The state of the Class of 2021 is…not strong. If we are being honest, our ranks are presently decimated by illness, wear and tear, and, yes, the brutal Southern California winter.*

(*Ha! Sucks to be you, bomb cyclone sufferers. Whatever that is.)

Three of us either have or have had the flu, which crippled me badly enough to call in sick to an ER shift while I spent the day in the fetal position at the foot of my bed, counting the hours until I could take another NyQuil. One has been hospitalized twice for totally unrelated ailments. Another can barely walk from a pulled muscle. Our happiest co-intern hasn’t smiled since October.

No one has heard from another since the World Series. I think he might have fled to Mexico.

It’s been a while since my last post; between then and now, I’ve rotated through an obstetrics service, the emergency department, and rode along on an ambulance for a couple of weeks. Now I’m on a pediatrics rotation, which consists entirely of otherwise healthy children with colds.

To sum up the last few months: Babies are just as terrifying and disgusting as they were the last time I wrote about it. ER rotations are hard work; they also continue to be the only time in the hospital where I feel remotely validated by my choice to submit a rank list to the Match. (More on that later.) Paramedics work tremendous hours, but much of that time is spent doing nothing; also, they are actually paid a commensurate salary for their time. Children in general are mysterious snot and poop bombs whose sole reason for existence appears to be to terrorize their nervous parents into ER visits and to then pass their assorted MiseryViruses on to the intern. Aka me.

See? None of those are quite worth a story of their own.

My memories of the last three months are perhaps clouded by an overriding resentment borne of the holiday season, which was neither a holiday nor seasonal.

Perhaps getting the flu got me down. Perhaps news of friends receiving holiday bonuses totaling more than my annual salary was annoying.  Or perhaps the omnipresent truth that we are indentured servants bound to a system careening toward imminent, catastrophic, dumpster-fire disaster tends to work its way into your brain.

Given all that, it’s not terribly surprising that the intern class is falling apart faster than a Senate bill.

I have been told that complaining is cathartic, and also occasionally amusing when tinged with characteristic anger. So here are a few gripes:

One. As med students, we were always told that “none of this matters” and that you learn everything you need in residency, not school. This tended to trigger episodes of either nihilism (in my case) or identity crises (if you remember C., this was her), but we got over it with the oldest of coping mechanisms: denial.

I was also drinking the Kool-Aid of medical education at the time and didn’t want to believe that my efforts on my three-month required research project, otherwise known as Testing The Liver Winter of 2015, were for naught.  Now as an intern, I can say with all honesty: none of this matters.

Let’s do a thought experiment. I want you to pretend that for your job, you have to apply to a training program, and you have to spend probably two or three thousand dollars to get there. Between standardized testing fees, interview flights and lodging, and opportunity costs, $3000 is a solidly conservative estimate of your expenses.

After you get in, you (or your loan company, who will destroy your life later) shell out $30,000-50,000 every year for four years of training. During that training, your supervisors repeatedly test you on things you don’t need to know, and the workers you apprentice with tell you over and over that your entire experience is worthless. When they are having a bad day, they will generalize this “worthless” critique to a general referendum on your existence.

You get yelled at a lot.  You cry. You learn seemingly important things such as “the umbilical vessels are surrounded by Wharton’s Jelly,” which has absolutely no relevance to anything. Later you learn that no one knows what is actually in Wharton’s Jelly. Again: for this privilege, you pay up to a quarter million dollars over four years.

Yes, this is a gratuitous picture of the umbilical cord in cross-section. Yes, it is still funny five years later.

Anyway. A quarter million dollars! You can buy a house for that much money!

(Maybe not here. You could probably get a nice shipping container in a decent school district for $250k here. But still.)

Then, after all that investment (literally and figuratively), you graduate from your training program. Now you have the privilege of paying more money not only to take certification exams but also to again fly around the country and convince bosses that you are worth hiring. The bosses base their decisions on two key factors: you are not an obvious axe murderer, and you scored well on your certification exams.

And then, after all that, you start almost completely from scratch. Eighty hours a week, underpaid, overworked scratch.

Who… who the hell would do this? What kind of insane person would knowingly subject themselves to an emotional and fiscal sinkhole whose only apparent purpose is to create an absurdly high barrier to entry?

I cannot imagine that we would have many engineers, architects, teachers, businesspeople, pilots, or politicians around. Sure, there would be a few people who did it out of true fanatical devotion to their chosen career, but there wouldn’t be enough teachers to fill a single school district –  much less a bloated, terminally diseased healthcare system that generates jobs almost as fast as it does waste.

I have no explanation for why we did this. Maybe we did it because we thought we could. Maybe we willfully ignored the people who told us it was a noble but impractical idea, or that it was too unnecessarily long a road. Maybe we did it because we wanted to help people while simultaneously wanting to be in charge, and we never stopped to pay attention to the veritable forest of red flags that everyone with either knowledge of the road ahead or a stake in our well-being threw up. I don’t know.

And now we are stuck.

Two. They don’t give me enough money on my meal card.

Three. The Genocidal Maniac Formerly Known as Tiller has a semi-rare autoimmune disease called “immune-mediated thrombocytopenia,” or ITP. This sounds very fancy, but it is actually one of those diseases where the name just describes what is happening since no one understands why. Incidentally, I went through Useless Med School thinking that ITP stood for “idiopathic thrombocytopenia;” close followers of this site will remember that idiopathic is medical code for “we have no idea.”

Here is Tiller, sick with a platelet count of zero:

He is supposedly going to be okay, after a round of chemotherapy (!) and enough steroids to turn Sheldon from The Big Bang Theory into The Rock. For right now, he’s not allowed any hard chew toys since he bleeds spontaneously from his mouth, like a real-life version of a genetically mutated Resident Evil dog. It’s kind of terrifying.

My fortunes seem to rise and fall with the Genocidal Maniac. And my meal card balance.