Special: The Thinker
Housestaff Morale:
Is It Getting Too High?
by Mort Kandless, MD

Dr. Mort Kandless

Note: Dr. Karl Newman, Q Fever!'s Internship & Residency correspondent, is on leave for psychic fugue this month.

As Summer turns to Fall, so turns Fall to Winter. And, by the transitive property, so turns Summer to Winter. Which is not to say that there isn't a brief stopover in Fall, but... may I suggest you bring a parka and something for your ears just in case!

And so here we stand at the cusp of spring, having endured another winter, during which the sun was at times so far south of the equator that the only daylight occured during a half-hour stretch of noon conference.

Yes, winter's finally over, and housestaff morale is soaring. No, not snoring... but soaring, as in a bald eagle that has lept from high atop a mountainous ridge, then been swept into the jet-stream, only to be deposited in a garbage dump in Newark.

On a recent stroll through a medical ward at my institution, loud cheering could be heard from the waiting room as students and housestaff developed a differential for an otherwise healthy male with new onset fatigue, rash and splenomegaly.

I believe they eventually agreed upon Rocky Mountain Spotted Fever, which was later confirmed by serology, and led to such a high degree of satisfaction that the senior resident bought a round of half skim/half whole/half capp, double-shot lattes with frangelico for the whole lot of them.

And that's not all. The MICU code leaders have apparently been sneaking into morning report even though they're not technically invited. I've even seen them skip meals to review hyperosmotic hypovolemic hyponatremia with their interns.

And those same interns are apparently publishing some revised guidelines for the use of that god-awful formula to correct a person's salt level.

What's this all about? If such purulent enthusiasm continues, extreme measures may have to be taken to reduce the number of housestaff on rounds and at conferences.

This is residency, for crying out loud, is it not?

Perhaps night float should be eliminated so that teams admit 24-7.

Or maybe housestaff should just plain be beaten and whipped. We can't have the public thinking it's all fun and games in here. This is about life, death and the occasional stale doughnut.

But I'm confident that the allergy-ridden days of spring, coupled with the specter of another lonely Easter, will be enough to bring the housestaff back to their baseline of utter misery and dissatisfaction.

In the meantime, there must be SOMETHING to complain about.

I'm Dr. Mort Kandless... and that's what I think.