It’s now coming up on two years since I finished residency, enough time to make a little room for some perspective on the whole experience.

My last rotation, and thus my last day was in the ICU. And I think my favorite memory of all of residency comes from that last day. We probably spent about 8 months over three years rotating through the unit, and it was staffed by only our ER residents, which made it somewhat of a unique environment. Our primary attending was this short Jewish woman, whom we referred to as RoRo, (never to her face of course, except for one or two senior residents who had balls the size of mellons). Coming in as interns, we were all warned about her, constantly, by everyone senior to us. “She made three residents cry last year”… “She’ll make you stay until the following afternoon post call”..”She is a Nazi”. I think everybody expected this hulking beast of pure fire spitting attending to walk through the double doors of the unit that first day. But no, it was just the thin framed 5’4″ RoRo with her hot pink iphone.  But she was tough as nails, make no mistake. I did indeed see her make fellow residents cry. On lunch break, all we would do was talk about her various cruelties and verbal beat downs. I never had another attending that was as demanding, or expected more from us than she did. You could get away with absolutely nothing. It was HER unit, and she wouldn’t let you forget that for one second. She was not afraid to get in your face if she thought you were slacking. But to be honest, those times I saw her dress somebody down, they had it coming. They were either being lazy, not paying attention or not caring. So long as you worked hard, did what was right for the patients, she would leave you alone by and large. By the end of residency, I saw her as entirely fair, and  I respected her more than anyone else, and actually came to really like working with her. When she was on in the unit, you knew shit would get done right, you would know what the plan was for each patient, and in the middle of the night, when you called her she would always pick up the phone on the first ring. Rounds with her were a bear, lasting forever, starting at 8:30 am and lasting into the afternoon (for a 20 bed unit). But so long as you demonstrated that you knew what was going on with your patients, knew what the consultants had said, what the labs were showing, you could expect to be relatively unharrassed. But god help you if you forgot to check the previous notes, hadn’t looked at the xrays. You would get dressed up and down. Do it more than once and you were likely to be forever on her shit list.

Some residents had a really hard time with her, feared her, had panic attacks over her and doing rotation in the unit. But these were often the ones that weren’t paying attention or had no idea what was going on. To me that sounds perfectly fair. I don’t think I was a particularly smart resident, but with her, I paid attention to detail. When I was senior resident, I ran tight rounds myself, closed loop communications, updated rounding lists, tight ship all around. And for that, she and I got along great. I loved when she was on in fact. It wasn’t fun, but you knew things were going to run right. There were other attendings who were an absolute blast to round with. I think I never laughed as hard as when this one guy was on. But you had absolutely no idea what was going on with the patients. Rounds were a laugh fest, but also a total shit show. Call him in the middle of the night and expect useful help? Forget about it.

At one point towards the end of third year, RoRo pulled me aside and asked if  I thought she was being too tough on the resident. Apparently some of the medicine residents had filed a complaint against her. I would have backed her up 100% if ever called on, as she had backed me up so many times before. I’d never actually seen a sign of affection from her towards anyone. A lack of critique was the equivalent of a “good job” from her. And this breif moment of candidness, felt overwhelmingly flattering at the time.

Anyways, last day of residency, I was on 24 hour call. I presented all my patients to RoRo in the morning, and as I was packing up my things, the team started to round. I gave a cursory wave, having already said goodbye to the other residents, when RoRo called out “Wait, don’t I get a hug?”  A couldn’t tell if she was kidding or not. When she actually put her arms out… The look look on everyone else’s face … “Wait, is this really happening right now?” Getting a hug from the cold as steel, ice in her veins RoRo, is probably the best feeling I ever had as a resident, and ironically my last, as the next moment I was walking out the doors of the unit, officially done with residency.



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