Where Medicine Has Taken Me Over the Years
“
Whew
, I survived !” My first night on call as an intern was almost over : up all night with five admissions after 8 p . m .; performed all necessary tests myself , including drawing blood and completing a urinalysis on each patient ; performed a trans-tracheal aspiration on a patient with pneumonia and prepared the sputum slides for morning report ; treated a DKA administering the diabetic medicine myself ; and discovered medical students did not take night call and thus I had to personally perform the NG tube ice lavage until the GI bleeding stopped . By 5:30 a . m ., everything was completed except the chart work , which included writing each patient ’ s H & P , completing all lab results and writing a diagnosis and a treatment section . I ’ d completed approximately 90 % of each patient ’ s chart when I was called for Morning Report .
Since I had not attended medical school at this institution , Morning Report was a new experience . The first intern had attended the medical school and knew the ropes . The attendings were abrupt and intimidated him , but he survived .
“ Dr . Dageforde , present your cases .” I was not nervous . About three-quarters of the way through presenting the first case , I heard
by DAVID DAGEFORDE , MD
a loud BOOM ! One of my loose-leaf patient charts was lying all over the floor where it had been thrown . “ Next case !” I was a little nervous but started my presentation . Two minutes into the case BOOM ! and another chart hit the wall . I barely mentioned the third patient ’ s name and BOOM ! BOOM ! BOOM ! the last three charts were all over the room where more than 75 individuals were seated including interns , residents , fellows and attendings .
“ Dr . Dageforde , you came to Morning Report and weren ’ t prepared .” I answered , “ Sir , I had five sick patients , did … blah , blah , blah … all night , and filled in the most relevant information on each chart .”
The chief of medicine said to another attending , “ Dr . …, you were an intern in this program . Did you ever come to Morning Report unprepared and then whine ?” “ No !” the attending adamantly replied . “ Dr . Dageforde , if you ever again come to Morning Report unprepared , you will be terminated .”
What an introduction to three years of being pushed to the limit . Did I wonder at first if I could endure the “ heat ” for three years ? Sure . However , the residency entrenched into me a super-type A attitude to give 100 % effort to every patient , to be 100 % prepared no matter what the circumstances and to always tell the absolute truth because I saw the consequences for those who did not do so . They were terminated .
During the second month of my internship , I was in the ICU at Ben Taub Hospital in Houston , Texas , on call 36 hours and off
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