Here we go.

Tonight is my last night of freedom. One could argue that I haven't technically been "free" for years, but one could also argue that being a 4th year medical student is much much easier than being a 1st year resident. In fact, I will argue this right now by stating that being an intern (a 1st year resident) will be approximately one million times harder than being a medical student. Now perhaps I am being unfair and pessimistic, because by "harder" I simply mean more responsibility, more pressure, more stress, vastly more time at the hospital, less sleep, less free time, and more ability to be sued for messing up... so its not really all that bad when you stop to think about it. To be honest, I will also be getting paid for the first time since I can remember.

But this might be the last night when I will be able to calmly eat lime basil sorbet at Sebastian Joes (my current activity) and then plan on calmly making dinner and watching a movie, without being oppressively exhausted. So I am going to enjoy this lime basil sorbet, gol darn it.

Tomorrow I have my first shift in the emergency room, which equates to my first official day as a resident and the first time I will introduce myself to a patient as "doctor." Hopefully, I will not start squeeling with uncomfortable laughter when that happens. My first month finds me on the emergency orthopedic service, which means that I will be focusing on musculoskeletal complaints such as fractures and dislocations and chronic low back pain that must be immediately resolved by narcotic pain killers. It also means that I will be working 12 hour shifts for many days a week. For example, every day next week except thursday I work the noon to midnight shift. And then thursday I have to come back in at 6:30am for conference. Lets just say there will be lots of learning taking place in this upcoming week, starting tomorrow. Lots and lots of learning.

Last week we finished our orientation, which consisted of 2 days of computer training, 2 days of Advanced Cardiac Life Support (ACLS) training, 1 day of watching videos about patient safety and airways, and 1 day of signing documents, peeing in a cup for drug testing, and getting fit tested for respirators, which involved a bunch of new residents wandering around a room with enormous masks over their heads trying to see if they could taste a saccharine solution while bending over, moving their heads around, and reciting prose. It was like a roomful of hazmat astronauts alternately doing calesthenics and reading educational literature. Very early in the morning. But now hopefully I won't get tuberculosis if I wear my little correctly-sized mask.

In the ACLS course I got to learn how to defibrillate (CLEAR!) and manage various flavors of cardiorespitory arrest. There is a very good chance, however, that I will retain precisely none of that knowledge in an actual arrest situation. "Doctor, the patient is in V-fib, what should we do?" "Boy, I don't know. Probably call a doctor or something." A real doctor.

In spite of all my recent training, and my years of medical education, I'm not sure that anything would be able to prepare me adequately for what will happen tomorrow. People use sayings like "diving in" and "trial by fire" and "the shit hitting the fan" as approximations of what will happen when I walk in tomorrow in my scrubs and long white coat, my pager newly affixed to my waist, from which it will be symbolically inseparable for the next three years. We were told to always carry it everywhere, even while off. We were also told to never get sick. Or more precisely, to never call in sick.

So.

Tomorrow.