We’ve now arrived at that peculiar time of the month, when the service is drawing to a close, and I am divided between sadness to leave the patients I feel responsible for, and attendings I’m now slightly comfortable with, and eagerness to move on to something new. At the beginning of the month I was disappointed in the high hopes I’d had for this rotation, but in the last week or two I’ve enjoyed the work that I actually am doing, rather than focusing on what isn’t going to happen. At last, with only two days left, I dare to recognize that I’m actually doing a good job. Which in the world of an intern means that it’s time to switch to a new subject about which I know nothing.

But perhaps it is time to move on. Today I was utterly disgusted to discover that, like every other intern by this time of the year, I hate my patients. Underneath all the other motivations and emotions, I hate my patients. I had about five or so lined up to be discharged today. One after the other, either while I was checking on them during pre-rounds, or later when the attending came around, they all discovered ways to stay in the hospital another day or two. I hadn’t previously felt much animosity towards any but one of them, but by the end of my list, I was seething. How dare they? “I think I’d just like to stay another day.” “I don’t feel quite up to going home yet.” “I don’t like the nursing home that has a bed for me; we’ll have to find another one.” The attendings, of course, blithely accepted these excuses, and even came up with some of their own: “He’s a little queasy today.” “Let’s have her work with physical therapy another day.” “The family’s not comfortable with the plan.” And every single one of the five is another ten minutes that I can’t sleep tomorrow morning, which I could have done if they would have left the way I wanted them to. 3:30am, again.

 So I’m disgusted with myself. I calmed down, of course, and said what a splendid idea it would be to keep five or six extra people on the list for another day. (They’ll leave tomorrow, but tomorrow is an OR day, so the list will still grow, despite my discharges, so the next day will be no better.) I went around later in the day and checked on them politely, and didn’t even flinch when they observed that they won’t have a ride till tomorrow evening around six, or maybe a little later (so I will be frowned upon for allowing my patients to loiter so late, occupying beds that could be used for new patients). Maybe I should dispense with my polite formulation about how we don’t evict people from the hospital, and just frown outright at such weak dilemmas?

Yes, definitely time for a new month. Or maybe a new year? I think definitely I’ll feel better in, say, July. Then, I’ll just have to get my patients out of the unit, and then the intern can worry about them.