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FORUM The Feel and Unexpected Weight of the 'Intern Blues'It was the first real snow of the winter, and my car was stuck. Already more than an hour late for the hospital, I had little hope of getting out soon, and I started to cry. Not silent, leaking tears, but loud, angry, hiccuping sobs as I haphazardly shoveled at a heavy pile of snow.This was not the me I was used to. Only six months into the first of my three years of residency, I felt as though I had the emotional resilience of a three-year-old. A baking fiasco, a glitch in a catalog order, a long grocery line reduced me to tears. Even as I stood sobbing in the snow, I recognized how inappropriate my response was. I managed the daily stresses of hospital life at work, but at home I melted into a quivering puddle.
I had been living hospital life for more than two years, since my third year of medical school, and I knew what to expect from internship. Yet the transition from student to doctor has been even more difficult than I had anticipated. I have always considered myself to be a strong, resilient person, and yet this year has stretched me to my limit. The grind of internship is certainly harder than my medical school days. In medical school, I pushed through the harder months and looked forward to the easier times ahead, always just around the corner. I was never afraid of my beeper as a student; I willed it to go off, signifying that someone had remembered my existence. As in medical school, the hours and the fatigue have been the least of my struggle. In fact, in a perverse way, I actually crave the deep, bone-tired feeling of postcall. I indulge myself with desserts and TV and crankiness that I (and my husband) would never otherwise tolerate. No sleep is as delicious as crawling under the covers with the realization that I am off the hook for the next three days. The stress of each hospital day makes internship hard. Every month I switch to a new area of the hospital, ready to confront issues that I have never dealt with and respond to questions whose answers I am not sure of. I had never set foot in a neonatal intensive care unit before, and now I am left to care for 30 premature infants overnight. Of course, I am never alone. Help is, at most, a phone call away, but by 2 a.m., my senior resident has usually gone to sleep, and I consider long and hard before picking up the phone. While most choices are relatively straightforward, the consequences of misjudgment feel overwhelming. Am I missing an infection? Should I have transfused that patient with sickle cell anemia? By the time I present my overnight decisions to the rest of my medical team in the morning, the decisions seem clear. But at 3:30 a.m., when I am tired and cold and lonely, the decisions are agonizing.
A Lost Life My senior resident began our first morning meeting of this past month by saying, "February is the hardest month of the year. If you don't have the intern blues, you're the exception." Then she plunked down a bottle of Centrum vitamins on the table for us to share. "I never took vitamins until residency," she said. Despite the miserable moments, I love being a doctor. After years of being a student bystander, I am finally enmeshed in my patients' care. I feel like I can participate deeply in their lives and make a difference. Last week I walked into my examination room, and my 10-year-old patient exclaimed, "It's my doctor, Dr. Ellen!" And she was right. Before, I had always surmounted and succeeded. Now, for the first time in my life, I am struggling to preserve my sense of self, my sense of dignity, my sense of personhood. --Ellen Rothman, HMS '98, a first-year pediatric resident at Children's Hospital Back to Top |
