Tuesday, July 28, 2015

Ten Random Thoughts Every New Medical Intern Has

As I near the end of my first month of residency, as a newly-minted intern (and bask in the glory of my first real paychecks after four years of living on loans), I once again get the itch to read, write, and reflect. So rather than opinions, I give you ten random thoughts.

1. I feel like I'm hitting my 10,000 steps daily, and then some. Now that the iPhone measures your steps (with at least some degree of accuracy) I occasionally look at that app. The amount of steps I take daily has actually diminished significantly since summer time...though I certainly wouldn't know it. I know I spend a lot of time in front of a computer typing up progress notes and making phone calls, but with the amount of time I spend walking the floors on rounds and checking on patients...I certainly feel a lot less lazy than I did while on vacation.

2. The value of a good poop. I know Scrubs sang about it. Older residents told me about it. I thought I was prepared for it. But I can't believe how obsessed I've become with making sure other people poop. Relief of constipation is a beautiful thing and sometimes has a dramatic impact on a patient's progress. I love it when people poop.

3. I am constantly fighting dehydration. I've never been one to carry a water bottle to work or in general. I just go get some water when I feel thirsty. But now I have these 13-to-16-hour days (at most...legally speaking) where all I have to drink is a thermos of coffee in the morning with my Clif Bar...and then sometimes I forget to eat lunch entirely. Don't tell my senior residents, they'll scold me (as will my mother if/when she reads this). So I find myself with dry mouth, dry skin, overusing Chapstick, and feeling generally sluggish. You know, the things that I see in my patients who are mildly dehydrated. So I'm working on that.

4. Medicine is invading my subconscious.  My first weekend, I sat bolt up right at 3:00 AM Saturday morning and immediately texted my co-intern (who was working the night shift) that I had forgotten to order labs on a patient. He told me to go back to sleep. And then in my third week I had an all-too-vivid dream about a patient who pooped too much (see #2) and then I came into the hospital the following day and discovered one of my patients had, in a fit of delirium, had stool incontinence and was trying to rub it on things until the nurses calmed him down. Dreams come true in the worst way sometimes (that guy is better now, by the way).

5. Weekends at a hospital sometimes demand the most patience for patient care. Doctors and nurses (and several other staffers) work any of 7 days a week, but when the weekend rolls around, everything slows down. Non-emergent procedures, diagnostic tests, anything that can wait until Monday, does so. I'm not arguing the point, necessarily, because frankly, that's the point of weekends. But it gets frustrating in the moment. Sometimes I wish weekends didn't matter unless they happened to be your scheduled day off (a notion that will vanish the first time I get a weekend to myself again).

6. I am exhausted. I've never been good at sticking to a hard bedtime. I know when-abouts I should sleep so I can get 5-6 hours before I have to be up, and I try to get to bed within an hour of that. Aside from that, between running around seeing patients and the fact that I am suddenly at the mercy of the office phone and the med team pager, and that I am constantly racking my brain for how best to treat a patient - at the end of the day it's all I can do not to fall into bed right away. And even there I can't escape the hospital (see #5).

7. Everything else has fallen by the wayside. I told my mother that I was gonna take charge of planning my wedding. I had seen other interns do it (mostly female, which is neither here nor there), and Reptar is studying for her upcoming Step 2 exam, so she'll be busy. So I would do it. I get one day off every week! Of course I can get a bunch of wedding stuff done on that one day. Except I forgot that I have no idea what goes into planning a wedding, and even though I eventually did get an idea, I still don't know how to execute it, how to pick vendors, what information I need. So by week 3 I had surrendered and delegated a lot of work to my mother (read: gladly accepted when she offered to help).

8. Well, everything WOULD fall by the wayside, except...my incredibly understanding family and friends keep me based in reality. Reptar is, as always, a blessing. The other day I managed to be late to dinner...by AN HOUR. Whoops. Thankfully she wasn't alone at the restaurant for that occasion, but I'm sure that will happen, too. But she understands, and doesn't hold it against me. My parents and sisters, too - they're really coming to my rescue with wedding planning, groceries, general fun stuff to take my mind off the workload...gotta love them for that. And my non-medical friends remind me that there's a world outside the hospital and fight to help me join them in it. For which I can't thank them enough, because I couldn't do it on my own. My best friends, especially - Ketan keeps me grounded and lets me know that even though I have this new job and crazy hours, I can't stop making an effort, while Eric reminds me of the sillier things in life while maintaining a higher level of discussion...this while they study and do extensive research and tell me how awesome I am. In addition...

9. Residency (at least mine) is like a family. We look out for each other. When someone is staying too long past their shift, we offer to help. When lunchtime hits, the senior resident always checks and makes sure the interns and students are eating, and vice versa. When an attending yells at an intern, the residents will later talk the intern through it. It's truly a camaraderie. And it makes me excited to come to work. Which leads into #10.

10. I am so pumped for this job. The hours are long, the days wear on us all, I don't see Fiancée Reptar much. But I am so excited to go to work every day, take care of patients, and do my best not to screw up. Ask me in 6 months, maybe I won't feel the same way. But for now, I've waited for this job for 21 years. So far...it's worth it.