“So you don’t think you ever want to talk to me again?” I asked.
“I’m not sure,” he replied, and I could see tears starting to well up in his eyes. “For now, I just want to be left alone. I don’t want to have to talk or think about anything.”
I told Andy how much he reminded me of myself. I told him about my pizza and Odd Couple routine. He smiled at this and said it hadn’t gotten that bad for him yet (he said his TV was broken).
To people like Andy, Mark, and Amy, who have long-term relationships, October can be a frightening time for loved ones. Because of the appearance of this first wave of depression, interns become introspective, largely ignoring everyone else; all an intern is concerned about is his or her ability to get enough sleep, enough to eat, and to find some kind of happiness without expending too much physical or emotional energy. And like Beth, this is a time when spouses begin to wonder what the future is going to hold.
That’s certainly the case with Carole, Mark Greenberg’s significant other. She and Mark have had a relationship that’s gone on for years and weathered all sorts of storms. And now, four months into his internship, she finds that Mark has no time for her. He falls asleep whenever they go anywhere together; he talks about nothing but life on the wards while taking no interest in her work or her problems. Carole is looking for some answers: She wants to know if the change she’s seen in Mark is permanent or temporary; she wants to know what effect all this will have on her life; and she wants to know if she and Mark will wind up getting married or not. Unfortunately, at the present time, Mark is in no condition to give her these answers.
Amy seems to be handling her life outside of work better than any of the other interns. From what she tells me, her relationship with Larry has not been adversely affected by her internship. I think there are two reasons for this. First, Larry is an exceptional guy; he’s very patient and understanding, and he loves to spend time with his daughter, which is pretty important, since he’s Sarah’s primary caretaker most nights and weekend days. Second, Amy is reacting differently than everyone else; she understands that she can’t come home, sit in front of the TV, and tune out life, because she has a second job that’s even more important than being an intern: She has to come home and be a functioning and loving mother. So far, Amy and Larry seem to be holding things together.
But even their relationship has clearly been stressed. Amy told me about an argument she and Larry had concerning Amy’s yelling at their baby-sitter. She said they almost never argue, but this one had occurred after a particularly bad night on call because Amy was overtired. So even for them, some small cracks have begun to appear in their ironclad marriage.
October also is a pretty hard month for the house officers who don’t have “significant others.” During the middle of this month, I went to the Recovery Room, a bar across the street from Mount Scopus, with some of the senior residents. Ben King told me he was a little upset because he was planning to go to his ex-girlfriend’s wedding this weekend. He and this woman broke up last year after a long-term relationship because she just couldn’t take it anymore. She didn’t like the idea of spending every night alone. “Even when I was there,” Ben told me, “I was only about half there.”
Usually, the only other single people unattached house officers come in contact with are other single house officers. There’s almost no time for them to hang around places where nonmedical single people congregate, and during what little time is available, there is a great deal of pressure to “succeed.” But most potential partners, like Ben’s old girlfriend, don’t want to put up with the bizarre hours interns and residents are forced to keep. So it becomes almost impossible to develop any kind of meaningful relationship that will last through training. For the men, this is just a major irritation; they figure things will straighten themselves out after their internship and residency ends. But for the women, it’s a lot more terrifying: They say they can actually hear those proverbial biological clocks ticking away inside their ovaries, and as time passes, they tend to become more and more fixated on finding Mr. Right.
So the overall effect of all this is that a great many interns and residents feel depressed. This internal turmoil can have far-reaching effects, causing the person to decide to make major changes in his or her life. Some interns decide to leave medicine; some (very few) decide to leave life by committing suicide; others decide to leave their program. This last seems to be happening with Andy.