Much is made of the date July 1st in the medical profession. Freshly graduated physicians begin their training career in medicine as interns. Although technically physicians, these interns are new to the clinical practice of medicine and all that comes with that. Much has been made of the experience of the new intern. Samuel Shem’s House of God is a renowned novel about medical training. Countless television series, chronicle the experience of newly minted physicians. It is common knowledge that July first is a huge date in one’s medical career.
However, there is a date in one’s career that is overlooked but may be more important than July 1st. June 30th never gets close to the same level of attention as the date preceding it. However, on June 30th, a resident physician crosses over from training doctor to the real thing. No longer is there an attending to ask questions. You could possibly be that attending. As I approach the end of my residency training, I realize June 30th has never seemed so important before.
The years in residency are nothing short of transformative. I see that as I train new interns currently and see how far my colleagues and I have come. I remember beginning intern year, thinking I was driven by fear. I felt I had too much power for someone so inexperienced. I remember thinking every day those first weeks, “please, don’t let me hurt anyone.”
I questioned every decision, leaned on my seniors for everything, and often felt lost trying to figure out what was important and what was not. When I think back at myself as an intern now, I realize fear was not driving me; it was the innate desire to do right by the patients I met. I thought it was fear I was filled with, but it was concern. I thought it was inexperience I was plagued with, but really I just had a desire to learn.
The qualities that make interns think they are driven by fear are actually the qualities that should stay deep within us as physicians. It is difficult in this climate of paperwork and administration to find the joy of medicine. Graduating residents are plagued with more debt than ever before.
However, I hope on June 30th and every day after, I remember the feeling I had as an intern; that it was my responsibility to do right by my patients. There are thing I have seen as a resident I could not have thought of before medicine. I never thought I would pronounce someone dead. I never thought I would have to tell a patient about a new cancer diagnosis. I never thought I would have a patient ask me, “How do I change my insulin regimen on the days I cannot afford any food?”
However, I have done all those things and answered those questions, many times over in my years in residency. These challenges do not take the emotional toll on me they did when I first started out. However, they bury themselves within me, finding a home inside of me. These experiences have become part of who I am as a doctor.
My experiences and my feelings are not unique. On June 30th, hundreds of young doctors like me will embark on the next stages of their career transformed from who they were before. Samuel Shem wrote 35 years after the release of House of God, “We doctors are privileged. In a culture that deals more and more with surface and sheen and falsity, we in our offices and house calls and surgeries are present with the deep, hard truth that comes out at crucial moments of our patients’ lives. The great themes of fiction are love and death. Death is always a theme in medicine. So too, I would argue, in its many spirits, is love. And one of those spirits is resistance to inhumanity, and injustice. Love and death. How lucky we are.”
We witness love and death and everything in between every day as resident physicians. To my colleagues who are approaching their June 30th, I hope we remember the intern within us.
Fatima Z. Syed is an internal medicine physician.
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