The benefits of being on night float:

1. The opportunity to wear a skin-tight muscle shirt and scrub pants in the hospital.

2. Not having to dictate discharge summaries.

3. Cancelling clinic.

4. Less work.

The detriments of being on night float:

1. Vampiric lifestyle.

2. Cleaning up the mess made on someone else's patients.

3. Four admissions in a row at 3:30am.

4. Getting paged relentlessly for really stupid things.

I am sooooooo tired, but I survived a long, drawn-out month of CCU!

See? See? I'm still smiling.... At least I was for the ten seconds it took to take that picture.

So let’s review a couple of the things that my doctoring skills have brought forth:

1.  76 year-old female with a past medical history of Diabetes, Hypertension, Chronic obstructive pulmonary disease, coronary artery disease status post Coronary Artery Bypass graft five years ago, Class III systolic congestive heart failure with an ejection fraction of 30%, presents with altered mental status, bradycardia, and bradypnea.  Her medications included, but were not limited to, Aspirin, Carvedilol, Lisinopril, Amlodipine, Lipitor, Coumadin, digoxin, Lasix, and hydralazine:

And she was like:

No, seriously, I shit thee not,

So I was like:

$5000 Miracle on yo ass!

And, within two hours, she was like:

Hells yes.

2.  You know how they all say one never ever ever sees the classic EKG pattern for pulmonary embolism?  Well, they are all wrong:

Yesh, finding this baby got me a whole lotta nurse-love.

And that is the actual EKG.  Recent fracture, resting dyspnea, oxygen-remediable hypoxemia, frothy blood-tinged sputum, Q1T3S3, new RBBB, caved T waves in anterior leads Cu-Lass-ICK.  I dropped tha Heparin wit da kwickness.  And then I got the CT:

Yeah, "holy shit" is right.

3.  Subvalvular Hypertrophic obstructive cardiomyopathy, Eisenmenger’s Syndrome, aberrant coronary arteries, therapeutic hypothermia, Broken Heart Syndrome: the pathology here is insane.  I treated some massive MIs that would cause a red-alert-fire-drill at most other hospitals but barely raises an eyebrow here.  It’s been a hard month, but I’m very glad that I matched here.  Nothing spells gratification like shocking a patient out of torsades arrest three times in one night and watching him survive to discharge fully functional.

4.  Nothing at work, however, would be satisfying if my life outside of work were not a good experience.  July, for me, was a month to build my arsenal of recipies.  I haven’t eaten out for dinner once this entire month.  No, I’ve managed to cook dinner for myself every night, despite my busy schedule. I’ve got the most fantastic recipes on earth, and I eat like a prince.

Two nights ago, I made Chicken with caramelized onions and sun-dried tomato on whole wheat pita:

And, how did it taste?  Fucking delicious.

Last week, I made filet cutlets sautéed in extra virgin and thyme:

And, how did it taste?  Fucking delicious.

The week before that, I made ham Panini on 50-calorie flatbread.

And, how did it taste?  Fucking delicimafuckinfkja;kous.

Thusly, the conclusion you should draw inevitably from this post is that I, clearly, am better than you.

*wink.