The people on my team seem pretty good. There’s Elizabeth, of course. She already told me she doesn’t like Infants’ and that if it were all the same to the chiefs, she’d rather be back on Children’s. And then there’s the other intern, Valerie Saunders. I don’t know about her, she seems kind of depressed. Our resident is Rhonda Bennett. She’s smart, but she treat us like we’re real morons. I mean, on rounds in the morning, she makes sure to go over every little detail two or three times, and then makes us repeat what she says and write it all down. It’s like being in first grade or something. Elizabeth said something to her like, “C’mon, Rhonda, we promise we won’t forget, cross our hearts and hope to die,” and she got real defensive and said she was just trying to help us and make it easy for us. Well, I’ll tell you, if she keeps it easy for us, I might have to murder her.
Wednesday, August 7, 1985
I’m going to kill them, I’m going to kill them all! I was on last night and today was the worst day of my internship. It’s bad enough spending the night running from room to room trying to keep twenty-eight babies from dying, but to do that and to have to spend the next day being nice to Rhonda and putting up with all the shit the chief residents are handing us, that’s a little too much. So it looks like I’m going to have to kill everybody to get any peace.
The first one I’m going to kill is that Hanson. He crumped again last night. He stooled out [developed diarrhea] and got acidotic [built up acid in his blood, a sign of deterioration] and shocky. I had to do a whole sepsis workup including a spinal tap and pull out his old IV and start a new one; the whole thing took over four hours. And then I had to call the ID fellow [the fellow covering the infectious disease service] and argue with him about what antibiotics to start him on. He told me to use three drugs, two of which I’d never even heard of before!
The second one I’m going after is Rhonda. She’s so damned cheerful all the time, it’s disgusting! At two o’clock in the morning, after I got off the phone with the ID fellow, I went to tell her what antibiotics he had suggested and she smiled and said, “Well I don’t know about that, Mark, I don’t know if those antibiotics give adequate coverage against enteric gram negatives [bacteria that normally inhabit the intestinal tract]. You did tell him that Hanson had chronic diarrhea, didn’t you?” Of course I hadn’t mentioned the kid’s diarrhea. It was late and the kid had been trying to die on me all night and I can’t be expected to think of everything! So, still smiling, she ordered me to call the ID fellow back and rediscuss the case with him. Of course the guy knew Hanson had diarrhea; he had suggested the drugs just for that reason.
The thing about Rhonda is if you go and tell her she’s a pain in the ass and that she’s making your life miserable, she takes it personally and starts to get teary-eyed. So even though she is a pain in the ass who’s making my life miserable, I have to be nice to her anyway. I don’t think I can take this for a whole month. So I’m pretty sure I’m going to have to kill her.
And the third one I’m going to have to kill is Arlene, the chief resident. There I was, sitting in the residents’ room at noon today, minding my own business, trying to catch my breath; I’d made it through the night; I’d worked up six admissions. I had managed to keep Hanson and all the rest of them alive; I had even managed to make it through work rounds and attending rounds without falling asleep or complaining much. All I wanted to do was finish my scut, write my progress notes, and get my ass out of there. But could I do that? No! Arlene came in, saw us interns sitting there, and she said, “Aren’t you guys going to the noon conference?” Well, Elizabeth said she had to start an IV on a kid who was supposed to go to the OR at one and Valerie said she had something else to do, and I just sat there unable to move. So Arlene said, “You know, these conferences are for you guys, not for us. It’s just more work for me to schedule them. If you interns don’t want to come to them, maybe we shouldn’t schedule them anymore.” None of us said anything back to her. I just glared. Here I was, having killed myself all night, having killed myself for over a month now. Maybe you’d think the chief resident ought to come up to us and compliment us every once in a while, tell us we’re doing a good job and that we should keep it up, but no, all we get told is that if we don’t come to conferences, they’re going to cut them out! So if she ever says anything like that to me again, I’m definitely going to kill her.