well-rested

It's a funny thing. It seems that the more careful I am about going to bed early when I'm on call, the fewer calls - and more sleep! - I am likely to get. So having gone to bed at 9:30 last night, I am pretty well-rested this morning, which is a lovely thing. Part of me almost regrets not having a resuscitation sometime last night, since I had promised the Whites to stop by their wee-hours-of-the-dawn Super Bowl party if I was awake. I'm not that sad, though. Sleep is lovely.

It was a busy weekend on call, but a good one, and it certainly could have been more busy, so I was fortunate in that as well. Rounds went smoothly both days - in some ways, when you're the only one rounding, it's easier to find a single nurse who will stick with you for the whole thing - and there were very few admissions. Undoubtedly the most interesting occurrence was in nursery on Saturday. I had been watching a small near-termish baby for a couple of days whose bilirubin (jaundice) levels were rising in spite of phototherapy, and Friday's level was high enough that I was particularly anxious to see the result on Saturday morning. I think I must have called the lab three or four times myself about it before I finally found out that it had continued to skyrocket, and I was really going to need to do an exchange transfusion. For those not in medicine: this is a (time-consuming) procedure whose end goal is essentially to replace the infant's entire blood volume with donor blood - twice, usually - by serially removing small amounts of blood from the baby and replacing it with equal amounts of donor blood. And let me tell you, in 2008, in Western neonatology, it doesn't come to that all that often. I've spent four months in the NICU back home and hung out there even more, and I've never even seen one. The true irony is that I had mentioned to Chuck on Wednesday that I was interested in having him show me how to set one up... and then I didn't follow through before he left for Nairobi.

*** The life of an on-call pediatrician never ends ***

I just got called to a baby resuscitation in the middle of breakfast, and it took long enough that now I'm late for morning report, so the end of my intriguing tale will have to wait until later! Be well, and thanks for praying.