From the Trenches
A steep learning curve
with lessons for life
Forum
Michael O’Brien looks at the strong bond that forms between
doctors as they go through their hospital internship
It was the best of years and the worst of years. Who can
forget their intern year? July 1, 1994 and we were a group
going from the top of the ladder in medical school to the
very bottom rung of the ladder in hospital.
When I say bottom of the ladder, that’s no exaggeration. We were seen to be lower in terms of respect than the
nurses, porters and even the student nurses! But we didn’t
feel that way. The interns at the Dublin hospital I worked at
in 1994 stuck together, and adversity brought us through
this most interesting of years. We worked and played hard
as a group and the bond was strong, and still is!
I can’t say I was looking forward to internship; contrast
that with other newly qualified doctors who couldn’t wait to
get going. Back in 1994 you were thrown in the deep end
on July 1 with no practical training previously done. Before
July 1 I had never performed a phlebotomy; never taken an
ECG (never mind read them); never put in an IV cannula or
a urinary catheter; and the holy grail, the ability to perform
an ABG without causing an aneurysm.
July 1, 1994 was a Friday and I was expected on the
ward at 7am acting as the orthopaedic intern with an intern
colleague. At that time, the ‘ortho’ job was seen as the
most difficult in terms of looking after the consultants, the
senior registrars and the SHO, never mind looking after the
patients. Finishing time was when we had finished all our
duties.
I remember that back then, when I was meeting members
of the opposite sex I would stare at their hands. Many of the
girls would notice this and ask what I was doing? At that
time in my life, I couldn’t help but look at people’s veins
as my whole life as an intern revolved around the ability
to insert an IV cannula promptly and efficiently. Nothing
worse than being on-call at 3am and being asked to put in
a cannula in an elderly obese woman whose cannula had
tissued. A large vein meant that I could have the cannula
inserted in one minute and back to bed in three minutes. I
still admire veins in people’s hands to this day!
I remember at the end of my first day feeling pretty
shocked, shattered and disheartened. I couldn’t believe I
had spent six years of medical school to get to this stage
and then realise that I did not like it. I seriously thought I
couldn’t face going in to work on Monday. With the swapping of everybody’s nightmare stories over a few drinks, I
realised that I was not alone and that we interns were in
this together.
That thought kept me going. That and the great sense
of humour and hard-working ethos of my co-intern got me
through the first few weeks. It was a very steep learning
curve, but after a few weeks we got over the initial difficulties and became very well-organised, managing emergency
admissions, sourcing x-rays for the conferences and even
treating patients.
In order to become a good intern, I realised you didn’t
have to be a good doctor, just a well-organised social
animal. It was worth making contact and becoming friendly
with those in power. Those in power included the radiology
registrars who could book a CT scan at the drop of a hat, the
ECG technicians who would put your ECG request at the top
of the list, and the phlebotomist who would try to get your
bloods done before her first tea break.
As interns, we learned many things. We learnt about
friendship, trust and integrity. We learned about people
and we discovered our own individual talents and flaws.
More importantly, we learned how not to get bleeped by the
nurses when we were asleep in our bed when on-call.
My most valuable lesson was learned one night as I was
the medical intern on-call writing a prescription in the
ward station. I overheard two nurses talking about which of
two surgical interns they would phone. Would they phone
intern ‘A’ who was a cantankerous guy who would ask a
lot of questions regarding the condition of the patient and
whether it was medically necessary for him to commit to
see the patient, or would they phone intern ‘B’ who was a
very pleasant guy for whom nothing seemed to be too much
trouble?
They decided to call intern ‘B’ as they didn’t want to wake
up narky intern ‘A’. From that day on, I became that narky
intern ‘A’ to the nurses, and life became a lot easier.
Looking back to that year, us interns spent a lot of time in
each other’s company. Some, if not all, spent more time in
the hospital than they did with their own families. It is no
wonder that the bond between us doctors was so strong.
That same bond was most recently demonstrated by the
medical graduates of Trinity College 2007, who have lost
three of their own in the Air France plane crash. Warm
words were spoken by their classmates and colleagues in a
remembrance ceremony held in Trinity and the lives of Jane
Deasy, Aisling Butler and Eithne Walls will not be forgotten.
All were held in very high regard, both personally and professionally. The Irish medical community is all the poorer
due to their untimely loss. My thoughts and prayers are with
their families and friends.
Michael O’Brien is in practice in Sandyford, Co Dublin
FORUM July 2009 45
Trenches.-NH2* 1
24/06/2009 15:07:13