So after two full weeks of playing doctor, I feel like a total fraud. I feel totally incompetent every second of the day. And it doesn't stop there -- even in my dreams, I'm constantly reminded of how inept I am. The one question that makes me want to vomit instantly in my mouth is, "So what do you want to do, doctor?" My initial reaction (after swallowing my vomit) is, "I don't have a fucking clue." I want to apologize to every patient I see before the visit even starts. Just as a common courtesy.

"Hi, Mr. Smith? Hi, I'm Dr. Spandex. So nice to meet you. Now, before we get started today, I want to go ahead and apologize for everything I say or do to you in the next 15 minutes."

Sort of like I want to apologize to anyone who stumbles onto this blog -- probably by some Google misfortune. Most likely some poor soul who is looking for more "fitted" scrubs -- something with a little more stretch; something that doesn't hang on one's body like a potato sack. And after doing a google search for that elusive, yet oh-so-desirable item (really, someone should invent said item), they were led here.

My apologies in advance.

I woke up yesterday morning, feeling tired, but overall pretty good. I squeezed in 7 miles before going to clinic at 7:45. Fortunately, my residency program knows just how dangerous interns are, so for this particular morning, I was assigned to shadow a senior resident while she saw patients, despite that fact that I have been seeing patients by myself for the past 2 weeks.

I am NOT complaining - I was delighted to just kinda sit back and cruise through the morning.

I love this particular senior resident. She's 8.5 months pregnant and about 5 feet tall and just so damn adorable. So anyway, the morning starts off. After about an hour of knocking out patients (figuratively, of course), we're in the room with this one woman. She's talking about some difficult issues and crying. I'm standing there, taking mental notes of how deftly my senior is handling this -- with perfect amounts of compassion, yet equal amounts of time-awareness.

I start to feel a little funny. Tachypnic, tachycardic, nauseated. And then I'm like, "hmmm, I feel like I'm gonna pass out.....wait....just take some deep breaths...just try to hold on til this lady quits crying, then you can excuse yourself and leave...oh fuck..."

"Excuse me, Dr. Resident, I don't feel too ...."

The next thing I remember is lying on the exam table, listening to my attending say, "ok I'm gonna take off your white coat because you're sweating so much."

Awesome. I'm soooo embarrassed. I keep on apologizing. I think my resident must of caught me somehow (And I probably weigh twice as much as her -- even though she's 8.5 months pregnant!). Not a good way to break in my first year.  Anyway, I lay there for awhile, get up and go sit in the chiefing* room with the attending. I still feel a little too shaky to walk around and shadow, so I figured that I'll just listen to people chief their patients and absorb all the knowledge being thrown around.

I felt pretty good after a couple hours - good enough to help out another fellow intern (who was running behind schedule) and was able to see his last patient for him. Went to noon conference where lunch was provided, and then went to the VA hospital to General Surgery clinic in the afternoon. Still don't feel 100%, but then again, I haven't really been feeling 100% for the past 2 weeks.

Saw 2 patients, no problems. After my 3rd patient, I go find an attending to chief with. The surgeon is probably 80+ years old -- a really, nice guy who I respect a lot (although, from stories that I've heard from his younger days, he has...well...mellowed with age...). So, after discussing the patient with him, he goes into the room with me to examine the patient and ask him some more questions that I would have asked if I was a real doctor, instead of the fraud that I am (see paragraph 1).

We're standing there talking when I start to feel that feeling again. Motherhell. I know that I should leave the room, BUT....the day before, I pissed off that surgeon because I left a patient's room to go answer a page. Since I already had one strike against me for interrupting patients' visits and leaving prematurely, I most DEFINITELY was NOT going to leave THIS patient. Even if it meant that I passed out a second time. Besides, we were almost done. All I had to do was hang on for maybe 30 more seconds. 

Yeah, not gonna happen.

"Excuse me, Dr. Grandpa...I don't feel..."

Again, the next thing I remember is lying on the exam table looking at 2 surgeon attendings. When they ask if this has ever happened before, I said, "Well, yeah. Kinda happened this morning." I think I must have said, "I'm fine" about two million times, but my words fell on deaf ears and I was wheeled down to the VA ED by a surgery resident (who, luckily is one of my friends, therefore less likely to judge me). I convince them that I don't need a blood sugar taken, I had just eaten lunch 2 hours ago blah blah blah...Just do some orthostatics on me and I'm golden.


Long story short: I was able to convince the ED doc and the two surgeons running clinic that I was in perfect health. So after way too much drama, I was able to hop on my scooter and go home. I started feeling pretty crappy about 2 hours later and that evening, discovered that my temp was 101.4. So yeah, it's probably just a virus.

Not the ectopic pregnancy that seemed to pop to the top of everyone's differential.

*"Chiefing" is just a fancy word for "covering one's own ass" -- residents will see patients and then formulate their own assessment and plan. Then they'll come to the chiefing room, where they'll run it by the attending (the big boss - who's ultimately responsible for the patient). The attending will either agree with the plan, ask some more questions (usually really good questions that makes you want to kick yourself and say, "why the hell didn't I ask that question?"), or not agree with you and come up with a better, ie correct plan.