The Intern Blues(135)

Take Amy’s problem as an example. Amy has done an amazingly good job. She has worked for an entire year as an intern, fulfilling all or most of her responsibilities. But at the same time, she’s also had to be a mother to Sarah, trying her hardest to fulfill the responsibilities of what clearly is a second important full-time job. She’s done all of this without anyone pointing the way for her; there are few faculty members around who could share their experiences as an intern and a mother with her. And although she’s had some help, mainly from her husband and her baby-sitter, she’s found little support within the system. The chief residents never wanted to know how sick her daughter was or what family obligations she had; they weren’t even happy or excited when Amy told them that she was pregnant; they only wanted to know that she’d be at the assigned place at the assigned time and that her job would get done.

And there are very few options open to female residents with children. The attitude is basically this: If you want to have a baby and you want to spend time with your baby, you should take a year or two off; if you want to work, you should put off childbearing until after residency training is completed. A happy medium—that is, working as a house officer halftime and spending the rest of the time as a mother—is at present available at very few hospitals.

Changes are occurring, but they’re occurring slowly. Eventually the young women who are house officers today will move into positions of authority, and the concept of medicine as a private club for men will gradually fade away and ultimately die out. At that time, a more realistic attitude toward women in medicine will evolve. And innovations such as shared residencies with two or more people fulfilling the responsibilities of one house officer, day-care facilities within hospitals, suitable facilities to encourage breast feeding, and fair maternity leave policies, which today are considered radical and expensive luxuries, will become commonplace. But as of now, Amy and her sisters in medicine must bear a heavy load.





Andy


JUNE 1986

Tuesday, June 24, 1986, 5:15 P.M.

My internship ends in three days. I’m moving back to Boston on the twenty-eighth. I can’t believe this is finally going to be over so soon.

This has been a tremendously long year, in some ways feeling more like three separate years than just one. The first year stretched from when we started back in June to when I finished on Adolescents’ at the end of September; that first period took me from the time when I was enthusiastic and up about medicine to the point where I reached my first real depression. The second year included University Hospital and my first three months at Jonas Bronck; this was the best time for me. I was “up” for a lot of it, I managed to get myself organized, I pulled some things together for the first time, and I really began to see that the experience was eventually going to turn me into a doctor; the time I spent on the east campus was the most optimistic period for me.

The last period, which has been the most difficult, took up about the past four or five months, from the time I first walked into the PICU until now. I’ve gone through hell these past five months; I became emotionally wrecked, much worse than I ever thought I could. It’s affected every aspect of my life, including my relationship with Karen, which I’ve always thought was unshakable. There was a time earlier this month when things had gotten so bad that we were seriously considering splitting up. This last period of internship has turned me into a very selfish and self-centered person. Thank God I’ve gotten some insight into what’s been happening. I think Karen and I have patched things up pretty well now, but it was very disturbing there for a while.

The hardest period of this year happened during the last half of May. I hit the big burnout. I really didn’t give a shit about anything; all I wanted was to be left alone by everybody. This lasted through the first couple of weeks of this month. At one point about two weeks ago, our attending sat me down and said, “You know, Andy, when you go to that new institution, it’s going to be very important for you to make a good impression during the first couple of weeks. Everyone is going to judge you for your entire stay there on how well you do at the very beginning. So snap out of this!” He realized I was just going through the motions, and it was nice of him to talk to me about it. I’ve pretty much recovered from that burnout now. I don’t know how, maybe it was because of what the attending said to me or maybe I just kind of woke up and realized what was happening on my own, but now I can behave myself most of the time without cursing and being moody and driving everyone crazy.