Half full or half empty?

I'm writing this from the far side of 6 months of internship. It seems so crazy that it is half over. It sort of begs the question: am I half-way to the amount of knowledge I am supposed to know at the end of this or am I half-way done with the hazing process called internship. Having spent every about 4th night in the hospital for the last 6 months, I know that some of what I say comes from pure fatigue. The funny thing is the way things change that I don't even notice because I am so focused on work, learning new things and not actively (or passively) killing people. Nine-thirty is my new bed-time, meals are rarely sought for enjoyment but simple necessity, I somehow haven't worked out in months and my weight has certainly ballooned to the largest ever....in my life. My tolerance for alcohol has all but disappeared -- now, I was a pretty cheap date before this adventure began but now one good drink and I'm good for hours....until I fall asleep that is!

Other things have changed too. In the last week, I "ran" two codes, meaning I was the first doc to the dying patient and I ordered 10-15 people around to give drugs, put in lines, get an airway and generally try to save the patient. Now, 6 months ago I didn't even KNOW how to do that and now, I wouldn't say I'm comfortable with it, but other residents have said that I "handled myself well". Procedures don't intimidate me as much; I can often help sick patients before calling for help. There are still moments of terror, but they are less constant.

As for knowledge, that feels different. It is not conceivable that I haven't learned anything in the last six months, but I have become so much more aware of what I don't know. Six months ago it felt like a vast and nondescript abyss. It's still a vast abyss but it has acquired some definition that some days make me hopeful that I'm making progress and some days feels so profoundly overwhelming. The knowledge required to be a good doctor is truly infinite: from how to treat a heart attack, to intubating and putting in a giant IV to the cheapest drugs to prescribe patients with no health insurance. I haven't quite grasp how to lasso in the infinite.

Emotionally challenges have gotten a little easier, although I don't know if its better or worse that I don't cry every time a patient dies. I know it makes it a little smoother to get through my days. No matter what your brain says about someone dying, it's always sad. There is always someone hurting over it and it always makes you face your own mortality, with which I'm not that comfortable with. I haven't really had a pediatric patient die yet, but the time is coming. I think that will be a whole other challenge. (Trust me, as it is you don't want to be in my dreams most nights.) As time passes, I just take these moments to be thankful, thankful for my health, the health of my parents and family, the love of those around me and all the luck I've had in my life. I'm thankful now to be taking off for a week with my loved ones and especially thankful that my significant other, Andy, will be moving to Alabama after the first of the year to share even more of this adventure with me. And I'm thankful for another six months to figure all this other stuff out!