Day 4

First rounds this morning. Start at 6 am. The ICU is still a little bit scary. Doesn't end til 930 am. People seem disgruntled that the med students (us) are not doing what they are supposed to be doing, even though they realize we do not know what we are supposed to be doing.

We are supposed to be removing and replacing surgical dressings. We have to figure out how to do this by tomorrow at 6 am.

The rounds go until 930 am. The senior resident is dashing and charming and it is amazing how intimately he knows each of the 40 patients. The interns are post call and irate. We stay out of their way.

The clinic is over flowing. They are depending on us to keep the flow, even though at this point we cause more delay than speed. There is only one attending. Patients wait for 3 or 4 hours shivering in their gowns.

I examine a mans genitals with great authority. He has an enormous hernia and a painful swelling of his testicles. His penis is retracted. He is an ex-con, a "street warrior," his skin scarred and bruised from knife fights and heroin skin popping. He has an odd affect, a mood disorder. He follows my directions. I examine him with gloves. When i return the attending examines him without gloves and has me do the same.

I watch a pretty nurse practitioner who is about my age, expertly pull a drain from a man's stomach. She is someone like me--a normal person, a young person--but her hands and her brain are like magic. She helps me figure things out and i am grateful for her patience.

We do not end for several hours. At 2 i realize it has already been an 8 hour day.

I receive an email from a star graduating student who responds to my fretting about the future. She tells me not to fret. I believe her. She tells me to work really really hard. I believe her.