A reality check

Short White Coat is a blog about learning to be a doctor. Posts appear here as part of White Coat Notes. Ishani Ganguli is a fourth-year Harvard medical student. E-mail her at shortwhitecoat@gmail.com.

Residents and full-fledged doctors have a habit of reminiscing about the slow pace of their medical school days, when they had time to spend with patients and learn about the diseases that afflicted them. I didn’t get it -- until now.

I am on my sub-internship in medicine, a taste of what my life will be like as an intern (in medicine). A classmate and I collectively make up one intern, so we are responsible for up to six or seven patients each, as opposed to twelve or fourteen. In a word, it’s hectic.

Our first day of the rotation transitioned into our first night on overnight call, and on top of the four new patients I was getting to know, I was also responsible for a list of 19 others, usually covered by other interns. When one of those patients nearly coded on that first night, the throng of medicine house-staff who reported to the scene asked me for vital details on a dying man whom I had met only moments earlier.

The trial by fire was both terrifying and confidence-building. I looked to the notes left me by his primary intern and started to make my peace with knowing just enough. I may not have been able to speak about how this man was first diagnosed with lung cancer, but I knew that he had metastasis to his brain that could cause a seizure, and that it was his desire to be resuscitated.

Since that night, the workload has become much easier to juggle as I learn the hospital’s computer system and develop my custom-fit system of checklists to ensure that I get my job done. What remains with me is this new sense of urgency, of constant mental triage that seems essential to survive a residency. Now, at least I know what I’m getting myself into.