Welcome to the House of God

It is 1220 hrs on July 2 and I just got home 30 min ago.
I have been awake and working since July 1 at 0640 hrs.

This is day 1 (or is it day 2 now?) of my new career as a
resident physician on the general internal medicine service.
I use the term "physician" loosely. July 1st is a bad day to
be on-call. And maybe a worse day to be a patient.

I have peed exactly 4 times during that period. I drank exactly
1 bottle of water, 1 can of diet coke, and 1 cappucino from the
coffee stand in the lobby.  I did not have time to change into
scrubs... until after i got home today. I am eating crackers
to appease the nausea of being up for 30+ hrs.
I am nauseated and hungry at the same time.

Our team comprised of 1 senior resident and 2 juniors.
Each of us juniors carried 3 pagers: our personal pager and
2 other teams' pagers and. As a bonus, 1 lucky intern got
to carry the code blue pager. The team pagers are twice as big
as our own pagers. I need a stronger belt for call.

I wear a long lab coat now. No more of this short-coats-for-clerks
business. But the bottom pockets bunch up when i sit down and
everything spills out of them,
including the 3 pagers clipped on the pockets.

I was assigned 4-5 inpatients to start with.  While on-call,
I picked up 2 more that another resident had admitted during the daytime.
I also admitted 2 new consults in the ER. I covered the wards for a
busy team trying to manage patients whom I knew nothing about.

One of them passed away last night, although I was warned to expect it.
I pronounced a death for the first time. 0215 hrs. I called the family.
I didn't know what she died of.  I learned to introduce myself as "Doctor".

I helped my team to do a therapeutic procedure on an elderly sick man.
It didn't work. I felt his faint radial pulse disapear under my fingers.
Both patients were elderly and very sick.  I learned later that neither
was unexpected.

I did not cry.
Nor did I sleep.

Our attending physician came in at 8am to hear about the patients
that came in during the night.  He told funny stories about things
that happened in his day as an intern.  We rounded with him at 9am.
He was gone by 10am.  We should have been allowed to go home based
on the union guidelines, but we could not leave the patients'
loose strings unattached.  I stayed until 11:30am.

Now I sit here, finally changed into my scrubs, in front of my computer.
Maybe I'll shower then try to sleep.  I have post-call adrenaline
keeping me awake. And hunger, but only for bland foods.

Tomorrow is a new day.... at work.

Signed,
Scutterbug, MD,
PGY-1, House of God Hospital,
pager 4444