What is there left to say? My own internship was the hardest, most devastating year of my life. It’s been eight and a half years since I finished that year, and some of the pain, the anger, the exhaustion, and the anguish is still with me. I don’t think my experience, or the experiences of Andy, Amy, and Mark, are unique. Everybody who lives through an internship is forever changed by the experience. The intern learns about medicine and the human body; he or she truly becomes a physician. But in the process, through the wearing down of the intern’s spirit, that person also loses something he or she has carried, some innocence, some humanness, some fundamental respect. The question is, Is it all worth it?
Afterword
January, 2001
“Is it all worth it?” A little less than fifteen years have passed since I wrote those words ending the manuscript of The Intern Blues. Even though by that time nearly a year had passed since Andy, Mark, and Amy had finished their internships, each was still engrossed in residency training; the experience was still too close, both temporally and emotionally, for them to be able to offer a valid response to my question. But now, with the perspective of time, of more than ten years since the completion of their training, they should be able to look back and offer some insight. So, when my friends at HarperCollins informed me that they wanted to put out a new edition of The Intern Blues, I began to search for the three ex-interns. In addition to getting an answer to the question I’d posed a decade and a half ago, I wanted to see what had happened in their lives since then.
Near the end of the epilogue to The Intern Blues, I stood in the rain, watching the truck Andy Baron had rented disappear down Gun Hill Road. With Andy driving and his girlfriend, Karen, sitting in the truck’s passenger seat, they were hauling Andy’s stuff from his apartment in the Bronx to their new place near Children’s Hospital in Boston, the facility at which Andy would soon begin his junior residency year. Although I did keep in contact with Andy via periodic telephone calls for the first year or so, we lost contact soon after and had not spoken since.
Finding Andy was quite easy: I simply searched for him on yahoo.com. Typing his name into the search engine, I immediately found him listed among the faculty of the Division of Neonatology on the website of the Department of Pediatrics at Boston University School of Medicine. After calling the main office, I was given the number of the Neonatal Intensive Care Unit at Wellesley Medical Center, a community hospital affiliated with Boston University, in which—at least according to the secretary—Andy worked. I dialed the number, and within a minute, he was on the line. To say the least, Andy was surprised to hear from me.
We spent a few minutes catching up. After driving that truck down Gun Hill Road, Andy got on I-95 North and headed for Boston, where, as expected, he spent two years completing his residency at Boston Children’s. Then, feeling wiped after the long, arduous process of residency training, he took a job working in a local pediatric practice, seeing patients three days a week. “After my residency, I felt . . . I don’t know . . . ‘used up’ is probably the best way to describe it,” he told me. “I needed to replenish myself. I didn’t have any direction, I didn’t really have a plan about what I wanted to do with the rest of my life. I knew I didn’t want to do general pediatrics forever, but the job gave me a chance to clear my head and think about the future.”
Andy got married during this period—to Karen, who was then doing her residency training in psychiatry—and they remain married (“happily married” in Andy’s words) to this day.
The general pediatric practice eventually grew to bore Andy. He worked there for a total of two years, then took another part-time job, this one doing shift work as a hospitalist [essentially a glorified resident] in a neonatal intensive care unit. “I always liked working in the NICU,” he told me. “There was always something exciting going on. I even liked it during residency, but back then it was mostly unpleasant because of the hours they forced us to put in. But when you’re working shifts, you can decide how much you want to work and how much you want to screw around. I played with my schedule until I had what I thought was the perfect mix.”
Andy liked working in the NICU so much (and was so good at it) that he decided to obtain formal training in the specialty, a step that would ultimately allow him to become a board-certified neonatologist. So four years after completing his residency, he returned to Boston Children’s as a neonatal fellow. “Those were three pretty grueling years,” he explained. “Each of my fellowship years was easily as hard as internship.”