The problem with having four interns and no seniors on a service is that we’re a bunch of tails with no heads. All the girls are being polite, so the guys get to be aggressive, and get away with most of the cases: which is really going to end tomorrow, as I’ve been saying for the last week.

On the other hand, there’s so little work to do, when you split it four ways, plus med students, that we’re completely at a loss. Working only eight hours a day feels completely sinful, and we can’t even relax when we’ve finished the work, because it feels as though we must be forgetting something. In real life, the only way you can be done with your list at 2pm is if you’ve forgotten all the important things. Here, the important things were done by 10, so we keep flipping through the list, trying to remember what we forgot.

Our biggest problem is the medical ICU team, which somehow got elected to run this ICU full of surgery patients. Which is kind of begging for trouble, because even when surgeons and internists don’t have methodological disagreements about ICU care (which is more important, lactate or base deficit, as a measure of rescuscitative success?), they tend to argue just because. And the senior ICU resident is one of these guys (I hate that men are all at least a foot taller than me, it makes it so hard to argue) with spiked hair who glares down at you and raises one eyebrow while you try to explain why they should really stop doing xyz because if they’re not careful it’s going to cause a surgical complication on our patient; and he shrugs and says, “whatever you want,” in a tone of voice which implies that he’s determined to do the exact opposite. (The fact that the nurses somehow decided to do xyz to the third power, without orders from either of us, leaving the blame hanging between the two teams, doesn’t really simplify matters; because we can’t seem to persuade the attendings that the mistake wasn’t generated by either side.)

That, and the fact that I’m now truly on call for critical patients. Maybe it’s a good thing that the nurses like to call the medicine people.

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