Monday, January 08, 2007

Top ten ways to get back at your intern

I’m not condoning an all out war with the medical intern; certainly, the most fruitful doctor-patient relationships are those built upon mutual trust and respect. Nevertheless, there are times at which it may be appropriate to behave in ways towards him or her that otherwise would be considered counterproductive, if not totally suspect. For example, let’s say you don’t like your intern. Maybe the guy’s an arrogant prick with about as much common sense as a rock toad. Maybe he went to Ohio State and you are from Michigan. Maybe he forgot (or so he said) to order your sleeping pill. Whatever the reason, an intern like that needs to be dealt with swiftly and severely, and I here offer a list of tried and true insider methods that are guaranteed to get his goat.

Before proceeding to the list, I’m going to warn you that some of the things I’m proposing may seem somewhat harsh and unnecessary. That’s nonsense. Part of the reason you came to a teaching hospital in the first place (besides the allure of the pretty, young female medical students and residents) was to allow your illness to help train the next generation of physicians. (And yes, it is reasonable to hold against your intern that he’s not a beautiful young girl.) What kind of training would it be without any challenges to overcome? Do you really want to be responsible for your physician-in-training failing later in his career because he was never tested during residency?

There’s another consideration as well, and that is the extreme boredom of staying in a hospital room for many days, simply staring at the ceiling or the TV. Nobody is going to fault you for infusing a little bit of melodrama into your relationship with the medical team, just for the heck of it. Besides, keeping yourself occupied will prevent the boredom from driving you to more dangerous kinds of mischief.

10. Think of your intern not as your doctor, but as your biographer: she is there to learn and record your life story. Do not leave out any of the details and do not let her cut you off. You wouldn’t want to compromise her work, would you? With practice, you can make a pre-round visit last up to an hour.

9. When your intern arrives with his attending on morning rounds, ask him to explain how your chemotherapy medications work. Seek out and exploit any weaknesses in the explanation.

8. When your intern first comes to introduce herself, suggest that the patient she is looking for was just moved upstairs. Start your timer to see how long it takes her to come back. Besides letting her know from the start who’s in charge, this will let you measure her competence. If she returns in less than a minute, you’ve got a star on your hands. If it’s within ten minutes that isn’t bad, but if it takes more than fifteen minutes, brace yourself because you’re dealing with a trainwreck who’s going to require a lot of extra training.

7. Writhe in pain on attending rounds, denying that you said you felt great to the intern thirty minutes ago. Alternatively, writhe in pain for the intern and look great for the attending. This will undermine the intern’s credibility in case she later tries to call you out on any of your pranks.

6. During attending rounds, claim that some rascal stole your jewelry. Compliment the intern on her bracelet and mention that it looks an awful lot like your old one.

5. When your intern comes into your room on pre-rounds, just before his exam declare an urgent need to use the restroom. Bring a good book for the toilet seat. Something like War and Peace.

4. On attending rounds, ask the intern if you were sleeping when she came to pre-round, because you don’t remember her visiting you earlier that day. If she recovers from that one, ask her if she really is sure that you’re dying.

3. Declare a game of hide-and-seek with your intern (don’t tell him, he’ll figure it out), with him being “it”. There are all kinds of interesting places to hide in a hospital.

2. After polishing off your breakfast and telling your intern that your appetite has been great, call down to the cafeteria and order a second tray, to be left untouched by your bedside waiting for attending rounds.

1.At the time of discharge, forget where you put your house keys. Have no idea how you are going to get back into your home. Consider it a final test of your intern: if he is able to see the discharge through and can arrange a way for you to be brought inside your home, then you know his training has been successful and that he’s ready to be let loose on the world.

Employing the techniques described above will undoubtedly enhance the entertainment value of your hospital stay. As a final comment, I'd like to point out that the discharge is one the most dangerous time during a hospitalization. Medications can be missed, follow-up plans neglected, and instructions glossed over, leading to re-hospitalization often under scary conditions. You don't want that, and neither does your intern. If you use my tactics of getting back (or simply getting at) your intern, you can be assured that your discharge will never be handled with so much careful attention to detail--the poor kid will do everything in his power to make sure that he never has to see your face again.


Intern: first year medical resident
Attending: supervising physician
Pre-rounds: when your intern checks in on you early in the morning before presenting your case to the attending
Attending rounds: when the intern returns to your room with the attending, so that he or she may also see and assess you