Part 2 | Part 3 | Conclusion

     Posted January 17, 2002. Intern E sat with her head bowed close to her knees in a creaky bed with a thin cushion neatly wrapped in fresh sheets inside the She-Interns' quarters. She was facing the slightly deteriorating wall, her back against the door. One could have easily ignored her except that she did not turn her shoulder a bit whenever a loud bang got generated by the screen-door anchored to the building's wall by a big rusty spring-like contraption.

     Until someone finally noticed.

     Intern J lightly tapped Intern E's right shoulder. Intern E refused to budge. Intern J noticed that something could be wrong. She tapped Intern E's shoulder again and out came an audible sob.

     Intern J understood and did not bother to ask questions. She tapped Intern E's shoulder again, this time as a show of sympathy.

     Intern E was three months into her Junior Internship but this was her first day at the wards. Her first 3 months were spent outside the hospital, the so-called "rurals", and the out-patient department. She had absolutely no idea what she got into. And that compounded the trouble.

     She was expecting nice, kind and approachable nurses, residents and consultants. Her first encounter with a nurse was a baptism of fire.

     Welcome to the world of a Junior Intern.

     During that night, her first, at the OB-Gyne ward, Intern E got a 1/8 piece of paper from Nurse A. Nurse A did not say a word, did not even bother to show her face, just handed over the piece of paper and turned away. In it was written, "IV follow-up, present - PLR". For a first-timer who just realized she had to endure the OB-Gyne ward for the next 6 weeks, the note was like a foreign language or some genetic code that may take months to decipher.

     She did what she thought was the right thing to do, which turned out to be something she regretted big-time. She asked Nurse A what it was for. Nurse A went ballistic, fired a salvo that rendered Intern E speechless as if a carpet bomb just hit. The words were 'unprintable' and Nurse A's face was so rude-looking, even Picasso would have a hard time drawing it. In so many words, it was like "you are an idiot". Well, in front of patients and volunteer nurses, Intern E felt like one. She just turned her back. Which takes us back to Paragraph No. 1 (see above).

     Ok, calm down and lighten up. Before you froth in the mouth and e-mail me with venom, I did NOT say there are NO nice nurses, and for that matter, nice residents and consultants. Most nurses are nice, if not all of them, and I've been close with residents and consultants, close enough to drink and get drunk with them. Besides, I did not say "not being nice" is necessarily a bad thing. Let us not sway ourselves away from the real topic here. Which is not "not being nice" or "hurling insults once in a while". The question is "is it necessary?". Is it effective?

     Personally, I don't really care. I've been insulted, mocked, scoffed at (go get a thesaurus and help me find more words) by nurses, residents and consultants, probably many times over than what Intern E (she is real, I'm telling you) had endured. Needless to day, I probably deserved them. I was a part of the "irrelevant" group of Interns, that's the group way below the "real smart" ones (in which Intern E was best classified) and a little above "dumb" if we have some kind of a "brain gauge".

     And "constant fear" may have helped me learn. During my earlier days at the wards, I assisted in a two-hour long operation that ended at about 6:30 in the morning. A little disoriented because of lack of sleep, I took a quick shower (or bath, whatever) knowing that morning endorsements would follow at 7:00. The senior resident bombarded me with questions related to the operation and the answers he said could be found in chapter 2 of this yellow book..etcetera..etcetera. I was dumbfounded. A junior resident who performed the operation was kind enough to answer some of the questions for me. But the senior resident was outraged. "What did you do from 6:30 to 7:00?" he sarcastically asked. I looked at him but never said anything. He continued to look at me with absolute rage, you'd think that I just boiled his wife and I'm just waiting to add the carrots. Moral of the story: Better to read your book than smell like a specimen in a morgue during endorsements.

     You see, these rantings by nurses, residents and consultants were nothing to me. If ever there was a positive side to it, it was probably the motivation part. I read whenever I could and that meant not taking a shower before endorsements. Before you cringe, I did brush my teeth, sprinkle water over my face, and put on a little deodorant. I never had to feel real bad or cry like Intern E because I learned to accept that it was normal, that it was a part of being an Intern, that I'm not as smart as I wanted to be, that it was a part of learning.

     It was a few years ago when I last talked to Intern E in person (she was already a successful consultant by then). Guess what, she disagreed with what I just said. "It is not normal," she e-mailed recently. "Fear has always been a hindrance to learning. Why they love doing that is beyond me. Sure, they want you to learn but there are more than a thousand ways to do that other than throw insults and tantrums. If you couldn't answer a simple question, or forgot to take note how many times the patient was given Diazepam on your very first night, they don't have to compare you to an 'aide'. That is an insult not only to you but to the hardworking 'aides' as well. An 'aide' is not synonymous to being 'dumb'. The next time you are at the wards, you make sure you take note of every chart activity of the patient. Is it because you were compared to an 'aide'? Hell, no. You do it because you were just made to realize you need to. And it is the right thing. There's no orientation of any kind. Making you feel bad is not going to do it...."

     "....Isn't it interesting why almost every Intern is at the mercy of the Operating Room nurses on their first day inside the OR?" continued Intern E. "Nobody tells them what to expect beforehand, and they are all too excited that everything will turn out fine, some of them don't even know how to properly wear gloves. I have this funny feeling that they are being set up to somehow get the wrath of the head nurse. You will hear every insult imaginable..."

     At this point, I got reminded of a certain incident where a senior nurse at the OR of the University Hospital, known to many as a 'blabbermouth of the highest order' and meaner than the host of 'The Weakest Link', got beaten up, outside the hospital, black and blue, by a Junior Intern and a few cohorts. You don't need the Profiler to know why. A few months after that, a senior nurse at the OR of the Western Visayas Medical Center suffered worse. He was near coma after a severe beating by supposedly and allegedly Post-Graduate Interns. I am not condoning these incidents. It is even wrong for me to mention them, but sometimes if you want to teach people a lesson by scolding vehemently, mocking with no absolute purpose, be ready for the consequences.

     While reading Intern E's e-mail, I felt that her eyes were turning red in rage, so I did not argue the issue with her. Instead, I e-mailed her back if she has any explanation why. Do you think this is necessary in the interest of learning? Since the College and the Hospital turned out and continue to turn out graduates who become successful in their respective fields, this 'process' is working right. In fact, most, if not all, consultants had gone through the same fate while they were interns or residents themselves. Somebody told me a story before about this super-smart and super-strict consultant (so smart, in fact, he considers the rest of us 'dummies') who used to 'shoe-shine' his senior resident's shoes. Well, if I had known that shining shoes would make one super-smart, I would have shined shoes myself.

     Intern E suggested to ask other doctors, in the interest of fairness. And why not. I started this column with Intern E's story, we already know what her opinion would be.

     I phoned a few acquaintances the past two weeks, and was lucky enough to get three colleagues to talk for this column, although they requested anonymity. Let's just call them Peter, Paul, and Mary. Three contrasting views, we will hear what they have to say next week.

     Meanwhile, I'm sure you have your own thoughts on this. Please send me yours by using the form below. You are not sending your name or e-mail information unless you fill those fields in the form. You will be completely unknown to me or to anybody. That will hopefully bring out the 'very opinionated' person in you, don't you think?

     to be continued...

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