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First month of internship

Before I forget.

1. On paid employment

That day when you know you are being paid. It’s funny what it does to you.

On the first day of work that I worked out the buttons on the pager for the very first time. We were given pagers as students but I always left it at home, feeling too lazy to work out how to use this ancient looking, clunky device that probably belonged in an antique store. On that first day, I did an IV cannulation for the first time in almost two years, because I had been avoiding them like the plague. That first week, I finally put in the mental effort to work out how a inpatient drug chart worked. I started making the calls that I never made as a student, because I found talking on the phone awkward and hated memories of people telling me that I don’t speak clearly. I thought less and less about how to escape before the end of my shift. Paid work comes with a (healthy) sense of responsibility.

2. On answering pages

“Thank you doctor,” a nurse had said after I had attended to my first page. I almost burst out laughing and honestly thought she was joking.

We might review this and that issue, but it seems that many times we do tests and hope that if enough time passes, the problem will go away. Let’s repeat that blood pressure, again, and again, and again, maybe with a different cuff, maybe on the other arm, maybe maybe maybe if we do it enough times there will be one normal reading.

3. On essential equipment

The stethescope hangs more like an adornment, and the real equipment seem to be a good pen that is easy to write with, and a mobile phone with reliable reception. Which some companies fail to provide, and have the audacity to tell you they have fulfilled their part of the contract because the original address at which you signed up with them has great reception. You are providing a mobile network, not a landline!

Quick arms and legs are good too.

4. On meals

That unfortunate day when hospital food smells appealing. Or that instead of eating, you gulp down something to be full. Having lunch, whether it happens earlier or later, should not be considered a luxury! We are humans too.

5. On hospital heirarchy

Having a legitimate reason to sit in front of the ward computers. Then the confusion at our first multidisciplinary meeting where the nurses were trying to move out of the way for the doctors, but the interns, in a sheepish student-like way, tried to move out of the way for nursing staff at the same time.

Then noticing how quickly, we begin to roll our eyes at others, because we finished medical school.

Being the scapegoats for the the hospital’s unhappiness with antibiotic choices, and wasted resources on unnecessary investigations. Yes we order under our own names, but who is making the decisions on ward rounds? Why would you want interns to do learning modules on appropriate prescribing, when the most effective way to change the liberally prescribed 1g IV ceftriaxone orders at the hospital, is to directly communicate that with the consultant.

6. On work relationships

Having the consultant comment that you have a look as if you aren’t serious, that you are “glossing over” what he says. I was surprised and wondered if it was because I didn’t look stressed enough.

That awkward moment when the same condescending consultant and you realise that you both read and love the scriptures.

7. On medicine, or surgery

“General medicine is just not rewarding,” said one of my co-interns. Indeed, it isn’t that satisfying to make small adjustments of medications and hunt for that one in some-small-number clinche diagnosis, midst the many cases in which there is no clear aetiology.

Never thought I would say this but I miss theatre more than wards, and that sleeping patients suit me as well as talking ones. Maybe I prefer wheel in wheel outs, to this continuity of care. But maybe I don’t. I’m fickle and think I will never do anything surgical one day, and then think that I will never be a physician the next. Well, perhaps it’s true that I will be neither.

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