Day One, Part II

Please see the previous post for Part I.

We admitted a patient from the emergency department, a gentleman with a severe COPD exacerbation who required emergent intubation. When he came into the ICU, the fellow asked me if I wanted to put in a central line. Central venous catheters, insertion of a "line" into the neck or groin isn't a minor procedure, but it was one I felt comfortable doing. Although I'd done central lines in the past, they were with quite a bit of assistance. Here, the fellow walked me through the steps but had me do everything independently. It worked. The adrenaline rush was surprising and thrilling.

I finally ate something at midnight. I realized I was exhausted: me feet hurt; my eyes were sore; I was thirsty and sweaty and gross. But the time had flown by so quickly. I was constantly multitasking, trying to juggle in my head things that needed to happen "stat," things I needed more help with, and things that could wait. The resident and I went around doing midnight rounds before sitting down to finish our notes. Documentation is the bane of the intern's life. I know how important and necessary it is, but at 2 in the morning, I was aching for some rest. When I was a medical student, I was appalled at how scant and bare some resident notes were; now I was writing these sparse notes.

Nothing prepares you to be an intern. I thought I understood an intern's life when I observed them as a student, but now in their shoes, I realize how fragmented, frantic, and scattered their life can be. At any point in time, I was multitasking half a dozen things; on my way to see one patient, I'd be sidelined to see another. Before I'd finish ordering a medication, I'd see a consultant I wanted to talk to. I'd type a sentence into a note before a family member would request to see a doctor. I had to be aware of and think about a dozen patients at once, and I had to be able to switch gears immediately. This is a skill I do not yet have, but I am sure it'll be one of the first things I develop as an intern.