The Intern Blues(146)

Following completion of his fellowship, Andy passed the boards in neonatology and took the job he currently holds, director of the nursery at Wellesley Medical Center. “It’s a small unit. We have only eight beds. Most of the time it’s manageable. But on those days when we’re really busy, it’s hard to get out of here at night.” He also continues to work only half-time, splitting coverage with two other part-time neonatologists. “When Karen and I first started thinking about having kids, we decided we didn’t want them to be cared for by nannies or grandparents or anyone other than ourselves. So we agreed that we’d each work part-time and spend the rest of the time caring for the kids.” The Barons have two boys, currently seven and three years old. “It’s worked out really well for us. Don’t get me wrong, it hasn’t always been easy. We’ve had to make some sacrifices. Believe me, we could be making a lot more money if we both worked full-time. But we’re comfortable, and how much money do we need? This way, Karen and I both have lives. I have time to paint and draw, things I used to love to do during high school and college but never had time for once I started medical school. And I’m able to watch my kids grow up. That’s worth a lot more to me than having a ton of money.”

I asked Andy to look back and consider what effect his internship had on him. He thought about the question for a while before answering. “You change so much during your training,” he replied. “You see such awful stuff, it has to have a permanent effect on the way you look at the world. But you change a lot as you get older, anyway, whether you do an internship or not. So I don’t think I can blame internship or residency for any big epiphany that occurred to me.

“The biggest change in my life happened when my first son was born,” he added. “Having kids definitely changes you; they change your perspective on patients, on their families, everything. I began to talk to my patients’ parents a lot differently after having my own child. I had a better understanding of what was important to them, and what wasn’t so important. Having a child definitely had more of an effect on how I deal with patients than anything that happened during my internship.”

And was it all worth it? Again, Andy considered the question for a few seconds before answering. “I’d say yes,” he finally replied. “I like what I do; I like being a neonatologist, and being able to set my hours and live the kind of life I live. None of this would have been possible had I not done an internship. There might be better ways of doing it, better methods of training young doctors, but all in all, it was a means to an end. I made it through and here I am. But there’s another question you should ask me, Bob.”

“What’s that?”

“Would I want my sons to become doctors?”

“Well, would you?”

“No. But it has nothing to do with my training. It has to do with insurance. The insurance industry has made medicine completely crazy. If you had told me when I was an intern about what I’d wind up having to do to get insurance companies to pay for what I think my patients need, I’d have told you that you were nuts. HMOs and the rest of the insurance industry have made the practice of medicine horrible, and I wouldn’t want my boys to have to go through this.”

We talked for a little while longer, but Andy had to get back to work. I wished him well, told him to give Karen and his kids a kiss for me, and we hung up.





Mark Greenberg was a little harder to locate: In contrast to Andy, he does not have a presence on the Internet. In order to find him, I sniffed around our department’s alumni records and came upon a letter of recommendation written by Peter Anderson (our chairman and the man whose lawn was the site of the original meeting between Andy, Mark, Amy, and me) and addressed to a hospital in central New Jersey to which Mark had applied for admitting privileges. Calling information in that town, I was given Mark’s office number. I hesitated before dialing the number.

I hesitated because Mark and I had not parted on exactly the best of terms. It took me more than a year to transcribe and edit the audio-diaries of the three interns that formed the basis of The Intern Blues. As I completed that work, I sent each of the by-then senior residents a copy of his or her transcript. A few days after sending his out, I got a call from Mark. “You can’t publish this crap,” he yelled at me over the phone. “I never said any of this stuff.”

“What stuff are you talking about?” I asked, a little surprised by his reaction.

“All this stuff,” Mark continued yelling. “Almost everything you have coming out of my mouth. Like here, during February, when I was in the NICU. You wrote, ‘And then we walked around and he showed us these so-called patients. My God, those things weren’t patients; they couldn’t have been human; they weren’t anything more than small pockets of pus and protoplasm! These things would have to quadruple their weight in order to be classified as patients. Right now, they’re nothing more than tiny portions of buzzard food.’ Bob, I never would have referred to preemies as ‘small packets of pus and protoplasm’ or ‘tiny portions of buzzard food!’ ”