Now that I’m halfway through internship, I’m thoroughly aware that being a good doctor and being a good intern/resident are not the same thing a bit.
Being a good doctor means listening to your patients and their families, advocating for them, thinking about their problems. You know, all Marcus Welby. Or even, twistedly, House.
Being a good intern means writing a crapton of notes, and fielding pages about critical lab values, microbiology results, and blood glucoses. And normal vital signs. (Please, RNs stop paging me about normal vitals. I DON’T FREAKING CARE.)
I really worry that I’m slowly turning into the kind of doctor I don’t want to be. I baaaarely see my patients — five minutes? if that — on prerounds, and spend the rest of the day trying to hide somewhere and document things. I try to prioritize as much as possible, but honestly, I find myself resorting to a series of knee jerk responses to the vast majority of these pages.
I ran a family meeting today (not my first, but undoubtedly my most disastrous), where the patient’s son commented that this was the first time, in his father’s 25 day hospital course, that people had kept their promise about the timing of things. And then, like an idiot, I let them talk me into promising a PEG tube for this gentleman tomorrow. The last thing he needs is a PEG tube. I don’t even know if it will happen tomorrow.
One of my resolutions is to try and be a better doctor. Even with the unbelievably frustrating patients, the ones that make me want to run out of the room, but I stay in the mistaken belief that maybe I can build a therapeutic relationship with this completely steroid-psychotic person. And I worry that because I’m trying to field pages on 14 patients at once, I’m missing things. (I know I’m missing things because my resident will be like “did you realize that Mrs. R. had 15 BM today?” and I’m like “whaaaat?”) I’m definitely not able to think about people very medically — I’m barely staying afloat of their day-to-day crap.
And yes, I know, part of being a good intern is knowing when to ask for help. My resident and attending have both been great in terms of backing me up. Today was simply a crappy day with several family meetings going down simultaneously, so we decided to divide and conquer. At least mine was better than the psych/ethics meeting on another guy, where they decided to take away his capacity to refuse medical treatment, but then said that if he protests the medical treatment we have to honor the protestation. WHAT?
Um. I’m going to watch Downton Abbey now. And drink some cider. And wake up at 5:30 tomorrow and try to be a good doctor.