Sunday, January 02, 2005

How Did Your First Day Go?

Say, do you remember the day you started your first full-time job? Do you remember how you dressed particularly carefully that morning, and how you felt light in the head and heavy in the bladder as you strolled awkwardly down the hall to meet your co-workers? By the time the afternoon shadows crossed your desk you were likely grinning with relief and chanting "I can do this!" more sincerely than a late-night infomercial. Before you knew it you were home, eating a slice or two and talking on the phone with your mother about your new boss. What a restful slumber you got that night! Why, as you sailed off to dreamland you even scolded yourself for worrying about your ability to handle this new chapter in your life.

Now if I was jealous of all you folks out there in the spiffy world of business, computers, law and any other job where wine is served with lunch I might just offer this following heartfelt message of congratulations:

Go jump in the lake!

Far be it from me, however, to douse the spotlights shining on these fond recollections of the dawn of your career. After all on television shows doctors seem to have fun too, springing out of elevators to rescue white-haired grandmothers, and shaming angry young men into dropping their weapon so they can have their face sutured. It seemed their first day on the job was so chock-full of action you would soon find it for sale as a paperback at Wal-Mart.

Well, I don't play a doctor on T.V. but I'd love to tell you about my first day on the job.

Let me think of how to start the tale...

I was a 26 year-old medical student on my first real working day, unqualified to practice the trade I had just spent eight years studying for. Having been anointed incompetent, I was therefore sentenced to three years in an internal medicine residency in a brave attempt to implant such Arthurian skills as wisdom, steadfastness, charity, et cetera so that the governing bodies would minimize their teeth-gnashing when they awarded me an actual license.

With cries of "Godspeed!" then this neatly pressed ambassador of Good Health climbed into his Corolla on a June morning many years ago and rattled off to his first day as a real doctor. I really didn't think it was necessary to memorize the complex of buildings that formed the Great City Hospital, so that morning I pulled into the behemoth for the first time.

Approximately one hour later I stepped out onto the 13th floor where to my delight my boss the director of residents was waiting to greet me - by name, too! What a personal touch he had! He guided me into the intern's orientation session, where upon my entry my comrades went out of their way to disprove the theorem that medical school relieves one of the obligation of sarcasm.

Oh, forget it...

Rather than drag out this sentimental narrative, perhaps it would be more instructive if I were to convert my memories into a short series of reminders designed to help future interns who might be in need of a bit of practical advice on that first day. Without further ado, here they are:

1. The intern's lunch is actually not supposed to come from "whatever you can find on the patient's tray".

2. An intern who wears a white tunic looks like a sous chef, not Dr. Kildare.

3. If the student comes to you and announces "I can't get a blood pressure on her" it is best to skip the rest of Jeopardy! and investigate chop-chop.

4. Any patient admitted at night with both fever and headache gets a free lumbar puncture, but not until 5 A.M.

5. Coffee can be kept potable by adding either orange juice or chocolate milk to it, but not both.

6. No song has ever been recorded that can gladden the soul at 3 o'clock in the morning.

7. The first thing to do at a cardiac arrest is to make sure you are not touching any part of the bed made of metal.

8. Never announce to the Chief Resident that your patient is now on "vulture precautions".

9. If you meet a female patient with golden slippers and blue hair, you may as well don a tuxedo and call yourself "Jeeves" for the rest of her stay.

10. If nothing else, remember the intern's Golden Rule: "A shower is worth an hour of sleep."

Mercifully all young doctors survive their first experience on the wards even if it lasts well into the next day. I guess what makes the intern return day after day to the ivory tower for more drudgery is the sense of pride he feels in his work.

Nah, that can't be it. What makes an intern return is the chance to laugh at it all with his fellow doctors. I came back, and I'm still laughing...and still working.


At 11:04 PM, Blogger Texas Libertarian said...

"7. The first thing to do at a cardiac arrest is to make sure you are not touching any part of the bed made of metal."

I had to laugh at that one. I reminded me of the time we were working a code in a flooded house when our brand spankin' new Paramedic (sewed her patches on that day) began charging the defibrillator and greasin' the paddles as I, (intubating), and my partner (compressions) were kneeling in 6" of water, working the patient...

To this day, I wonder how that would have progressed had I not been able to reach the power button.

At 5:40 PM, Blogger esclava said...

Interesting to see some of the background of those on the other side.


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