Thursday, December 20, 2018

To the new interns

Congratulations! After many gruelling years of study, you've obtained your MBBS and are now a real live doctor! It's an accomplishment to be proud of, and I hope you and your loved ones celebrated accordingly at your graduation. Right now you're probably enjoying your uni-free, work-free days; maybe you're even in the midst of a family holiday. All too soon, though, you'll be making your way into the hospital, perhaps a little nervously. It will be time to step into the role you've worked so hard to earn - time to be a doctor.

For the first few weeks or so, being called 'doctor' will feel incredibly strange. And why wouldn't it? Just a couple of months ago you were a mere medical student, and you're now somehow a doctor despite being the exact same person as you were back then. Don't worry, doctor - you'll get used to it. Everyone desensitises eventually. After a while, you realise that your title only matters in the sense that the nurses need you to document something, you're the one who writes in the drug charts, the patients and/or their families want to speak to you. You grow to accept that these tasks are yours, because you are the doctor...and somewhere along the line embrace the title that you initially struggled to accept.

Of course, with great title comes great responsibility (Stan Lee just rolled in his grave). Probably every intern's worst nightmare is killing a patient, and I'm sure we've all heard the cautionary tales/urban legends regarding this. The prospect of now being able to prescribe medications and perform simple procedures unsupervised can be slightly terrifying. To be honest, I believe this fear is good - it makes us check and double check, and keeps us accountable for our actions. To those who find their fear excessive and difficult to deal with, here are the wise words of a Med reg to her new intern: "It's actually quite hard to kill a patient". Realistically, the chances of you killing a patient when you're working with a team are lower than you think. You're just the intern, so you mostly just carry out the consultant's plans. Anything you're unsure of, you run by the registrar. Nurses and pharmacists will be your saving grace many a time by quietly pointing out an incorrect dose that you've charted in the drug chart. There are almost always safety nets against human error, and there is always help available. Don't be afraid to seek it out!

When you can, try to help out your fellow interns as well. The first few months of internship is tough for everybody, and just checking to see if someone's eaten or if they need a coffee could mean a lot to them. Many people forget to eat; some tell themselves they don't need to, which is worse! My first after hours Med shift was particularly nightmarish - the calls kept coming, the jobs list was endless, and one patient deteriorated for no discernible (to me, anyway) reason and ended up in ICU. I was stressed out of my mind and hadn't eaten in nine hours. While sorting out the pre-ICU patient, the Med reg took me aside for a stern word. I needed to eat, they said. The hospital wouldn't fall apart if I took fifteen minutes to sit down and eat. If anything bad happened, the nurses would call a MET or a code. Also, if I didn't start taking care of myself now, how was I going to survive later on in my career? They wanted me to go eat, now, and send them a picture of my dinner so they knew I'd done as they said. It was all I could do not to bawl in front of them, I was so touched. A little act of kindness really does go a long way. Check in on others if you can - it might mean more than you know.

Speaking of crying, you will probably do that at some point during your internship. If you're someone who's prone to tears, you're going to cry a significant amount this year. How much, you ask? Well, try to guess how much you're going to cry over the next twelve months; multiply that by five and that'll be the rough figure. As a doctor, you're going to witness or be involved in many difficult situations - death, aggression, resuscitation, grieving families, breaking bad news. It will be hard, and sometimes extremely emotionally taxing. After a particularly bad day, try to do something for yourself, something nice that's just for you. Have a nice dinner. Go on a long walk or drive. Watch a movie. If you want, find someone to talk to and get things off your chest (fellow interns are great for this, since you're all in the same boat). Take care of yourself, particularly when the going gets rough. Remember, you took an oath!

Internship can be hard, but it can be wonderful. At the end of the first rotation, you'll look back and marvel at how far you've come; at the end of the year, you'll be amazed by how much you've grown as a person and as a doctor. The learning curve is scarily steep, but exciting in its promise of exponential growth. There is so much to learn, so much to explore, so much to do - you are a ball of pure potential, unmarred and unjaded, ready for what the next twelve months will bring. I hope you will find your internship rewarding and fulfilling, and learn and grow incredible amounts. Be brave, be humble, and be compassionate. You will do great.

Go forth and doctor!

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