Confessions of an Intern

Week Two

I have successfully completed the second week of inpatient service. And my first weekend on call. I survived, and so did all of my patients. In the middle of last week, there were events I wanted to share, and I wish I'd written them down. While it does not seem like so long ago, I have put in many hours and have had many experiences. I am on day 8 of 12 in a row, last week I put in 73 hours on the job. That is more than I have ever worked in a week before. I used to make sure that I had my time off. Now the program owns me. When I was accepted to the program, I got a T-shirt in my goody bag. On the front is says 'Property of RMC'. Now I realize they meant that literally.

All that said, I am having the time of my life. I love taking care of people. I only wish that I knew more. I know a lot. More than most interns, simply because of my experience. I don't say that to sound uppity, it's just the truth. Many of my peers have told me repeatedly that they wished they had my practical knowledge. Things that I learned through years of doing seem like grand feats of skill to them. I take it for granted, but I really am grateful that my life has gone the way it has. Many years ago, right after graduation from my ADN RN program, I went to the health care career counselor. I told him I wanted to go to medical school and wanted help to get there. He barely glanced at me and said, "Come back when you're serious."

Now you can probably imagine my reaction. I was offended and put off, and thought the nerve of that man, how dare he say that to me. However, eight years and three babies later, I realized he was right. I was not ready back then. The moment I knew it was meant to be came three months after my youngest son was born, and I was called to step in where a fellow nurse could not. In respect to the subject, suffice it to say, I had my 'Aha!' moment when my hand was literally pushing intestines back into a patient's body. Some say 'gross!' others say 'Awesome!'. I say 'Thank God! I can do this!' That day, I signed up for the MCAT, registered for some prerequisites and scheduled an appointment with the same career counselor from eight years before. I reminded him of what he told me, and he denies that he would have said that. I thanked him for it though. He turned into my biggest advocate and help on my trek through medical school acceptance. Now I would not change a thing. I could never have the appreciation for the human condition that I learned as a nurse, had I not spent my time in the trenches.

I've learned every person who comes in with a main complaint of pain is not a drug seeker. I've learned more often than not, those patients who are belligerent and uncooperative are those who need to listened to the most. They often have a life story many, if not most, would not believe. Some of the worst physical pain can be caused by deep rooted emotional agony. If I just go in, sit down and treat the proud, young, black man like a human being, not a drug seeker with pancreatitis/sickle cell/diabetes, I get much farther with them and their willingness to make wise health decisions. Sit down and let them cry, let them talk about their babies, the baby mama drama and the bad hand they've been dealt by fate. Then, when you tell them they are the one who decides how they play that crappy hand, they will listen and not bristle up and throw it back in your face.

Culture is a funny thing. We were taught cultural sensitivity classes in nursing and medical school. To a point that is good. But the generalizations become stereotypes, the fine line between the two is foggy and gray. Some days, I feel like I wish I could have been born into a tight knit Mexican family, or have a family like some African American families, where the women are held up and respected. Then there are the exceptions to those. Not all of any culture follow the generalizations. Many white families are cold and distant, but just as many are warm and caring. I feel we are taught this to the point it is a detriment. Some of my younger peers go into interactions with other cultures with only these classes as their reference point. I feel like I've had a good go of things with just about any culture I've come across. Maybe even a little surprisingly, as my good 'ole Nebraska family are as bigoted as they come. My mom broke that cycle, to a certain extent. When my parents divorced, my mom moved us from a cushy suburban neighborhood into an old urban one, where we were often the minority as white kids. We had gang markings on the trees on the boulevard in front of our beautiful Tudor style house, and the city park we played at during the day was a war zone at night. My grandfather unknowingly gave me an LA Raiders coat for Christmas one year when I was eleven (the height of the Bloods and Krips reign). I wore it outside in that area only once.

I've had some very interesting life experience when it comes to interpersonal relationships. Ms. Hughes was the foster mother of one my brother's best childhood friends. She was a proud black woman who was ultimately kind to me and my brother. His friend Trent tried to act up and she would back hand him upside the head and tell him to act right. She loved that boy. I sent her Christmas cards every year, until I got a letter from her sisters telling me that she had passed away. They thanked me for my devotion to her. Maybe that is how my mom broke that cycle. I don't know.

Anyway, I feel that I am in my element. I feel alive and vibrant. It helps that I realize I know more than I think I do about medicine. Yes, I already know how to do NG tubes, IVs, and most medication names roll off my tongue like a second language, to the point I feel like I know more than some of my attendings about general drugs, not that I think I am smarter than they are. I have years of many long days, discharging three patients only to admit two or three more. For my peers, one admission is a nearly insurmountable task. I say bring it on.

I've watched the completely psychotic turn as gentle as a lamb, been given drawings by a developmentally delayed guy, I've advocated for someone who does not have the capacity to talk, argued with a patient's family that someone was too sick to go home, talked a sick patient into staying who wanted to leave and met a fire breather (who learned the hard way not to breath 'in'). I'd say I've had a great week.

P.S. With all the craziness of the last two weeks, while I've done so many amazing things, I've failed in one of the most important areas. I forgot my grandfather's and my uncle's birthdays. I had to miss another uncle's funeral. I forgot to play tooth fairy for my youngest son until a week after he lost his tooth. Last night he said to me, "Mom! The tooth fairy still hasn't got my tooth. Don't you know I can't grow a new tooth until she takes the old one?!?" Picture an 8 year old boy with hands on his hips and a completely incredulous look plastered on his face. So, on my way out the door at 5 am, I had to scrounge up a handful of quarters from the laundry change. I'm having serious mom guilt. I cried myself to sleep last Thursday night.