Due to some convolution of hospital politics (of which no one has really informed me; I deduce its occurrence by the effects on me), I find myself covering yet another service, about which I know even less than some others. Talk about sink or swim. Fortunately none of the patients I’ve handled like this have been truly sick yet, although they always come billed as something quite frightening, and it takesĀ a little investigation to assure myself that they’re actually stable. Also the attendings are still new enough at having resident coverage at night that they actually appreciate my calls – unlike some other attendings, who now take us for granted and regard my calls as a nuisance.

At one point tonight I found myself wandering into the ICU to check on one of my few patients there; I didn’t really want to check on them (since the simple act of a doctor looking at an ICU patient tends to remind everyone of previously ignored issues that need to be addressed now), but somehow I felt like I had to. And there around the corner was another patient crashing. So I got to watch the senior resident taking care of him, for quite a while, which was instructive. I think a major part of his technique consists of putting his hands in his pockets; it’s hard to get too agitated in that posture. I need to practice that.

Lately I’ve started shadowing the senior residents as intensely as, a year ago, I watched the interns. I can remember making quite a nuisance of myself back then. I know this, because the medical students now are nuisances: very eager and enthusiastic and anxious to learn – but only the fact that you can never again leave the hospital early makes one realize how special it was to be a student who could be sent home, or to bed, away from the boring routine chores. So I don’t really mind the students being there, but somehow the fact that they could be free makes me mind having to do the chores even more.

And now I’m hanging around the senior resident at night, asking intrusive questions like, who did you call? why did you call them? what are the rules for calling people at night? why did you do that? why did you pick that medicine? because I’ve only got three months left of being a carefree intern (used to think that was an oxymoron). So far he’s being very nice about it, explaining what he’s doing; I think because he knows quite well how terrifying it will be to pick up those responsibilities in July. It’s good for me to watch his style, because I think up to this point I tend to imitate Brad a lot; and he is way too much of a cowboy. He has the experience to pull it off; but I don’t, and it will be good for me to imitate a resident with a little more restrained manner.

Which brings up another point: now that I’m a little more comfortable with taking care of patients, and then calling somebody who’s outside of the hospital to tell them what happened and ask for further advice, I’m able to feel guilty for waking people up. They, after all, have to come to work the next day. It makes me feel really bad to wake up people I like, and hear them struggling to pay attention and think about the question. That’s also not going to be fun next year, having to call the same person several times a night, especially knowing that they’ve been up in the hospital the last couple nights.

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