It’s getting to the point where, whenever I feel good about accomplishing something or managing a patient well, I start looking for the catch, because that good feeling is usually about half an hour ahead of finding out I did something very bad, or made yet another mistake, or was again unable to present key information to the attending.

I thought I’d muddled through rounds with a minimum of difficulty, until the chief caught me an hour later and asked what had been going on between me and the attending. She had the idea I was in trouble, whereas I had thought I was getting off lightly. I must be reading this attending very badly. He must be more unhappy with me than I’ve perceived so far.

If I could only steel myself to wake people at 4am, I wouldn’t be in so much trouble. But I can’t make myself do it any earlier than 4:30am. Fortunately at that time this morning, one of my patients was delirious, and very happy to talk to me. Unfortunately, I hope I fixed her problem, so tomorrow she’ll be sound asleep. Then I can wake her up. How is that an improvement?

Basically, which is more important: me getting organized and stopping stumbling during rounds, or my patients sleeping for half an hour longer?

Then the medicine folks dumped three nasty consults on us right when we were getting ready to leave the hospital. Admittedly, at least one of them did need to be seen; but I can see how pretty soon there’s not going to be much love lost between us.