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Volume 2, Issue 3
Autumn 2006:

Chapter 2: The First Day of Residency

Robert McKersie

Cell 2 Soul. 2006 Autumn; 2(3):a3

July 1, 1999

My first day of internship found me awake at 4 A.M. trying to decide what I was going to put into all of the pockets of the trademark long, white jackets residents wear in the hospital. Attendings, the top of the physician pyramid, pride themselves on having nothing in their pockets, thus displaying to all that they have all of the information in their heads. Interns, on the other hand, put our egos aside, cramming our pockets full with every book that we might have to reference during the day. We often look like overstuffed hippopotamuses waddling down the hospital's corridors attempting to keep pace with our less-encumbered attendings. Interns often live by the motto, "No factoid of information shall be more than an arm's length away." I decided on a heavy informational load for my pockets.

My stomach churned with apprehension as I drove the thirty minutes from my apartment to the hospital. Along the highway were many exits, and as I approached each one, I thought about taking it, turning back, and going home. It seemed like the proper thing to do. At this time of year, many new interns, including me, have fears that it is a complete fluke or mistake that we are doctors. We surmise that maybe in fact we are just fakers or actors and nobody has found us out yet. Our fears make us forget about the countless hours of studying during the four years of medical school just finished; we irrationally convince ourselves that we do not know enough to be doctors.

But I did not turn off at any of the exits and parked next to the hospital. As I entered, the security guard looked up and said, "Good morning, doctor!" I turned around to see who that doctor was, but all that was behind me was a long empty hallway. And all that was before me was a hospital full of sick and vulnerable people, the unknown, and my own fears.

Baby X was the first patient assigned to me on my first day on the Maternal Child Health ward; it was her twentieth day of life, all of which had been spent in the hospital. She arrived as a thirty-two-week premature infant, weighing just over two pounds, born at home — into a toilet. Her mom, perhaps not realizing that she was pregnant at the time or that the child she had just given birth to was still alive, tried to flush her down the toilet. The paramedics, called to the house by her eight-year-old son, found Baby X lying in the toilet. She was blue, had stopped breathing, and had a pulse of forty. They rushed her to our hospital, and here she has been for the last twenty days. I found Baby X in an incubator sleeping quietly. Her arms and legs were as thin as sapling twigs. Her skin was loose and looked as delicate as tissue paper. Her face was drawn and her eyes were shut. I stood there for quite some time peering at her through the transparent incubator, pondering her cruel start in this world. I wondered if I had it in me to take care of this fragile creature barely larger than my outstretched hand. Instinctively, I put my hand into my pocket to find a book to reference, but quietly realized that there was not a book in the world that I could hide behind now. I hesitated. And then I put my hand into the incubator. I touched her warm, transparent skin and felt her labored breathing. I moved my fingers down her tiny body and found her femoral pulse; then I laid my stethoscope onto her thin chest and listened to her heart, and thus began my internship.

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