Remembering my first call as an intern on the HIV ward at BIMC in NYC. 9 Linsky. Seven admissions, three LPs for PCP, 2 paras (HCV coinfection), and 2 lines for patients who went to the unit. Staff/uninsured service so attending did chart rounds only. It was hard. 1/ #MedTwitter
In the morning the attending was hyper-critical. Berated us for not performing rectal exams in every patient. Nurses told us, “I’ve done enough IVs and blood draws, it’s your turn now,” and they laughed. We transported patients for tests that we had to beg for. 2/
It was the medicine I had read about in House of God and I assumed the system was operating as it was meant to. I didn’t think I had the power to change it. I cried in the morning, out of fatigue and weariness and a sense of intense foreboding about my future. 3/
The attending took pity on me and said, “you have what it takes.” As if if one didn’t survive it was their problem. A defect. A lack of resilience. We lost two interns to suicide. It was gutting. And since then, Medicine HAS changed. We are the system. We can make it safe. 4/
If you do nothing else as these new physicians enter Medicine and join us, please just keep them whole. Recognize the flaws in the system are ours to fix, and their feelings are in fact their super power. They will show us how we are failing the patients. 5/
Change can be imperceptible from day to day, but from year to year (decade/generation) you begin to see it. Have faith we can be better for each other. Be the change you needed back then and I will promise to do the same. We’ve got this. #MedTwitter
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