Weekend rounds with myself in charge of the service. . . I could barely get myself out of the hospital, because I kept going over the list trying to figure out what I’d forgotten. Before there was always someone else to check on me. Now, it’s my job to decide what needs to happen today, what I and the intern need to get done before we leave, how much we can sign out, and to make sure that we sign out all the important things.

I need to go study. The interns and students expect me not just to be able to answer questions, but to spout whole lectures about all kinds of subjects, with detailed information; and I ought to be able to. The attendings, as well, regard the junior residents as the ultimate pimping targets. Yes, the medical students – but at this time of year, they’re pretty lucky if they can present the patient on rounds without having to be straightened out a couple of times. Yes, the interns – but they’re excused for not knowing a whole lot. The junior residents, on the other hand, are fair game for anything: incidence of PEs? mortality rate of PEs, treated vs. untreated? Incidence of pancreatic cancer? Mortality rate, life expectancy? Proper treatment of acute cholecystitis? Failure rate of conservative management with antibiotics? Mortality rate of persons taking coumadin? That was from one hour’s worth of rounding, and that’s not counting questions about patients’ obscure surgical histories before they arrived in our institution, and their labs and imaging studies for the past two months.

Advertisements