First day of intern year is over! Only 364 to go. You would think it wouldn't be much of a transition from medical student to intern, but I have to admit it's a lot more different than I realized. For the first time, you're actually on the hook for knowing things. You're the one who has to be the expert on the patient-- you're not just the observer. And when the attending says the patient needs this test or that test, this medication, that dosage-- you're the one who's going to have to implement it. So I ended up with eight pages of scrawled notes at the end, everything the doctor said, and then I spent my afternoon deciphering it. It used to be so easy-- you just listen and nod, and if you tuned out for a second, it didn't matter. Now I'm actually the one who has to do this stuff. It's stressful. More than I thought it would be.
At the same time, it's so weird that now when I'm introducing myself as a doctor, the patients really do sit up and listen. Twice they asked how to spell my name, so they could write it down-- so they could refer to me later. As in, "Doctor so-and-so said I should take that pill." As if I know anything! My first patient asked me about a research study the attending wanted her to sign up for. She asked me if she should do it. And it's not like I can say, "oh, wow, it's my first day as a doctor-- ever! And not only have I never heard of that study, I've never met that doctor, and I've never even learned anything about how to treat the disease you have! In fact, right after this, I'm going to go on the Internet and google what you have, just so I make sure I know what it is-- and then I'm going to look back at my textbooks from medical school and see if it's in there, so I have some clue about it and don't sound like an idiot! But, yes, I think the study is great, and, yes, even though this hospital is supposed to be the best place you can go for the thing you have, you're still stuck with people like me who have absolutely no idea what they're talking about."
If patients knew how little I know... if they knew how little most of us know.... It's really scary how much faith people put in doctors. It's scary how much they assume we know everything and we're going to fix them. Truth is, most of the time, even the best doctor is faking it to some extent, and doesn't know a whole lot. We can look things up, and see what the accepted course of treatment is... but if you have something complicated, we have no idea how your body is really going to respond, and why one person heals and one person doesn't, why one person lives and one person dies. We're trying our best (most of us), but we just don't know a lot.
I looked up the research study after I left the patient's room. I couldn't find anything. I have no idea what to tell her. The only thing I know I can do-- and maybe this isn't nothing-- is listen, hold her hand, and tell her we're doing our best. I'm trying, I really am. But it's an awesome responsibility, and at least on day number one, I'm just not ready for it.