peritoneal dialysis A procedure performed to “cleanse” the blood in patients with kidney failure, in which fluid is placed into the abdominal cavity and later drained out.
PFC Abbreviation for persistence of fetal circulation, a complex physiological abnormality encountered in newborns who have aspirated meconium.
pH Measure of acid in the blood. Determined routinely as part of a blood gas (see above).
phototherapy A treatment for jaundice of the newborn in which the infant is placed under ultraviolet light; through a mechanism that’s not clear, this therapy lowers the level of bilirubin in the blood.
physsies Internese for physical examinations of the newborn performed in the well-baby nursery.
PID Abbreviation for pelvic inflammatory disease, an infection of gynecological structures. Often caused by gonococcus (see above).
pneumococcal meningitis An infection of the spinal fluid caused by a very virulent and damaging form of bacterium.
pneumothorax Collapse of a lung; must be treated by placement of a chest tube that drains out the accumulated air.
PRN Abbreviation used in medication orders meaning “as needed.”
prolapsed cord Condition in which the umbilical cord passes out through the cervix before the baby. Dangerous because if the cervix narrows, blood flow to the fetus can be blocked, leading to hypoxia (see above) and brain damage.
pseudomonas A virulent bacterium.
P2C2 Abbreviation for Pediatric Primary Care Center, the clinic at Jonas Bronck Hospital.
pulmonary hypertension Increased blood pressure in the pulmonary arteries, usually as a result of heart disease. Is a nonreversible condition that eventually will lead to death.
pyloric stenosis Narrowing of the lower part of the stomach, leading to inability to pass stomach contents into the intestine. Occurs most commonly in first-born male infants during the first two months of life.
q4h When written in a medication order, means “every four hours.”
QNS Abbreviation for quantity not sufficient.
rales A particular sound heard when listening to the lungs through a stethoscope and that implies the presence of pneumonia.
renal biopsy A technique in which a needle is passed through the back or side and into the kidney. Allows sampling of kidney tissue and therefore diagnosis of specific diseases affecting the kidney.
’roids Internese for steroids, an anti-inflammatory class of drugs.
scut A collective term for the routine work that an intern must do.
sed rate Short for erythrocyte sedimentation rate, a test used to determine if an inflammatory disease is occurring.
sepsis Bacterial infection in the blood.
SGA Abbreviation for small for gestational age. Used for babies who have not grown to adequate weight while in the womb.
sickle-cell anemia An inherited disorder in which an abnormality of hemoglobin, the protein that carries oxygen, causes deformation of the red blood cells and serious consequences. (See painful crisis, above.)
sigmoidoscopy Examination of a portion of the colon using a device called an endoscope.
spina bifida Synonym for meningomyelocoele (see above).
status epilepticus Condition in which patient is having constant, uncontrolled convulsions.
straight cath Passage of a tube through the urethra into the bladder to obtain a sterile sample of urine.
strawberry hemangioma A purplish birthmark; these often disappear by the time the child is six years old.
subarachnoid hematoma A collection of blood between the arachnoid membrane and the brain.
subinternship A two-month rotation in the fourth year of medical school in which the student acts as an intern.
suprapubic tap Synonym for bladder tap (see above).
tachypnea Rapid breathing.
thrombocytopenia Deficiency of platelets, structures that aid in the clotting of blood. One of the features of pancytopenia (see above).
tight as a drum Phrase used to describe a patient with asthma who, because of the disease, is having difficulty breathing.
tolazoline A drug used in persistence of fetal circulation (PFC—see above).
tox screen Short for toxicology screen. A test done on a sample of blood, vomitus, or urine obtained from a patient in whom ingestion of a toxic substance is suspected.
TPN Abbreviation for total parenteral nutrition, in which all the nutritional requirements are supplied via an intravenous route.
transillumination Technique used to “light up” a particular structure. Used to diagnose pneumothorax (see above).
traumatic arrest Cessation of cardiac activity caused by a traumatic event, such as an automobile accident.
triage box The place in the emergency room where the charts of the patients waiting to be seen are piled. Patients are triaged according to how sick they are.
trisomy 18 A condition caused by an extra No. 18 chromosome; patients with this disorder are born with multiple anomalies and usually die before their first birthday.
turf Internese for sending a patient to another service.
UA Two meanings: (1) abbreviation for urinalysis, a test performed on urine to see if a UTI (see below) is present; (2) abbreviation for umbilical artery, a blood vessel in the umbilical cord that carries blood from fetus back to mother.
URI Abbreviation for upper respiratory infection. Also known as the common cold.
UTI Abbreviation for urinary tract infection.
UV Abbreviation for umbilical vein, blood vessel in the umbilical cord that carries blood from placenta to fetus.
vagitch Internese for nonspecific vaginitis, an inflammation of the vagina.
varicella The virus that causes chicken pox.
V-fib An abnormal cardiac rhythm, the next stage after V-tach (see below).
VP shunt A plastic tube inserted into patients with hydrocephalus and that drains excess spinal fluid from the ventricle of the brain to the peritoneal cavity of the abdomen.
V-tach An abnormal cardiac rhythm that, if untreated, can lead to death.
About the Author
Robert Marion, M.D., a professor of pediatrics and obstetrics and gynecology at the Albert Einstein College of Medicine in the Bronx, New York, is the director of clinical genetics at both the Montefiore Medical Center in the Bronx and Blythedale Children’s Hospital, Valhalla, New York. He is the author of six published books, including The Intern Blues and Learning to Play God: The Coming of Age of a Young Doctor. He lives with his family in Westchester County, New York.
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Copyright
A hardcover edition of this book was originally published in 1989 by William Morrow and Company.
THE INTERN BLUES. Copyright © 1989, 2001 by Robert Marion. All rights reserved under International and Pan-American Copyright Conventions. By payment of the required fees, you have been granted the nonexclusive, nontransferable right to access and read the text of this ebook on-screen. No part of this text may be reproduced, transmitted, downloaded, decompiled, reverse-engineered, or stored in or introduced into any information storage and retrieval system, in any form or by any means, whether electronic or mechanical, now known or hereinafter invented, without the express written permission of HarperCollins ebooks.
First Perennial edition published 2001.
Library of Congress Cataloging-in-Publication Data
Marion, Robert.
The intern blues : the timeless classic about the making of a doctor / Robert Marion.—[2nd ed.].
p. cm.
ISBN 0-06-093709-2 (alk. paper)
1. Interns (Medicine)—United States—Biography. I. Title.
R153.M37 2001
610’.71’173—dc21
[B]
2001021502
Epub Edition © OCTOBER 2012 ISBN: 9780062243188
01 02 03 04 05 WB/RRD 10 9 8 7 6 5 4 3 2 1
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*Like everything else, the interns’ months are different from other people’s months. In order to allow continuity of care, the interns switch to new rotations a few days before the calendar month begins.
The Intern Blues Page 44