The End

As the automated doors swooshed open I walked out into the warm summer's night.

I looked down at my watch... it read 01:28am

I looked forwards... remembering words from a 'long time ago'*:

"Don't look back...before you go.
Eyes forward.
Choices to make...dreams to realise.
Don't look back...before you go.
Know the truth; learn to let go

It will be a hard life;
One without reward, without remorse, without regret.
A path will be placed before you, the choice is yours alone.
Do what you think you cannot do. It will be a hard life,
But you will find out, who you are.."

I slid the Litmann stethescope over my head and shoved it into my pocket, dangling out like a schoolboy's handerkerchief. I looked up at the dark summer sky and breathed it in.

It was over. Internship. And what a way to finish.

[1400 earlier that day]

It began like any other day. Rocking up to cubes to put in my time sheet (seeing as I was going to be on holidays when they were due next week) so I got paid. licking on the computer to check how many patients were queued up and which other doctors I'd be working with this shift.

Picked up my first one, a darling little old lady with "knee pain"... opened the door and started my usualy spiel, "Hi Mrs P, my name's J and I'm one of the doctors... do you want to tell me what's been happening?"

[1800 that same day]
There was no more room in the inn as we churned thru the patients and the day staff tried to hand over their remaining patients to those on night shift (ie me). I tired to discharge a patient with chronic cellulitis only to have my enthusiasitc registrar diagnose 'erythema multiforme' (she'd only seen it once in her entire life!) and thus relegating the patient to the medical registrar instead of home.
Mrs P sat in her room, with her faithful husband by her side, having just returned from the CT scanner... her bones were osteopenic and almost no bone density whatsoever. Her husband had been caring for her day after day since she lost her sight and I looked at their relationship feelign envious... their love apparent... not in displays of affection.. but in the daily sacrifices he made for me to care for her.

[2100 that evening]
A rather hungry intern named J started to sway from side to side from low blood sugar as the waiting room list exploded with patients who really shoudl know better. A young girl (20) hobbled in with her mother complaining of back pain after she had got a friend to 'crack' her back and [gasp] developed back pain shortly thereafter... like duh!

It was at this point all hell broke loose.

I walked out to the acute area to see a sea of stretchers with young men in hard collars being shoved into the ED. However as there were no beds free (due to a few infarcting oldies) they were just dumped in the walkway of the ED. I found out of my registrar that there had been a big MVA** and you could see the excitement in her eyes. Next minute she was gone, off to play 'trauma' and see some action and so I duly found myself abandoned with a department full of cubicle patients requiring registrar review. Truth be told their was an overseas doctor on as well, but he committed a cardinal sin and started sifting through the files to pick up simple finger fractures and lacerations... leaving me to pick up the miscarriages, the bizarre neurological symptoms and the meningitis patient.

It reminded me of an episdoe of ER I saw last year. All the senior doctors are out farwelling Dr Carter and the interns are left to run ED. A balcony collapses and the interns are forced to assume responsibility and it all makes for a very nice dramatic TV show. However in real life it just drove me nuts. I had cranky patients wanting to be seen in the waiting room. I had cranky patients in the rooms wanting to go home. I had cranky nurses wanting to know "what's happening" with each patient.

I just kept plodding along... reminding myself that if I lost it, I would be of no help to anyone.

"Just take one patient at a time J... one at a time" It was reminiscent of that firstovertime shift from hell in Whoop Whoop. And yet I was more confident.

And so I kept working them up, sending off bloods. Charting analgesia for people in the waiting room so as to at least "do no harm".

Eventually at 1am, the 2 registrars and consultant emerged from the chaos of the acute area dn came around to see how I was faring.

Exasperated I began my final handover "Mrs P is a 77 yr old female who was brought in by her husband after she sustained a twisting injury to her left knee. She had a CT of the left knee and was assessed by ortho as having no fracture and is for med reg review for analgesia and mobility seeing as she is blind and can't go home with her husband whilst she is immobile"

Why med reg? Why wont ortho accept? Why didn't you tell them about the ED's 'one referral policy'? How's she going to manage at home if we just keep her overnight?

Mrs P got admitted I think... the last patient I saw as an intern.

To be honest... I was over it. I made the last few phone calls, handed over the patient who needed a lumbar puncture and walked out the door for the last time as an intern. I had survived.

This week I'm on annual leave before starting back as a resident. Lats night i met up with almost all of my med school friends at our local Thai restaurant. The last time we had gathered there all together was after we finsihed med school. How fitting then that our reunion of sorts occured in the same place after our internships were finishing. Somehow we've all made it through (which given the high suicide rate of JMO's is a great feat to be thankful for) and none of us are drug addicts (or at least admitting to it).

To all of you readers out there who've read my blog/called me up and left messages of empathy, frustration, encouragement and urged me to persevere thru this... thankyou! No man is an island... and particularly fellow brother and sister interns... you guys rock! Congratulations!

It's time for "The Intern Experiment" to end. Don't worry I will now start writing the resident equivalent (http://theresidentexperiment.blogspot.com)... but as my internship has now come to a close... so must this blog. A closed chapter now to look back on and laugh, cry and smile at the biggest year of my life to date.

And so I want to finish this blog... with some quotes from ER... only because then encapture things that I cannot sum up any better:

When you do everything you can, sometimes more than you thought you could, you've got to walk away knowing you fought the good fight. You fought the good fight, Lucy. And tomorrow you'll fight another one.

You are wedges. The wedge is the most primitive tool known to man. That is you. You think you know what you're doing, believe me, you don't. Breakfast with your Senior Surgical Resident Dr. Benton will begin in 15 minutes. Dr. Benton is an intern's worst nightmare. He's smarter than you, he never eats, he never sleeps and he reads every medical journal no matter how obscure. He is the Antichrist. Beelzebub. Lucifer. A devourer of wedges. You will go to sleep at night wishing plague and pestilence on his unborn children and you will wake up every morning praying for his approval. You won't get it. Welcome to hell, ladies and gentlemen.

Patient: Are you married?
Doctor: No, I'm a doctor.

Patient: Oh, God, I see a light!
Doctor: You're not dying. It's just your ankle

Doctor 1: They can make your life easier or they can make it miserable. Whatever you did, I suggest you apologize immediately.
Doctor 2: I didn't do anything.
Doctor 1: Apologize anyway.

Most interns send their samples without knowing what happens once they're there. Let's pretend we're a urine sample and find out.

I'm beginning to think that "ER" stands for "everyone's retarded".

Rule #1, feed the nurses. It makes the job 50% easier

See, there's two kinds of doctors. The kind that gets rid of their feelings. And the kind that keeps them. If you're going to keep your feelings, you're going to get sick from time to time. That's just how it works. That's part of it. Helping people is more important than how we feel. Hell, I've been doing this eight years, and I still get sick

You set the tone, Carter!

* Star Wars Episode I The Phantom Menace Trailers ("One Love" and ""One Destiny")
** motor vehicle accident for my non-ER-watching friends