1. Everyone has a story about getting stuck in an elevator/stairs/hallway
2. Physicians tend to be lazy so there are usually forms for everything. Which means you don't actually need to know the insulin sliding scale--you can just check the box and sign your name
3. You will sign your name at least 25 times a day
4. All ICU patients eventually die
5. All trauma patients live long enough to tell you that you're not adequately managing their pain
6. The two most common patient responses to "I'm a resident" are "So where do you go to medical school at?" and 'My niece is a PA also!"
7. The most important phrase of your intern year is "what do you usually do in this situation?"
8. Everyone has caused a complication at some point in time.
9. The first two times your pager goes off are kind of exciting. After that, you realize it's just someone telling you that you forgot to do something.
10. Google does not always have the answers.
11. Attendings are really freaking elusive
12. Little kids cry a lot.
13. 60mEq KCL IV and 40mEq KCL PO
14. Attendings and nurses only call you "doctor" as a joke
15. The duty hour rules are designed to keep you from working over 80 hours a week. The culture of medicine is designed to make you feel guilty about that.
16. Every specialty in the hospital hates every other specialty
17. And everyone really hates the ER
18. The ER really hates everyone
19. Regardless of how legitimate your consult is, the consultant will be mad that you asked him/her
20. At some point, you will have to order a crap consult for something and then the consultant will really hate you
21. When giving a presentation, remember: you are the only person in the room who does not know everything you are about to say. So you better get it right.
22. Competition for the good surgeries and procedures is fierce
23. Medical students are actually kind of annoying.
24. You have to round on 15 patients by yourself every morning. Good luck with that, sugarbeet.
25. Regardless of how hard you try, you cannot leave work at work. Which is not helped by the fact that pretty much everyone you know is in medicine.
26. All your dreams involve medicine
27. Residents love to brag about how little they've slept and how many hours they've worked
28. Free food is still exciting
29. If this is the specialty I've chosen to spend my life in, why do I find most of it boring and confusing?
30. Hospital employees are used to crying interns. So don't feel bad--they won't hold it against you.
31. If however, you fall asleep at the nursing station, people will bring that up. Repeatedly. Endlessly.
32. Trauma season is a very real phenomenon
33. So is cardiac season and respiratory season
34. It is impossible to find privacy. Patients and their relatives can still find you when you're in the bathroom
35. People will ask you for directions all the time if you're in a white coat. Unless you know how to get to "outpatient mammogram," don't ask visitors if they're lost when you see them doing the "deer in the headlights" thing.
36. Most meals are eaten standing up
37. Very little studying actually gets done over the course of the year.
38. It's better to be dangerous than lazy
39. It is possible to get fired from internship.
40. You spend most of your time feeling like you're behind your co-interns and that everyone else has a better grasp on this stuff than you do.
41. Water&Shame-->surgical lunch
42. You can tell when the new lab values get posted because your pager explodes with all the nurses calling to tell you that the patient's K+ is 0.01 below the cutoff value
43. Examine your own wounds/incisions. And you have to at least look at them before the patient gets dischaged.
44. There are battles over who has to be the primary team for a patient
45. Regardless of the problem, it can be temporarily fixed by tylenol and a stool softener
46. Old people love to talk about their bowels
47. Patients get cranky when you wake them up at 5AM but at least they get to go back to sleep afterwards
48. When your department head says he wants to hear your opinions, he does not actually want to hear your opinions
49. Neither does anyone else
50. It's generally better to be quiet than right
51. Patients only code after 1AM
52. Code status is one of the more awkward discussions you will ever have
53. Most people skip the family history in their H&P. If the patient fell in a hole, it probably doesn't matter that his mother had breast cancer. But you have to say it's "non-contributory" to be able to bill at a higher level
54. Every now and then, someone will make a miraculous recovery
55. But don't hold your breath
56. It's a bad sign when your patient gets a "gift of life" consult
57. Everyone on the "general medical unit" has a diabetic foot ulcer
58. Regardless of your specialty, you will be consulted for a diabetic foot ulcer
59. There are still very few meaningful patient interactions. And when you have 10 patients to see in an hour, it's hard to engage people in meaningful and witty discussion. Or to care about the fact that you haven't.
60. Regardless of how easy your last name is, no one will be able to pronounce it, spell it, or remember it
61. On my first day of intern year, my attending made me fix his printer. That's what 4 years of medical school gets you.
62. Personal hygeine takes a nosedive
63. Bring underwear with you on call, otherwise you're stuck wearing the same pair for over 24 hours
64. If you forget your toothbrush on call, usually they have ones for patients in the supply/medication rooms. They're not great, but it beats using your finger
65. But don't bother using the patient deoderant or patient baby powder.
66. People only say to you "you look really tired" when you're feeling pretty good. So then you start feeling bad about yourself
67. Driving home post-call can be kind of scary
68. Introducing yourself as "doctor" over the phone can get results. If nothing else, usually you can call an outside hospital and get lab results without having to fax over a "release of information" form
69. Memorize your DEA number. Because 90% of what you do each day is write scripts for pain meds for patients.
70. If someone offers to help you, take them up on it
71. Laughing at your attending's jokes tends to get you on their good side
72. Surgeons still do not let you do anything in the OR besides retract and cut knots
73. As far as I can tell, everyone assumes that I will one day wake up and know everything. And until that day, no one trusts me to do anything. Man, I can't wait for that day.
74. All patients in the hospital have previously been admitted to the hospital
75. You only get consults when you already have a stack of consults to do
76. Most days are either busy as sin or boring as sin
77. Saturday call is terrible.
78. Dictating is actually much quicker and easier than writing everything down. Downside is, then you have to wait for it to get transcribed to find out what everyone's plan is.
79. Discharge summaries are a pain to do
80. The more prepared you are for something, the fewer questions you will be asked
81. The rules from medical school apply: If you are on rotation with someone, he/she will be your BFF for the month
82. Your senior has the power to ruin your life
83. It is really hard to not take criticism personally, constructive or otherwise. You would think you would get used to it after spending all day, every day, being corrected, but hey.
84. Patients spend a lot of time complaining about their previous physicians. Which means they will complain about you after you're gone
85. Residents drink a lot
86. Attendings drink a lot
87. When people ask you how you're doing, they don't really want to know about how much you haven't slept recently. They're just asking to be polite.
88. If you're going to sleep with another resident, choose one from a different department
89. White coats do not stay white for very long.
90. Most people become serious coffee drinkers
91. Comfortable shoes are a must
92. The way my attendings talk, you would think the physicians at every hospital that wasn't this one were sub-par and potentially dangerous.
93. The more advanced you are in your training, the fewer things you carry in your pockets. Until then, you are jam-packed.
94. It's surprisingly hard to find a stethoscope around the hospital if you forget yours.
95. No one will ever try to teach you anything on a weekend
96. You always find out you were or weren't supposed to do something after the fact
97. Having something to do after work guarantees that you will be done late.
98. A lot of parts of this job are actually kind of depressing
99. I asked my attending at what point you start to feel like you have everything under control and he said 'I'll let you know when it happens."
100. Everyone lies about their duty hours
101. Be nice. Seriously, be nice. It's the most important thing you can do. I promise.
The usual rules apply--feel free to add your own!
Have a great day!