Orientation was mostly boring. Every single department in the hospital administration, it seemed, sent someone to lecture us about coloring inside the lines. The billing department talked about not using up and down arrows in notes to indicate hypo- or hyper- states, infection control about the importance of washing hands, pharmacy about not prescribing outside the formulary (which seem not to include the five most favorite antibiotics of surgeons at my old school; it’s going to be interesting to cope with this), the safety department about closing doors and pulling alarms in case of fire, the risk management people about not writing rude or dangerous things in the notes, and not lying to patients; and so on.

During breaks, we got our parking passes, IDs (mine says resident; it feels like there’s a mistake), and meal tickets. We began to get the impression that they wanted to make sure we turn up Sunday morning. . .

There was also a lengthy non-explanation of the insurance benefits available; since this involved more paperwork and complicated loopholes than I’ve ever seen in my life, I was about ready to give up on obtaining any kind of useful insurance, when the words “health-savings account” caught my eye. Aha. Finally a chance to put my political convictions into practice. HSAs work in conjunction with high-deductible insurance. You and your employer put matching funds into the HSA (these are before taxes), up to the amount of your deductible ($1-2,000 for individuals). If you have a small expense (doctor’s visit, prescription, lab test), you can pay for it with funds from the HSA (no taxes paid when withdrawn). If you don’t use the money in one year, it stays right in the account, earning interest, and accumulates over however many years you stay with that employer. When you leave the job, you take the HSA with you; and if you die, your heirs inherit whatever’s left. Beautiful.

Finally, the surgery department interns made their way over to the surgery office, where the secretary, the most cheerful, welcoming, and motherly person we’d met all day, had our white coats, surgery textbooks (including Zollinger’s atlas, describing how to do all these things), and piles of pens, trauma shears, and other fun gadgets. (And yes, most of them derived from the salesmen of the three most prominent drugs excluded from the hospital formulary; no comment!)

And most importantly, from the chiefs and ex-interns, some very specific recommendations about how to not tick off the various attendings, the taboos for various services, when and where to report on Sunday, and who to get sign-out from. They think they told us everything we could possibly need, but we left with a sinking feeling that we were still missing some vital information (like what on earth I’m supposed to do, covering plastics call on Sunday, when our team is apparently taking their turn on both facial and hand trauma, and the attendings according to legend don’t like to come see – what am I going to do with that?!). I still have only the vaguest idea of where the cafeteria is (this is relevant because my team apparently rounds there, not because I necessarily have to eat on Sunday), where the patient rooms are, where the ER is, or where to find computers. I’m on call starting at 6am, but I’m seriously considering turning up 3o minutes or an hour early just to wander around and get my bearings.

On the cheerful side, I shook out one of the white coats today, and tried it on. It’s splendid, finally the right size, so much nicer than the student coats. It’s got big pockets, and I stored all my memory cards, ACLS cards, meal cards, phone numbers, and other-potentially-useful-information in it. Now I just need to not forget my beeper in the morning.

My perspective on Sunday feels like the sine wave of a function approaching zero without a limit: flashing instantaneously between a nonchalant idea that I have all the theoretical information I need, and this ought to be manageable, to pretty thorough panic – what made them think I could be a surgeon? Better just not to think. I really don’t have enough time or money for this, but I sense a new craft project coming on as a sort of displacement reaction. . . There’s a JoAnn’s fabric store just around the corner. . .

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