My First Day Redux

So, it's the end of the first day. I think the most surprising thing was the fact that I spent very little time with patients today. Don't get me wrong, they were on my mind almost all day. But, I spent very little time with them. As a medical student you are the one who spends 30 minutes talking to each patient, but spend absolutely no time worrying about their management. Today I fretted over the dose of pain meds, whether to discharge a patient or not, the state of their wounds, their mental capacity but I spent very little actually talking to them.

I always thought the residents I'd worked with in the past were callous for not spending time with their patients. I guess I'd never realized how much time they spent dwelling on their patients even when they weren't there. Right now as I sit here typing this I keep thinking back to the Polish man who woke up from surgery with a strange dry patch on his face, the woman whose endocrinology follow up I'd scheduled and all the other patients from today. Their faces and our brief conversations keep swimming on the periphery of my psyche.

But, I have to shut that all out. Because my alarm is going to go off at 4 am, I need to be in the hospital at 5 am and I go on call at 6 am . . . I'll get off again sometime after 6pm on Sunday. That's a 36 hours in the hospital. 24 of them responsible for all the burn, plastics, vascular and neurosurgery patients in the hospital and an additional 12 in charge of just the burn patients. It's my first call as a grown up a doctor. I really need my subconscious to settle down so I can get a few hours sleep.

My First Day

Some of you may know that the pilot episode of Scrubs was titled "My First Day." Some of you, with lives, probably don't know that. But I'm sure that most of you know what Scrubs is and that for doctors, it's the most realistic medical show on TV. Well, I recently got into a surgical residency and was supposed to start work on at the end of June. But because of a number of unfortunate delays getting my license I'm only just starting. Hopefully tomorrow.

So, I'll be about a month behind my co-interns. I'll be the only intern still getting lost, forgetting to sign out my pager and making people wonder why I was hired in the first place. I've been looking forward to starting my residency for years. I've studied, I've worked hard, I've spent sleepless nights in hospital trauma bays all leading up to this one moment. And suddenly, a terror is gripping me. I'm feeling it right now in the pit of my stomach. It's been growing slightly larger ever since I got the call saying my license had been issued. I've spent the past few weeks in a state of panic convinced that this moment would never come and now that it's here I'm wishing I'd done more to prepare myself.

I know it's totally irrational, and that every new intern feels the same way I do. But I also know that tomorrow marks the actual beginning of my career as a doctor and that today is the last day I can use the "I'm just a student" excuse. From now on I am the one that is responsible for ordering the 3 am labs, for writing admit orders and for making sure the prescriptions are renewed on time. I know all the things I am supposed to do. I even have an inkling of an idea as to how to go about doing them. And I also know that no one is expecting perfection on my first day. Except me, of course.

"Four years of pre-med, 4 years of med school and tons of unpaid loans had made me realize one thing . . . I don't know jack" - Dr. John "J.D." Dorian