There’s really not much to say about this academic year, so far. I haven’t gotten to do really any more surgeries. The chief keeps intending to let me, but then the case turns out so wildly complicated that I can’t honestly say it would be a good idea to let me in, so I can’t complain.

I don’t know any more now than I did a week ago, it’s just that the amazingly naive intern at my heels makes me look relatively well-informed, and even almost sophisticated. (One thing I learned the painful way: you do not have to tell the attending every single detail of what happened in the last 24 hours, such as, we wanted to check such and such a lab, but it took forever to draw, and then the lab lost the blood sample, so it was twelve hours after admission before we discovered. . . The tactful thing is to say, About twelve hours later we discovered that. . . And if the attending cares, he can take up the twelve hours, and then the chief can explain; but the intern should not attempt it, neither such details as, The patient had a fever eight hours ago, but since the nurses haven’t checked since then, I don’t know what the temperature is now (to which the answer is, a thermometer is a simple piece of equipment, if you consider it important to know the temperature, go find out; similarly for pulse and blood pressure and pulse ox). As I said, I learned that the hard way, by having both the attending, and then later the chief, jump on my unguarded statements. Trying to blame the nursing/lab/radiology staff for your own lack of information does not go over well.)

I do have my hands fairly full trying to manage the intern plus the patients. It’s amazing how much simpler it is to just do the work myself, rather than to gently show the intern how to do it, and then stand back and give them time to do it themselves. I shudder to think what a headache I’ve been giving the rest of the residents for the last year, and must be giving my chief now; it’s astonishing that they still talk to me.

In a few days we’ll have a completely fresh batch of medical students, and then the chaos will be complete. All we can do is be thankful that this year (unlike last) the medical students’ first day doesn’t coincide with the interns’.

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