Not much going on these days. The medical students are fun. They’re so incredibly young and naive and eager to please. It’s a great responsibility, to feel that we’re responsible for their first experience of clinical medicine, their first understanding of how to deal with real patients and function as part of a real team. I’m afraid we’re rather a dysfunctional bunch, this month, and I hope it doesn’t teach them too badly.

I’m not happy about the case distribution, but I’m telling myself that all the cases belong to the chief, absolutely; if he decides to let me do any, it’s a gift, not a desert. I knew that last year, because I made myself have no expectation of doing any cases at all; then I was purely grateful if the chief threw me one. I need to hold on to the same attitude this year: if the chief lets me operate, it’s a gift. I wish it weren’t that way, but that’s how the chief sees it, so I’d better fall in line.

It’s actually still a little funny to me, how little say the attendings have, openly, about which resident comes to which of their cases. They make general rules – no interns or second years in cases of a certain complexity – but beyond that, they don’t say anything, even about the residents they like the least. The chiefs control who goes where, even to the point that some chiefs can send junior residents into big cases if they want to. My chief this month is not the kind to do that; he’ll go recruiting residents way beyond our service to cover cases, if he thinks the case is too big for me, and he won’t let me operate at all unless we have two rooms running constantly. I don’t appreciate that, but it’s July, and I’m sure in a year or two I’ll be horrified to see young second years doing anything like good cases.

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