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CR3 #87: The Intern Blues by Dr. Robert Marion

As many of you may know (or have guessed by now), I work in the hospital system. I'm not a medical professional by any stretch of the imagination--I am strictly administrative--but I work with physicians, and occasionally I wonder how some of them managed to get through medical school. After reading The Intern Blues I am still wondering how they managed to get through, but this time it's because I'm not sure how ANYONE could make it through that insanity.

Dr. Robert Marion worked with a group of interns (first year of medical residency out of medical school) who were going to spend a year rotating through two pediatric hospitals in the Bronx. The year was 1985, and on top of all the normal childhood ailments, AIDS infections, crack-addicted babies, and domestic violence were on the rise. Dr. Marion asked three of his interns to record their experiences over the course of the year, which--along with his own observations--are what he used to put together this book. The interns begin completely overwhelmed by how much they don't know, and also by how often they are put in positions where they have to make decisions they don't feel at all qualified to make. They work endless shifts, sometimes thirty-six hours on at a time, and are pushed to the brink by exhaustion and stress. However, they also start to develop confidence in their abilities as well as an affinity for the work they're doing. By the end of the year, they all look back at their experiences and try to decide what they want to specialize in.

The book is extremely well-organized. For each rotation (usually about a month long) there is a chapter from each intern and an explanatory chapter from Dr. Marion. All the medical terms (as well as intern slang) are defined within the text, so reading the book isn't a struggle form someone not familiar with pediatric terminology. Since each of the interns' sections are transcribed from tapes they made, they come across as very personal. Another interesting thing is that since all three rotated through the same areas of the hospitals, you can often get three different perspectives on the same environment, sometimes even on the same patients.

Two of the interns, Mark and Andy, were great to read. Although both succumbed to the stress at various points, they both managed to maintain a sense of humor. They were likable and fun to read. Mark specifically has a biting, sarcastic, cynical sense of humor that I really enjoyed. His battles with sickly preemie called Hansen are the highlight of his sections. The third intern, Amy, was...not likable. She had just had a baby two months before starting the internship, and spends most of her time whining about no one understands how HAAARRRD it is to be away from her BAAAAAAAABY! And why don't they all let her leave early without complaining? After all, SHE HAS A BAAAAAAABY! Why do the people who have to cover for her complain when she wants to take off on a night when she's on call (even if means that someone else will have to work an extra all-night shift on top of their usual three per week?) Don't they understand that her BAAAAAAAABY is sick? Or when she wants to call out on another day she is supposed to be on-call to sit with her father after he's had minor surgery? She spends nearly half of her chapters whining about everyone else and how no one is nice to her and no one makes allowances for her and how everyone is OUT TO GET her for NO REASON AT ALL. Then when she turns up pregnant again toward the end of the year, she is SHOCKED that everyone is more concerned about who will be responsible for coverage during her six weeks of leave the next year rather than showing unfettered joy for her MIRACULOUS FUTURE BAAAAAAAAABY! Oh God, how I hated her. I certainly understood why no one liked her, and why they seemed  put out at her insistence that having a baby should result in some kind of special treatment. All of them were working 100+ hour weeks, and if anyone slacks off, that work has to be made up by someone else somewhere along the line. Having a BAAAAAAAAAAAAABY doesn't make you special. It makes you a mammal. Women like Amy give other women who want to have both careers and families a bad name. There are plenty of women who can balance both without behaving as though they deserve some kind of special treatment.

Hmm. I hadn't really realized how strongly I felt about that until I got all CAPS-lock ragey back there.

Anyway, the edition I read had a new forward and epilogue. It turns out that not too long after the events in the book took place, regulations were enacted that limited the amount of time interns could spend working. It prevented the long, sleepless weeks and endless shifts that had pushed these interns nearly to the breaking point. Dr. Marion discusses how this happened and the effect it had on medical training. He also looks up the three interns that participated in the book to see where they are, more than a decade after they had done their internships.

On the whole, I think this is a great read for anyone who works in or is interested by the medical profession. It definitely gave me a lot more respect for the physicians I see on a daily basis (most of whom probably did their internships back when this was the way things were).

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