Wrapping Up the First Year (3) - An Intern's Perspective
A few months ago, I was still a clueless, bottom-of-the-barrel intern, far more accustomed to being called "student" than "doctor." And on that day, too, I was peacefully doing all kinds of odd jobs in the emergency room. Here, "peace" meant a passive sort of peace—one that came from having absolutely no responsibility to decide a patient's life or death with my own hands. That was just what interns did. Sprinting to the lab with an ABGA sample at three in the morning when the pneumatic tube system was down for maintenance. Processing dozens of backlogged EKG printouts at seven in the morning. Loading a patient scheduled for a 2:00 PM CT scan onto a rattling stretcher, wheeling them down to radiology, and going back to fetch them an hour later. And answering the endlessly ringing phones to pass along messages. That was the daily life of an intern.
But out of everything, blood draws were by far the absolute worst.
"Ouch!"
The needle in my hand missed the elderly woman's thin, fragile vein yet again. It was already my fifth attempt. Her bony forearm was covered in dark purple bruises, like physical evidence of my own incompetence.
"Doctor... do you really have to draw blood? My mother is in so much pain..."
Ultimately, the nurse who had been watching this scene approached me with a deep sigh.
"Intern, step aside for a second."
The charge nurse retied the tourniquet. Then, without a single moment of hesitation, she precisely located the vein I couldn't find. Dark red blood smoothly filled the syringe. I stood beside her, wishing the floor would open up and swallow me whole.
I was the kind of person who poked patients' arms multiple times just for a blood test, only to end up needing a nurse's help, and then returned to the station only to get chewed out by a resident senior asking if I even had hands attached to my arms. The emergency room I had imagined during my medical school days and the reality I faced as an intern were vastly different.
Dramas always made the emergency room look so dramatic. Every single day, patients with stopped hearts would be rushed in, and a genius doctor would miraculously save them. I dreamed of becoming that hero. But reality was different. During the month I rotated through the emergency room as an intern, dozens of cardiac arrest patients were brought into the Resuscitation Room. We performed chest compressions like madmen, poured in medications, and delivered shocks. Yet, out of all of them, only a single person walked out of the emergency room alive. Most cardiac arrest patients were already dead before they even reached the hospital, or, despite all our efforts, they ultimately grew cold on the Resuscitation Room beds.
The emergency room wasn't a place where we only saw dying patients every day, either. In fact, it was quite the opposite.
'My nose has been a bit stuffed up since yesterday. Can you prescribe some cold medicine?'
'My office is nearby. I have a headache from a hangover, so can you just give me a vitamin IV?'
'I looked it up on the internet, and my symptoms are exactly the same as late-stage pancreatic cancer. Please give me a CT and an MRI right this second.'
And the doctors in the emergency room were far from the heroes I had imagined. Rather than heroes, they looked like brawlers, locked in vicious fights with diseases, trauma, and sometimes even the patients themselves or doctors from other departments. They weren't emergency medicine specialists; they were just ordinary human beings struggling to somehow save the single patient in front of them, or to safely transfer them to another department while they were still breathing.
During my internship, many of my illusions shattered. My illusions about the medical profession, about the wonder of life, and even about myself.
At the very beginning, I had wanted to specialize in Emergency Medicine. Back when I was a student, I was obsessed with a medical drama that everyone called a masterpiece. The emergency room on the screen was always tense, and the doctors were always heroes. Even in near-impossible situations, the protagonist never gave up on a patient and saved lives like a miracle. In that drama, I saw the path I was meant to take. That's a real doctor. A person who protects a patient's life with their entire body on the front lines of life and death. That's it. That's exactly the kind of doctor I want to be.
Yes, it was probably because of that drama. Meaning, all of my illusions had stemmed from that well-written script and flashy directing.
"Baek Eun-seo, are you crazy? Emergency Medicine having a good work-life balance is a thing of the past. There are way more downsides!"
"With your personality, if you go to the ER, you won't last a month before running away. Fighting with drunks every night, getting grabbed by the collar by guardians, and cleaning up after patients coughing up blood—that's not your dream, is it?"
Despite the discouraging warnings of countless seniors and peers during my university days, I didn't waver. To my burning sense of duty, their advice sounded like nothing more than the excuses of losers. I actually pitied them, thinking they lacked the passion to throw their entire lives on the line to save a patient like the protagonists on screen. I counted down the days, eagerly anticipating the moment I would step into the emergency room.
But the reality I faced as an intern was more horrific than any hell I could have imagined, crushing me under the weight of a massive, irreconcilable disparity.
In dramas, when a patient with a stopped heart was brought in, the protagonist would rush over and miraculously save them. But the first CPR I witnessed in the real emergency room failed. In dramas, a rookie doctor would save a patient with a groundbreaking diagnosis and procedure, receiving praise. In reality, the first patient I ever performed chest compressions on died right before my eyes. Listening to the professor's flat, emotionless voice pronouncing the time of death, a suffocating wave of helplessness washed over me. I ran out into the hallway, collapsed against the wall, and sobbed. I think I cried like that for a very long time.
The emergency medicine doctors fought diseases and trauma. At the same time, they fought with stubborn patients, clashed with other departments that refused to admit patients, and battled the hospital's strict budget-cutting guidelines. Their faces were etched with a bitter, deep-seated cynicism rather than a noble sense of duty. That reality did more to push me away from Emergency Medicine than any warning from my seniors or peers ever could.
Ah, this isn't it, I finally realized near the end of my internship. The hero I had dreamed of didn't exist in this hell. No, they didn't exist in this world to begin with. I gave up on Emergency Medicine. But I couldn't abandon the path of being a doctor entirely.
Let's at least go to another department that deals with saving lives, I thought. If I wasn't on this hellish front line, if I was in a slightly more organized and predictable environment, then maybe I could get even a little bit closer to the doctor I had dreamed of becoming. It felt like the last remaining way to preserve whatever naive convictions I had left.
Of course, it wasn't that the people in the ER were bad. In particular, the first-year residents I ran into the most were holding out in their own ways. Han Hyeon-jae and Jo Suyeon were kind.
Even when I failed ABGA blood draws dozens of times, Han Hyeon-jae never showed a hint of annoyance. In between seeing his own patients, he would slip over to my side and calmly teach me how to angle the needle and feel the arterial pulse. Of course, he never actually demonstrated it himself. Why was that, I wonder?
Kim Ji-hoon... just always looked busy. He was constantly typing away like a madman in front of the station computer or glued to the phone, making calls.
And Choi Min-jun... just seemed a bit clueless. He always walked down the hallways with a blank expression, and sometimes he even seemed to forget what orders he had just placed. Sorry, Senior. That's just my honest impression.
The first-year residents were all good people. But their exhausted, hollowed-out appearances felt like a warning. That will be me in a year. I absolutely did not want to end up like that. Yeah, Emergency Medicine is definitely not it. That was the firm resolution I made on my very last day in the ER. The moment I walked out of those doors, I would never even look in the direction of Emergency Medicine again.
And then, on that day, a trauma patient was rushed in. Without a siren, without any warning. A man collapsed onto the floor, pouring blood, with a steel rebar impaled in his abdomen. Everyone scrambled, and despair was written on every face. His blood pressure had bottomed out, and his heart was on the verge of stopping. I watched the scene unfold, frozen in the corner of the Resuscitation Room.
See? This is reality, I muttered to myself. This is the true face of the emergency room. There are no heroes from dramas. There are only ordinary humans collapsing helplessly in the face of overwhelming death.
That was when it happened. One person began to move. The first-year resident, Han Hyeon-jae. His voice, his gestures—everything had changed.
"Scalpel."
Everyone froze at that single word. The seniors screamed, asking if he was insane. They shrieked that his license would be revoked. But I saw it. I saw Han Hyeon-jae's hands moving faster and more precisely than those of any surgeon I had ever seen during my clinical rotations. The entire process of pouring betadine and laying down the sterile drapes felt like a work of art. The scalpel held in Han Hyeon-jae's hand saved a fading life without a single shred of hesitation.
He was the only person I could see. A doctor who held a blade in the midst of blood and death, transcending all regulations and common sense, driven solely by the single conviction to save the patient. Ah, this is it. My heart began to beat again. This is the scene I saw in that drama. Of course, it looked different. It wasn't noble like in the dramas; it was desperate, raw, and bloody. But the essence was the same. So this is Emergency Medicine. Only then did I finally realize.
And just like that, I changed my mind. Yes, I made a firm resolution. Let's go to Emergency Medicine. I didn't know if I could ever become like him. I didn't have the confidence to become a monster like that. But at the very least, I wanted to be a doctor who wouldn't run away from the middle of a battlefield like this, standing right behind him. That night, I gathered the shattered pieces of my broken dream once again.