Thanks everyone for the encouraging comments. I think things are getting better overall; I can handle four more days.

Today continued to be splendid. My efforts to discharge patients to the floor succeeded mainly in disgruntling the floor staff, and led to one of my . . . episodes . . . with an attending today. All the hard work didn’t do me much good, because we just admitted more patients through the ER as fast as I could discharge them to the floor.

Yes, I seem to have ticked off every single attending in this group – three of them today. That has to be some kind of record for the worst resident performance ever, wouldn’t you think? With one of them I really did something wrong – forgot something that a resident four days away from being a responsible junior resident shouldn’t forget. That was very bad, dangerous even. As everyone within hearing range pointed out to me, I can’t do that stuff as a junior resident, I have four days to mend my ways, and I’d better watch out.¬†And I have to agree with them, which feels worse..

The other two attendings, I don’t know what happened. Apparently I’m such a bad communicator that even when I say, “Yes, sir, absolutely,” meaning, “Yes, sir, absolutely,” it comes across as “No way, you #$*&^, why are you even asking me? &^%” Or that’s what the attendings told other people they thought I’d said. Which is pretty hopeless. Because if a nurse is angry, and I respect her, I can go talk, and we usually sort it out. But there’s absolutely nothing an intern can say to an attending even by way of complete apology that doesn’t make everything worse. My latest plan is to say nothing but “yes” in the most colorless voice I can come up with, to anything that anyone says to me (except requests for pain medicine). I’m sure the only attending I haven’t infuriated yet will perceive this as incompetence combined with negligence, and then I’ll have antagonized a quarter of the attendings at this hospital. Brilliant, Alice.

On a brighter note, I took care of some sick patients today, and except for that one really disastrous oversight (ahem) did ok; a lot better, I think, in the department of not panicking when patients are screaming and blood pressures are dropping. I certainly refrained myself from paging people and suggesting calling the OR, which is a key technique (since the junior residents are relied on, at night, to sort out who needs surgery and who doesn’t, and when an attending needs to be called in from home, or not).

Four days to go, and then, as everyone as explained to me, I’ll really be in trouble, so much so that this month will look like cake. At least that stops me worrying about hospital politics, and gets me back to considering how incompetent I may be, which is slightly more cheerful, because it’s at least within my control.

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