Just Drink the Kool-Aid!

by Alexandra Ewenczyk, MD

Eighty percent of people entering medicine do so after being told they should strongly reconsider their choice. I was in that eighty percent, but I went into intern year bright-eyed and bushy-tailed anyway.

“Intern year’s really quite fun!” I’d swear. For the sake of honesty, though, I will now remove my rose-colored glasses and deconstruct intern year by its four major stages. 

1. Live it like a boss.
2. Add carbs.
3. Consider alternate career, i.e. struggling artist.
4. Admit it …. the Kool Aid is tasting pretty good.

  1. Like a boss: The first day of intern year is like showing up to the first day of school and realizing that you don’t speak the language and, coincidentally, you’re also naked. Five minutes into the day, the staff is demanding medication changes. More laxatives! More Dilaudid! This is the time to frantically search UpToDate and convince yourself that your decisions are evidence based. The only thing you can do to make it through the day is smile, order Tylenol 650 mg with confidence, and whisper “like a boss.” Over time (six to eight weeks), you realize that you are throwing in orders confidently and perspiring only slightly more than average (though that could also be the low-dose antidepressant that you prescribed yourself on day 1… like a boss).
  2. Desperation more carbs: I’d be lying if I said my love affair with carbohydrates started in residency. In truth, it’s been a lifelong affair/disease. As I write, I have one hand in a bag of sour cream and onion chips and the other grasping an ice-cold diet coke. This said, rock bottom is 10:00 PM on your first medicine rotation when you realize that the cafeteria is closed and fries will not be in your immediate future. Intern year is an unsettling time with high anxiety. Snacks become your kosher Xanax and when they’re not available, fear of a mental breakdown is very real.  My #1 piece of advice for anyone starting residency: you can’t have too many snacks in your white coat pockets …  and chocolate stains on your shirt are totally reasonable.
  3. Should I drop out and become a struggling artist?This statement speaks for itself. At some point, every intern thinks it may be an easier path to live in a 2×2 foot apartment with a mouse as a roommate. This exact moment happened for me on February 23rd at 17:05 (yes, we use army time in medicine). I think the only reason I didn’t quit was that I was never any good at oil painting, either.
  4. Drink the Kool-Aid! All that said, intern year is one of the most exhilarating and exhausting times of your life. I look back on the days and nights and laugh at the ebbs and flows of my anxiety. When all is said and done, I love what I do and I still find myself getting “butterflies” when hearing about a new study or discussing an interesting case. First I drank the Kool-Aid, now I’m swimming in it.

Nina Wylonis, MD is a second year psychiatry resident at Penn who we appreciate for contributing her signature humor to this issue.

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