Every time a code bell rings, an angel gets its wings

I finished another short run through the MICU. It's what I want to do. For me it is the most bang-for-the-buck, in terms of learning and thinking, in terms of intervention, in terms of patient/nurse/doctor interaction. When you are working a 30 hour shift, and you know that your active patients aren't going to let you sleep much if at all, might as well be busy instead of sitting around repleting potassium. That said, it inevitably comes with soul-crushing disasters: sad stories, sadder families, a feeling of utter powerlessness in the face of overwhelming disease.

It is one thing being busy overnight. It is another being busy and dealing with a flaming trainwreck of a code and then having to wake up a husband and tell them that their wife died. But it comes with the job. I guess some people have to suction septic tanks. We get that.

We get good at having a firm grasp on patients and their diseases. The MICU is the place where that grip is constantly challenged. It's a bad feeling to not be able to get your hands around a new admit. It's far worse to have someone slip out. And I'm on a bad run of that.

The second one

Top 14 albums of the year:

1) Radiohead -- In Rainbows
2) Andrew Bird -- Armchair Apocrypha
3) Wilco -- Sky Blue Sky
4) Arcade Fire -- Neon Bible
5) Budos Band -- Budos Band II
6) Okkervil River -- The Stage Names
7) Dan Deacon -- Spiderman of the Rings (Baltimore's Own!!)
8) Modest Mouse -- We Were Dead Before the Ship Even Sank
9) Caribou -- Andorra
10) Beirut -- The Flying Cup Club
11) Bjork -- Volta
12) Blonde Redhead -- 23
13) The National -- Boxer
14) The White Stripes -- Icky Thump

Also strong efforts from My Teenage Stride, Spoon (whom I don't ordinarily like despite going to school in Austin), Ted Leo, Sigur Ros (despite it mostly being live), Dr. Dog, Deerhoof, The Shins, etc...

I have to say Radiohead gets top spot in my book for the sheer revolutionary-ness of the whole thing. Name your price, eschew label, etc. But Andrew Bird is my big new discovery this year; the album is a pearl and destined to go into my "comfort album" list. Some people have comfort food -- sweet cornbread, fried chicken, turkey and dressing, etc. I have comfort albums that get me through the night or the post-call day: Curtis Mayfield "Superfly", Arcade Fire "Funeral", Pavement "Crooked Rain Crooked Rain", Badly Drawn Boy "Hour of the Bewilderbeest" and a few others. "Armchair Apocrypha" is securely on the list.

And I bought the Iron and Wine 2 days ago so I can't rank it yet.

Recruiting dinner tonight. Drank heavily and ate like a glutton. Life is good for now. It will be miserable soon again.

The first one.

Rather than wasting time on bad TV or trying to find redeeming value in Second Life and rather than being productive like reading or studying for the Step or even signing up for the Step or cleaning the house or even practicing piano, I've decided to start a blog. Mostly because it seems like one of those things you should do to consider yourself internet-savvy. I have no delusions that people will actually read the thing. Nor do I have any delusions that this will be a grand project that I will continue once I get bored with it. Or once work gets busy. Or once the new baby gets here.

I'm a second year medicine resident. I'm in the process of applying for Pulmonary and Critical Care fellowship programs. I'm on my first 2 week vacation of the year, though I had a month for research in August. I spent the first week visiting parents and in-laws. I'm pacing myself during the second week so that I won't be so bored that I'm knocking over liquor stores by the end of it. Mostly, though, I sleep. A lot. Unapologetically.

I've had 2.5 months of q3, 1 month of q4, and 1 month of running a team without call since July 1. So it's been busy. Not as busy as intern year, where I was q4 or q3 for 10.5 months out of 12. There is still a kind of sucking dread associated with July 1, 2006 to June 30, 2007, a Lovecraftian Thing Which Cannot Be Named. It is like there is a giant pair of parentheses bracketing off that year. I suppose it did make me Strong, however, and I'm grateful that those parentheses seem not to be extending around the whole 3 year residency shebang. Although you never know -- it could all be a giant math equation and those parentheses could really be inside a set of square brackets inside a set of curly brackets...

So I'm going to tuck in now. Back to the new Pynchon, made accessible by the wiki. In fact, it is a great utilization of the wiki concept. No more sitting with Gravity's Rainbow on the lap with the Weisenburger reader's guide next to me. Now I get to sit with Against the Day on the lap and the wiki on the laptop open next to me. Ahhh, the march of progress.