Memorial Day weekend + the first good weather in a few weeks = traumas galore. And if you bring in enough trauma victims, sooner or later you’ll find enough serious injuries to keep the ORs running. Ortho, neuro, general surgery – the attendings were resigned, the residents were fairly cheerful, but the techs and circulators who got called in for backup and more backup when they were trying to sleep were not exactly pleased.

In addition to the trauma scene, the black cloud that’s hanging over the surgical services continued to rain. The ER couldn’t tell what had come over us: we spent the day in the ER, admitting like there was no tomorrow. Every time they gave us a name, we took one peak and said, “Yeah, sure, it’s our patient, they’re sick, it’s our problem, call for a bed.” No discussion, no fights. I don’t think we even looked at the labs. They’re sick, bring them in. No question about it. At one point one of our attendings was even walking through the hallway looking for patients. The ER had barely sat them down on a chair in the hallway before we agreed to admit. (Ok, those were surgical complications, and they’d called the attending before coming in. Streamlines the process, for sure.)

And in the OR, we just gave up on keeping track of night and day. Another case? Sure, book it right now. At one point, my attending and chief looked at each other and said, “What gives? It’s 2am, we’ve been in here all day and all night, let’s just do the next add-on case now, instead of waiting till daylight, and then we can all round at 5am and maybe leave the hospital.” That didn’t really work out as well as expected. . .

The junior resident was nearly overwhelmed with calls, and started handing me his work, and I took it, and looked down the calendar a month. I thought I was getting slammed with calls and admissions; he was hearing all my reports, plus the other intern’s, plus a constant barrage from the ICUs. I am not looking forward to that.

I’m making a resolution, to stop talking to anyone (in my real life) about how unprepared or puzzled I feel. “Professional” covers a lot of ground, and it includes acting like you know what you’re doing, and not letting on to the nurses or those junior to you that you’re scared and confused by a situation. I was on call Sunday, July 1st last year. I was so lost; I didn’t even know where the units were. I got stat pages, and was running in circles around the elevators trying to figure out how to get to the patient, or where a phone was so I could ask the junior for help. The greatest thing about that day was the junior. He strolled around (this is a different one; strolling is good) and calmly sorted out everything I said. I realize now that it was his first day taking call like that, and he must have been at least as stressed out as I was, figuring out what to do with the ICUs. But he didn’t show me any of that. He acted as though everything was under control, and he could help with anything that happened. So that’s going to be my gift to the new interns: I’m going to try to act as reliable and cool as that, because if I let us add my worries to theirs, we won’t be able to function. Plus, if you act calm and intelligent hard enough, you actually will be calm, and at least semi-intelligent. Sometimes, now, I tell the medical students that I don’t know what’s going on. I’m not going to do that anymore, to students, or to the new interns. If I don’t know, I’ll be quiet; but I won’t talk about it. (But I will call the chiefs if I need help; that’s different.)

If Memorial Day was bad, I can’t imagine what Fourth of July is going to be like: bigger parties, better weather, and residents newly promoted everywhere. . . Please, folks, if you have to ride a motorcycle, wear a helmet. That way at least you’ll be able to wake up and talk after we repair all your broken bones and arteries.