countdown

this has been a month of firsts and countdowns. i managed my first cardiac arrhythmia this month. i prescribed my first 'big gun' drug without asking if it was the right decision. i helped my first family along in the decision to withdraw care from their braindead daughter. i pronounced a person dead for the first time. i really feel like i've taken some huge independent steps in exchange for long hours and hard work, and i'm proud of myself for that.

but i am counting down, too. counting down micu calls; at the moment, i am 4 down and 2 to go. counting down patients, whether they go out to the floor or out to the morgue. the need to discharge has grown to mythic proportions as each patient represents hours of work each day, dozens of numbers to sort through, too many failing organ systems, each with a corresponding specialist to keep up with. i'm counting down days, too; 11 more until i start dealing with sore throats and runny noses again and leave all the critically ill patients behind me. and did i mention counting down hours of sleep? i've started to do it subconsciously. 10pm already? that's less than 6 hours of sleep. 11? less than five.

this has not been the month of hell that i thought it might be. i genuinely love being challenged, working hard, although i do confess a terrifyingly strong urge to be careless at 3am in the name of perhaps a few moments of sleep in a too-intense 30 hour shift. but i am getting better at thinking in the middle of the night, and that is progress considering a few months ago i could barely make it through a doorway post-call without catching at least one shoulder on the doorframe.

to sum up? i am staggering less. i am whining less. and i think i know more today than i did yesterday, and that, my friends, is more than a little victory.