The Intern Blues(30)

I’m worried about all of us, but I think Val’s in a lot more trouble than Elizabeth or me. She’s really depressed. She says she’d rather be hiding under her bed than working in the hospital. Now I’m no psychiatrist, but that sounds pretty abnormal to me. She was on Sunday and spent the whole day trying to start an IV in Hanson and doing a lot of other technical scut. To hear her tell it, she missed every single time. And then the senior resident would come along and plop a needle in and get it on the first stick. Val got so frustrated that by Monday morning she couldn’t even get blood from the veins of the easy kids. She walked around like a zombie most of the day. Rhonda had to tell her to go home in the early afternoon because she wasn’t doing anybody any good. I think Rhonda felt better about Val leaving. I get the feeling Rhonda would be happiest if we all would leave. That way, she’d just take care of all the patients herself without anybody to bother her. Have I mentioned yet that I’m going to have to kill her?

Well, all this may not make much sense, but it sure as hell made me feel better to get it off my chest. I can now go to sleep without worrying about tearing my pillow to shreds.

Thursday, August 8, 1985

Maybe Rhonda isn’t so bad after all. At the end of attending rounds today, Claire, the other chief resident, came into the residents’ room and said, “It’s come to my attention that maybe we haven’t been paying enough attention to you guys.” That’s an understatement! She told us how sorry she was about it and that she wanted to find out what the chiefs could do to make our lives easier. And before anyone could say anything else, Rhonda yelled, “This makes me so damned mad!” and immediately broke into tears. She caught her breath and said, “Here we are, working our rumps off. I had eleven admissions the other night [on nights on call, Rhonda was responsible for all patients admitted to both the Infants’ and the Children’s ward] and Arlene knew it but not once did I get a ‘You did a good job last night, Rhonda’ or anything. All she gave me was, ‘If you can’t get your interns to conferences, we just won’t have them anymore.’ ”

Then Claire got a real concerned look on her face and asked, “Rhonda, what’s wrong?” and Rhonda yelled back, “You want to know what’s wrong? You treat us like dirt! It wasn’t so long ago that you were doing this! You can’t tell me you don’t remember what it’s like to be the senior on Infants’ with all these sick kids and all these admissions and all the attendings coming around to bombard you with demands every second of the day! But neither of you seem very sympathetic. All you can do is complain that we’re not coming to conferences. You know I’d love to be able to go to the conferences, I’d like to learn something. But I don’t see you or Arlene volunteering to cover the ward for me so I can go!”

I wouldn’t have believed it if I hadn’t seen it. Elizabeth felt the same way. Neither of us thought Rhonda had it in her to stand up for herself like that. She seems like too much of a robot to show that much emotion. I mean, she’s feeling as rotten about working on this ward as we are.

The rest of the exchange was pretty amazing, too. After Rhonda finished yelling, Claire said, “Rhonda, you know what we think of you. We might not always say it, but you’re the best we’ve got. Whenever I see your name on the schedule, I breathe a sigh of relief because I know you’re never going to do the wrong thing.” And then Rhonda said, “You sure have a strange way of showing it. I don’t expect a pat on the head just for taking night call, but I don’t expect to be yelled at either.” They talked a while longer after that, but it wasn’t as good as this first part. It was pretty amazing. It made me feel a little better about working with Rhonda. Who knows? Maybe I won’t have to kill her after all.

Tuesday, August 13, 1985

What a calm, relaxing night last night was! I got four admissions, all of them in the middle of the night, all real simple: a kid with congenital heart disease that’s so complicated I need a medical dictionary, an anatomy textbook, and a road map just to get through the old chart; I also got a ten-month-old who had GE reflux [gastroesophageal reflux, the reflux of acidic stomach contents back into the esophagus] that was corrected surgically when he was a couple of months old, who got diarrhea over the weekend and got himself pretty dehydrated; a straightforward meningitic who happened to be seizing; and a three-year-old with meningomyelocoele [a congenital defect of the spine that causes paralysis of the legs, bowel and bladder incontinence, and hydrocephalus; also called spina bifida] who came in with a high fever and looked like shit. We thought he probably had meningitis, too, but it turned out he probably only has a UTI [urinary tract infection, a common problem in children with bladder incontinence]. I managed not to get any sleep again. And then today my pal Hanson, who was getting better, decided to get a fever. He looked pretty good so I didn’t make too much out of it. I figured he had the virus that’s going around but then Rhonda heard about it and took a look at him and said, “Well, it may be the virus, but I don’t like the look of those IVs” [fever in a child with IVs can be caused by infection of those IVs]. I was planning to spend the day writing my notes and getting the hell out of there. But did I do that? Of course not! I wound up spending the afternoon sticking needles into Hanson’s body, trying to start new IVs. I must have stuck him ten times before I got one in. The kid’s totally aveinic [internese for “without veins”].