Clinical, Featured, Intern Year, Surgery
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The Intern

The following manuscript was submitted to the March 2017 s/p The Match — One Year Later Themed Writing Contest.

From the moment I set foot in the hospital as an intern on June 24, 2016 at 4:55 a.m. to the present as I write this reflection, my life feels as though it were playing in fast forward. It is hard to believe Match Day was almost a year ago. I can still relive the palpitations and tingling in my fingers as the 10 second countdown to opening the letter that would determine my fate began. My letter held the added significance of revealing my specialty as I had dual-applied to both plastic surgery and general surgery programs across the country. In the months leading up to Match Day, I had convinced myself that life would become significantly easier after I opened that letter. I would have a place to call home. After adopting a near nomadic lifestyle during away rotations and interviews in fourth year of medical school, I anticipated planning for my future instead of fathoming various outcomes of it. As I read the words: “Lehigh Valley, Plastic Surgery — Integrated” I felt the cloud of uncertainty lift to reveal the next exciting phase of my training. I expected to work the hardest I had ever worked in my life. I expected having some difficulty balancing my personal life, studying and working.

Little did I know that my first word to describe myself as an intern would be: exhausted. Over the past seven months of internship, the physical and mental energy I use on a daily basis is more than I thought I possessed. The word “busy” takes on a new meaning. Among answering endless pages about the over 40 patients on service, preparing for the OR, seeing new consults, and rounding with attendings, the days blur together. At first, the simple act of starting a patient on intravenous fluids was a source of worry as I deliberated for minutes about what fluid and what rate to enter. I would double and sometimes triple check all my orders I placed. I constantly felt and still feel overwhelmed with the amount of material I must learn in the next six years.

The changes of intern year extend into my life outside the hospital as well. I transitioned from living with my parents to becoming a home-owner in the short span of four months. Trips to visit my significant other — who is an internal medicine resident in Phoenix — decreased in frequency. We now see each other once every three months. Hobbies I maintained from childhood through medical school including classical Indian dance and piano seem impossible to continue. Anticipating plans with friends on nights off evolved into anticipating glorious extra hours of sleep.

The changes of intern year have been exciting as well. My day can transition from firing the final staple load separating an inflamed appendix from its mesentery in a laparoscopic appendectomy to performing a primary survey on an injured child in the trauma bay. The excitement of operating and variety of patient conditions make intern year the best year in my medical training so far. I feel supported at all times in the hospital with the guidance of my senior residents. I now learn from many different angles whether it be from plastics lecture every morning to retracting to provide better exposure for the attending and senior resident in an exploratory laparotomy overnight. As second year soon approaches with critical care as its main theme, I am both terrified and excited for the many experiences to come.

My best recommendation to incoming interns is to follow the five-second-rule. You will fall and make mistakes. What matters is how fast you are able to learn from them and move on to the next crisis at hand. This ability makes intern year both physically and mentally possible to endure. I allow myself five seconds to reflect on my oversight or mistake, sear it into my memory to prevent it from happening again, and move on to my next patient requiring care or the next step of the operation. Always be willing to learn from your patients, nurses, senior residents and attendings alike. Although we may not realize it, with each patient we see from rounding in the morning to answering pages at night improves our clinical judgement.

Intern — used both as a noun to describe a trainee and as a verb to describe the act of detaining a prisoner — to me represents a year of transformation from the mindset of a care-free medical student to a responsible physician. Although I may feel interned at times in the hospital when on back-to-back 16-hour weekend call, I am thankful for every learning opportunity l have had thus far and look forward to what the next five and a half years of training hold for me. One year status-post Match Day, I find I have grown both as a physician and a person. I feel more confident about my ability to help people and of when to ask for help from my seniors in the management of an acutely ill patient. However, the most important factor of my successful transition from medical school to intern year is the continued support from my family, significant other, friends and co-interns.

Image creditScalpel by Markus Grossalber licensed under CC BY 2.0.

Mamtha Raj, MD Mamtha Raj, MD (1 Posts)

Resident Physician Contributing Writer

Lehigh Valley Health Network

Originally from Boston then Chicago for medical school, I am now a plastics-integrated intern at Lehigh Valley Hospital in Allentown, PA. I am also an avid foodie, dancer, and creative writer.