July 13, 2010

• Big Man on Small Campus

  A couple weeks into residency, and I actually feel pretty good about myself. In a previous post, I think I mentioned something about taking some magic pill on the last night of intern year and then waking up the next morning with all the knowledge you need to have as a resident. Well, there are days I actually feel like thats happened.

  I know I learned a lot over the last year, but so much of it has been relegated to my subconscious its like I have a secret identity from myself. I’m currently on pulmonary consult, after finishing my intern year in ICU. It’s been a pretty nice transition in the sense that I feel very comfortable with managing ventilators, putting in central lines and taking care of the sickest of the sick. I am still terrified to run a code however…that much of my inner intern hasnt quite been overcome, but I will get there.

  The way you are treated almost changes overnight. No longer at the bottom of the totem pole, the new interns look up to you, not realizing you have only been in a position of authority for about a week. With somewhere for $h*t to run after you, the attendings ask for your thoughts in a way that guides you, rather than pimps you or puts you on the spot. And if you dont know, you go and look it up without having to be told or lectured, because it’s YOUR patients and you WANT to know what you could be missing. The Fellows treat you, if not as equals, then as peers with a good knowledge base. And even the RN’s stop calling you as often for the bs reasons.

  Most of the patients have no clue of this momentous transition. They dont see the disappearance of the prelim class, the extra pep in the step of the new residents when they enter a room as someone with KNOWLEDGE! of SCIENCE! We dont second guess ourselves as much anymore, and we start taking on more of the tough situations that our residents would protect us from during intern year, thing like talking to the family when we know someone is going to die, or more importantly, should be allowed to do so.

  The fact that we can see the future, in most cases– we can predict, pretty reasonably, what’s going to happen, even if we can’t stop it– is a powerful thing. It’s power, to know if someone is going to live or die a day before it happens. It’s sad and pointless and ridiculous power, but it’s something to hang onto, something to use to say to yourself, hey, I’m a doctor, I know things, I’m actually qualified to do this job, at least a little bit.

   

  • 4:38 pm
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