Forethought

Medical internship is an initiation, a ritual endured: in hospital wards, operating rooms, outpatient clinics, and in emergency units, the young inexperienced doctor is cast headlong into a direct confrontation with illness and death.

While this would be true for interns working in almost any hospital, interns in South Africa face perhaps a broader spectrum of damaged humanity: from the humblest shack-dweller to the mighty millionaire, the hospital intern is required to bestow on each an identical level of care, while each patient provides the doctor with a unique interaction, every experience a tale of its own.

These stories, from my own years as a Student-Intern and then as a newly-qualified doctor, a Medical Intern, in Cape Town in the 1980s, will hopefully pull back the screen a little and allow a peek into the array of conundrums faced by a naive young doctor-to-be as he traverses the interminable corridors, being moulded within the crucible of hospital internship.

Grahamstown

South Africa

November 2019

Introduction

After half a decade of medical school, we encountered the penultimate challenge: Final Year, the clinical year, eleven in-hospital months before facing the fear of Final Exams. We had been wholly ejected now from the campus of the Illustrious Medical School, leaving in our wake the lecture theatres, laboratories, medical library, and cafeteria, which, over the preceding five years, had become our stamping-ground.

Since our arrival here as naive Freshers we had played out our teens and early twenties, trudging the uncertain paths of academia, overshadowed continuously by the great old training hospital (The Grot), to which we most of us were headed. The Grot, seemingly, at last, content with our recently acquired, paper-thin academic knowledge, now opened her maw, as she did each year at this time, and consumed us, her latest intake of final year medical students, (aka Student-Interns) entirely. Once entwined within her wards, clinics, and operating theatres, we were supposedly to cement our bookish, newly-minted knowledge by the bestowed privilege of hard work. We would, it was expected, be rendered capable practicing physicians, well, capable of passing our final-year exams anyway.

On our first day as Student-Interns, we were berated for an hour or so by several stern looking medical superindents, and then presented, briefly, with several serious looking documents: indemnity forms, confidentiality agreements, applications for parking discs, and such. Having signed our lives away on the various dotted lines, we were assigned in groups to each of the major iatric disciplines, held captive in each for blocks of two months. For the first block - surgery, a handful of us were privileged to be allocated to one of the Grot’s particularly prominent surgical firms, one headed by a prodigioulsy intelligent young English gentleman…