Sergeant is yelling at Forrest asking "what is your soul purpose in this army?" and only wants to hear Forrest say "whatever you tell me Drill Sergeant!" This of course, varies greatly depending on which attending you are working with and what rotation you are on, but there have been plenty of times when I am listening to my attending where that scene pops into my mind and for better or for worse, the best thing to do is say "yes sir, I'll get that done!" and say nothing else. Now, before people take this all wrong and start to worry that I'm unhappy with my career let me set the record straight and say that I really do enjoy my work and I look forward to many more enjoyable and fulfilling years in this profession but that does not change the fact that there is an often amusing hierarchy in teaching hospitals that looks like this (from top to bottom):

Attendings > Senior Residents > Nurses > CNA's > Janitors > Harmless Bacteria on the toilets > Disease causing bacteria > Ebola virus > first year residents.

Let me illustrate how this principle translates over to patient care in the real world (those of you who have spent time in hospitals will begin to recognize these things).

Attending: I want to start rounds at 5:00 am

Resident (in his head): That means that I have to start my pre-rounds at 3:00 am…why can't we start rounds at 9:00 am?

Resident (out loud): Yes sir! What a brilliant idea!

** at 3:00 am the next morning after the resident walks into a the patient's room and wakes him up**

Resident: How was your night's sleep?


Perhaps only those who have been woken up or who have done the waking at 3am to ask this question will see the irony here, but it kills me every time! :)

No comments: