A friend of mine introduced me to Intern, a recount of a cardiologist’s experience during medical internship. The author, Sandeep Jauhar, trained at New York Hospital–it is now known as NYP-Cornell. While internship is difficult regardless of where you train, his book details many of the experiences that still have gone unfettered by social reform, at least in NYC hospitals. Certainly, the unionized nursing staff in the city makes even basic morning labs and vitals a chore for the house staff, even to this day.

From what I saw as a student in the ivory towers, overnight cross coverage still remains harrowing, with an incessant onslaught of pages, difficult patients, and codes. What this experience amounts to is not only a learned resident, but a tome of unfathomable tales that you’d otherwise imagine only to be fabricated.

On one occasion in his book, Dr. Jauhar describes performing a paracentesis on an ascitic patient. He instructs the patient, with tubing in his peritoneum draining the fluid, to remain still while he checks on another patient outside. When Dr. Jauhar returns, bodily fluid covers the floor. When asked to explain why he moved, the patient stated that someone walked into his room and seized, knocking all of the ascitic fluid bottles over.  Frighteningly enough, that actually happened.

I had cared for an elderly gentleman (86-yr old) when I was a 3rd year medical student. He was bawdy and demented; on several occasions he would ambulate around pantless, and void in the hallways as if he were hoping that someone would slip on his urine.  His behavior was probably not entirely due to age; his brain was ravaged by neurosyphilis. One evening I saw him with a bruised forehead and ecchymotic eye. Had he fallen despite having a sitter? No, it turned out the sitter had punched my patient. I had a helluva time explaining that to my attending in the morning.

I’m relieved that I escaped from the city for internship. At times, however, I wonder whether this rite of passage would have made me a better doctor. It sure would have added to my list of stories I could reminisce over with friends at the bar.  Regardless, I’ll be back soon enough.

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