The computer room needs an air conditioner.

No post last night; got home at 4:30 AM after doing my overnight shift. Things slow down around 3 AM, but before that we were wicked busy. It was a warm, clear summer night, just right for running into things, falling off of Go-Karts, and generally causing mayhem. Highlight: 21-year-old K. hit a horse, which then came down on top of her car. Got to help pick glass off, get her off a backboard, and watch the show. Her face is fucked up but will recover. She's going to be fine. Highlight: Dr. H, at the end of his shift, turns to me and says: "I want to thank you. For a third-year student, you've been really quite useful. A lot of them are worthless." Highlight: Felt I performed adequately on my late-night pimping regarding the most cost-effective way to screen someone who comes into the ED with vague abdominal discomfort. No dirty looks, only a fair amount of prompting. It's hard to get into the mindset where one says "If we make an incidental diagnosis of a problem, fine. But what we're really worried about is the stuff that can kill people, so rule that out first." So, our cost-effective workup is the following: An EKG, a CBC, a chest X-ray, an upright abdominal X-ray, a urinalysis (with pregnancy test when the patient is female), and a lipase measurement. That should rule out all the things that can kill you. And I needed relatively decent prompting to think through it. He didn't seem displeased, at least. Highlight: Stopped to chat with a cop who was in for a twisted ankle (make sure it's not broken) and got to hear the story of the old lady who fell, and after two days was still conscious enough to yell "get me off this damn floor" at the police who broke in to rescue her. He said if he saw me on the street with a cigarette, he'd stop me for underage smoking. I laughed. That made at least twice last night I was told I didn't look older than 17 or 18. Then there was the OD, I jotted a few notes down on the spot: Let's call her V. She came in today having taken an OD of something because of her pain. She's nearly 60. Her husband was cheating on her and she kicked him out today. I talked to her , stayed after the nurse left because I felt called to. And for once I knew what to say, listened to her tell me all the things that were going on. And I quoted Hebrews to her and told her I would pray for her. She needs it. She needs that and a good psychiatrist and dear God when I crossed her forehead, let the right I felt be the right of that brief momentary click of the divine. I felt it again, finally. I hesitate to call it a highlight, but it was.something to carry deep in my heart. Highlight (, share the joy): I saw a man today with primary sclerosing cholangitis. This is something we learned in Pathology and figured we'd never see. His wife explained his whole history to me, and let me put on the collection bags to drain his stents. Yay for rare diseases! Driving home at 4 AM I heard a bird chirping. Just one, but it was insistent about it. Window wide open, defrost on high heat (did I reset that, Angel?), and the night just spanning out around me. Ah, beautiful. Oh, and : I know cryptic just drives you nuts, but that would be telling. You'll see at least one of them in toto, soon enough. And now to wrestle up enough will to get lunch before I go out (seems like fast food, even Arby's, makes my stomach all twisty any more), go downtown, and hit the library and the traffic violations court. And if I'm lucky, muster up the energy to hit Curves. Unlikely. Tonight is 4-midnight, tomorrow I do 8-4. I'll definitely go then. I might even go Saturday, to wake myself up. ED is going to do wonders to my appetite. I'm living on ice water and apple juice half the time.