“Hi. I’m the new very, very late intern. Where should I be?”
I just didn’t want to get yelled at. I knew I could make it through the day if the attendings and NPs were just politely irritated with me, but if I got outright YELLED at I’d definitely start crying -, and if there’s one thing I’ve learned neonatologists have in common with surgeons, it’s absolutely zero tolerance for clinician breakdowns.
So that was going to be my order of priorities:
- #1, Absolutely no crying, and
- #2 demonstrate that, on the plus side, I’ve already had the month of hell that is NICU as an MS-4 and I at least know the relevant math and fancy acronyms and therefore am not too much of a burden and perhaps might even (hope to god) be useful.
It was go-time.
Source: http://www.hyperboleandahalf.com
I had thrown on my scrubs while calling the chief resident (who, upon learning that I was not in fact actually dead, seemed just as disappointed as I was about it. Can’t blame him for that one: there’s probably a set protocol for dead interns. It must be less clear how to manage the dumb oversleeping ones.)
After almost locking the door behind me, I suddenly realized what I needed, and took 20 seconds to run back into the house just to grab a pair of thick, horn-rimmed glasses.
No, I don’t need glasses. I never wear them.
But if there’s one thing I learned from TV it’s this: Nobody yells at the girl with thick glasses. They just vastly over-estimate her IQ and general reliability.
Yes, it’s dumb, but that kind of over-estimation was just what I needed to pin my hopes on in order to not just succumb to my innate desire to write off the entire month and possibly also drive off a cliff.
The difference between “Aw, poor girl – that’s a rough start to the rotation” vs “Irresponsible and needs YELLING.”
It might sound dishonest, but I was honest where it counted: when the unit secretary pointed me toward the neonatologists, I walked up and told them straight-up “Hi, I’m Action Potential, I have no excuse. I slept through my alarm. I know it’s inexcusable. What should I get started with?”
Apparently the answer was an ABG, a central line, and pre-rounding on 4 patients in the 30 minutes I had before rounds.
BUT! No yelling!
… Yay?
So, had I been allowed to do ABGs and central lines in medical school, we would be back in the territory of things I could conceivably do.
But I wasn’t.
So we weren’t.
On the bright side: I prerounded on everyone and managed to come up with plans that made some clinical sense and just generally didn’t suck.
On the shadier side: ABGs and central lines on infants weighing less than a kilo… whose parents trust you because you are wearing a long white coat and introduce yourself as a doctor before torturing their tiny, innocent baby in the name of “practice”…
The NICU and I just don’t get along.
I am beginning to think we never will.
Action Potential 
This story made me laugh because it illustrates what happens when a worst fear is realized (being late). Nothing makes me feel sillier when something I dread happens and everything is fine. The NICU is its own beast — when I floated down there as a nurse I just felt like I was in a whole other (awful) world with its own rules that someone just made up. Can’t say I miss that.