Comfortable shoes. And pens.

I only just barely manage to survive every 30 hr shift. Like a desert nomad or an island castaway, one develops strategies to hang on to life, even if it is just a bare semblance of what your life used to be.

This means routines. How to admit patients. When to sleep, if at all -- do you take your chances before all your patients are tucked in for the night, leaving work for the morning, or do you push it back till 5 AM, when you will most likely be interrupted several times by the lab reporting critical values and the nurses trying to square away everything before shift change at 7? Scrubs when the clock strikes 6PM for the interns. Dinner at the same time every night, if possible (I like to eat late). Sleep vs breakfast vs shower. There's rarely time for all 3, and usually not time for 2.

For me, I have a thing for comfortable shoes. I know exactly which shoes I can make it through call in, and which ones to avoid. I wear Merrells for most calls, because I don't have to lace them if I go to sleep and need to jump out of bed for a code. For the unit, where we have long rounds and we don't walk around the hospital all that much, I wear Naot clogs. Not the most fashion conscious choices, but just a survival strategy.

For me, another big thing is pen selection. We still hand write admission and progress notes, so this is big. Since I am a loser of pens, there's no way that I'm going to use nondisposable pens. Many residents start with the Pilot G2 .07s. I kind of have micrographia so I quickly moved on to the micro point (.05). In my opinion, though, there are a number of problems with this pen. The first, universal to all gel pens, is that they run out quick. They last only a week or two at most. Second, there is a relatively high failure rate for the roller ball -- you'll be using the pen a few days and then it gets either unusuable as it will start to sputter. More importantly, though, is that the G2 is prone to leak. When you are wearing a white coat, leaked black ink in the bottom of the pen pocket is a sign of the G2 user. After my third lab coat done in like this as an intern, I switched to the Uni-ball Signo 207 .05 pens. They do not leak, but there is a relatively high failure rate still of the roller ball. At around $2 a pen, this irks me. Two problems with this pen is that I have yet to find them in bulk at Staples and they cost too much. Like the G2, they are refillable, but I'd rather have a fresh body for the $1 I will save by refills.

Just in time for my Last Call Ever (hopefully), though, I have two new candidates. Today at Target they had the Pilot G2 0.038 Ultra Fine. Enough to make me reconsider the G2. I also picked up the Sharpie Pen fine tip, which I am very excited about.