Cleaning House

As my alarm rang this morning at 5:15 am...I was decidedly *not* looking forward to going to work! Due to the insanely busy events of the previous call, I was facing the prospect of taking care of eight of the most critically ill patients in the entire hospital, all without the aid of my capable intern Ali (who had by all criteria earned a day off). How long would I be stuck in the hospital? 5pm? 7pm? 9pm? The chances of none of these eight patients crashing and burning during my time there was exceedingly low...

But the stars were aligned, and my list is looking far more manageable at the end of the day. One patient had died overnight--which for the most part was not a big surprise, as he had been coasting along with a blood pH just a shade over 7.15...not exactly compatible with life. Another guy who had been getting sicker and sicker--on top of his alcohol-ravaged heart disease, liver failure, and pulmonary infection we had just discovered a very large stroke covering a good chunk of the right side of his brain--his family decided that he'd had enough and asked us to stop with our resuscitative efforts, which of course we respected. Three other patients had actually improved over the course of the past 24 hours (it does happen sometimes!) were deemed well enough to move from the intensive care setting to more normal places in the hospital, and all of a sudden my list was down to THREE at the end of the day...