The Intern Blues(23)

Truthfully, I’ve only actually gotten the chance to lie down in the bed in the on-call room once since the first night of the month, and that was only for about fifteen minutes or so. It was last week, at about five in the morning. The bed was unmade, the room was a mess, but it felt great! I fell asleep right away but I got woken up about fifteen minutes later: This weird guy who must have been high or something was in the room with me. He was opening and closing the door and doing all kinds of weird things. I lifted my head up and yelled, “Who the fuck is that?” and he ran away. I got up and locked the door, but my beeper went off and that was it for dreamland. Oh, well.

There were a couple of exciting things that happened the other day. There was a twenty-nine-weeker [born eleven weeks prematurely] who was an extramural delivery [born outside the walls of the hospital]. We got stat paged to the ER, so we went running down the stairs, and there’s one of the pediatric residents holding this tiny, tiny baby. The guy looked uncertain about what to do. So we took the kid, who was doing fine at that moment, and we whipped him upstairs and wound up intubating him [placing an endotracheal tube into his trachea so that direct ventilation of the lungs could be accomplished] and so on and so forth. And it turns out the mom’s a drug abuser. She claims not to use them intravenously, but who knows? So I might have gotten my first AIDS patient, although it’s a little too early to tell, but who knows?

I went and talked to the mom later in the day. She doesn’t want the baby at all. It’s really sad. The father is nowhere to be found; when she was telling me this she got really teary-eyed.

So I didn’t get out of there until six last night and I was just delirious. I’m not as good a doctor postcall as I am precall; I don’t think anybody is. You just can’t make as good decisions when you’re that tired. I think postcall, I function at about 80 percent, which is not bad, but that extra 20 percent, that’s got to be important sometimes. I think it’s really stupid, I just think this whole unbelievable call system is stupid because it really makes you . . . you’re just not as good! Don’t misunderstand me, I’m not so much complaining that I’m unhappy about having to take the abuse of being up all night every third night, I don’t like that, I don’t like the way it makes me feel, but the thing that really bothers me is I don’t think I can give as good care. If you’re trying to give the best care in the world, you should be able to work out a system where doctors can function at their best. Anyway, I’m sure this won’t be the last time I tirade about the evils of call.

Monday, August 19, 1985, 6:45 A.M.

I can talk only for a minute or two because I have to go back to work. I’m glad that I have only another nine days to go in the NICU and that I have only three more calls (one of which is tonight), because I don’t think I’m wild about neonatology. I can’t say it’s been a horrible experience, but I wouldn’t want to spend my life with tiny babies. There’re much more interesting things in pediatrics than little tiny critters.

This morning I’ve been feeling kind of low; I’ve been missing Karen a lot. I talked to her yesterday morning, but she could talk for only a minute. I tried to call her last night, but she wasn’t home. I really feel cut off. I fell asleep thinking about her and missing her and I woke up this morning feeling kind of low and lonely. I never want to do this again, be apart from her for so long, never, never. I never want to feel this homesick for Boston again either. It’s eleven more days until Karen will be here, and she’s coming for a month. It’s going to be great, really great.

In the meantime, nine of those days I’ve got to go bust my butt. So that’s what I’ve got to do. I’m on call tonight with Larry, the third-year resident in the NICU; I’m kind of glad about that. There’s a definite difference between the second-year resident and the third year; the third years let you do things on your own; the second years hog all the procedures. So with the second year, all you do is scut, but when you’re on with the third year at least you get to feel a little bit like you’re doing something. And Larry’s a good guy; he’s a really fun guy, I’m sure we’ll have a good time.

Well, I guess I gotta go. I’d rather go back to bed. But I gotta go . . . I know I’ll feel better about it when I get there; it’s always hard just getting there, though.

Friday, August 23, 1985, 7:20 P.M.

I’m in bed, and I’m going to go to sleep because I was on call last night and I didn’t get any sleep, and I’m really tired because I worked my butt off. It’s really ridiculous, this every fourth is crazy . . . I mean every third. I suppose I should have a lot to talk about . . . it’s all so much of the same shit . . . you know . . . creatinine, BUN, all that shit . . . it’s all gobbledygook. I’m going to sleep. . . .