FOLLOW DR. KO: End of Intern Year

Melody and patientIt seemed not so long ago that I had to ask my second-year resident about everything.

The nurse paged me about a patient with high blood pressure; I asked my second-year which medication I should dispense. A patient complained of shortness of breath; I asked my second-year what to do. My prescriptions wouldn’t print; I asked my second-year what was wrong with the printer. It felt ironic to me how one day I was nothing but an annoying medical student, and the next day everyone was calling me “doctor,” and yet I didn’t feel any different.

This time, however, I do feel different. In a few days, on that notorious first day of the month of July, a new batch of Interns will come in, and I will be that second-year that they come to for answers.

Unlike in Canada or other countries where first-year residents are merely called “R1”, the hierarchy in the American medical field is further underscored by the terms “Intern” and “Senior.”

“Internship” is often said to be the toughest year of residency, during which the young doctor with her newly donned white coat has to prove to the world that she is tough enough to be a doctor. And of course, being at the very bottom of the feeding chain (because medical students aren’t even on the radar), interns, or first-years, are given all the “scut work.”

Scut work is basically tedious and what one might consider menial tasks that no one likes to do but which have to be done. Common scut work includes calling a patient’s primary care physician to obtain their background information, faxing papers, waiting for papers to be faxed back, drawing blood, bringing the blood sample to the lab, filling out paperwork, running around the hospital looking for a cane because the patient cannot be discharged without one… the list is endless, and so are the hours. Mel checks IV

I remember being awakened in the middle of the night by interminable pages. Feeling frustrated over a dispute with a nurse; angry because of a rude and aggressive patient; incompetent about not being able to figure out what was wrong with a patient and discouraged about just being a cog in the wheel.

And then one day, recently, I heard a code. A patient had crashed. I ran to the scene where my co-intern Dr. Aaron Pickrell was already giving chest compressions to a patient who had collapsed on the floor, and giving nurses orders. In that split second, I felt pride for my colleague and friend. I rushed to his side and took over the chest compressions. We asked the nurses to get the patient’s finger stick to check her blood sugar level, checked the patient’s blood oxygen level with a pulse oximeter, ordered dextrose, glucagon, epinephrine, ordered the respiratory therapist to administer oxygen… Of course it was not perfect, and it was messy, but there we were, “little interns”, acting like doctors.

More experienced residents and attendings arrived shortly, and guided us in our efforts to save this woman’s life.

Yes, this time, I do feel different. I feel like a doctor.

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