“Engage or Run”: Reflections on my Intern Year By Brian Lindman, M.D.
Perhaps the most significant personal transformation of this intern year has been the shift of the fallenness and brokenness of this world from an intellectual apprehension and more theoretical consideration to a monkey on my back that weighs me down, beats me down, taunts me, and dares me to give up and give in. Did I know the world was fallen, cursed, and broken before this year? Yes. Had I experienced it? Yes, but… my experience was far more limited. My life was insulated, with walls around it, protecting me from having to “touch” the brokenness in all its messiness and ugliness. The brokenness I had experienced previously in my own life and the lives of my close friends and family always seemed finite and fixable; it did not seem out of control. Was I wrong to see it this way? Sure, in some sense. Was I blind to the infiniteness of sin even if more “minor”? Probably. But that is not my point here. My point is an existential, internal, emotional one. In some ways, I felt like sin, the fall, and its ramifications were contained. But, over the course of this year, that feeling has been destroyed.
My clinic and inpatient experience is an uninterrupted procession of people with poor insurance, an inability to afford medications, unaware of the seriousness of their medical problems, obese, poorly groomed, smelling, with grandchildren who steal their food, husbands who abuse them, addicted to cocaine, alcohol, or cigarettes, asking for the newest Viagra equivalent to keep up with his 2 girlfriends who don’t know about each other, paging me once a month for a refill on Percocet for chronic pain of dubious etiology, complaining of joint pain while not recognizing that their body mass index of 35 may have something to do with it, letting their blood sugars go unchecked for two years and letting a foot ulcer develop out of control to the point where an amputation is the only option, arrested for drug possession, admitted for an abscess in the groin because there was nowhere else to shoot the drugs than under the skin, not being able to be placed out of the hospital (including to the prison from which he came) because he is such a difficult/manipulative person to deal with, someone admitted from a psych hospital for chest pain where she was involuntarily committed after trying to stab her husband with a knife, a lady admitted with chest pain on the anniversary of her son being shot in the head.
In the face of this, what is one to do? Everything in me wants to run, retreat, disengage, turn off my pager, get these people out of my office or off my inpatient census. I get depressed, impatient, and distant. I get angry at these people because they have so many problems and so many non-descript complaints that I don’t know where to start and I don’t feel like I have the time, energy, or resources to get started. My tendency towards condescension and pride reaches new heights as my
Medical Christian Fellowship 