July 1st

Tomorrow is July 1st, a rather momentous day for those involved in medical education.

Every July 1st, a new class of interns and residents (and even medical students) begin working in hospitals around the country. For those entering their 3rd year of medical school, the clinical rotations begin, and you leave the books behind and begin working with real flesh and blood patients (literally). For the med school grads, you trade your short student coat for a full-length lab coat; you are no longer cocooned in your relatively safe student status, but are now full fledged MD's. It is often a rather daunting prospect.

At the beginning of my junior year of med school, my first rotation at Charity Hospital was in Pediatrics. I somehow ended up in the Newborn ICU, absolutely lost mentally and geographically (the hospital was huge, and loomed nightmarishly large to me); I was pretty convinced that I was going to be responsible for the demise of some poor premature infant through my ineptitude. The physician I was assigned to seemed just as lost as I was (I think she was entering her 2nd year, but somehow it was her first experience at Charity), and on top of it all, I was scheduled to be on call that very night. I was convinced that the cosmos had coalesced into some horrible, fate filled configuration. I remember watching my classmates happily skipping out of the unit at about 5 pm, and there I was gazing longingly at them like some little kid stuck in his room, unable to go out and play. I muddled through the next few hours, assigned to the menial, "scut" tasks that med students are doomed to forever perform, a growing sense of despair creeping over me. At one point, I remember looking up through my funk, and seeing Rich Manthey (a classmate of mine) bringing me a bag of chips, "something to get you through the night, man," he said. I somehow made it through the night without any loss of life.

I was, and will always be eternally grateful for that bag of chips.

Two years later, I began my first rotation in residency. For some reason, my memory is less distinct about that night, I think partly because I was even more terrified than
the medical student of two years before. I think I was on call that first night also. You don't really sleep; the beeper goes off throughout the night, paging you for different tasks and "scut" work that is the bane of every intern--check somebody's blood pressure on the floor, rush down to L&D for a delivery, work-up an admission in the ER, etc. I can look back on it with some fondness and laughter, but going through it was a different story. All of your fears of being competent, about not knowing what to do, about wanting to do the right thing because doing the wrong thing might cost someone their life--it's all right there, in your face. Somehow we get through it; I do remember clearly finally heading home around 7 the next evening, completely engulfed in relief and fatigue.

So, tonight, somewhere, some poor med student, some shaking intern is trying to not to get too freaked out, trying real hard not to turn into some drooling idiot, and trying hardest of all to remember every last thing that he or she has learned in the last 4 years. EVERY LAST THING.

So, a request, and some advice.

My request--pray for that poor student.

My advice--stay out of the hospital for the next few weeks. There's a lot of learning going on.