Surviving: Tips of Internship By Dr. Pete Lim, Senior Medical Registrar, Royal Prince Alfred Hospital, Sydney Originally published in The Intern and Resident Guide 2008 by AMSA
Internship is a bit like the TV show Survivor. Here are the ten golden rules of internship to help you not get voted off the island...
RULE #1: Don’t shit where you sleep. Don’t leave things like admissions and med charts for the overtime shift intern to do, because one day it will be you. Don’t call in sick unless you have a GCS of 3 either, because one day when you are on sick relief, someone will call in sick and you will have to go in.
RULE #2: Load the boat. If you have a patient who is looking unwell and looks like they are going down, make sure you load the boat. Ask anyone and everyone for help, because you don’t want to be the only one on a sinking ship. Remember that as an intern, the only stupid question is the one you don’t ask.
RULE #3: There is no such thing as an urgent cannula (unless there is 3L of blood on the ground...). Internship is about prioritising. It is a busy job and no doubt you will be paged and asked to do a lot of things, often at the same time. Be organised. Also, remember that a patient won’t die if you take 10 minutes to have a bathroom break (most of the time).
RULE #4: One good turn deserves three others. If you are getting a consult for your team, or asking for help, make sure you have worked the patient up thoroughly. If you ask for one consult, a registrar will probably ask you three (or more) questions about your patient or the work up. It’s onlu common courtesy that you have that information sorted.
RULE #5: Don’t sleep with the enemy. This includes nurses, allied health... It can often be difficult, but remember what your role is and draw strict boundaries as to what you should and shouldn’t be doing.
RULE #6: Sleep with the enemy. This includes nurses, allied health... Medicine is a team effort and you won’t be able to survive without the help of the other members of the team. Nurses and allied health staff are valuable members of that team, and not only will it pay off to get along with them to get the work done, but it makes the many hours at hospital more enjoyable.
RULE #7: The consultant is always right (in front of the patient anyway...). Remember that consultants are responsible for patients overall and remember that you are working on their behalf. So be professional in your work and in your behaviour. And most importantly, don’t ever lie to impress a consultant or registrar – you will always, always, always be caught out.
RULE #8: The most important form is your time sheet. You’ve lived through your vow of poverty that is med school. Don’t ever forget to put your time sheet in. It’s the most important but of paperwork that you will fill out each fortnight.
RULE #9: Don’t turn around, or you’ll be stabbed in the chest instead. You will no doubt be aware that medicine is a very small community and if you are unprofessional or lazy, it will be common knowledge before the end of the week. Your colleagues are just that – colleagues so don’t badmouth them behind their backs.
RULE #10: Never drink alone. We’re all in the trenches together. Support your fellow interns and junior doctors. You will have a lot more fun and have a better working year if you work as a team.
And finally, remember that if you’re not enjoying internship, you’re probably not doing it right. Good luck, enjoy and try not to kill anyone.
Almustafa ... had waited twelve years in the city of Orphalese for his ship that was to return and bear him back to the isle of his birth. And in the twelfth year, on the seventh day of Ielool, the month of reaping, he climbed the hill without the city walls and looked seaward; and he beheld his ship coming with the mist. Then the gates of his heart were flung open, and his joy flew far over the sea. And he closed his eyes and prayed in the silences of his soul.
But as he descended the hill, a sadness came upon him, and he thought in his heart: How shall I go in peace and without sorrow? Nay, not without a wound in the spirit shall I leave this city. Long were the days of pain I have spent within its walls, and long were the nights of aloneness; and who can depart from his pain and his aloneness without regret? Too many fragments of the spirit have I scattered in these streets, and too many are the children of my longing that walk naked among these hills, and I cannot withdraw from them without a burden and an ache. It is not a garment I cast off this day, but a skin that I tear with my own hands. Nor is it a thought I leave behind me, but a heart made sweet with hunger and with thirst.
Yet I cannot tarry longer. The sea that calls all things unto her calls me, and I must embark. For to stay, though the hours burn in the night, is to freeze and crystallize and be bound in a mould. Fain would I take with me all that is here. But how shall l? A voice cannot carry the tongue and the lips that gave it wings. Alone must it seek the ether. And alone and without his nest shall the eagle fly across the sun.
Then Almitra spoke again and said, "And what of Marriage, master?"
And he answered saying: You were born together, and together you shall be for evermore. You shall be together when the white wings of death scatter your days. Aye, you shall be together even in the silent memory of God. But let there be spaces in your togetherness. And let the winds of the heavens dance between you.
Love one another, but make not a bond of love: let it rather be a moving sea between the shores of your souls. Fill each other's cup but drink not from one cup.
Give one another of your bread but eat not from the same loaf. Sing and dance together and be joyous, but let each one of you be alone, even as the strings of a lute are alone though they quiver with the same music.
Give your hearts, but not into each other's keeping. For only the hand of Life can contain your hearts. And stand together yet not too near together: For the pillars of the temple stand apart, And the oak tree and the cypress grow not in each other's shadow.
Po Ying Tan-induced lead poisoning: Po Ying Tan is a folk remedy used mainly by Chinese people to treat minor childhood complaints. This folk remedy has the potential to cause lead poisoning due to its relatively high content of lead. Children are more susceptible to the effects of lead. The use of folk remedies is still prevalent in some cultures. Lead poisoning can result in serious illness and even death in severe cases. More detailed information about the symptoms, causes, and treatments of Po Ying Tan-induced lead poisoning is available below.
(Adapted from an article: A Self Assessment Questionaire to Determine Morningness-Eveningness in Human Circadian Rhythms. by J.A. Horne and O. Ostberg, International Journal of Chronobiology, 1976, Vol. 4, 97- 110).
Read each question carefully. Select the most appropriate answer and note the corresponding value next to it.
1. If you were entirely free to plan your evening and had no commitments the next day, at what time would you choose to go to bed.?
2000hrs - 2100hrs..... 5
2100hrs - 2215hrs..... 4
2215hrs - 0030hrs..... 3
0030hrs - 0145hrs..... 2
0145hrs - 0300hrs..... 1
2.You have to do 2 hours physically hard work. If you were entirely free to plan your day, in which of the following periods would you choose to do the work?
0800hrs - 1000hrs..... 4
1100hrs - 1300hrs..... 3
1500hrs - 1700hrs..... 2
1900hrs - 2100hrs..... 1
3. For some reason you have gone to bed several hours later than normal, but there is no need to get up at a particular time the next morning. Which of the following is most likely to occur?
Will wake up at the usual time and not fall asleep again.....4
Will wake up at the usual time and doze thereafter............3
Will wake up at the usual time but will fall asleep again......2
Will not wake up until later than usual...............................1
4. You have a 2 hour test to sit which you know will be mentally exhausting. If you were entirely free to choose, in which of the following periods would you choose to sit the test?
0800hrs - 1000hrs.....4
1100hrs - 1300hrs.....3
1500hrs - 1700hrs.....2
1900hrs - 2100hrs.....1
5. If you had no commitments the next day and were entirely free to plan your own day, what time would you get up?
0500hrs - 0630hrs.....5
0630hrs - 0745hrs.....4
0745hrs - 0945hrs.....3
0945hrs - 1100hrs.....2
1100hrs - 1200hrs.....1
6. A friend has asked you to join him twice a week for a work-out in the gym. The best time for him is between 10pm - 11pm. Bearing nothing else in mind other than how you normally feel in the evening, how do you think you would perform?
Very well................1
Reasonably well......2
Poorly.....................3
Very poorly.............4
7. One hears about 'morning' and 'evening' types of people. Which of these types do you consider yourself to be ?
P.S. The first time I took this test, I was Schizotypal and Obsessive-Compulsive. See, this is what happens when you eat KFC for dinner. P.S.S Wohoo! I'm finally antisocial!
2. "No! My beloved peasant village!" The hero's home town, city, slum, or planet will usually be annihilated in a spectacular fashion before the end of the game, and often before the end of the opening scene.
5. Logan's Run Rule RPG characters are young. Very young. The average age seems to be 15, unless the character is a decorated and battle-hardened soldier, in which case he might even be as old as 18. Such teenagers often have skills with multiple weapons and magic, years of experience, and never ever worry about their parents telling them to come home from adventuring before bedtime. By contrast, characters more than twenty-two years old will cheerfully refer to themselves as washed-up old fogies and be eager to make room for the younger generation.
8. Nominal Rule Any character who actually has a name is important in some way and must be sought out. However, if you are referred to as a part of a posessive noun ("Crono's Mom") then you are superfluous.
11. Let's Start From The Very Beginning (Yuna Rule) Whenever there is a sequel to an RPG that features the same main character as the previous game, that character will always start with beginner skills. Everything that they learned in the previous game will be gone, as will all their ultra-powerful weapons and equipment.
13. The Higher The Hair, The Closer To God (Cloud Rule) The more outrageous his hairstyle, the more important a male character is to the story.
14. Garrett's Principle Let's not mince words: you're a thief. You can walk into just about anybody's house like the door wasn't even locked. You just barge right in and start looking for stuff. Anything you can find that's not nailed down is yours to keep. You will often walk into perfect strangers' houses, lift their precious artifacts, and then chat with them like you were old neighbors as you head back out with their family heirlooms under your arm. Unfortunately, this never works in stores.
19. "Silly Squall, bringing a sword to a gunfight..." No matter what timeframe the game is set in -- past, present, or future -- the main hero and his antagonist will both use a sword for a weapon. (Therefore, you can identify your antagonist pretty easily right from the start of the game just by looking for the other guy who uses a sword.) These swords will be far more powerful than any gun and often capable of distance attacks.
22. MacGyver Rule Other than for the protagonists, your choice of weapons is not limited to the prosaic guns, clubs, or swords. Given appropriate skills, you can cut a bloody swath across the continent using gloves, combs, umbrellas, megaphones, dictionaries, sketching tablets -- you name it, you can kill with it. Even better, no matter how surreal your choice of armament, every store you pass will just happen to stock an even better model of it for a very reasonable price. Who else is running around the world killing people with an umbrella?
26. Local Control Rule Although the boss monster terrorizing the first city in the game is less powerful than the non-boss monsters that are only casual nuisances to cities later in the game, nobody from the first city ever thinks of hiring a few mercenaries from the later cities to kill the monster.
30.Selective Paralysis Your characters must always keep both feet on the ground and will be unable to climb over low rock ledges, railings, chairs, cats, slightly differently-colored ground, or any other trivial objects which may happen to be in their way. Note that this condition will not prevent your characters from jumping from railroad car to railroad car later in the game.
31. Bed Bed Bed A good night's sleep will cure all wounds, diseases, and disabilities, up to and including death in battle.
34. Zap! Most villains in RPGs possess some form of teleportation. They generally use it to materialize in front of the adventurers when they reach the Obligatory Legendary Relic Room and seize the goodies just before you can. The question "if the bad guy can teleport anywhere at any time, then why doesn't (s)he just zip in, grab the artifact, and leave before the adventurers have even finished the nerve-wracking puzzle on the third floor?" is never answered.
35. Heads I Win, Tails You Lose (Grahf Rule) It doesn't matter that you won the fight with the boss monster; the evil task he was trying to carry out will still get accomplished somehow. Really, you might as well not have bothered.
50. Short Attention Span Principle All bookshelves contain exactly one book, which only has enough text on it to fill up half a page.
58. But They Don't Take American Express Every merchant in the world -- even those living in far-off villages or hidden floating cities cut off from the outside world for centuries, even those who speak different languages or are of an entirely different species -- accepts the same currency.
61. Henchman Quota (Nana, Saki, and Mio Rule) One of your antagonists will have three lovably incompetent stooges whom you fight over and over again. Although they're trusted with their boss's most important plans and equipment, they will screw up repeatedly, argue incessantly among themselves, blab secret information, and generally only come out victorious when their job was to be a diversion or a delaying tactic. A high point of the game will come when the True Villain reveals himself and you're able to convince the stooges you're all on the same side. They won't help you out any more successfully than they helped the antagonist, but at least you won't have to fight them any more.
62. Thousand Year Rule The Ancient Evil returns to savage the land every thousand years on the dot, and the last time it showed up was just about 999.9875 years ago. Despite their best efforts, heroes of the past were never able to do more than seal the Evil away again for the future to deal with (which brings up the question of just how exactly does this "sealing away" work anyway, but never mind.) The good news is that this time, the Evil will get destroyed permanently. The bad news is that you're the one who's going to have to do it.
70. Sixth Law of Travel Nobody gets to own a cooler ride than you. If you ever do see a cooler vehicle than the one you've got now, at some point before the end of the game you will either take over this vehicle, get something even bigger and better, or else see it destroyed in a glorious blaze.
74. If You Meet The Buddha In A Random Encounter, Kill Him! When you're out wandering around the world, you must kill everything you meet. People, animals, plants, insects, fire hydrants, small cottages, anything and everything is just plain out to get you. It may be because of your rampant kleptomania (see Garrett's Principle.)
80. Friendly Fire Principle (or, Final Fantasy Tactics Rule) Any attack that can target both allies and enemies will hit half of your allies and none of your enemies.
86.Wait! That Was A Load-Bearing Boss! Defeating a dungeon's boss creature will frequently cause the dungeon to collapse, which is nonsensical but does make for thrilling escape scenes.
87. Supply and Demand Axiom Killing a powerful enemy will usually yield an item or weapon that would've been extremely useful if you had gotten it before killing that enemy.
98. Experience Not Required When the main character is forced to do some complex or dangerous task for the first time, even though he has never done it before he will still always be better than the oldest veteran.
101. Law of Productive Gullibility (Ruby Rule) Whenever anybody comes up to you with a patently ludicrous claim (such as, "I'm not a cat, I'm really an ancient Red Dragon") there's an at least two-thirds chance they're telling the truth. Therefore, it pays to humor everyone you meet; odds are you'll be glad you did later on.
102. Perversity Principle If you're unsure about what to do next, ask all the townspeople nearby. They will either all strongly urge you to do something, in which case you must immediately go out and do that thing, or else they will all strongly warn you against doing something, in which case you must immediately go out and do that thing.
103.Near-Death Epiphany (Fei Rule) If the party is not dealing damage to a boss character, then there's a better-than-even chance that someone in the party will suddenly become enlightened and instantly acquire the offensive skill that can blow the creature away in a matter of seconds.
106.Law of Traps No matter how obvious the trap, you can't complete the game unless you fall into it.
111. Principle of Archaeological Convenience Every ancient machine you find will work perfectly the first time you try to use it and every time thereafter. Even if its city got blasted into ruins and the machine was then sunk to the bottom of the sea and buried in mud for ten thousand years, it'll still work fine. The unfortunate corollary to this rule is that ancient guardian creatures will also turn out to be working perfectly when you try to filch their stuff.
112.They Don't Make 'Em Like They Used To (Cid Rule) Modern-day machinery, by contrast, will always break down at the worst possible moment (for example, when you only need one more shot from the giant cannon to defeat the final boss.)
113.Place Transvestite Joke Here (Miss Cloud Rule) If the male lead is required to dress up like a girl for any reason, he will be regarded by everyone as much more attractive than any "real" girl. If the female lead cross-dresses as a man, she will be immediately recognized as who she is by everyone except the male lead and the main villain.
119. Don't Stand Out Any townsperson who is dressed oddly or otherwise doesn't fit in with the rest of the townsfolk will either:
Join your party after you complete some task,
Be in the employ of your enemy, or
Befriend any female member of the party, and then be immediately captured and held hostage by the villains.
120.Little Nemo Law If any sleeping character has a dream, that dream will be either a 100% accurate memory of the past, a 100% accurate psychic sending from the present, a 100% accurate prophetic vision of the future, or a combination of two or all three of these.
121. Child Protection Act (Rydia Rule) Children 12 and under are exempt from death. They will emerge alive from cataclysms that slaughter hundreds of sturdily-built adults, often with barely a scratch. Further protection is afforded if the catastrophe will orphan the child.
126. Absolute Power Corrupts Absolutely (Althena Rule) If a good guy is manipulated to the side of evil, they will suddenly find a new inner strength that will enable them to wipe out your whole party with a wave of their hand.
138. Well, So Much For That After you have completed your mighty quest to find the object that will save the known universe, it will either a) get lost, b) get stolen, or c) not work.
142. Thank You For Pressing The Self-Destruct Button All enemy installations and city-sized military vehicles will be equipped with a conveniently located, easy-to-operate self-destruct mechanism.
143. Falling Rule An RPG character can fall any distance onto anything without suffering anything worse than brief unconsciousness. In fact, falling a huge distance is an excellent cure for otherwise fatal wounds -- anyone who you see shot, stabbed, or mangled and then tossed off a cliff is guaranteed to return later in the game with barely a scratch.
148. Gender Equality, Part 1 (Feena Rule) Your average female RPG character carries a variety of deadly weapons and can effortlessly hack or magic her way through armies of monsters, killer cyborgs, and mutated boss creatures without breaking a sweat. She may be an accomplished ninja, a superpowered secret agent, or the world's greatest adventurer. However, if one of the game's villains manages to sneak up and grab her by the Standard Female Character Grab Area (her upper arm) she will be rendered utterly helpless until rescued by the hero.
154. Gold Saucer Rule The strongest weapons/items/spells in the entire game can only be found by doing things like racing birds.
155. Evil May Live Forever, But It Doesn't Age Well Even though it took the greatest armies in the world and all of the world's greatest magicians to seal away an ancient evil in an apocalyptic war, once said ancient evil breaks free three fairly inexperienced warriors can destroy it.
168. Way To Go, Serge It will eventually turn out that, for a minimum of the first sixty percent of the game, you were actually being manipulated by the forces of evil into doing their sinister bidding for them. In extreme cases this may go as high as 90%. The clear implication is that it would have been better to not get involved in the first place.
171. World of Mild Inconvenience The devastating plague, noxious gas, planet-obliterating meteor or other large-scale disaster that led to the death of millions will affect your party (and your party's friends and family members) in no way whatsoever, save that a few party members may become lost and you can find them later.
176. "Evil will always triumph, because Good is dumb!" If the villain needs all ten legendary medallions to attain world domination and you have nine of them, everybody in your party still thinks it is necessary to bring the nine to the villain's castle and get the final one, instead of hiding the ones they've already got and spoiling his plans that way. After you foolishly bring the legendary medallions to the villain's hideout, he will kidnap one of your companions (usually the main love interest) and you will trade the world away to rescue your friend.
183. Adam Smith's Revenge By the end of the game you are renowned everywhere as the Legendary Heroes, every surviving government and authority figure has rallied behind you, the fate of the world is obviously hanging in the balance, and out of nowhere random passers-by give you a pat on the back and heartfelt good luck wishes. However, shopkeepers won't even give you a discount, much less free supplies for the final battle with evil.
189. The Moral Of The Story (Ghaleon Rule) Every problem in the universe can be solved by finding the right long-haired prettyboy and beating the crap out of him.
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