Saturday, August 24, 1985, 8:00 P.M.
In another couple of days I’ll have finished my second rotation. Two down out of twelve and already, so early on, I feel tired. I’m not worn out, I’m not whipped yet, but I feel tired. I feel the effects of this every third night, it’s already wearing on me. And I already hate the system; I think it’s a stupid and foolish system that rules your life and hurts your patients. And already I’m losing some sensitivity toward people—you know, as hurting, suffering human beings.
This morning when I woke up, I thought, What will I do with myself today? I got this fantasy; I thought about going back to my college, Princeton in New Jersey, and just spending the day down there. I figured I’d look up a couple of my professors and try to go see them. And then I got into the shower and the more I thought about it, the more appealing it got. I had it all planned: I’d go into the city and catch the train down to Princeton. I thought of all the beautiful green lawns and the tall trees reaching way up over the buildings, and about the flowers that would be in bloom, and the serenity and peacefulness of the place since there wouldn’t be any students there yet. I became entranced with the whole idea, how quiet and pretty and pastoral it would be.
Then I got out of the shower and as I sat around thinking, I realized that I wasn’t going to go to Princeton, it was all just a fantasy. My professors weren’t going to be around, they were going to be out of town on vacation. And I couldn’t just go and hang around there. I just wanted to escape from the difficult times I’m having right now into the past, when life was easier, when I didn’t have to worry about all the diseases and falling asleep on attending rounds, the jaded attitude of some of the residents, the oppressed lives my patients and their mothers lead, the crummy neighborhood I live in and the fact that I’m far away from my loved ones. I think this’ll blow over. When I finish this year and my residency and I’m just a practicing doctor when my hours are more regular and I’m more used to the responsibilities, it won’t be so bad. I don’t have any control over my life now, and that’s very difficult.
I know I’m just saying this stuff over and over again, but it’s just so difficult! I knew internship was going to be hard, everybody tells you that, you see the interns work their butts off, you know it’s hard! But somehow you don’t believe it. I was trying to tell my friend Maura about being an intern tonight, she really wanted to know. I told her a little bit, I told her a story, and then I just shook my head and all I could say to her was, “It’s just really hard.” I was thinking, Why am I trying to explain? I don’t want to explain anymore, I don’t want to tell anybody about this, it’s just too crazed.
Amy
AUGUST 1985
Tuesday, July 30, 1985
University Hospital is a strange place. I’m not really sure what I’m supposed to be doing there. I’ve got about eight patients, but none of them is really mine. Everyone has a private pediatrician, and the attendings are the ones who run the show. So we make rounds in the morning and decide what we’d like to do on each patient and then the attendings come around and tell us what we’re really going to do. Having us there seems pointless. It doesn’t make any sense.
We started yesterday and I got out at about three in the afternoon. Then today, I got home at three-thirty. All you do is eat lunch, write progress notes, and leave. My patients don’t keep me very busy. I’ve got this eight-year-old named Oscar who was in a car accident or something last year. He had a really bad head injury and was in a coma for months. They had to trach him [perform a tracheostomy: create an opening into the trachea, or windpipe] because he was on a ventilator for three months. He’s much better now, although he still needs a wheelchair, and ENT admitted him to take out his trach tube. He’s been in the hospital for two days so we can watch him breathe, and he’ll have to stay for another day or two. Very exciting!
My only really sick patient is this six-year-old renal transplant kid. He was born with dysplastic kidneys [abnormally formed and nonfunctional kidneys], and he’s been in renal failure his whole life. They did the transplant yesterday morning using his mother as the donor. He was sick as a dog all last night and most of today but I couldn’t even get near him! The renal service is running the whole show. Occasionally one of them will talk to me, to tell me what scut they want me to run. I probably could be learning a lot, but I can barely squeeze myself into the room!
This whole place is depressing! My patient is the newest of four transplant patients on the floor. The other three are all in some phase of rejection [rejecting the transplanted kidneys]. It’s a real pleasure to go into their rooms; they all want to die because they know that if they continue to reject, sooner or later they’re going to wind up back on dialysis.