You’re just the anesthesiology resident

You always knew they didn’t care about you.  The administration, I mean.  But you knew that going into it.  It’s just four years that you have to endure until you can be respected, until you make the big bucks, until you’re treated like a human being.  Four years is not that long.

But you knew this going into it. That they didn’t care.  You’re just a resident.  Now more than ever, you are seeing just how far they are willing to go to use you, to abuse you, to disrespect you, to put your life on the line while they sit in their home offices getting paid for your work.  It all started the “intubation team.” But it really shouldn’t be called a team.  It’s just you and a pager. It alarms seven times in four hours. You call for help, and no one comes.

The American Society of Anesthesiologists mandates that the most experienced intubator should be intubating these patients.  It increases the first pass success rate. It makes sense. But they don’t care.  They don’t want to be exposed.  It’s OK for you to be exposed.  You will be fine. You’re just a resident.  So, you put on your N95 mask that you have used for the past seven days in a row and head into the patient’s room.  The patient is scared.  You are scared.  But you try not to show it.  You act confident, but your whole body is shaking, and no one can see the sweat pooling inside your mask.  You urge the patient to call their family before you intubate them.  This is the last time they will be able to talk to them before the tube goes in.  This may be the last time they talk to their loved ones ever.

You think, “Where is he? Where is my attending? He should be doing this intubation.  He is more experienced than me, and he said he would come help.”  You gather the tube, the laryngoscope, and the drugs.  You try to take a deep breath, but you can’t.  The mask is suffocating.  Or maybe you can’t breathe because you’re trying to hold back your tears.  Your masked face will probably be the last face this person will see before he dies.  But you can’t think about that.  You can’t let that thought drag you down.  You can’t have emotions or empathy.  You’re just a resident.  You put the patient to sleep and hope to God the intubation will be easy.  If you can’t intubate, there is no one here to help you.  You’re just a resident. You know you shouldn’t be doing this, but you’re all he has, and you don’t have time to wait.  The tube goes in as you exhale a sigh of relief.  And you step out of the room to document the procedure and endorse the note to your attending.  Make sure you fill out a billing sheet.  The attending has to get paid for your work.  You do that same routine six more times that night.  You hope it will get easier every time.  But it never gets easier to look into your patient’s eyes and muster up false words of reassurance and hope.  All this while the attending is sleeping in his call room.  But you knew this going into this.  That they didn’t care.  That you’re just a resident.

You enter the ICU.  The COVID ICU.  You were supposed to have ICU training during your residency, but you were always pulled away because you were wanted in the operating room.  You weren’t needed, but the attending didn’t want to do the case. He didn’t care about your education. You’re just a resident.  Well, you got what you asked for.  You wanted an ICU education.  Here it is.  You’re in the COVID ICU.  But it’s as hot as a sauna in there, especially with all of the PPE.  You’re sweating profusely.  Your mask is fogging up.  You beg them to cool the makeshift unit.  But they say they can’t because it’s a negative pressure room. But they don’t know what it’s like because they’ve never set foot in the unit.  Your mask is making an imprint on your face. Much like these patients are making an imprint on your heart. No amount of bandages can prevent the pain.  You can’t even think straight. But you will be fine.  You can handle some heat.  You should be happy to have a new N95 mask.  You don’t really deserve a new mask.  You’re just a resident.

Two patients pass away, and the families need to be updated.  But you haven’t finished your progress notes, and now the attending wants to round.  And you feel like you can’t emotionally handle breaking the news. Because what do you know? What would you say? You’re just a resident.  Six hours later, you finally take your only allowed break for the day.  Only six more hours to go.  Why should you get a break? You don’t need to hydrate or eat.  You don’t need to urinate. You don’t need to empty the sweat that has been filling your mask and shoes all day.  You’re just a resident.  You hurry to eat and drink something, to use the bathroom, to decompress before you head into the fighting ring for round two.  You feel light-headed.  About to pass out.  But you have to push through it.  Your health isn’t important right now.  You’ll have time to be healthy after residency. But for now, you’re just a resident.

Again, you enter the ICU.  The COVID ICU.  But this time, you’re not just a resident.  You’re a patient.  You’re on a stretcher with a tube in your throat, and you’re scared.  Another resident sick with coronavirus.  When will they realize? When will they begin to care? How many lives will be lost before the abuse ends? If not now, when?  But you know it will never end. You know you’re another burnout statistic.  Swept under the rug because you’re not important.  You’re replaceable. You’re just a resident.

But to them, it’s OK.  Because you knew this going into it. That they didn’t care.  You’re just a resident.

The author is an anonymous anesthesiology resident.

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