Pediatric Residency

The Life of an Intern

Morning... Mornings are tough. The nervousness creeps back in. Can I really do this? Am I smart enough? I crawl out of bed and get ready. What if I screw up? Alright-  big breath. I can do this. There are some really great seniors and attendings waiting to help me out every moment and help me learn from the inevitable mistakes. And I really am having fun along the way. Plus, I'd miss my patients too much to bail out on them now. Off to the hospital.

Walking into morning sign-out I am greeted by smiles and laughter. Both teams this month are a great mix of med students and residents and we can't help but enjoy each other's company. We all laugh remembering yesterday when I accidentally tried to read an upside-down EKG! I laugh along and friendly teasing ensues. The night team looks tired but yet satisfied. They got slammed overnight but they grin with pride that each and every patient was well taken care of. We run the list hearing about the new patients and the overnight updates on the old ones. Some patients are doing a whole lot better, some still need careful monitoring. Sadly, Nathan, one of my Heme-Onc patients, spiked a fever overnight. Cultures were drawn and antibiotics started but he's still febrile and feels awful. I've cared for him during his last 3 admissions and I've grown close with his family. Next, the sepsis work-up came back as clean for my 17 day old infant admitted with a fever, Aiden. His parents will be so relieved. And my teenager with a Crohn's flare-up, Megan, is eating again and using less pain medication. 

The list done we all split up and get to work. I check in on all of my patients, talking with parents and nurses, checking labs, and reviewing the orders. I especially enjoy playing silly games with my younger patients so they don't realize I'm actually doing an exam! Nathan's mom and I talk for awhile, each giving the other the support we need. Nathan bravely finds a smile for me before I step out. I get a couple notes done and slip down to Morning Report. It's a great case about skin lesions and I'm thrilled with how many of them I got right! Back on the floor our teams assemble and bed rounds start with the floor attendings. Every member of the team gets a voice including the patient and their parents. We work to find a plan everyone can agree to. Next, our team checks in with the specialty services- I update the GI doc's on Megan's progress and we make plans for a smooth discharge and follow-up. The Heme-Onc doc's are equally sad to hear about Nathan and we revise our plan. Rounds completed, I split off to update my orders and finish my last few notes before going down to Radiology Rounds. A peds radiologist walks us through the images for all of our patients on the floor including Nathan's chest CT from yesterday. The tumor doesn't seem to have progressed but isn't responding yet to the chemo. Bugger.

Lunch time. I spend a few minutes with my fellow interns eating out in the courtyard. Sharing stories we laugh, we cry, we bond. I can't image a group of people I've ever been closer to. 

Upstairs, I spend 20 minutes with the med students from my team reviewing how to do an infant exam. They were so nervous; many had never even held a baby before. But by the end they're all way more confident and one declares himself the "Baby Master", grinning proudly! Knowing that I have something to teach, even the little things, makes me feels good- like maybe I did learn something in med school!

Off to the ED with my senior for an admission. It's a very sick 4 year old girl named Maddison. She needs a lumbar puncture. I cringe with dread- I never have good luck with procedures. Patiently, my senior helps me set up and talks me through it. Suddenly- there it is! Clear fluid! I can't believe I did it! I thank my senior over and over again for their help! We get Maddison upstairs and settled in. My attending helps me finalize my plan and get my orders entered.

I do another quick lap of the floor to check-in on all my patients and head to evening sign-out. There, my senior interrupts to make a big announcement. The lumbar puncture I did earlier came back as a perfect sample!!! I can't believe it- a "champagne tap" my intern year! Everyone gives a little cheer and I blush from head to toe while grinning madly.

After sign-out I slip back to Nathan's room. He's asleep but I talk with his mom. Tomorrow is the soonest we'll know more about his cultures and for both us the waiting is always the hardest part. But we'll do it together. We hug before I leave and I walk away from the hospital- no, my hospital. I belong here, and for that I am more grateful than words can express.

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