Diary of an intern: my first week

If you’re just graduating this year – yikes, you copped a bad one. But you’ll make it. Look at me, I survived.

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If I were starting internship next year I’d be shitting myself. 

I had a final-year med student with me last week, and he mentioned that he’d done all of one day per week of placement over the last 18 months. Mostly because of covid. I really felt for him. And for every other med student graduating this year, preparing for their baptism of fire. 

So, if you’re shitting yourself about next year, please take a few minutes to look back on the first week of a fellow intern, faithfully diarised, and shitting themselves along with you.  

(Spoilers: I made it past the first week alive. I reckon you will too.)

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20/1/13

Feeling nervous.

I oscillate between: “Oh, it’ll be fine, we’ll have no responsibility” to “Oh God I’m going to make a deadly mistake, kill someone, then find myself jobless and having wasted 4 years of my life.”

Eh. I’ll be fine. (Probably.)

Hey, it might even be fun. I’m on theatre duty this week, maybe I’ll get to do / see something super cool.

Grandma died on the table during a carotid endarterectomy. I hope that doesn’t happen while I’m assisting on one.

Stop being morbid.

Behave, brain.

Ok sure, I’ll behave.

Now I sound extra crazy.

Oh well.

Addendum 2144 20/1/13: Maybe I’ll structure this diary like a daily ward round.

S.O.A.P.

Subjective.

Objective.

Assessment.

Plan.

Except instead of a hospital patient it’ll just be my life. 

Day 1: the ward round of life

S is for soooooooooooo tired. Eyes feel like cotton wool. Head feels like there is a mosquito buzzing around in an empty space up in there.

Objective: went from 0630 -> 1945. Oh God.

Assessment: Just caught my reflection in the mirror. Look like shit already.

Plan:

1. Don’t freak out.
2. Remember today’s funnies: 
   • Anaesthetist asked Mr X how he was feeling as he was going to sleep for his operation, Mr X’s response was a giggle and a slurred “Yaaaaaaay!”
   • Mrs B’s main concern about having a groin wound post vascular surgery: “Can I play bowls on the 1^stof February?”
   • Don’t forget to eat tomorrow. (I mean eat during tomorrow’s shift. Not become some future-eating monster.) (Making so much sense right now… Ugh. Bed.)

Day 2

Was sick. Weird nausea/fever thing. Possibly psychosomatic. I think maybe a part of it was psyching myself out, thinking I can’t cope with 13-hour days. But I can. It’s all a matter of teamwork, eating and drinking, and finding a moment here or there to laugh.

Day 3

0700 -> 2100.

14-hr day.

Strangely ok about it because:

1. Managed to eat and drink fine.
2. I was useful. Or at least I think I was. (Is that the same?)
3. Got to run the morning peri op clinic with one of my fellow graduates.
4. Heard my resident refer to new registrar as Dr Dreamy-Eyes (ha!).

PS Stuff the SOAP format. Too much reflection required. Minimalistic notes instead. Night!

Day 4

0700 -> 2230

Flipping HECK.

Would’ve been ok if I didn’t have to do that MAMMOTH discharge summary. At the END of the evening.

Funnies:

1. After 15.5-hour day, enter my apartment building, find myself waiting for the lift beside a giant cockroach, waggling its antennae expectantly. When the lift comes I scare the cockroach into it and send it down to the basement, and call a second lift for myself to go up in.
2. Once home chatted to flatmate for a little while about what heaven it will be to work together after being on our respectively hellish first terms (vascular myself and colorectal surgery for her).
3. I kind of love my resident. At one point today we were both singing: “The best things in life are free, but you can give them to the birds and bees, I want MONEY ^{That’s – what I want –} that’s what I want!” Because overtime. So much overtime. And she laughed at my comparison of the hospital to school and myself to the Trunchbull, in my thinking today that the best kind of hospital would be one in which there are

NO PATIENTS!!          

Haha jokes. Night.

Day 5

You know you’re an intern when:

• You think that getting to work at 7 allows for a glorious sleep-in.
• By the end of your first week a 12.5 hr shift seems AMAZING.
• That immediately vital page you answered was to get your registrar coffee.
• Your patient asks you how long you’ve been doing this job, and you watch their face fall as you say: “Five days…” with that upward inflection at the end that instils just so much confidence.
• Your friendly Reg (for whom you fetched coffee, earlier) wishes you goodnight as you settle in to write up those discharge summaries that the NUM needs “ASAP”.
• You realise that the gym membership you signed up for is redundant as
• you get enough exercise running around the hospital (as the lifts are possibly dangerous black holes in space) – mainly to PACE2s and
• you’re not home early enough to use it anyway.
• Up & Go’s seem like reasonable foodstuffs. (Breakfast only slows you down.)
• Eating lunch at 6pm seems totally reasonable.
• You assign transparent code names to good-looking registrars.
• You find yourself attempting (and failing) to watch the same episode three nights running. And falling asleep each time.
• You realise you’re the kindergartener, the resident is the year 6er, the senior reg is the year 12er, and the consultant is the teacher, and GPs are that weird kid in the class that nobody wants to invite to the party. But not quite that kid in the corner eating the paste. Haven’t figured out who that kid is just yet. (Let’s pray it doesn’t turn out to be me.)

Day 6

Interesting points from today: 

1. Totally pissed off one patient by giving her a med certificate that would only last her til the end of the week in order to force her to see her GP. But she needed follow up, so frankly I didn’t care. Yay for getting more callous! (I think.)
2. Helped a med student put in her 2^nd cannula of all time!
3. Managed to finish by 1830! Only a 12 hr day! LUXURIOUS! (Not even kidding.)
4. Have an overly friendly / talkative patient that I’m starting to find a bit irritating. But somehow, you just have to make allowances for old codgers with bilateral forefoot amputations. Negated if the patient still smokes.

PS. I really like my team. All gold.

Day 7

Today – a series of unfortunate events.

Paged to go to an emergency caesar. “Get in there quick smart!” they said, so was in too much of a hurry and for some reason didn’t check the green gloves properly, and ended up putting R on L, then was too embarrassed to admit that I needed another pair of undergloves, so just ended up putting the white ones on top, and trying to ignore the fact that my hands just wanted to curl up into tiny crampy balls whilst I was supposed to be holding surgical instruments.

THEN, as a result of being hungry, and thirsty, and hot under those STUPIDLY bright lights they always use for caesars, started to get faint. They said well done for warning them early, but still felt stupid.

THEN, while lying on the floor trying to recover from pre-syncopal episode, could feel my lower abdomen starting to twinge. Period hit then and there, and flipping heck it wasn’t nice. Was trembling in the tea room and trying very hard not to cry or vomit, eventually retreated to the change rooms for some privacy and then the lovely scrub nurse told me to go home, and even called switch for me to organise a replacement. Felt really bad, but what else could I do? Ah the joys of being a doctor with endometriosis.

“Learn to take good care of yourself,” one of the nurses said, “because nobody else will.” But she took care of me, and I was sure to thank her for it. Make friends with the nurses.

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So, if you’re heading into intern-land next year and you’re currently freaking out, I just wanted to say: you’re not alone. I survived my hellish first term, and so will you.  

There’s always a kind boss or theatre nurse somewhere who will give you a biscuit and a cup of tea after you’ve fainted during your first caesar while wearing the right glove on the left, and the left on the right.

Ask for help. Help others. Be kind. Triage your tasks. Breathe in, breathe out. Sleep when you can. Be inquisitive. Learn stuff. Be humble. Admit when you don’t know. Thank people. Write down the funnies. Debrief the sads. Cultivate your friendships. Take leave. Exercise. Eat well. Drink water. Try non-alcoholic beverages. If you want to die, ask for help. I remember what it was like. I’m here for you.

Jess

Dr Jess Webster is an FRACGP practising in Sydney