Monday, December 21, 2015

Cryin' shame

I was just thinking about one morning during my intern year. One of our patients had died the night before, and my resident Annie had given consent to have the body transported to the morgue. I don't remember the exact details of what happened, but apparently she didn't have proper consent, which she hadn't realized, and she got bawled out by the coroner. I think the words "you're going to be in big trouble" were thrown around.

Annie and I were alone in the resident room. And as soon as she got off the phone with the coroner, Annie started crying hysterically. She was actually sort of a tough cookie, but I guess it was all too much for her: having her patient die, being awake for 30 straight hours, and now being told she was in big trouble over some confusing issue. I made an awkward attempt to comfort her, mostly just saying I didn't think she'd really be in big trouble, but I was pretty tired and depressed too.

Annie managed to pull herself back together before anyone else came into the room. So nobody but me knew that she had been crying. But even if they had, I'm pretty sure nobody would've done anything about it. We all would've just looked at her awkwardly, and tried to pretend like it wasn't happening.

That's how residency is a lot of the time. You hate your life, you cry, and nobody really seems to care.**

What baffles me is that this is OK somehow. That we were all so miserable, we did nothing to help each other, and everyone basically pretended like it wasn't happening. Despite the fact that the responsibilities heaped upon us were enormous enough that we really should have had our mental health monitored better.

Granted, it's been a long time since the morning that Annie cried in front of me. But I'm pretty sure that things haven't changed much.

**Except in PM&R presidency. There you go to work for a few hours, then head to the beach, and nobody really seems to care. (Just kidding.)


  1. I'm an RN working on a cardiovascular unit. A few months ago, we had a (brand spanking new) resident who was in 'big trouble' over a non-issue, and she was berated in the hallway by her senior resident. She started bawling uncontrollably at the nursing desk, and afterwards her coworkers (residents and nurses included) were rolling their eyes and commenting on the fact that she "couldn't handle it." If one of my nurse colleagues has an awful day and is that overwhelmed, everyone is supportive and kind. What's the difference? What an awful system.

  2. I'm a resident working overnight in the micu this week and the people who yell at me the most are nurses! I've never cried at work though.

  3. Fizzy, does the medical community understand that when you eat your own like this, it tells us how you might treat us? If you can't have compassion and use other ways to reach out to someone, then what are you going to be like with us?

    Yes, medicine is tough and you have to have a thick skin but my gracious.

  4. so, my moment came in my third year of residency, months into my adult neurology year (I'm a child neurology fellow). I was hours into a 28-hour call and my pager went off with a hyperacute stroke activation. something snapped in me and I started crying as I rode the elevator down and rushed to the ED. the ED staff asked me if I was ok, if I needed to sit down for a moment, if I needed coffee or a coke, but I couldn't because of course this was potentially a life-or-death/morbidity type of situation for the patient. I cried my way through the NIHSS (for non-medical folk, it's a quick exam meant to very quickly assess whether someone is having a stroke and if there is something we can do about it, and there's a very narrow window of time in which we have to do it, so seconds/minutes matter). there were no family members present, and the patient was unconscious (and thankfully it wasn't a stroke, either) -- I don't know if I could have held it in had I had to be patient-facing at that moment. my attending (who is the program director) actually came down to the ED (I'm... actually not sure why or how, because she wasn't the stroke attending?) and I think I told her that I wasn't doing very well. she said a number of very understanding/calming things, took the pass-around pager from me, told me that I was off for the rest of the day, made a few calls, and a very, very good friend came and took my call that day. needless to say, I idolize her a little. :)

    all in all, I know it's not like that everywhere, and there are some very malignant programs/specialties out there. my husband continually wonders why the culture of medicine is like this (what you described above) and why we keep doing it to ourselves.

  5. Do not wish for "mental health monitored " , because that would make the stress worse, not better. What can they do? Give a pill/drug? Do you know any drugs that make you smarter and healthier? The magic mental health pill does not exist.
    Someone to talk to? That is called a friend and you typically do not pay for a friend to listen.

  6. This isn't complicated; they are just getting you ready to deal with the general population. Everyday I get "scolded" if not cussed for something by some patient parent or grand parent with a 76 IQ. Surgery rotation as a third year taught me not to take it personally. Now, nothing bothers me.

    So if you'll excuse me, I'm going to wash down a Xanax with two shots of Jack and go to work.