White cloud

When I was a little kid, we had a yearly raffle at my elementary school that I won every year with such weird regularity that I started to think of myself as lucky. It’s been a long, downhill slide ever since, but when I started residency a couple of weeks ago, it seemed I might have gotten my game back: against all odds, I was a white cloud.  

In hospital slang, white clouds are people who, through good luck alone, have fewer difficult patients on their services and fewer unpleasant call nights. As one of them, my call nights had been easy. I’d been getting more sleep than any person reasonably should on a MICU rotation. I woke up only to tweak antihypertensives or prescribe Benadryl. The code bells, which signify a patient’s need for cardiopulmonary resuscitation (CPR), never rang. Whereas other teams admitted 4 to 5 patients to the MICU each night, the most we ever admitted was one.  

In some ways, this was a good thing. I mean, I like to sleep. But when bad things happen at night, opportunities for learning and doing open up in places where they don’t during the well-staffed days. Being a white cloud gets me better rest, but it does not get me experience. Even as I stumbled sleep-headed out of the call room on mornings after my quiet calls, I knew this, and it gave me a little twinge of regret.

A few nights ago, things changed. In the space of two hours, three patients crashed elsewhere in the hospital. We admitted one of them, along with three patients who came in through the emergency department. I learned to put in a central venous line on a dying man, and thirty minutes later, I put in another one on a woman who’s probably going to make it. I put in an arterial line–my second–and I did chest compressions that actually worked. I didn’t get much sleep. But as I rubbed my eyes the next morning on the way to rounds, it felt like my luck had taken a turn for the better.

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