I admitted my first patient today.
Last month I worked on a consult service–so I never had any of my “own” patients.
That all changed today when I admitted a patient with pulmonary hypertension.
It was mostly grunt work–filling out orders, doing a rectal, etc. Ya know, the normal intern stuff. We got the patient a bed and I then promptly “checked out” to the intern on call for the evening. I felt a bit guilty dumping a sick patient on the overnight intern–but that’s what the 80 hour week does for us.
It’ll be my turn on Sunday when I have my first call day/night.
Should be a blast.
There’s a very famous book in medical circles entitled The House of God that deals with the life of an intern at a major U.S. hospital during the 1970s.
It is hilarious. It is frightening. It is dark. It is…well…damn good. Imagine Catch-22 for medicine and you can begin to understand the style of Samuel Shem’s most famous novel. Or…you could just watch Scrubs.
Author Stephen Bergman, MD (Shem is a pseudonym) is a psychiatrist at Harvard now–years away from his internship at Beth Israel Hospital in Boston, but his laws for The House of God live on:
I. GOMERs don’t die.
II. GOMERs go to ground.
III. At a cardiac arrest, the first procedure is to take your own pulse.
IV. The patient is the one with the disease.
V. Placement comes first.
VI. There is no body cavity that cannot be reached with a #14 needle and a good strong arm
VII. Age + BUN = Lasix dose
VIII. They can always hurt you more.
IX. The only good admission is a dead admission.
X. If you don’t take a temperature, you can’t find a fever.
XI. Show me a BMS who only triples my work and I will kiss his feet.
XII. If the radiology resident and the BMS both see a lesion on the Chest X-Ray, there can be no lesion there.
XIII. The delivery of medical care is to do a much nothing as possible.
I suppose “cynical” would be a good word choice to describe Shem’s view of medicine–at least as it relates to his fiction.
For those in the medical profession–or entering the medical profession–who have not read this book, go get a copy. It’s certainly worth the read.
