Back in the saddle again

The end of vacation means the beginning of my third Va Spa MICU rotation as an upper level. Tell you what, the MICU is just not my thing. Codes, lines, and intubations are too high adrenaline and only serve to age me prematurely. My rheumatology-loving heart just can't take the stress. But my desire to avoid gray hair does not impress the ACGME, so I will take my mandated time in the MICU with a smile, albeit a fake one.
I can't think of anything much scarier than being the upper-level MICU resident. As such, I am the highest level of medical decision-making on the premises overnight. No pressure. But we've all experienced the numbing effect of repetition, and even this insane level of responsibility for human life somehow seems more manageable than it did in July. Titrating pressors, pushing dilt, and dialing vents up and down are just part of the daily routine now. I do confess adenosine* still scares me.
So bring it on, MICU. I can do anything for 24 hours. The sun will always rise and bring the sweet relief of the situation being someone else's problem for a little while.
And in 501 days, I will be living the dream of life as a rheumatology fellow. Have you ever heard of a rheum fellow dropping a central line or rushing to the cath lab at 3am? I can venture to say you haven't. So with my light at the end of the tunnel, I brace myself for the onslaught of MICU call tomorrow night. Good night and good luck to me.


*You push this drug as an attempt to re-set cardiac rhythm, which often results in a brief period of asystole (flat-line) followed by hopefully normal rhythm. This will be the longest 6 seconds of your life, not to mention the patient, who often experiences a sensation of impending doom during the asystolic period.