The worst parts of intern year

I'm pretty sure I'll have more bad days as an intern because that's basically what this year is.

I had a month at one point where I'd come in at 5am everyday because it's a busy service and I'm paged and answering calls as soon as I arrive and the night intern is pushing tasks on me even though he's technically covering.  I do it anyway because I'm a team player.

I started one morning by getting called to the bedside to pronounce a patient dead.  It was emotionally terrible but I didn't have time to think about it because I had to do a mountain of paperwork and I was an hour behind in preparing for rounds and no one really cares what you have going on.

I typically answer a phone call every 20 minutes, spend more time writing patient notes for the purposes of billing and proving I'm not a fraud ( as in, hours writing patient notes..), and chase close to 200 data points a day, and get called to the bedside to talk to family while I field calls about crashing patients, go tend to them, then go back to the family and explain to them their loved one is sick and dying while being as understanding, polite, humanistic, and direct as I can be, providing constant emotional support.

I spell everything out as simple as possible for families who have loved ones who are sick and dying and getting worse.  They always tell me "Well, X years ago, they were perfectly fine!  I know they're going to get better," and they disregard my medical education and professional opinion that end-stage disease is end-stage and terminal.

It complicates things for sure, especially talks about code status.  This is a fictional example, but many times you have a patient who is 70+ years old with metastatic cancer, end-stage pulmonary or heart disease, in intolerable pain from said metastatic cancer, with dangerous cardiac conduction abnormalities, little to no renal function, and the family or patient wants everything done to save their life.  Even though you explain in detail about the patient's suffering and how there's the option of keeping the patient comfortable and having a good chance at a decent quality of life.

Then I see those patients go into cardiac arrest because they're so sick, people line up to do chest compressions, ribs are broken, a pneumothorax happens, surgery hurries in to put in a chest tube, and that same patient is on the ventilator unresponsive and they stay that way for weeks because the family still has hope that they'll fully recover even though they have so much going on and ACLS might have been going on for 45 minutes.

It's tragic.  Families start looking for tiny improvements in this lab value or this blood pressure in their loved one who is extremely frail and essentially on life support with no physical reserve left.

I need a break