The Intern Blues Impressions

I recently decided to read The Intern Blues. For those who don’t know–and there’s no way you’d know unless you were a medical junkie– this book was a project conceived by medical doctor Robert Marion (known as Bob) back in the 1980’s. At orientation he met three interns, Andy, Amy, and Mark, and came up with the idea for each of them to chronicle each month of their internship into an audio cassette. Through it, they detailed the experience of working at the different pediatric hospitals throughout New York. What results is probably one of the truest experiences of working in a hospital I have ever read in a book.

Disclaimer: I am a certified pharmacy technician who works in the ER. I am not a doctor, and definitely not an intern.

So, to back up and explain for the uninitiated. The year someone spends being an intern is the time they go from being a medical student with little real world knowledge to being a real functioning doctor. Additionally, the year is widely known as an incredibly brutal experience for doctors as they work long hours, acclimate to hospital life, and often have little support beyond each other.

So, this book followed three interns. First, we have Andy. He’s like the valedictorian jock kid you went to high school with. Andy is a natural at being a doctor, even though he’s inexperienced at first. But he doesn’t really want to be in New York. His first choice was to do his internship in Boston, where all his friends, and family are, but things didn’t work and he ended up in New York. He’s not happy about it, and spends the first fourth of the book resenting being there.

Then there’s Amy. She is my absolute favorite. She also has the unfortunate problem that I envision her as Elliot from Scrubs. Amy just had a baby and wants to be a good mom. Unfortunately she’s in a field where the expectation is to prioritize the job over her home life. It was true in the 80’s and is still true today. Add onto that the sheer amount of sexism that she faces as a woman and a doctor and you have someone who’s in for a bad time. Amy spends the book fighting an uphill battle to be respected by her superiors and have her needs as a mom respected. Sadly, she often loses these battles. Which is a shame as I have a lot of respect for Amy. She was the most compassionate of the three and witty as well. I loved reading her describe patients. 

And finally, there’s Mark. He is my least favorite. He’s the class clown who’s constantly angry at the world. His entries are full of jokes that are just either in poor taste, unfunny, or both. I often found myself rushing through his sections, as to me he was unbearable.]

He’s a sad angry clown…get it? I’ll show myself out.

What follows is a grueling year as they work as interns. After all, hospitals are intense places. There’s always too much work and almost never enough staff. Patients are often in bad moods due to not feeling good and/or there not being enough staff to pay them adequate attention. Everyone is overworked and tired, so good luck if you need to flag someone down for something, and if you do, expect to be snapped at or ignored. In particular the doctors talk about fighting with nurses and lab techs. And that’s when caring for stable patients. Factor in the critical patients who roll in with almost no warning, and will die without (and sometimes even with) immediate medical attention. Add typically needing to pee for three hours, and not always getting a meal break, and you have a typical day in the hospital. It’s a very particular way of life that is not for the faint of heart. (Reading this, I love my job but oh god why do I do this to myself?) 

On top of that, in this program, these interns would be on call in the hospital every third night, often being up 24 hours or more. Factor in rounds and clinicals, and this resulted in chronically tired and burned out interns. 

This book documents the doldrums and small battles of hospital life. A lot of books about the medical field focus on weird patients, medical mysteries, and adventures about working in the field. This book is not that. It’s a really quiet read. The months blend together, and the interns field similar complaints day in and day out.  Not that interesting things didn’t happen…Bob does a piece providing context to the events in the book each month, and some wild stuff does go down that the interns fail to mention. They’re just so desensitized to all of it. Hospitals might seem exciting to outside people, but at some point the drama becomes the norm, and not much stands out anymore.

Except when it does. There is child abuse and there is death, and both of these things shake up the interns. I found the interns thoughts on these topics to be interesting. They’re difficult topics for anyone, but it’s a necessary part of life in a hospital. A good mentor and proper training can help make this easier, but that’s something our trio doesn’t have.They often find themselves navigating these situations without guidance. These sections are hard to read, and you can feel the fear and frustration in the interns tackling these topics. After that, it’s back to everyday life.  

Personally, I really enjoyed reading this. That said, I really think this book is for a very particular audience. In the preface, Bob tells us this book is meant as a teaching tool to help loved ones of interns understand what their life is like. In the end, I really think they are the audience for this book. It’s a very accessible story for anyone who doesn’t know much about medicine, and offers a down-to-earth and humanzing view of hospital life. Other than that, without a connection or interest to medication, I don’t think it could hold someone’s interest.

For me though, this book was a very important reminder to me that I’m not alone in the frustrations I experience with hospital life. This book may be from 1985, but many things about hospital life remain the same. I’m hoping to reread this book at least once a year. But that’s me personally. I’m honestly really glad this book exists, even if it’s not what I would call a casual read.

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