My last weekend intern call!

It was as bad as I expected...maybe worse. I was up fo 30 hours.

Got to work at 8am. Rounded with my pulmonology attending until noon.

The highlights of my insane night include:

Admitting the mean, drunk homeless guy at 1am who smelled so bad I thought I was going to vomit when I walked in his room. I didn't think it was possible to smell that bad.

Trying to intubate a girl in the ICU with cystic fibrosis and having her jaw clamp so tight when I gave her sedation that I had to paralyze her (by myself) to get the tube in. I was shaking I was so scared. They say you never forget your "first time". Well, I'll never forget the first time to give succinylcholine by myself. One thing that was nice to hear was that the ICU nurse and the respiratory therapist that assisted me said that was one of the calmest intubations they have been in. Little did they know how scared I felt and the ONLY reason I was calm was because they were calm. ICU nurses are truly a gift from God.

Not being able to intubate a guy and having his oxygen sats drop to 20 because he was difficult to ventilate with a bag/mask. I think that's about as scared as I've ever been on call. A stat call to the ER doc saved me (and the patient!).

Getting called at 4am because a new patient with atrial fibrillation suddenly became unresponsive. His oxygen saturations dropped and I had to intubate him without giving any sedation, causing him to have a vagal reaction and drop his heart rate low enough to make us call a code blue. Got him intubated without any problems, and thought maybe he'd had a stroke with the a-fib, but couldn't get him to the CT scanner because his blood pressure was low. I tried to get his blood pressure up as much as I could but nothing worked. 20 minutes on the ventilater he suddenly woke up and started responding to us and answering yes/no questions. He died 2 hours later from what turned out to be a huge clot in his left ventricle.

After all this, I had to round on a bunch of pulmonology patients until noon today.

A hangover feels better than how I feel today.

I'm grateful none of these events happened to me last July when I was a brand spankin' new intern. They would have had to carry me out in a straight jacket.