* * Anonymous Doc

Wednesday, June 24, 2009

One week until the busiest year of my life begins, and so of course I've decided to start a blog. Personal details out of the way: I'm a 29-year-old guy about to start my intern year at a big-city hospital it's probably better not to name (but you've heard of it). Or maybe I'm not, and I'm just making all of this up. Either way, after four years of the craziness that is medical school, you get like two months to take a deep breath-- before starting all over again from the beginning. Except this time I actually have to know stuff or people could die. Well, sort of. This whole week has been full of people telling us there's a safety net and we're never going to be made to feel like we're in over our heads. We're not going to be able to cause anyone to die, at least not yet. Assuming the system works right. Which of course it won't, because if they can't even figure out how to print our ID badges correctly, I don't have a lot of faith they're going to be able to make sure I'm never put in a position where I can kill someone by accident.

As a potential patient, you should be happy to know that before they let us pretend we're doctors, the number of bureaucratic hoops we have to jump through is staggering. Somehow we're expected to believe that one day patient medical records can be digitized across hospitals such that you can see a patient's entire medical history when he comes into the ER-- except they haven't even figured out how to avoid having doctors fill out an entirely new set of paperwork for every hospital, even within the same system, that we might ever have to visit. There are four hospitals interns in my program will rotate through. For each one, I've filled out the very same forms to get the very same security check and a completely different ID badge. I've taken four tuberculosis tests, given blood four times, and had four drug tests. Drug tests, I feel compelled to tell you, that they've each allowed me to schedule myself. If I were taking drugs-- which I can promise you I'm not, at least not yet-- hopefully I wouldn't be taking so many that I wouldn't be able to figure out that I could schedule the tests all on one day, and just stop taking the drugs for the appropriate amount of time to get them out of my system-- and then once the test is done, just go right back to the regimen. I suppose they're still able to screen out users so screwed up they can't even stop for long enough to take a self-scheduled drug test, but if I'm a patient I'd kind of want the bar to be a little bit higher than that.

I didn't grow up in a family of doctors, I didn't know any doctors when I was a kid except my own pediatrician, who graduated from medical school back when they were still using leeches. So I went into medical school with the same preconceptions patients come into the hospital with-- that doctors are somehow super-human, and special. That's part of what made me want to be a doctor. I wanted to seem special, even though perhaps in reality I'm not. Medical school very quickly kills that notion, and the start of residency doesn't help bring it back. Doctors are like everyone else. Flawed, mostly stupid, and often not even particularly nice. There are exceptions. But, sadly, I've come to believe that most people would decide to chance their luck healing on their own 95% of the time if they really knew the people who they were trusting with their lives. I happen to be starting my intern year at a fine institution, with mostly smart people who all went to perfectly respectable medical schools and who I would probably at least trust to know when they don't know something and not put me directly in harm's way if it could be avoided. But if you live in the middle of nowhere-- or you live in the middle of somewhere but just don't know any better than to go to the closest hospital-- you have a pretty good chance of ending up with a doctor who wasn't smart enough to get into a legitimate medical school and paid $180,000 for a semi-absurd medical education in Dominica. Admittedly I haven't been in the system very long-- but I have never, ever seen a hospital patient ask their doctor where he or she went to medical school. Or college, for that matter. (I've also never seen anyone ask if their doctor is board-certified in whatever it is they happen to be doing for you-- but that's a whole different story.) Like any other profession, there are some who do this well and some who don't. People ask their plumbers for references, but assume their doctor is just fine simply because he puts out a sign. Not all care is the same.

But I've lost track of the initial point. I'm lucky to be at a hospital that acquits itself well when it comes to things like not leaving forceps inside of patients' chest cavities and not cutting off the wrong limb by mistake. I'm amazed, just in these first days of orientation, how much this feels like high school. We're being divided into separate "clans" entirely for social purposes-- a ready-made set of friends, as if any of us are going to even have time to see our real friends, let alone these new folks. And as if any of us are going to want to hang out with doctors when we're not on duty. The last thing I'm going to want to talk about is medicine.

I worry-- and looking at my life now compared to my life four years ago, it's a reasonable concern-- that very soon I'm going to be like the doctors I met when interviewing for medical school, unable to talk about anything besides their patients and some crazy story about a bodily fluid that somehow ended up in a hilarious place (we all love stories about bodily fluids that come out of any and all cavities, unexpectedly and without warning). I used to be interesting (I think). I used to have opinions about things. I used to have hobbies, interests, extracurricular activities. I don't anymore. And I can't see how that's going to change once the 80 hour work weeks start. I'm a bit ashamed to admit-- and I haven't been admitting this during the orientation exercises at all-- that I spent most of these past eight weeks of vacation sleeping and watching the Food Network. Alone. I actually made up a trip. I've been telling people I went to Spain with three friends from college who all lost their law firm jobs with the economy ridiculousness. I looked on Wikipedia and got some details about stuff I could say I saw and did. But I've never been to Spain and don't even really have three friends anymore. Okay, not entirely true-- I have three friends, I just don't see them half as much as I should, because no one ever seems to know when they're going to get off work and once people flake on dinner plans three or four or nine times in a row, you start to lose patience.

I shouldn't be so down on myself-- I have friends. I'm just worried I won't see them anymore. And I'm thoroughly annoyed at myself for somehow getting to this point in my life without having a settled and stable personal life. There are all of these single doctors you meet in med school and the first reaction everyone has is to pity them-- they missed the chance to find a match in college, and now there's really no shot. With the overnight shifts and the 6-day-a-week schedule for the next three years it's impossible to start a real relationship with anyone who isn't on the same schedule. And so to have not locked someone up by now-- to have not settled for something, anything to make sure I'm not going to spend my whole life alone-- it's a failure on my part, and now it's too late to fix it. And if this is all I'm going to have for the rest of my life-- if I'm going to be hanging all of my happiness on being a doctor, and not have the family to go home to-- I worry I'm setting myself up for a bit of disappointment in life. Certainly my parents are disappointed at the prospect of me being 33 when I finish my residency and still no closer to giving them grandkids.

Tomorrow we have a get-to-kn0w-each-other party, following eight hours of CPR training. Trust me, if I'm the one giving you CPR-- you are not in good shape.

Hope I can keep the blog going. Thanks for reading. More soon.


  1. You seem depressed in this post, but this is the first post I've read. You're interesting like I'm reading a novel or something. hahaha, i hope it gets interesting.

  2. I am a HUC. And I know idiot doctors.

  3. There is nothing absurd about the medical education received in Dominica. It's quite brazen to say American schools are the only legitimate medical schools. I know you wrote this post a number of years ago so I hope you've since realized excellent doctors can come from all institutions.