INTERN by Doctor X. 404 pages. Harper & Row. $5.95.”People think of surgery,” writes the author, “as a grim, tense business
with the surgeon snapping 'Scalpel!' and 'Clamp!' and everything going
along in dramatic silence except for the click, click of instruments.
This is just a lot of hogwash. About half the time the surgeon is
telling dirty jokes with the fixed intent of embarrassing the scrub
nurse. The rest of the time there is bickering, or gossip, or talk
about how things were last winter in Palm Springs, or how many suction
cups on a squid's tentacles, or whether a woman has an orgasm at the
instant she is hanged. Of course, there are times when you just shut up
and work.”From this passage it should be quite clear that Dr. X, a physician now
in practice, has no intention of deifying the man in white. Some of his
colleagues may conclude, though wrongly, that his purpose is to
destroy medicine's meticulously protected public image. The book logs
the author's internship year at an unidentified metropolitan hospital
in the Southwest, just as he recounted it into a tape recorder at odd
moments snatched from duty. Its candor conceals nothing but the true
names of patients and staff. The result is a rare and unforgettable
account of that underpaid, overworked, fumble-fingered and annealing
process by which the medical-school graduate at last earns the right to
practice.Some readers will depart these pages vowing to die rather than set foot
in another hospital. Many of Dr. X's glimpses of what goes on there are
indeed horrifying. An obstetrician funks a difficult delivery, leaving
it up to the intern, who has never presided over any birth at all, much
less a critical one. An addicted nurse steals morphine from her patients.
A surgeon carelessly ties off the wrong artery in a simple operation;
gangrene sets in and the patient not only loses her leg but is charged $3,000
in hospitalization and extra surgery charges resulting from the surgeon's error.Despite such horror stories, the book's effect is reassuring. Once a
week, at 7:15 in the morning, the hospital staff convenes for a
no-holds-barred critique of its own performance. “I wonder how many
laymen,” writes Dr. X, “ever even dream that 60 of the city's doctors
gather voluntarily for the sole purpose of keeping themselves sharp and
on their toes?” For every lapse of skill, Intern cites ten occasions
where a brilliant diagnosis, or a skillful stroke of the scalpel,
frustrated man's ultimate enemy.
