So, we’re interns now. At some point in the last two weeks, someone handed me a pager and an ID badge that says “M.D.” after my legal name. Next week, my co-interns and I start taking introductory shifts in our emergency room.
Actually, we “started” residency almost two full weeks ago with an EM-specific orientation and ongoing Swag Handout. I’ve gotten to know my colleagues in the department and have signed my name on endless paperwork more times than I can count. At this point I have signed away:
- Freedom from work e-mail
- Freedom from the Thirteenth Amendment (although this is technically voluntary, indentured servitude)
- Any semblance of privacy
- Control over my own cell phone and computer
- A healthy amount of sleep
- A healthy amount of financial compensation
Not that I’m complaining; they let me play with intubating equipment yesterday, so it’s a wash.
Curiously, I also signed an oath swearing to protect and defend the (aforementioned) Constitution of the United States of America against all enemies, foreign and domestic. I am not making this up. This bizarre document is apparently a holdover from the Red Scare of the 1950’s and McCarthyism, when people were nervous that the commies would infiltrate state and local governments. No one has bothered to repeal this in more than sixty years, because that would imply the existence of a functioning actual government.
Anyway. Despite starting nearly two weeks ago, the official orientation for all housestaff – that’s what interns and residents are collectively called, since the hospital sadly becomes home – was this past Tuesday.
This orientation was a generally numbing day where various Important Hospital People with lengthy academic titles were paraded in front of us to declare how exciting it was to be an intern, and also that if we ever mentioned anything about our jobs in public or on social media, a large man would find us and unceremoniously slice off our thumbs with a finger vise.
(Actually, we would be fired.)
Thus terrified, I must disclose that I am in fact an intern in emergency medicine in a residency training program somewhere in the United States. Providing more information than this would be grounds for immediate death by tank shell, so that’s all you’ll get from me.
Intern year is sold as something similar to the rotation year of medical school: the goal is to expose you to a wide range of jobs in the hospital so that you better understand what everyone else is doing once you begin your specialty training in the second year. As an ER intern, we spend a lot of time in intensive care units, on medicine teams, working with obstetricians on labor and delivery, etc. This is, of course, in addition to time spent in the emergency room.
That sounds pretty good, right? Under the radar, though, is that fact that the intern is also the scut worker and that the large majority of administrative and annoying tasks that must get done each day fall to the interns. This is mainly so that no one else has to do them. We are the hired help in the hospital.
Again, not that I’m complaining – on the upside, we also are expected to do Fun Things such as put in central lines, sew up cuts, maybe intubate if we’re lucky, and other Doing Things things. While trust is still an issue (and will be, until we make friends with the impostor syndrome that plagues us all), at least this time we are technically allowed to Do such Things, as opposed to having to convince a nervous ICU fellow to please be nice and potentially allow the humble medical student to touch the patient today.
Our actual intern year doesn’t start until mid-July. Until then, we have a handful of lecture days covering common complaints and treatments, along with a handful of heavily supervised ER shifts. This is because the leadership recognizes that everyone does some variety of Nate’s Six Vacation Months Where He Did Zero Medical Things Of Value between the winter and the start of residency. It would be unwise to dump us directly into responsible patient care roles.
For instance, this is what I did in March:
You get the idea.
Once “boot camp” is over, I begin on an ultrasound rotation, which is about the chillest way to ease in to residency as I can imagine. Some of my much brighter co-interns (which, you will be unsurprised to learn, is all of them) start on more intense rotations, like the ICU, because the leadership somehow know they can handle early stress. In contrast, I require a great deal of hand-holding, TLC, and all my foods pureed.
(Upon receiving my schedule, I had a brief moment of Typical Medical Person High-Strung AnxietyPanic where I thought “oh my god they really do think I’m an idiot.” Then I realized that this reflects well on their forecasting and calibration skills, so maybe I should calm down and trust the process like I preach. Also, I keep telling myself I am not that high-strung.)
Following ultrasound, I get a hard welcome to residency with my trauma surgery rotation, which all the residents here assure me is not as bad as I am envisioning. On my med school trauma rotation, I painted a fun picture of playing trauma junior because I didn’t want to complain all the time. In reality, my three weeks on trauma that year were highlighted by the following:
- The fifth-year resident suffering a nervous breakdown on rounds and running off the ICU floor crying;
- Eating the saddest peanut butter and jelly sandwich you’ve ever seen at three in the morning;
- Rounds that lasted six hours. I am still scarred from this.
I am assured that trauma is a lot more fun here, and especially a lot more interesting when your presence is occasionally acknowledged by those in charge.
Anyway. First ER shift this week. Fingers crossed that I still have fingers by then.