Tuesday, December 2, 2008

Life as an Intern



I thought these were two neat shots of the West Texas sky.

I was glancing back over some of my old posts and I realized that I have never really talked that much about what life is like as an intern in internal medicine. I just realized I need to change the blurb on my blog to read, "Life as an INTERN. "Run with patience the race that is set before us, looking unto Jesus the author and finisher of our faith." Internship has really cut back on my free time and that has certainly meant less time to post on this blog. The blog isn't the only thing in my life that has been neglected though.

I started off internship on CCU. The call is Q4 which means every fourth night you are working a 30 hour shift and you only get the day off if it is a weekend and it isn't days 1 or 2 of your four day cycle. Needless to say, it was a busy month. You have to learn quickly when you are on call by yourself and at 3am in the morning, someone starts complaining of chest pain or their heart rate jumps to the 180s and they start complaining of shortness of breath. I can't remember as a medical student having to interpret EKGs, but it is a little different when you are the only one looking at it and the person with chest pain and possibly have a heart attack is in the next room. It was a fun month though and some of the attending physicians at my training program were excellent instructors.

The next month was spent on the "wards" which means inpatient internal medicine. We were on call Q5. There is a greater variety of patients. They tend to stay in the hospital longer and there are more social issues. It was also my first time to have medical students working with me. As an intern, it is really a struggle to take care of your patients, do all the paperwork, keep in touch with the attendings and consults, and then do a good job of teaching the medical students.

The next months was an elective in ophthalmology. This is the are of medicine that I am going into starting next year so it was fun to get some early exposure. It was a change of pace from inpatient medicine. The month made me realize just how much I have to learn before I start next fall.

The past two and half months have again been back on "wards." There are certainly times when I would like to go back to being a fourth year medical student. The other day at noon lunch/lecture, I was talking to an old medical student friend of mine who took a year off from medical school to study at Bible college in Canada. I did three years of medical school with her, but now is is one year behind. It was funny. I think it was a Friday and she we were discussing what we were up to next. I had the next two days, the weekend, off and was thrilled. She had the next two months off.

The hours for internship are tough. I know that it used to be harder back in the day, but it certainly is no walk in the park these days. Four days off a month is not much. Most days start for me at 5am. I try to get there at 6am or soon thereafter. We average one day off a week and every fifth day is a 30 hour shift. I have certainly come to have a great appreciation for my time off. A weekend off is something to be treasured. Friends that you used to see everyday at school, you might see every month or two if you are lucky. Trying to coordinate the schedules of people who are working 80 hours a week is tough.

Last spring when I was enjoying my fourth year, I managed to get bumped off two flights and picked up two vouchers. Both have to used within one year. I guess starting in July, it didn't really dawn on me that it might be April before I would get more than two days off in a row. Last night I drove the airport and I now I think I have something worked out where I can still get some use out of the vouchers.

Making it out the assembly is also another challenge. You are working about 50% of you Sundays. And going to the weeknight meeting is tough because you are often either on call or have to be at work early the next morning. I am very grateful that several people from the local assemblies live nearby and I can meet up with them outside the regular meetings.

The first two months of internship I was living with an older Indian couple here in the Dallas area. They were kind enough to take me in for a bit after my lease ran out on my apartment and before I found a more permanent place. I ended up buying a home not too far from where I will be doing my residency next year. Being a first time homebuyer was a learning experience. There is a lot of work that has to be done to keep up a place too. Three months later, I still have boxes spread out around my place. There is still quite a few things I can't find. I am sure they will show up eventually. Two days ago I went to put on a pair of boots and realized there was a dry erase eraser in there so who knows were everything is going to show up.

Well, I have a little free time tonight and going to try to catch a racquetball game before it gets too late. You have to eat, sleep, and exercise when you can in internship.