Don't bother trying to learn anything

I'm recovering from my first full call day in the medical intensive care unit, the MICU. Call in our MICU is a morning-to-morning shift, which means being awake all night, unless you can justify sleeping. It was a relatively quiet night for us, so we got about 5 hours of sleep-a full night's worth, more or less.

I made my first death pronouncement at 10:35 p.m. last night after a family withdrew care from a woman who was only 48 years old. I hadn't taken care of the patient at all; I just pronounced her as practice.

In the middle of the night, I mentioned to my residents that I was going to read about some subject and could present a little summary of what I'd learned to my team in the mornings. They both looked at me as if I were insane. "We don't do that," one said. "You're not in medical school any more," said the other. "Your quality as an intern is measured by your efficiency, not by how much you read. Don't bother trying to learn anything; when you have free time, sleep, eat, or pee. That's the most we can expect you to do."

Maybe I'm still really naive, but this is not an ethic I'm eager to buy into. I guess it might seem reasonable eventually, but for now, I'm going to keep reading.

Signout, by the way, is short for the transfer of information between patient care teams in the hospital. When one team leaves the hospital and another comes in, the old team signs out-or gives signout to-the new team.