Retrospective

One year ago, I was learning how to drive. One year ago, I was having dreams about tripping over gurneys and patients while running through the hospital halls...naked. One year ago, I was moving into my first apartment without a roommate, and assembling all of my IKEA furniture without a man or power tool to guide me.

What a difference a year can make.

I'm no longer afraid of driving on freeways and I road rage along with the worst of them. I moved again, and am back to living with a roommate, but I'm now living with this guy. And well, now that I'm about to officially become a senior resident, I'm still stressing out and having dreams about teaching interns and med students and not remembering what the mnemonics DIGFAST and SIGECAPS stand for. (But hey, I'm not naked in my dreams this time around. It's good to know that at least my neuroses can mature a bit from year to year.)

But all in all, I can't believe I'm finally though the proverbial tunnel and basking in the light. Intern year is officially over.

And it's been one heck of a learning process. It's like how that one Charles Dickens' tale starts -- it was the best of times, it was the worst of times. I never want to go through intern year again. Ever. Calls were bad, scutwork was never-ending, and on top of it all, we had to navigate a whole new world called the county system. There were days when I sat in my car and had to cry it all out before I could even start the engine. There were days when I wanted to throw in the towel and just walk out in protest. There were days when I wanted to scream at the top of my lungs and wring a few necks here and there. And there were many days where I went from work straight to the bar and drank a bottle or two of wine.

But looking back at it all now, I wouldn't change a thing.

Because, gosh darn it, we survived. It was a boot camp of sorts and the worst hazing of our lives, but we made it through. I've made some lifelong friends this year - friends that I know I can depend on, friends that I know I can blackmail, friends who can blackmail me in return, and friends that will only tease me a little bit when I inevitably consult them regarding some silly neuro or medicine question like first-line treatment for hypertension.

Above all else, it feels so good to finally be doing what I went to med school to do, what I went to undergrad for, what I've strived for ever since my sister had her asthma attack fifteen or so years ago. I wanted to be a doctor, and this year, that's exactly what I did. I doctored.

I took care of a patient who thought he was a T-rex. I took care of three Jesus Christs - all at the same time. I got slapped by a delusional patient who thought I was his ex-girlfriend. I watched my senior resident sign a death certificate and then have to re-register that patient into our system when he came back from the dead. I took care of brain-dead patients so that families could say their last goodbyes. I threatened to deport delinquent families who refused to care for their grandparents. I took care of kids who were sent to the hospital for neglect or abuse after DCFS intervened. I explained the birds and the bees, and tried to stay away from scabies and bed bugs.  

I think that's what intern year is all about. Sure it's crazy, sure it's busy, but intern year is about realizing that no matter how crazy or busy it gets, everything you're doing is for patient care. It's about realizing that you genuinely care for your patients, even when you can barely communicate with them beyond a few words in Spanish. It's about being responsible for their care, and owning that responsibility. It's the year when you learn to do the right thing. Because you have to. Because these patients depend on you. Sure, there are ACGME rules in place to make sure that you're being supervised and mistakes don't get made, but in the end, the buck ends with you. And having that responsibility is what makes you keep going. And sadly, it is effecting that responsibility that makes intern year so difficult. It's what prevents you from cutting corners, it's what makes you want to read and learn more, and it's the reason for the long hours, the crazy nurses versus doctors warfare, the inevitable long ugly cry when there's a bad patient outcome. Intern year is when you realize that with your MD, comes great responsibility -- a responsibility to always do right by your patient.

So sure, intern year is over. But the responsibility is just beginning.

And starting Monday, it all begins again.