When I was an intern. . . .

Today I'm reflecting on my internship. . . 1996. . . .back in the day. . . (insert wiggly fingers here as we go back in time)

When I was an intern. . . . 

• I didn't have an email address.
• Or a working cell phone that wasn't the size of a football or that didn't cost $500 per second. 

When I was an intern. . . . .

• Clinical questions were explored in the big fat textbooks that sat on the shelves of every ward. (Up-to-date? Chile, please.) 
• I read the Washington Manual so many times that I could tell you what page you could find "management of gastrointestinal bleeding" without even opening the book.

When I was an intern. . . . 

• "Duty hours" was this obscure thing you heard of occasionally mentioned with regards to training programs in New York state. They allegedly had some rules about how long one could work (although no one I knew in New York state was following any kind of rules regarding them back then. . . .)
• Post-call (meaning: you've been up all night admitting sick patients) essentially meant very little to anyone besides you.
• Nobody cared if you were speaking in tongues or writing in hieroglyphics at 4:35 p.m. during post-call sign out rounds due to lack of sleep. (Or if you had clinic the following day.)
• "You okay with sticking around a bit longer?" was not an unusual thing to hear at 1pm after being up all night-- when the only alternative to eking out a tiny "o.k." was to swallow hard and blink fast until you no longer wanted to fall to your knees in tearful exhaustion. ('Cause you knew that if you dared protest, you'd hear a soliloquy that starts with "When I was an intern. . . .")

When I was an intern. . . .

• I once (stupidly) took call two nights in a row because my co-intern and I both wanted an entire weekend off during our "one in three" call schedule month.  (Translation: I worked more than 48 hours straight. Not. Smart.) That Sunday morning while rounding with my attending, I recall him saying, "Who's the on-call intern?"  "Me."  "Uh, okay. So where's the post-call intern?" "Also me."  "Uhhh, can you do that?"  "I think so."  "Uh, okay.  Who do we have first on our list?"
• I was so tired on that Sunday that I had to call a friend to come and drive me home.

When I was an intern . . . . 

• I practiced presenting my patients in the car on the way to one of my ICU rotations because I was so intimidated by my take-no-prisoners attending that I felt it was 100% necessary.
• Case in point: That same attending in the ICU held his hand up to his ear in the middle of my patient presentation one day and said, "Ssssshhhhhh! Do you hear that? Listen."  Everyone looked puzzled and tried to listen to whatever he was talking about. He then narrowed his eyes and exclaimed (yes, exclaimed), "It's the sound of your patient yelling around his endotracheal tube, 'Help me! Help me! This intern is trying to kill me!' " This was followed by a laugh that originated from so far in the deepest parts of his belly that I thought it would never end.  Um, yeah, so that's why I was practicing my oral presentations on the way to work. . .
  
• The only comforting thing about that ICU month was that this same take-no-prisoners attending did not discriminate when divvying out the insults. One of my all time favorites remains: "Do you know what this patient would say if she could talk?"  "No, sir."  "She'd say, 'Somebody save me! I'm surrounded by a group of snot-nosed intern assassins!' "  

When I was an intern. . . . .

• On my ER rotation in December of 1996, I was scheduled for twenty-two "twelve hour" shifts. (My four clinic sessions were folded into two full-day sessions--on my OFF days. Nice.)  
• Oh, in the aforementioned month? Nearly all of my shifts were from 2pm to 2am--exactly perfect for making certain that I had no time for any possible meaningful contact with anyone not requiring stitches, IV fluids or a splint.  
• Whoops, I almost forgot. I did get one shift that wasn't from 2pm to 2am--Christmas Day--which was 10am to 10pm. Exactly perfect for guaranteeing that I would have no time to do anything remotely exciting before work or make anybody's celebration after getting off. 

When I was an intern. . . . . 

• I burst into tears on rounds after my attending kept pimping me on obscure pharmacology questions post-call. 
• I cut the back of my hair with a pair of Fiskars from my sewing kit because I didn't have enough time to go to a professional. (And actually had such a distorted view of style that I thought it looked pretty darn good.)
• Blinked out my left contact lens every single time I intubated someone. ("Eyes on the vocal cords. . . steady, steady. . . . and I'm in!" Blink. "Damn.")

When I was an intern. . . . 

• I fell asleep in my car in the parking lot post call. In Cleveland, Ohio. In the winter. (Fortunately, a security officer tapped my window and woke me up before I developed frostbite.)
• I called my chief resident after the first big snow and asked what I should do about coming in. My chief laughed so hard that I was sure he would tear an intercostal muscle somewhere. That was the answer to that question.

When I was an intern. . . .

• I learned so much that I thought my head would explode.
• I was often more terrified than I had ever been in my entire life.
• I made some really, really great friends who sometimes carried me away from the battlefield on those days when I could no longer walk for myself.

When I was an intern. . . .

• I cried so hard when I lost my first patient that I wondered if I was cut out for this profession.
• I sometimes wasn't sure I'd make it. 
• I prayed. A lot.

Funny how much has changed since I was an intern. New rules, new war stories.  . . . but some things remain the same no matter when you trained or how gruesome your personal version is of the "when I was an intern. . . ." saga:


You learn.
You try.
You grow.
You cry.

And if you're lucky. . . this doesn't end when you finish your internship.  :)