Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

How I learned to be realistic and survive internship

Robert S. Golden, MD
Education
October 23, 2014
90 Shares
Share
Tweet
Share

I don’t remember all of the details. It was the summer of 1990, sometime in the first 3 months of internship. I spent those months on the 11th floor of the VA Lakeside Medical Center (now the vacant lot just east of the hospital). The VA was familiar territory for me. I spent 3 months there as a third year student, also on the 11th Floor. 11 East, to be exact. Another 3 months later that year on surgery. So I was back on 11 East, now with a longer coat. A long light blue coat — coats were all color-coded at that time.

It couldn’t have been in the first month. Maybe it was late in the second month. I don’t know. It was always busy, and the patients were very sick. Sick with really bad things: end stage cirrhosis with huge ascitic bellies; lung cancer presenting with tremendous pleural effusions; men with HIV and AIDS-defining illnesses; or gangrenous limbs. And also demented or disabled patients left at the hospital for 2 weeks of respite care, a benefit afforded to families of veterans so that they could have a brief break from caring for their family member.

There was always something to do for your patients, and always the sense that if something needed to happen, it was the intern who had to make it happen. Need an x-ray right away? Wheel the patient to radiology yourself. Need a peripheral smear reviewed? Go find it in the lab and bring it to the hematologist to review with you. Need that x-ray reviewed right away? Go back to the x-ray file room, pull the film (yes, it was still on film) and bring it to the radiologist to review. Need to get somewhere, anywhere, in the hospital? Of course you can’t wait for the elevator because it takes forever. Take the stairs.

My knees would ache by the end of the day. I wore through a lot of shoes that year. I wish I could go back and put a Fitbit on the 1990s me just for a day or two, just to see, you know?

It was that sense that I, as the intern, was all that stood between my patients and neglect and certain death, which started to get to me. To be honest, it was partially true. But it also fed into the innate perfectionist tendencies of medical trainees, that feeling that if you could just keep track of everything, then your patients would be OK, at least for today. Of course, it wasn’t sustainable.

What I don’t remember is what was happening that day. Well, all of this was happening that day. Everything. Hundreds of things to get done, results to collect, phone calls to make. Notes to write. I was overwhelmed, and I lost it. Picture me, losing it — does it involve tearing of hair? Screaming?

No, I lost it the way you’d expect me to lose it — you don’t know me, but I think you can imagine that for me, a quiet, diligent intern, “losing it” meant sitting next to my desk in the resident work room at the end of the hall, and just quietly crying. I was miserable. Sitting there, crying in front of my co-intern (the other intern on my team).

My co-intern was a wonderful guy. He said something like: “You don’t have to take care of ‘everything,’ every day. Some things can wait until tomorrow. What do you need to finish today? What test results need to be followed up, what phone calls need to be done, what notes need to be written today?”

I pulled out my stack of index cards and my to-do lists, started to calm down, and started going over it with him. He sat down, started pulling out charts, and started writing my notes, working with me to check things off my list.

I honestly think it was my first lesson in understanding, really understanding, when good enough is really good enough. There are a lot of places where I think you can fool yourself into thinking that you are nearing perfection, with all the i’s dotted and t’s crossed. Not at the VA. Not for me that summer.

Robert S. Golden is an assistant professor of clinical medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL. 

Prev

Lesson learned: Not everyone is crazy

October 23, 2014 Kevin 4
…
Next

How blogging relieved a physician from the daily grind

October 24, 2014 Kevin 0
…

Tagged as: Hospital-Based Medicine, Residency

Post navigation

< Previous Post
Lesson learned: Not everyone is crazy
Next Post >
How blogging relieved a physician from the daily grind

More in Education

  • How Tratak yoga reshaped my USMLE Step 2 prep

    Dr. Nikita Mehdiratta
  • The role of income in medical school acceptance

    Carter Do
  • Balancing tension and kindness in medical education

    Chloe N. L. Lee, MD, MPH
  • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

    Nandini Erodula
  • A chance encounter in Chicago: lessons in compassionate medicine

    Emily S. Hagen
  • Business education’s role in preventing physician practice decline

    Curtis G. Graham, MD
  • Most Popular

  • Past Week

    • The erosion of patient care

      Laura de la Torre, MD | Physician
    • Challenging the diagnosis: dehydration or bias?

      Sydney Lou Bonnick, MD | Physician
    • COVID-19 unleashed an ongoing crisis of delirium in hospitals

      Christina Reppas-Rindlisbacher, MD, Nathan Stall, MD, and Paula Rochon, MD | Conditions
    • Air quality alert: Reducing our carbon footprint in health care

      Shreya Aggarwal, MD | Conditions
    • A teenager’s perspective: the pressing need for mental health days in schools

      Ruhi Saldanha | Conditions
    • Physician return-to-work policies

      Deepak Gupta, MD | Physician
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • The erosion of patient care

      Laura de la Torre, MD | Physician
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
  • Recent Posts

    • Physician return-to-work policies

      Deepak Gupta, MD | Physician
    • Communication, power dynamics, and organizational culture in health care

      Beth Boynton, RN, MS, CP | Conditions
    • How my patients’ Zoom backgrounds made me a better doctor

      Joseph Barrera, MD | Physician
    • Understanding reproductive rights: complex considerations

      Anonymous | Physician
    • Innovations in surgical education [PODCAST]

      The Podcast by KevinMD | Podcast
    • Everyday dangers unknowingly impacting our health

      Tami Burdick | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Recent Developments in Crohn's Disease
  • Woman Develops Chorioretinal Anastomosis at Site of Photocoagulation Scar
  • Pharmacists Improve Diabetes Control for Hispanic Patients
  • Clean Up the COVID Booster Mess by Returning to a Single-Payer System
  • Want to Improve the Patient Experience? Let's Start With Discharge Planning.

Meeting Coverage

  • Hot Flashes: Precursor to Alzheimer's Disease?
  • SABR Offers New Hope for Older Patients With Inoperable Kidney Cancer
  • Menopausal Women With Obesity Endure Worse Symptoms, Less HT Relief
  • Study Pinpoints Growing Use of Cannabis to Manage Menopause Symptoms
  • Fezolinetant Benefits Women Not Suited for Hormone Therapy
  • Most Popular

  • Past Week

    • The erosion of patient care

      Laura de la Torre, MD | Physician
    • Challenging the diagnosis: dehydration or bias?

      Sydney Lou Bonnick, MD | Physician
    • COVID-19 unleashed an ongoing crisis of delirium in hospitals

      Christina Reppas-Rindlisbacher, MD, Nathan Stall, MD, and Paula Rochon, MD | Conditions
    • Air quality alert: Reducing our carbon footprint in health care

      Shreya Aggarwal, MD | Conditions
    • A teenager’s perspective: the pressing need for mental health days in schools

      Ruhi Saldanha | Conditions
    • Physician return-to-work policies

      Deepak Gupta, MD | Physician
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • The erosion of patient care

      Laura de la Torre, MD | Physician
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
  • Recent Posts

    • Physician return-to-work policies

      Deepak Gupta, MD | Physician
    • Communication, power dynamics, and organizational culture in health care

      Beth Boynton, RN, MS, CP | Conditions
    • How my patients’ Zoom backgrounds made me a better doctor

      Joseph Barrera, MD | Physician
    • Understanding reproductive rights: complex considerations

      Anonymous | Physician
    • Innovations in surgical education [PODCAST]

      The Podcast by KevinMD | Podcast
    • Everyday dangers unknowingly impacting our health

      Tami Burdick | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

How I learned to be realistic and survive internship
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...