October 27th, 2004

White Coat

I raise my eyes to see the heavens...

...finish that line, O Best Beloved...
Such a beautiful thing, an eclipse, and the moon red as a worn-out cliché, shadows sweeping over it and bringing not darkness, but a sullen sort of light - every moment of sunrise and sunset on this bewildering planet reflected back at the night sky.

imagine a sullen moon, and call it your god
after all, it is light.

It was a strange day, and were it not so late and I needing to drive several hours to dinner in the afternoon tomorrow, I would tell you about it.  I will summarize instead.
Do you think I come across as arrogant?  Resident to medical student.  The politic thing would have been to say no.  I told the truth.  I like this man; I think it is simply that he is the kind of hard-driving problem-solving person who comes into a situation, makes the best of the tools he has, and then presents it with such an air that he trips the fine line between confidence and arrogance.  We discussed it, off and on; he returned to the topic now and again as I wrote an admission H&P on a man who just yesterday was shopping at Marsh with his family.  "Active?" His son laughed.  "He outdoes some twenty-five-year-olds I know."  And yet today we are trying to figure out why this man is barely capable of opening his eyes when you shake him and call his name.  Semi-purposeful movements.  We suspected metabolic encephalopathy.  As the panels came back normal, one after another (including a champagne tap of a CSF read, no red cells and one white), we were not so certain. 
Perhaps it is West Nile.  That would be exciting.  West Nile would be worth having stayed at the hospital until 6:20 PM for.

I have been remiss: My Emergency Medicine Clerkship grade is back.  Honors.  It feels quite good, and from here on out there will be only electives.
And now, O Best Beloved, it is bedtime.  Tomorrow, it begins.
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