I was prepared for every question, except that one

I don't know what other people see when the walk into an ICU. For a medical student starting third year, the way I used to see it closely approximated Mark Twain's definition of adventure (we're on a Twain kick this week): long hours of boredom punctuated by moments of stark terror. As my exposure to and familiarity with the environment has grown over the past years, I've started to develop a sense for the vast coordinated effort that goes into running this operation. Vast amounts of data, very ill patients, and the inconstant stream of relatives: sad or mad, directive or pleading. But always before I was only there briefly, to pick up or drop off a patient, or to round postoperatively and very quickly.

Yesterday was my first day on the ICU side of this environment. One great thing about the SICU is that it is run by an anesthesia/critical care attending. Anesthesia docs tend to have a healthy regard for balance in life, without the hospital junkie attitude of most surgeons. (And cardiologists, I'm sad to say) So rounds are at 8, signout is at 4, except when I'm on call. This translates to working about 6-4, which is absolutely wonderful hours as a sub-intern. I think I'm going to like this, even if it didn't mean a return to more medicine, and less surgery.

The catch here is, my attending, Dr. Benedikt, is legendary, and not in a very good way, around the hospital, for his style of pimping. Once, last year during surgery, he quizzed me for nearly half an hour (I could see the clock over his shoulder) on the physics of the Bovie electrocautery. So today, presenting my first patient, it was no surprise that despite the reading and preparation I had done, he still managed to ask the one question I didn't know the answer to. *sigh* I guess this will force me to read more on my patients.

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In other news, I've enabled comment moderation. I know it's a bit of a hassle, but some recent comments necessitated it. My apologies.