Fatigue and frustration…

Going towards the finish line, here…and our medical team is on attending physician #3 in 28 days. Yet another beyond-busy call night, without a blink of sleep. At around 4AM, I started answering my pages angrily, but I hardly remember what I said because I was only half awake. And then to begin the morning, after 24 hours of work, to commence rounds with someone who likes to micromanage…it pushed me over the tipping point. I am ready to leave medicine and never come back. A patient’s family was nice enough to bring food to us in the unit – one of his relatives is a well-renowned chef. But then the nurse comes in and yells at me because I am sitting at the table, trying to eat the first bit of food I’ve had in 24 hours, that it’s her patient and there are no plates left. I just sit there, with my plate, alone in the room, and stare blankly. I have nothing to say. On my way out of the hospital, I follow a group of five sophisticated businessmen in well-trimmed suits. They are laughing about something or other. I begin to wonder if they are donating money to the new hospital construction projects, and then I begin to wonder if they would have enough sympathy to donate money to me, a poor, disheartened intern, not even beginning to break even with my loans on $10 an hour for a job where 2 minute breaks to eat or urinate are few and far between – a true luxury. If I could write off my loans, I would not be bound to this hardship…day in, day out of no sleep, of little respect, of being the low man on the totem pole. And to have achieved this after 4 years of post-college education and over $200,000 of investment. Given the circumstances, I haven’t quite been able to figure out how the hospital is so full – full of eager interns, of earnest residents. What are their reasons for being here? What are mine? It is when those reasons begin not to matter anymore…it is when you forget those reasons…that you have lost the idealism which brought you to this place of healing in the very beginning. It is the process of losing that idealism that has shaped my intern year. This is real medicine: no lofty ideals, no honor, no dignity. This is the down and dirty, high-intensity, high-volume job where sleep is viewed as exceedingly unimportant, where the concept of caregiver well-being is brushed aside, and where anyone who dares to bring up these issues is viewed as weak rather than well-balanced.