4 Minute Read
Intern Year Day 85:
“Honestly, doc, I’m not answering any more questions this morning. You can go,” an ornery 60-something-year-old patient said to me with a dismissive wave of his hand. I usually tried to mirror my patients’ body language and tone to build rapport, but this morning I had probably come in the room too loudly, with too large of a smile on my face. The patient had told me once before, “It’s rude to smile too much at a sick patient; he’ll think you’re laughing at his misfortune.” I had simply been attempting to ask him how his afternoon was going and do a quick physical exam, but he was in one of his infamous moods. “Really, doc, I’m done talking,” he said and turned off his bed light. I tried hard to stifle a laugh while I walked out of his room, resulting in an short, awkward snorting sound. I heard him mumble softly, “Laughing at my d*mn misfortune” as I closed the door.
The truth is, I had been laughing at inappropriate times on-and-off all day. For example, I snickered during noon conference when the speaker made a comment about professionalism. It took all of my strength to hold back a chuckle when a patient told me she had mild abdominal pain. I used my free hand to hide a giggle as I sat in the team room sweating bullets because it was so hot, but nothing could be done about it. This was all because I knew that underneath my prestigious, long, sought-after white coat, I was sporting a scandalous crop-top.
To explain how I found myself in this predicament, I should introduce you to my favorite (cough, cough) part of residency life, the 80-hour work week. The Accreditation Council for Graduate Medical Education (ACGME) is the body that accredits medical residency programs in the US, and sets rules and regulations to standardize how these programs are run. ACGME rules mandate an 80-hour weekly limit on duty hours averaged over four weeks (meaning you may go slightly over 80 hours one week, as long as it’s less on subsequent weeks) and one day off in seven, also averaged over four weeks.
Practically, this means that on the medical wards I typically work 12 to 13 hours a day, 6 days a week. Not to mention, I also attempt to go to the gym most days, eat a decent meal or two, write/practice poetry, and commute to and from work (I live 45 minutes away from the hospital, but that’s a story for another day). I know, I’m doing what the kids nowadays like to refer to as The Most. On my day off, I usually have to choose between sleep, errands such as grocery shopping and laundry, and spending time with family and friends. As you can imagine, sleep is usually the winner, and I often go back to work the next week without having completed all (or any) of my desired tasks/errands.
Before you start to feel sorry for me, I should mention that most of the doctors training us had it much harder back in their day, before work-hour limitations were implemented. In fact, “residents” were originally referred to as such because doctors in training used to actually live in the hospitals that they worked for (or in housing provided by the hospital). Their lives revolved completely around work. For their time and services, they would have room and board paid for and be given a small additional salary. The major assumption at that time was that residents had very few obligations outside of their medical training. Now, programs generally acknowledge the fact that we have loved ones, hobbies, and social lives. So all-in-all, though we have a *LONG* way to go in combating resident stress and burn-out, it seems as though things are moving in the right direction.
Anyway, I remember that day clearly because I had worked the last 8 days straight, didn’t have time to do laundry, and ran out of clean work-appropriate tops. No matter how sleep-deprived I was, I wasn’t willing to show up to work smelling like the dirty hamper, so I frantically searched through the closet for ANYTHING that wouldn’t look completely crazy. In an effort to get to work without being late, I quickly settled on a clean, forest-green crop top, knowing that my white coat would hide the ratchet truth.
My white coat had also been used to hide other misfortunate situations over the years during my medical school days including the annoying gaps in button-up tops (women know what I’m talking about), broken pant zippers, and the occasional lunch-time shirt stains. Somehow, though, I had never gone so far as to wear a top that showed my midsection to work before. The end result of this was an uncontrollably giggly mood throughout the day, with multiple trips to the bathroom to unbutton my white-coat, look at myself in the mirror and laugh. Those who know me well know that I have the comical quirk of crying when I laugh (got it from my dad), so it’s usually hard for me to hide when I think something is funny. If I manage to be successful at holding back my audible laughter, trust me, tears are silently racing down my face.
I noticed that although I was tired, I had been in a better mood than normal because of the crop-top. It was the first time in residency that I realized how important laughter was for my soul, especially at work. Instead of getting annoyed as I typically did when my resident micromanaged me while I placed orders for patients, I thought, Man, I wonder what he would think if he knew I had on a crop top under this white coat! When a patient yelled “NURSEEEEE!!!!!” at me to get my attention, I thought, Butttttt does your nurse wear a crop top to work though? And at close of shift while I waited in line to tell the night team about what happened with my patients during the day, I thought, Ya’ll need to HURRY UP so I can go home, looking like a snack under this white coat!
Bottom line: In the future, if you ever notice that my giddiness is out of proportion to the situation at hand, you can probably assume something hilarious is going on, even if it doesn’t meet the eye. It’s all for the best — a girl has gotta laugh to make it through!
Until next time,