The Birmingham age-herald., 1907-12-15
STRENUOUS LIE
 IN NEW YORK CITY The Young Interne In the City
 Hospitals TWENTY-F0UR HOUR DAY
The Physicians GrueIling six-Year Apprenticeship-Rea For De- creasing Number of Gradu-
 ates of Medical Schools.

New York, December 14.-What class Of men live the most sstrenuous lives in New York? was a topic recently in the lobby of Broadway hotel by broker, who, with the frenzy of panic activity still upon him, declared that no one was so hard worked as, the man who labors on change. A lawyer pooh-poohed this, and claimed the title for his own profession, while other persons advanced the claims of rail- road men, newspaper reporters and sweatshop workers.> Finally a pbvsi- elan got the floor and described the routine of an interne at one of the city hospitals. Thereupon the company unanimously conceded the palm for strenuousness to the young disciple of Aesculapius.
 The hospital interne, it can safely be said is the hardest worked of all in the city who toll with brain or hands. It Is equally true that the young phy- sician serves the most arduous ap- premiership demanded of any pro- fession. Before he can even enter upon his two years of hospital service he must have had at least four years of hard grind in a medical college.
 As medical student, from the very start he has an intellectual nine-hour day. In the University and Bellevue Hos pital Medical College of New York uni Versity, the largest university medical a pff fnr I. student is busy from o'clock in the morning until o'clock at night. hay ing solid chunks of medical lore hurled at him in the lecture halls working with microscope or scalpel in the lab oratores, or getting actual bedside ex- perience at the clinic of one of the big city hospitals. The only interruption is time for hurried bite of luncheon. On Saturday he may leave Jew min utes earlier. But often he may be found toiling over some bit of labora- tory work until far into the night.
 But it is at the end of these four gruelling years of study, after he is an M. D." and has become an interne at one of the great hospitals of the city, that the student begins the hard est part of hIs apprenticeship.
 Practice Is Essential
 HIS loSullal apprenticeship IS con- sidere1 so essential to a physician that all the high standing men In the med ical sch ools enter into the stiffest sort of examinations to qualify for service at the best institutions. If man is admitted to this coveted slavery, for which he receives no emolument, he will be about 30 yeaw of age when he leaves the hospital, and, as young doctor starts to. build up a private practice.
 Bellevue, the, great free hospital, maintained by the city, constantly has over 50 such internes. The fact that the sick population of this hospital, exclusive of patients at the free dis pensary, averages close to 1000 daily is evidence that the interne's day Is full of crowded hours. The patients are of every nationality in the world, and have collectively. all the ills that flesh is heir to. All social classes come to this house of thousand dis eases. A man whose name is house. hold word for success may be driven. crazed from drugs, In between the grim gates in private carriage at the same time that the ambulance hauls in an unknown hobo. shrieking with delirium tremens. Both become the concern of the white-clad interne.
 The Typical interne.
 The typical interne at Bellevue starts. say, as a junior in surgery. A large part of his time in this position is spent in the laboratory, analysing samples of blood or other fluid taken from pa tients, or gazing at the interior of various parts of the human anatomy with the aid of the X-ray. In addi- tion, in the wards, he makes daily phys ical examinations, gives anaesthetcs, and works at the operating tables. He may be called upon also, in the course of an afternoon, to make as many as 20 dressings for wounds, each of which may require from five to 40 minutes of the most dexterous and patient work. At odd times the histories must be fixed up, for an exhaustive personal record is kept of every patient. The interne must include not only the per sonal history of the patient. his hab- it's, characteristics, past diseases. and a complete diagnosis of his present state. but his family history as we'll There are scores of thousands of these records stored away in Bellevue.
 To attend to all this work the junior in surgery begins his day at o'clock, and, with scarcely a break for lunch, is at his various tasks until dinner, at 6 o'clock. After dinner he tolls again in the wards or laboratories until mid night or later. And even after he has flung himself down exhausted on \his dormitory bed, his snatches at sleep are likely to be broken several times each night by hurry calls to locate a bullet with the aid of X-rays in the body of wouldbe suicide, or to set a splintered bone. or stop an artery.
 The comparative quiet of the rou- tine in the surgical ward is varied by six weeks of service amid the profan- ity of the prison pavilion, the coughing of the tuberculosis division, or among the shrieking inmates of the psycho- pathic or alcoholic wards.
 During this first six months service the interne has much less time to him self than a servant Of two selected at random, for questioning, in Bellevue, one had had three evenings and one afternoon out in six weeks, and an- other one Sunday and eight evenings in nine weeks.
 Ambulance Service.
 From the surgical wards the interne goes to months of ambulance service Ion the bus" 1t is called in the hos pital-then to three months in the gyh- geological ward; next to six months as a senior in medicine. or whatever he is specializing in, and finally six months as "house" incomplete charge of a department and on duty all the time.
 It is while on the bus that the in terne manages to get some fresh air but this period of his existence is probably the most strenuous of all. Bellevue runs a four-'bus system with four physicians constantly on hand.