Monday, June 21, 2010

My First Night of Internship

I finished medical school two weeks ago, and have sinced moved to Spokane, Washington to start my year of internship at Sacred Heart Medical Center.

Last night was my first experience as a new doctor/intern. My first rotation is "Night Float ICU," which basically means I take care of patients in the ICU overnight while their primary doctors get some rest. I also take care of any new patients that come to the ICU overnight until the main team comes back the next day.

I showed up at 5:30 pm and got the scoop on who I would be taking care of. Here are some highlights/lowlights of the night:

-- Writing my first order as a physician: "Ok for patient to take ice chips by mouth."
-- Introducing myself as Dr. Weed for the first time and thinking that it sounded silly
-- As I'm sure you know, the ICU is full of really sick people. I have never done an ICU rotation before, and I can't remember the last time I felt as inadequate as I did last night. These poor people are in bad shape. Some are young, most are old. I kept cursing the situation that puts me in this position.
-- The senior resident was fortunately extremely patient and kind, and made me want to work harder and better so I didn't disappoint her.
-- An older woman lost feeling and movement below the waist yesterday due to bleeding around her spine. As soon as it was recognized, the neurosurgeon removed the clot, but the prognosis is grim for her recovery, and she knew it. What am I supposed to say to comfort someone who now possibly faces a life of paraplegia? That I'm sorry? That's all I could think of, but it seemed like so little.
-- There is a young woman in there who is extremely ill and we don't yet know why. I feel like I should figure it out.
-- I participated in two "codes." At around midnight, I got paged to go to the 6th floor. There were about 15 other doctors and nurses already there, doing CPR on an elderly man. I did chest compressions part of the time. The man was having a massive heart attack. 20 minutes later he still had no pulse. We stopped CPR. His wife and sisters came in, crying. We talked for a bit and then shuffled out of the room. It was horrible.
-- I didn't even so much as lay down all night. Miraculously no caffeine was involved. Around 3 am, I went to the cafeteria for a "rally breakfast" of bacon, eggs, potatoes, and chocolate milk.

I haven't wanted to quit anything so much since the first few days at the MTC. I've never wondered if I was really cut out for this until last night. It was a long, fatiguing night filled with feelings of inadequacy interspersed with a few moments of pride and exhilaration. I'm hoping that tonight, when I go back there, the patients are doing better, and that I feel at least a little more comfortable than last night.


Brian said...

I feel you man. It's like the start of third-year all over again, but worse. I have my first day of real work on Thursday. Hope tonight works out better for you.

Lee and Melody said...

Night shift ICU is a hard place to start out, and it sounds like you got a load of all the things we hope we never see in one night. Calling a code sucks, and I completely agree with you- "I'm sorry for your loss" never feels adequate.

I wish you a better night tonight!

Hey, isn't Sacred Heart the hospital where Scrubs takes place?

Diana said...

I LOVED this, and I hope that you keep it up. I know that there will be times that you will be too exhausted to do this, but try to contribute to it at least once a week. One day you will love reading your thoughts as you evolve from student to the man you will become. Who knows, it may make a great book some day.

Brock said...

I thought they didn't let you people loose on the world until July. :)
Hang in there. I hope that it gets better.

Tarawhiti Girl said...

I read this with huge tears in my eyes and so much love in my heart for you. I want you to know that your friend all the way in New Zealand is so very very proud of you!!!

Brady said...

Sounds pretty crazy! I hope things are already feeling better for you. Congrats on graduation and best in your internship! See you soon hopefully, on the water at Waitts!

Carson said...

Really, really interesting stuff Matt. Thanks for sharing, and keep us posted. I'm anxious to hear how things progress.

samantha said...

I am sorry for the hard night! I know you can do great things, you already have! Keep on trying. Call me if you need anything.

Annette said...

You have a noble heart, and that will see you through. My prayers continue.