It feels like it's been a lot more than three days of intern year. I'm ready for tomorrow's day off. We started a patient on a new drug intravenously and all of a sudden she started shaking and coughing the most frightening coughs I've ever heard. Her family started screaming-- I was definitely thinking I was about to watch a patient die right before my eyes. And the nurse looks at me-- "what do we do, doc?" I nearly threw up hearing the question-- how do I know what to do? I'd never seen anything like this. And I'm supposed to know? I'm supposed to be in charge? I called the attending. He laughed-- laughed!-- and said this happens sometimes with a patient's first exposure to this particular drug, just give her a bit of this other thing and keep a close watch. Well, fine, maybe it's normal after you've seen it a few times, but in that moment I just wanted to run out of the hospital and never come back. I'm not ready to be the one in charge.
And all throughout the day the nurses are asking me what to give this patient for that, and that patient for this, and how much-- and I don't know dosages, or what you're supposed to give for nausea or a headache or anything else in combination with the drugs they're already taking. In medical school we learn the mechanism of disease-- how it progresses over time, what it's doing in the body-- but we don't learn how to act in the moment, what the best course of action is when a patient feels one way or another. The nurses seem to know from experience, but they look to me like I have something to add. I don't. At least not yet.
Speaking of nurses: it's pretty crazy how they just accept being treated as second-class citizens. I've been introducing myself to them-- which itself gets a reaction like it's unusual-- by my first name, instead of Doctor ______. They're the same age as me, it's not like I feel more important, if I'm going to call them Frank or Ginger, it seems bizarre for them to call me Doctor _____. I certainly don't feel like "Doctor" yet anyway. At the end of the day one of the nurses thanked me for being so helpful. I wasn't helpful-- I didn't have an answer to anything she asked all day. But I was polite, and I think that was what she wasn't used to. I hear the attendings-- and even the more senior residents-- yelling at them, cursing even, and I can't believe that's really the acceptable and normal behavior. The whole thing makes for an uncomfortable workplace. I don't want to feel like everyone's looking for reasons to yell at each other. I want to feel supported and like we're all part of a team. In surgery maybe I'd expect it, but in medicine?
It's been a long three days and I'm already sleep-deprived. I don't eat lunch, I don't go to the bathroom, I can't predict when it's going to be slow for an hour or when a patient is going to crash and I'm going to have to rush over and pretend to know what to do. It's funny, we can't leave until a certain time, in case someone needs us-- but what could someone possibly need me for? I know nothing. I have no answers, and barely even know the questions. Surely that will change, but today, having gotten through this first half-week, I'm not sure I can remember why I even want to be a doctor. That's the sleep-deprivation talking, but, gosh, I don't know if I care enough. By the end of the day I just wanted to go home. I felt bad for my patients, but I didn't want to answer any more questions, and I didn't really care how they were feeling as long as it wasn't going to keep me there any longer. That's a terrible way to feel on day three, and I know it is-- but, man, I just wanted to leave and go to sleep.