At any given moment, the brain has 14 billion neurons firing at a speed of 450 miles per hour. We don’t have control over most of them. When we get a chill...goose bumps. When we get excited...adrenaline. The body naturally follows its impulses, which I think is part of what makes it so hard for us to control ours. Of course, sometimes we have impulses we would rather not control, that we later wish we had.

I have five rules. Memorize them. Rule number one, don't bother sucking up. I already hate you, that's not gonna change. Trauma protocol, phone list, pagers, nurses will page you. You will answer every page at a run. A run! That's rule number two. Your first shift starts now and lasts 48 hours. You're interns, grunts, nobodies, bottom of the surgical food chain. You run labs, run orders, work every second night until you drop, and don't complain. On-call rooms. Attendings hog them. Sleep when you can where you can, which brings me to rule number three. If I'm sleeping, don't wake me unless your patient is dying. Rule number four: the dying patient better not be dead when I get there. Not only will you have killed someone, you would have woke me for no good reason. We clear? Yes?

Rule number five: When I move, you move.

People have scars. In all sorts of unexpected places. Like secret roadmaps of their personal histories. Diagrams of all their old wounds. Most of our wounds heal, leaving nothing behind but a scar. But some of them don't. Some wounds we carry with us everywhere and though the cut's long gone, the pain still lingers.

The thing people forget is how good it can feel when you finally set secrets free. Whether good or bad, at least they're out in the open... And once your secrets are out in the open, you don't have to hide behind them anymore.... The problem with secrets is even when you think you're in control... You're not.

I've heard that it's possible to grow up - I've just never met anyone who's actually done it. Without parents to defy, we break the rules we make for ourselves. We throw tantrums when things don't go our way, we whisper secrets with our best friends in the dark, we look for comfort where we can find it, and we hope - against all logic, against all experience. Like children, we never give up hope...

The key to surviving a surgical internship is denial. We deny that we're tired, we deny that we're scared, we deny how badly we want to succeed. And most importantly, we deny that we're in denial. We only see what we want to see and believe what we want to believe, and it works. We lie to ourselves so much that after a while the lies start to seem like the truth. We deny so much that we can't recognize the truth right in front of our faces.