It's a wonderful life

Yesterday I was post-call on a 30-hour shift. It is standard humane practice for the team to round on the post-call intern's patients first so that s/he can leave somewhere around the 30-hour mark. When my attending arrived for rounds she asked,

"Who's post-call?" (Rests her gaze on me and hesitates) "PGYx, you're not post-call, are you?"

"I am!" I said, smiling.

"Wow, you look great! You look the same as you did when I left last night!"

(Picture the same pony tail I'd had since the day before and an unwashed face. It had been a busy night. I was still wearing mascara from the day before, but somehow it had not run or flaked. I had brushed my teeth, at least).

"I must have looked pretty bad last night," I joked.

"Look at her, she even looks happy to be here, too!"

And I was. I smiled as I thought about how content I am to be working in the unit despite the long hours of near-complete immersion in the ICU millieu.

I have so little time outside of work that I've had to discard all but the most essential aspects of daily life. I only just finished my taxes(!) and have hardly spoken to a soul outside of work in weeks. After spending most of my waking hours extensively communicating with patients, colleagues, and family members, I feel drawn to silence when the day is done.

These days the hospital is my home away from home (fortunately it's a really nice hospital). I bring a big bag of nourishing food, wear my pajamas to work, and get to work with a team of some of the brightest and most competent folks -- from nurses to residents to attending physicians -- I've had the pleasure of knowing. I feel a little sad to know that I won't be able to learn more from them next year.

Together, we help bring a few folks back from the brink of sometimes wildly unexpected critical illness, allowing them to return to function in time. Sometimes we keep people alive long after they would ask to die if they could speak for themselves. Other times, we help families to understand when their loved ones are at the end of life.

It's not perfect but satisfying overall and each night I leave work tired but happy to be giving my best effort to patients and their families. My thorough approach is well-suited to caring for very sick people with problems in multiple organ systems. Today one of my attendings told me that I'm "really good at Medicine" and that she hopes I will continue to use it extensively even after I specialize.

I've caught myself entertaining fleeting fantasies of pursuing a Pulmonary and Critical Care fellowship -- in an unrealistic alternate universe where I stay in Internal Medicine. This represents a near-tectonic shift in my perspective. After the initial months of intern despair, I feel so so grateful to have had the opportunity to train in my current program.

Sometimes I find happiness where I least expect it. I'll try to remember that for the next round.