I'm sitting in my call room at 1 AM here at the hospital. It's been a non-stop day since I arrived here at 6:15 AM. Dr. O. told me this morning he had worst call night he's had in three years of being a surgery resident. The greatness has continued throughout the day. I didn't stop to take a breath until right about now. However, I'm not complaining whatsoever. I'm actually having a great time, and I'm learning A LOT! Dr. Tidswell is in charge tonight, and he has been exceptionally informative and pleasant. Dr. Perez has also been on his a-game, as we've discussed several topics, most notably the portal venous system (which is basically the blood flow from the intestinal track and spleen to the liver...look it up).

I have amazing patients tonight--one who was shot through the brain and is still living. He is proving to be a challenge, but I think we've stabilized his intra-cranial pressure for the time being. There is no way to know if he will ever recover, but at least he's still alive for now. At least he has a chance which sometimes is all we can ask for in the ICU. I also have a patient who had his portal vein, splenic vein, inferior mesenteric vein, and superior mesenteric vein tied off. I'll explain how difficult a situation that is at a later time. Right now we're just trying to keep the patient alive until his surgery to fix all of that this morning. A also watched a young girl of around 33 years die tonight. The medicine team's attempts to resuscitate her with CPR and heart boosting medications were not enough to bring her back. It was a very emotional situation as the boyfriend was there in the room encouraging his girlfriend to pull through, but it just wasn't to be. This job will certainly be full of ups and downs. There are plenty of ups to speak of as well. I have become friends with a patient who has been here longer than I have. His wife is delightful and I can't wait to tell her that her husband will be transferred out of the ICU (hopefully) tomorrow. That will be a great moment for me, as this patient has really struggled for about a month now, enduring complication after complication. I think he's finally in the clear, and nothing will be more gratifying than to send him to the regular patient floor. I also had lengthy conversations with two of my other patient's families tonight. Being on-call affords me the time to spend with families, which is also very gratifying (for them and me). I get no better pleasure to explain things to the patient and family...especially if the news is good or encouraging. There was plenty of that tonight, mixed with the bad as well.

So this surgery thing is going to be a game of ups and downs. Hopefully the ups will outweigh the downs as I move forward as a surgeon. Things are looking great so far...