My mother waited eagerly for me to get home on the first day of my internship, after I successfully (but seriously idk how) passed my final exams. But I didn’t come home. She calls multiple times so I pull out my phone from the pockets on my scrubs mid NG tube insertion and try to answer the call. She hears multiple shrieks, some of them my own and she frantically asks if I’m okay. My voice breaks (because the network coverage at my hospital is shit) and I hang up. The patient vomits all over me.
I get home the next day, a complete zombie, depleted of all my ATP from every single source. Even from essential protein. I am a skeleton now.
My mother screams in terror and runs for her life.
That, is the story of how my first on call went. I was so exhausted that while doing CPR on a patient, my own heart betrayed me and went into asystole and my colleague had to CPR me. Kind of like a CPR-inception. Anyway, you know how I’ve been complaining about med school all these years? To give you a better understanding, if med school was a problem, it would be a first world problem like not getting an uber on time. Internship is like welding metal yourself and making your own car AND drilling the ground and extracting petrol for said car AND making it to hospital at 4.30 am when you are actually required to go at 9 am.
So obviously I gave myself 6 months to recover from the malnutrition and nightmares and the panic attacks before I could sort through all those memories and write a survival guide on how to survive internship. I think a better title would be ‘how not to die a violent and painful death during internship’ but we’ll keep this one because it’s more aesthetically pleasing.
- As soon as you enter the wards, scope out the glucometer and the sphygmomanometer and protect them with your life because your dumb resident doesn’t understand that a patient who is alive and well and sitting upright while voluntarily ripping his IV line off for fun isn’t hypotensive, and the hypertension patient on anti-hypertensive medications isn’t hypertensive anymore. She will give you mindless orders like “check the BP of every person in the entire world”. And we have manual sphygmomanometers, the ones that you have to inflate BY HAND. Both my hands have contractures now.Also she wants you to check everyone’s random blood sugar because she is completely jealous they got to eat a proper meal last night and she only ate McDonald’s. Boohoo.
2. Whatever you do, don’t be over eager to do stuff in the first days of your internship. Because blood hungry residents are on the constant lookout for interns who can work overtime for/instead of them. I live in constant fear and clutch my phone while saying a prayer that it won’t ring. Because 10 years from now when I’m dropping my kids off at school, I’m scared my resident will call me and scream at me for not adjusting the drip rate on a patient’s IV from 10 drops to 12 drops.
3. Be mentally and physically prepared for rounds. I suggest lifting weights and becoming a world heavyweight lifting champion would help, because you have to carry all the case files of every patient admitted since 1947 while on rounds. Because you being the intern are obviously the mule to carry things for everyone else. And by being mentally prepared, I mean you should be able to shout out diagnoses for any patient/scenario that the attending asks for. For example:
Attending : Hyperglycaemia and fruity breath?
Me: DKA
Attending : Hemiplegia and deviation of mouth?
Me: Stroke
Attending : The sun is shining brightly today
Me : PUO
Attending : That wasn’t a question. Did you know the Aquaman movie is coming out soon?
Me : Aquaman? Must be Diabetes insipidus.
4. Call your local human rights advocate because when you ask your attending about your working hours he will smile and say “you only have to work 80 hours PER DAY. And I suggest self catheterisation so you don’t waste 5 minutes for pee breaks”. If you start crying or get apprehensive about this, your attending will tell you stories of how he had to walk 800 km to his hospital as an intern and how he performed 53 emergency appendectomies before morning rounds even though he was interning in dermatology at that point. He also claims he discovered the life cycle of the scabies mite in his lunch breaks when he was an intern.
Pro tip: Don’t ever shake your attending’s hand.
5. If you’re an intern working in orthopaedics my thoughts and prayers are with you because you will need new joints after your residents and attending wear them out making you run around for consults. I suggest laying down some ground rules like
But Dr. X! Having a pulse doesn’t mean the patient needs a cardio consult!
The guy with the fracture neck of femur has a headache because his wife keeps nagging him. I don’t think a neurosurgery call is necessary.
We don’t need an Internal Medicine consult because this patient is allergic to strawberries.
Do we really need a dermatology consult just because you can’t spell ‘Stevens-Johnson syndrome’?
6. Working in ob-gyn automatically qualifies you for a lifetime achievement award. You can’t even cry about how much work there is to do in one day as an ob-gyn intern because your sobs are drowned out by only 7000 ladies in active labour forming a weird scream-acapella group. But somehow your resident screams even louder asking you to deliver 10 babies in a row while she drinks her placenta flavoured coffee. Swimming underwater and against current is a good skill set to have because it is a little known fact, but the word ‘tsunami’ was actually coined for when an amniotic sac breaks and floods the whole country in neck deep fluid.
7. If you can’t remember what medications the patient is on, don’t waste time sifting through stacks of papers of case files. Because most residents seem to remember what drugs and doses their patients need, it’s easier to pester them instead.
This has the potential to backfire though, because once I told my resident that I’m stuck in traffic and the roads are congested and he asked me to “give 40mg lasix IV”.
8. You’re going to have to deal with all kinds of patients and their families, whose sole purpose of being in the hospital next to the patient is to ask you questions and make snide remarks until your shift is done. Then they will do it to the incoming intern all over again.
There are the kind of patients who think the most appropriate time for them to cough violently is when you lean in to auscultate.
Or the ones that pester you to send bloods for ALL the labs possible but you have to explain to them that they have pancreatitis and a full body scan or complete DNA sequencing is highly unnecessary.
There are also patients who have ripped out their intravenous catheter every single time and the only vein left to cath is probably the superior thyroid vein.
The survival list is exhaustive but I can only write so much as my PTSD is kicking in. So my dear fellow interns, don’t forget to play hide and seek with your residents at all times and most importantly, don’t forget to transfuse one unit of 5% dextrose to yourself. You’ll need it.
humerushumorous 