I look down the signout list in preparation for the day. My heart sinks and I feel myself sweating. Palpitations ensue and I have to stop and take my pulse and an aspirin. No, I’m not having a cardiac arrest. At least not yet. The patient in room 1 stole that thunder already.
Am I back in the adult ED again this month? Nope! PICU is the flavor of the month! Back into the world of rounding for hours on every system of the body, discussing vent settings, sedation drips, whether or not to diurese, whether or not to feed, whether or not to extubate; and yet all of those things are not why I opted out of doing a PICU fellowship. The medicine is great! I love a challenge, and these patients are certainly not disappointing me in that way. I am in way over my head and being inundated with a dictionary of words from a language that I have not used in several years. So why the heck am I so exhausted when every day is a steady adrenaline rush?