Any intern no matter how smart or stupid can quote the the hours regulation. 80 hours max per week. 24 +6 at a time ( 24 hours straight seeing new and old patients and 6 hours to tidy up loose ends) Any intern up to snuff also knows what a crock of shit it is.
Internship was once termed "the last sweatshop" in America, by the AMA no less, and that it still true today. In no other job do you have no right to quit, have forced uncompensated overtime, are denied lunch breaks, bathroom breaks, or the luxury of sleep. We have no protection from abusive bosses or nurses for that matter as shit runs down hill and at the bottom of every hospital is a pile of interns. Complain and you will be thrown to the wolves. There are no truly anonymous ways to fight back. Whistle blowers have been forced out of their residency programs or denied letters from their program directors to get their liscence. We are forced do to it in the name of patient care, because the patient comes first. Ahead of our families, ahead of our selves.
The hours are by far the most painful aspect of my life. I wake up before the sun comes up, before my daughter wakes up and trudge off to a world that will never be understood by outsiders ( though I appreciate you trying). Once there it is a whirlwind of lab results, progress notes, problem lists and admissions. Everyday you hustle, you sacrifice. Then before you know it, you look up and the sun has set, normal people begin the long trek home but not me. If I'm lucky I remember to call home before my kid falls back asleep, if not then I can't help but grieve for my husband who feels like a married single parent. In the hospital there is no distinction between night and day, like some twisted perversion of Las Vegas ( and by the way, what fuck ups happen at the hospital, stay at the hospital). All night long I admit new patients, follow up labs, answer phone calls about patients I have never seen, and replace electrolytes. The one thing I don't do is sleep. Or just rest. I deny myself a most basic of human needs. Before you now it the sun is rising again. I have to prepare for rounds, track down that x-ray, collect vital signs. It's so exhausting. My knees ache in the way that only someone who has been standing for twenty four plus hours can understand. My sense of balance is off because the most primative part of my brain is screaming to just get horizontal for 10 minutes. Even if I can't get sleep , I just want to be horiziontal, maybe even on a bed. After rounds end I start the difficult task of finding the car. Everyday blends into the next and its not unusual to see several post call interns searching for their cars. Like a Seinfield episode magnified by a hundred. Oh and the light. You're so tired that the sun is blinding, you literally can't see. After 24-30 hours of hospital light your eyes just can't make that adjustment. Some interns bring sunglasses. The drive home can be the scariest and most exhausting 20 minutes of call. I never change lanes because I just don't trust my abilities. It's akin to being a drunk driver (A recent study actually proved that being post call is equivalent to being legally drunk). When I get home my daughter smiles so wide, she does a little dance and claps. I try to stay up late enough to put her down for a nap and we sleep together. A little unconscious mother-daughter bonding. My husband gets her when she wakes up because I'm so tired I don't hear her. Sometimes she screams for me, she holds on to the toddler gate and screams Ma, Ma, Ma. The definition of being exhausted is ignoring your screaming child who just wants to see you after she's been waiting all day and all night.
Now repeat every third day, over and over again. For a year.
So why should you care, just one intern bitching about the hours. Because I fell asleep the other day. I fell asleep while driving. I was less than a two blocks from home, I stopped at a stop light and I had pulled my emergency brake (a learned trick to prevent roll back). I guess I set my head down against the steering wheel, I'm really not quit sure it's all a blur. But I woke up to the sound of a little old lady tapping on my driver's side window. Apparently a line of cars honking hadn't woken me up so this poor woman had to get out of her car to come see if I was okay. I can't believe I fell asleep. I can't believe that I was that tired. But what I really can't get my mind around, is that a half an hour ago, I was treating patients.