The Intern Blues(83)

The other attendings and I all left the party early; that’s also become traditional. The latter part of the Christmas party belongs to the house staff, a time for them to let loose without having to worry about being judged by their bosses standing off in the corners. The morning after, there were a lot of exhausted but happy interns running around the Bronx. They’ve got six months to go. In many ways, these last six months are much tougher than the first six.





Andy


JANUARY 1986

Sunday, January 19, 1986, 1:00 A.M.

I started my vacation, as planned, in Portland [Maine] with Karen and her family. We were there for Christmas. I ate like it was going out of style, I vegged out and slept a lot, and I got to know Karen’s family a little better. Three days never went so fast.

After leaving Portland, we went back to Boston but we only stayed overnight. We had originally planned to go to New Orleans, but we went to California instead. We decided not to go to New Orleans because we saw in the newspaper that it was forty-five degrees and rainy down there and we heard that one of the big college football teams was going to be in town for a bowl game and there were going to be millions of crazed football fans running all over the place. So we spent a week out in Santa Barbara instead. We stayed at Karen’s sister Kathy’s house. Kathy was still out in Portland with Karen’s parents. My brother and his wife, Debbie, and Karen and I shared this little bungalow with a porch in the backyard where you could sit and look out and see the Pacific Ocean in the distance. It was very quiet, very beautiful, and warm. We did a lot of walking that week; we walked on the beach and in the hills and around town. It was really a good kind of meditative thing to be doing. I had a chance to look back and think about what had happened to me over the past six months, what this internship had done to me. We watched a million movies on Kathy’s VCR, just one after the next. I slept a lot, and that was very good, too, just having the chance to catch up on some of the sleep I’ve missed. And I balanced my checkbook, which I hadn’t done in six months. I brought all the stuff out with me because I knew I wouldn’t do it otherwise. And I felt like my life was a little more back in order again.

At the end of the week, we were all very sad to go home. Karen and I were still enjoying each other’s company a lot. We went back to Boston, where it was frigid and bitter cold. I had a few more days there. I saw a couple of old friends, and then Karen and I packed up all our stuff and got ready to come back to New York. Karen has come out to stay for two whole months. She’s doing a subinternship in psychiatry in Westchester.

I came back from vacation relaxed and happy, and I was hoping my mellowness would carry me along for a couple of weeks, at least into February, when I’m scheduled to be in the ICU. The depressing thing is that the pace of being back in the ER, the aggravations of being an intern, the frustrations that come with taking care of patients all mounted very rapidly, and it took only a couple of days before I felt like I’d never left. And it’s kind of a drag. I mean, here I am, only back for a week and a half, and already I’m feeling aggravated.

Most of the patients I’ve been seeing have been really abnormal children, really abnormal! During OPD, I spend two out of five weekdays in clinic, and that’s what’s killing me! All the kids I follow now seem to be abnormal; I’ve picked up tons of patients who’ve been discarded by other doctors. I’ve got kids with MR-CP [mental retardation, cerebral palsy], kids with seizures, kids with weird syndromes, psychotic adolescents I picked up while on the ward; you name it, I’ve got one of them in my clinic. I seem to have no straightforward, healthy children at all.

And in the ER, well, we do see relatively normal kids there, but it’s such a bad situation. The parents are exhausted, they’re frustrated, they’ve had to wait no less than forty-five minutes before they’re seen; most of the time they have to wait a couple of hours. Half of your interactions with parents in the ER are not very good. I try so hard to make things go off well, but it’s so hard. By the time they get to see you, the parents are so aggravated that you get aggravated. It’s just a vicious cycle.

There were a couple of bad things in the ER today. I had one kid who came in and got worse right in front of my eyes. We wound up nearly coding him. And then we had a kid with 20 percent second-degree burns to the perineum [the diaper region] that didn’t look very nice. How do you think those got there? It was another abuse case, of course.

Then a thirteen-year-old stab victim came in. The stories are always the same with stab victims: They say they were just going to the store to get their grandmother some ice cream or something like that when somebody out of the clear blue came up to them and stuck a knife into their chest; they’re always innocent. This kid wasn’t really that bad. And he was about the worst we had today. I didn’t have to do any pelvics. So that made it a pretty good day.