Brian Secemsky, M.D.: Day 1 of Residency: Go

As this is the season for spanking-new physician trainees to flood hospitals around the U.S., I decided to chronicle my own very first 24 hours as a doctor so the reader can get a better insight into this annual event.

2000 hours, evening before first day: With my newly-starched white coat, stethoscope and light pen packed neatly into my Tumi man-purse, I make believe that I am sufficiently prepared for the first day at the hospital. As a precaution, I look in the mirror once more to greet myself as "Dr. Secemsky." Again it sounds fake, and I continue to believe I am an imposter. I proceed into my bedroom by 8:15 p.m. as if I've always turned in while it is still light outside.

2000 - 2200 hours: I convince myself that by skimming a medical textbook in bed eight hours prior to my first day as a working physician I will somehow bring back the 10,000 teaching points I had learned throughout medical school. I quickly discover that this is not the case and begin skimming the equally intimidating Game of Thrones. I fail at this as well and turn off the reading light.

2200 - 0200 hours: Insomnia ensues. This episode is different from past occurrences, as if every bit of my subconscious effort is focused on delaying the inevitability of the coming day. I begin the old routine: changing positions every five minutes, taking off and re-wearing socks, tapping my fingers to the most recent radio hit (clue: It wasn't not to Carly Rae Jepsen). I get up and stumble toward the mirror in order to try on my new doctor title once more. It sounds even more pathetic watching my reflection mumble barefoot while draped in an old Alf T-shirt. I stumble back to bed.

0530 hours: I wake up to three blaring alarms, as scheduled. I am at first convinced that I haven't slept a wink. Then I remember the dream I had of heading back to my family's home outside Chicago after being fired for inadequacy. I now wish I hadn't slept at all. I shower while absentmindedly humming Meatloaf's infamous ballad "I'd Do Anything for Love (But I Won't Do That)." I question my emotional stability.

0600 hours: I head to the coffee maker and begin my daily brew. I stop halfway. The vow to avoid coffee and cocktails for the first few weeks of residency emerges from the depths of my weary brain. I boil some hot water and reluctantly sip stale hibiscus tea I find in the back of the cabinet.

0615 hours: Carpool full of first-year resident physicians (interns) arrives to pick me up. I enter the car and nod a greeting to my new colleagues, joining the nervous silence. I am relieved not to be the only one in complete despair of the coming day.

0630 hours: Arrive at the hospital and meet my team of senior residents. Handshakes and shoulder pats soon follow my entrance. I do my best impression of looking casually happy to be there. I can only muster a half smile, half grimace while awkwardly hanging my thumbs from my belt loop. Afraid of smelling like fear, I amble toward the furthest seat from the conference room table as the team begins discussing the patients on the floor.

0635 - 1130 hours: Names, conditions and management decisions fly by me left and right as if I am Matrix-ing past any comprehension of the day's events. My fellow senior residents must have sensed my obliviousness as they are now penning down all the information for me to keep in my white jacket. By the time I am ready to make rounds, I end up looking like an origami figure, full of contorted papers sticking out in all angles from my jacket pockets. I look ridiculous. I head out to meet my first patient.

1130 - 1200 hours: I am lost in the hospital.

1200 - 1230 hours: More of a serendipitous discovery than a planned event, I stumble upon Ms. B's room. I strut up to my first real patient as a physician, puff out my chest, cross my arms and wait for myself to make a grand introduction. I do not make any such statement. In fact, I stand foolishly in complete silence while poor Ms. B throws me a tired look of acknowledgement. "You must be my new doctor." I resist the urge to turn around looking for such a specimen. Instead, I clear my throat and begin my meticulously practiced monologue. "Hi Ms. B. I'm Dr. Secemsky. I'll be your physician while you're here at the -- "

Ms. B immediately cuts me off. "I'm thirsty. Get me some orange juice." I jump at this opportunity, as this is something I feel I can handle without consulting the senior resident.

1230 - 1250 hours: I am lost in the hospital.

1250 hours: I return with apple juice. Ms. B lets off a distasteful grunt as she takes it from my shaky hand. It is obvious to me now that she is in complete control of this new doctor-patient relationship. I am somewhat relieved by this fact.

1250 - 1850 hours: I finish interviewing and examining Ms. B and make rounds on the rest of our teams' patients. As I still feel unfit to make real medical decisions without my senior physicians' input, I stick to the nutritional aspect of their health. This essentially involves making now-familiar refreshment runs while intermittently getting lost in the labyrinthine hallways of the hospital. I question the difference between my present position and that of a medical student. I quickly come to the realization that title means nothing without experience.

1850 - 1945 hours: Evening sets in at the hospital. I sit down at a resident-designated computer to document my patient encounters. As I write my notes, I am amazed at the actual work that has been done. Besides ensuring that my patients were well-nourished using all the juice that I could pillage, I was able to independently examine my patients, answer their questions of care (with the help of my senior residents) and establish what I hope to be an enduring and meaningful relationship throughout their hospital stay.

2000 hours: I return to my apartment, toss my bag in the nearest corner, and head straight toward the mirror. I look directly at my reflection and greet myself. "Hello Dr. Secemsky." I turn around to enjoy the rest of my evening before the coming workday.

* The patient's name in this piece was changed in order to maintain confidentiality. Many of the details above were an exaggeration if not a complete fabrication of the days' events. The first real day on the job was such a wonderfully normal day that it does not merit publication.

For more by Brian Secemsky, M.D., click here.

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