First days, first mistakes, first lessons in life

       It was my very first day of Internship. After spending four years in college pursuing an undergraduate degree, then another four years spent toiling in Medical school, Internship had initially seemed like light at the end of the tunnel. But at 6:30 am on June 27th, 2009, Internship seemed more like a deep, dark, endless pit I'd fallen into. Or wait, was that the pit in my stomach?

   
       The day before the first day had been very discombobulating. After a grand picnic in the Programs Director's beautiful back yard, meeting all my new fellow-interns for the first time, I headed out home for an early night to prepare for the next day. The next day was the day of doom; the end of the world, the first day of Internship. As I drove hurriedly home, in the fast falling dusk, an idea came to me - why not completely fill up my car's gas tank to allow for uninterrupted hours of undivided caring for patients in my new life as a dedicated clinician. With such high and noble ideas, I headed to the closest gas station. Once I had filled the gas tank and was about to put the gas nozzle back, there came a deafening deluge of foul smelling wetness all over me. Yes Ladies and Gentlemen,  that's right, you guessed correctly. I  had, in fact, wet myself. I had forgotten to let go of the gas nozzle's lever and was spraying my poor car, my self and the whole area around me with a very large quantity of horridly expensive lead-free, regular-grade gasoline! Though it seemed like death from embarrassment was imminent, I bravely apologized to the air around me and allowed it to dry as much of the gasoline off as possible, sat back in my car and drove into the sunset.

       Next morning arrived much sooner than I had expected. At 6:00 am on June 27th, with my shiny new, sparkling white, and appropriately long lab-coat trailing behind me, I jumped into the gasoline-scented car and drove off to face the first day of the rest of my life. Once inside the hospital, I was graciously shown to the designated Resident Work-Room by a kind desk clerk, I was greeted with surprising good cheer by my Senior Resident. I like to fondly remember this Resident as Dr. Blue. As I was about to be filled with a warm, pink, gooey sense of reassurance, a pager was handed to me. I would henceforth be Dr. 16675 and our team was on-call today.  Our team, which comprised 2 interns and a resident, would take all new admissions and manage all life-threatening patient emergencies ("Code Blue" alarms) for a 24 hour period. A Code pager was given to me as well. Code pagers are known to make the most evil noises when Code Blue alarm is sounded and are cause new and seasoned Interns alike, all sorts of palpitations and night terrors. All reassurance brought about by Dr. Blue's beatific smile fled and the stomach pit made its presence felt.

      For the next 30 hours, I became someone else. I had a new identity thrust upon me - someone who knows things and, more importantly, knows what to do when things go wrong! As teaching rounds with the attending Staff Physician happened, disastrously so, and more and more new admissions rolled in, it was apparent that I was alarmingly unprepared for this new role. The day went by in a blur. Night came, unrelenting in its savagery - the pager beeped every few minutes, constipation was rampant among patient ranks, pain reached new proportions, tachycardias increased in frequently, falls and delirium poised new challenges, and respiratory depression was the new fashion. At every step, I was exhausted, beaten to the ground, shamed, challenged and declared unfit. It was hard to believe when, the next day, the Dr. Blue told me that it was was all going to end. It was time to go home. By this time, nearing noon on June 28th, I'd had my last of three second-winds.  My blood's coffee content was already at least 50% by volume. "Sign-over your pager and go home", announced Dr. Blue in the general direction where my and my co-intern sat huddled over our computers.

      Signing-over of an alpha numeric pager involves calling a hospital phone number, punching in your pager number and putting in a "covering" pager number.  If this signing-over process goes well through mysterious tele-technology forces, every time your pager number is paged, the message is automatically redirected to the pager number designated as your "cover". When instructions came to go home, the same key that I had been pressing on the keyboard in an attempt to type an intelligible sentence, was suddenly let go. "Home", I thought to myself, "what is home"? That place where I was once safe and warm not too long ago. I stumbled forward, crazed in my urge to leave the work room. My fingers flew over the phone, I signed-over my pager, grabbed my purse, fell into my car and started driving. 10 minutes later, I woke from the fugue that had enveloped me during the drive, barreled into the house and onto the bed and was asleep in nanoseconds. Almost 15 hours of dreamless coma-like sleep later, the alarm clock sang out. Silencing it grimly, I sucked in deep breaths to steel myself for another day at the hospital.

       My entrance in the Resident work room seemed to trigger giggles and guffaws from the present residents, interns and even from the lowly medical students. Dr. Blue though seemed charitable and non-judgmental, happy to see that I had returned for another day, and smiled hugely."Maybe I was not as abysmally incompetent as I had thought", I mused inwards. The work of the day started and so did my attempts to forget the old traumas. Things went well after this - I learned the ropes of the game of Internship. About midway into the month, a fellow-intern told me about the status line posted by my resident Dr. Blue on a social media website. It said something about having the "most hilarious intern ever". By this time, armed with the almost Dutch-like courage of having survived a few weeks of Internship, I assumed that this notorious intern must've been my co-intern on our team. After all, he had seemed equally flabbergasted and out of depth. And clearly, the probability of Me, the eminent 10-day old Intern, having done something hilarious was very low.

      Alas, my bubble of self-contented reassurance was soon burst. A month later and on a new posting now, I ran into my resident Dr. Blue. He asked me how I was holding up. After my reassurance that things were fine and that I had not actively been responsible for adding to mortality statistics of the hospital, he started smiling and did not stop. "What are you smiling at?" I asked nervously. His reply came swiftly, in great style and to my cheek-reddening shame. "At the end of that first day, when our team was post-call, you signed-over your pager to Environmental Services pager". I was not the non-hilarious Intern. All hopes of effortless awesomeness and coolness were dashed. Apparently, after I'd left for home that miserable second day, a janitor had burst into the Residents work room, claiming that he was being paged incessantly about a constipation medication prescription that was holding up a patient discharge!

       Such is my recollection of the first day of internship. Lessons learnt - I'll survive somehow, though not with my self-esteem intact, and not without a few good laughs at myself!