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Until recently, I didn’t know what it felt like to get 4 pages at the same time.  The pager makes this high pitched whining sound like it’s about to die.  By now I’ve almost reached the point where not much surprises me.  I know that if it can go wrong, it will.  If it can bleed, it will.  If it can stop beating, it will.  You get the point.  I’ve gotten more to the point where I am more limited by the number of hands, arms, Mudphudders I have to deal with this stuff.  What do you do overnight with essentially no oversite when you’re taking care of >40 patients most of whom could realistically crump?  (FYI, crump = really bad stuff–usually involves “shocking” someone or getting a machine to breath for them).  What do you do when you get 4 pages at once and all are about pretty serious stuff?  I gotta tell you, I’m glad I’m doing this stuff now and not earlier in the year.  It really tests one’s ability to triage problems.   It’s a great challenge.  But sometimes you gotta wonder how much of a razor thin margin of error there is for holding off on attending to one patient because you’re treating the other.  I mean, it feels pretty scary sometimes but I suppose the system (residency) is built this way for reason (i.e. maybe it’s not as bad as the butterflies in my stomach make it out to be).  At least I hope so.  Still though, I wonder how many is too many?   How much is too much acuity?   I think there are definitely services at every academic teaching hospital that push this limit all the time.   To be the physician on one of these services, though–wow.  It’s an amazing experience–exhilirating, exhausting, awesome.  Tremendous learning experience.  Running on adrenaline.   Like walking on a tight-rope.   I just hope I don’t fall off. 

Enough–I’m going to bed now.


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