I had just settled down to read my critical care articles (another subject about which I could stand to learn a great deal more), and was trying to figure out how to pray for something to happen without intending for anyone to get seriously hurt, when the trauma pager started going off. So far we’ve had three patients, increasing in severity, to the point that Brad stopped scoffing at me for haunting the ER, and came down to see too. But in spite of all this, the patients seem to have surprisingly avoided serious injury. Even with serious mechanisms of injury, nothing horribly irreparable has happened.

I haven’t said much about Brad lately, which is kind of unfair, since he’s one of the most important parts of night float. He has some personality quirks; but I owe him a lot for simply laughing at only a third of the silly things I suggest. I suspect that quite often when I call him, he does what I do with some nurses’ calls: listen quietly, and privately wonder when I’ll grow out of worrying about such small things. Of course, when he does lose patience with me, he can be quite cuttingly sarcastic; and always profane, whether he’s happy with me or not. Overall, I’m in awe of his ability to juggle twenty or thirty ICU patients and two feckless interns all at the same time. He seems to know everything surgical that’s going on in the hospital: which vascular surgeons are in the OR till 9pm, when the transplant for the night is coming in, the final opinions of the attendings on three silly consults we saw yesterday, the path report on the appendix from night before last, the urine output of three of my patients, the physical exam of the questionable admission in the ER, the cardiac status of four ICU patients – and on and on. So far I’ve acquired the concept that night is not for sleeping, which seems foundational to the senior residents’ ability to know everything. Some other factors include being endlessly curious about every patient on every surgery service, and particularly every CT scan, which I’m working on; refusing to trust anybody’s signout, but insisting on going and checking on all pertinent facts for yourself, which I’m still a little naive about, not having gotten burnt enough yet; and being on good enough terms with the nurses all over the hospital that they’ll call you, and you can call them to check on anything, which is a more efficient way to check on 100+ patients than walking by every single one.

Overheard the other day: “That’s got to be a chief’s worst nightmare, hearing that your patient is coding, and that Dr. Joe is in the room.” I do not want to become that kind of doctor.