Inspiration
I found a random spam email containing an intriguing document- I cannot ascertain the author’s identity, but here is the document in full.
A C@*l to Arms
In January 1961, then president-elect John Kennedy delivered one of the most iconic speeches of the 20th Century, encapsulated by the line, “Ask not what your country can do for you – ask what you can do for your country.”
Kennedy made this speech during the height of the Cold War, amidst the uncertainty of the accelerating nuclear arms race and rising geopolitical divisions spanning the globe. Now, more than sixty years later, much has changed – the Soviet Union has dissolved into its constituent republics, East and West Germany have reunited, and the United States has emerged at the forefront of nations.
However, some things have remained the same. A quarter-century into the new millennium, John Kennedy still reigns at the top, not as the 35th President of the United States, but rather of the Stony Brook Orthopaedic Resident hierarchy.
In contrast to that of many other programs, Stony Brook Orthopedics utilizes an atypical duumvirate as two fifth-year residents are granted the power to serve in the “Chief Resident” role; this structure echoes the diarchy of ancient Lacedaemon or more perhaps more closely resembles the consulship system of the Roman Republic.
These two Chiefs, accompanied by the rest of their cohort and the entire fourth-year cohort are together known as “Senior Residents”, or “Seniors,” in contrast to those residents in the lower resident hierarchy – first, second, and third-years – termed “Junior Residents,” or “Juniors.” At the very bottom of this caste system are the first-years, or “Interns.”
There is a significant distinction in role and power between these two main classes of residents not unlike the traditional divide between the plebeian and patrician classes of S.P.Q.R. Seniors wield immense imperium over Juniors, with terse commands such as “Change the dressing” or “Do the consent” being commonplace and expected, to even extrajudicial punishment in the form of cumulative “Strikes” for infractions both minor and severe.
Nevertheless, any righteous society depends upon a set of norms and values that must be enforced through law and order. That there exists a power divide between Juniors and Seniors, or even a wider hierarchy within the field of medicine that goes beyond that of residents (encompassing other medical staff members – nurses, physician assistants, attendings, et cetera) is but a neutral observation made by the author. The goal of this document is not to flatten the resident hierarchy through inciting revolt amongst the lower resident class – rather, it is to provide a sense of perspective to the reader before delving into the crux of the issue.
One Word, however, differentiates Itself in Its wickedness, Its implications, and the devastation provoked through Its presence.
C@*l.
C@*l is the bane of the existence of a Junior Resident, the thorn at the side of a Senior Resident, and a periodic irritation to an Orthopaedic Attending.
At Stony Brook University Hospital (SBUH), the brunt of C@*l is borne by the Junior Residents, who serve as the first-line of defense against long-bone fractures, hand lacerations, and cord compressions. The Senior Resident serves in a supervisory role, in charge through not one, but two twelve-hour guard shifts, while the Attending Physician forms the final line of defense, coming in only in cases of operative urgency or emergency.
Thus, the working relationship between the Junior and Senior Resident during the C@*l shift is of utmost importance, and appropriate delegation of responsibilities and clear communication between the pair of residents can often make-or-break a busy day/night at the hospital. Moreover, a stellar Senior Resident can buck the traditional trend of “trickle-down” delegation and actually save the Junior significant time and effort, a magnanimous investment that often rewards the Senior with more bountiful rest later in their shift and endless paean from the plebeian class.
Now, we are in the midst of the season when it is the traditional role of the Interns to hold the Pager, a task that has been assigned to these first-year bottom-dwellers in the back half of their year. This is a true formative experience, a trial-by-fire, to emerge out the other side with nerves and ability tempered by four weeks of C@*l, also known as “Hell on Earth.”
As we are approaching the dreaded summer months, as rising temperatures directly correlate with kids slipping off monkey bars, grandmothers tripping over their walkers, and motorcyclists misreading speed limit signs, there will inevitably be the days when stars misalign and C@*l becomes a nightmare of nightmares! These are the days when even the best of the patricians cannot put out the flames spreading throughout the emergency department.
On these days, it is easy to ignore an Intern’s request for help, to view it as but the wailing from the lowest of the low of the Resident body. Thoughts of “But my Seniors didn’t come help me when I was an Intern” might and likely will course through the minds of most in the Residency. But, harken! Do not give in to this temptation.
It is precisely in these trying times when we must all think back to our own personal histories, of our very own stint on Pager as an Intern, that dreaded month, those endless days, that no doubt still emerge sporadic@*ly in form of night terrors and post-traumatic stress, and respond when the c@*l for help rings out.
To paraphrase the timeless words of our co-leader, John Kennedy:
“I do not shrink from this responsibility – I welcome it… the energy, the faith, the devotion which we bring to this endeavour will light our Residency and all who serve it – and the glow from that fire can truly light Stony Brook Hospital.
And so, my fellow Residents: ask not what your Pager Person can do for you – ask what you can do for your Pager Person.”
Thank you.
Reflection
Well, that was certainly an odd, rambling piece. I wasn’t sure if I should add it to this website or not, but maybe a reader will come across it and will be inspired to do something (positive).