The Intern Blues(81)
I said it was the attending. She said, “Well, call him and tell him to come in and see if he can talk to her.” And then she left. Very helpful.
Well, I called the operator and got Hal Loomis’s home number. I felt a little funny calling him that late for something like this, but when I told him the story, he said, “No problem; I’ll be there in a half hour.” He actually seemed happy I had called him at home and woken him up! These attendings are really weird.
About an hour later, Hal walked out of the elevator and onto the ward. I led him into the treatment room and pointed to the stretcher. She seemed to be asleep, but when we got close to her, she opened her eyes and started yelling at us. “You stay where you are, you fucking son of a bitch. Don’t come any closer or I’ll kick you in the balls, you asshole.” And, without missing a beat, Hal yelled back at her, “You watch what you say, you little bitch! We don’t want to have anything to do with you either, but you’re here and you’re sick and it’s our job. So you better let us do what we have to do or we’re going to tie you down and do it anyway. Now, which way do you want it?”
Well, it was great logic, and I think it would have worked if she’d been in her right mind, but, of course, she wasn’t. So when Hal and I got close to her again, she started punching and kicking and biting us. But with him there holding her down, I at least could get some sort of a physical exam done. After about a half hour of that, I said I was finished, and we tied her down to a bed in one of the rooms with leather restraints. Then Hal headed back to Westchester, I got a couple of hours of sleep, and this morning she was a real pussycat, believe me. She’s just fine today.
So I didn’t mind being on call last night. If I could watch an attending make a fool of himself every night I’m on call, I think I wouldn’t even mind being an intern.
One more week to go on this damn ward. One more week and the year’s half over. I can’t wait!
Bob
DECEMBER 1985
This month marks the halfway point in the interns’ trip through this horrible year. The first half of internship officially ends on December 28, and I’m sure that on that night, as they lie in their beds trying to fall asleep, or sit in nurses’ stations around the Bronx trying to finish yet another admission note, many of our interns will take a minute or two to reflect on what’s happened to them since July 1 and try to work up enough enthusiasm to propel them through next June.
The pediatric department’s annual holiday party was held on Wednesday night, December 18. Most of the interns managed to turn out. That’s surprising when you consider that a third of them were supposed to be on call and another third were postcall and many of these guys probably hadn’t slept in a couple of days. So the fact that so many were there was nice.
Just watching them, it was clear that something had changed since the last time this group had met at a prearranged site for a party. At the first orientation party, the interns had seemed isolated, nervous, and scared to death. Now, six months later, they were a strong, unified group. Tight bonds had formed among them from the mutual sharing of the good times and bad that have occurred over the past six months. On the dance floor, at the bar, sitting at the tables, there was a lot of backslapping, a lot of laughing, and a lot of inside jokes. These guys have built a strong support network for themselves; they’re there to help each other out. That’s exactly the way it should be at this point in the year.
Thinking back on it, these people have definitely changed. They’ve gone from being frightened, untrained, technically awkward but very concerned medical students to competent, overworked, and chronically overtired interns. It no longer takes them all night to start an IV or all morning to draw the routine bloods on their patients. They’ve become masters of scut; they’ve learned how to manage their time so that they no longer have to stay until eight or nine o’clock on the nights when they’re not on call, as they did when the year first began. They’ve learned the shortcuts that are necessary to survive.
They’re also beginning to feel comfortable being around critically ill patients. They no longer feel the impulse to run away as fast as they can when they hear that a three-year-old who’s in the midst of a convulsion or a six-month-old with signs and symptoms of meningitis has appeared in the emergency room. They’ve started to be able to formulate a plan of management by themselves, not relying as much on the residents or attendings to tell them what to do and when to do it. And they’re beginning to develop good instincts; they’re now able to figure out which patient is truly critically ill and in need of immediate attention, and which patient is not so sick and can wait. But these skills are still in an embryonic state. It’ll take a few more months before any of the interns feel confident enough to reject advice given by an attending physician. But one day that will happen. They’ll suddenly realize they can do it all themselves.