All the worse for starting off well. I guess this is what happens when I break the rule about interns never sitting still. I actually spent a little time in the library this morning, having finished my to-do list.

It stayed finished until 3pm. At the beginning of the day, they had actually proposed to send me to cover a small case, since both the seniors would be busy in other rooms. I spent all day walking through the OR, calling the OR, calling the ICU, to make sure that I wouldn’t miss the case when it finally went to the OR. At last, 3pm, the attending and I were in the OR, getting set up, and the junior resident walked in and said, “I’ll do this for you, Alice, and you can go make sure everything’s in order on the floors so we can leave at 6.” As though she were doing me a favor. I muttered that I’d already made sure everything was in order, but obviously that wasn’t what she meant, so I left.

I thought that was bad enough – my one shot in the OR for a month, gone, but it got worse. Things had fallen apart since I’d last checked, including two patients who’ve been in the hospital forever, and looked like they were on the upswing, turning around and getting worse. I felt horrible to see them feeling so bad, and I also felt horrible at the thought of rounding on both of them for another week. Then a consult showed up on the computer, which no one bothered to call me about. I set off to see him, remarking to myself that I don’t really hate patients, that this was a chance to take care of Jesus, that if Jesus had so much as a small laceration, I would be begging for the chance to take care of it. I had just talked myself into it, when I saw a commotion in another room I was walking by. Yes, it was a code. And yes, I was the first doctor on the scene. And no, I didn’t handle it any better. The nurses were actually doing all the right things, and just when some active participation by me was called for, five other surgery residents materialized on the site. I figured I’d be better off seeing the consult than learning how to run a code right now, and left. (Jesus, I’m happy to see you, but do you have to be in two places at once?)

And various other jobs showed up that I was supposed to be doing, or had done wrong, or questions I had forgotten to ask; so we were all there late, and it looked and felt like my fault. But what I say is (and this is me being bitter, and exaggerating; things aren’t really this bad – I think): if the chief would just talk to me, I wouldn’t have so much trouble; she expects me to read her mind, which I could do by spending more time fiddling with the computer program, but if she would just tell me, it would take thirty seconds, and it would be more like a team. I know I’m nothing, really, but they do expect me to get work done, so they ought to communicate with me. Whereas all the senior – and junior- residents call each other, and the nurses call them, because they know them, and all I get are silly calls from the nurses, not the ones that explain what’s really happening. And I’m tired of doing scut on the floor all day so the chief can be in the OR, and then still being in trouble at the end of the day, no matter what I did. I know, that’s how it works, sometime I’ll be the chief, and someone else will be the scutmonkey; but I’m tired of it, and there are a million weeks still to go. I know it’s good for me, and I’ll learn a lot, but I’m tired of being educated right now. How about if we take a break from educating the intern?

The only thing that makes the prospect of seeing twenty patients in two hours – and writing notes on all of them – tomorrow morning, is the medical student, who is absolutely too good to be true. He undertook to see way more patients than a third year should be expected to, and I know that he will, that he’ll have all the correct information, and that he’ll present them to the attendings almost flawlessly. I love him. Only the fact that no one talks to him either, and he doesn’t quite know when a patient is in trouble, and when not, prevents him from being more intelligent/useful than me. (Funny – that’s one thing I have learned from the chief scowling at my conversational efforts: when not to be concerned about a patient. Delirium for three days doesn’t make me happy, but I’m not interested, either.)

(And the attendings admit all their lap choles for no good reason, and I’m disgusted, because that’s four more people for me to see tomorrow.)