I can’t believe I’m done with the medical ICU for this year (still got cardiac ICU but that’s for another month to deal with). It was busy, and when your body hadn’t done 28 hr calls in a while, it takes some adjusting.
And when you’ve never done a 28 hour call before, it’s a rough transition. This was the first rotation where I (finally) had an intern yay. He had never done 28 hours, and he wasn’t a fan of the call to say the least lol.
The poor guy asked “when do we eat dinner?” / “when do we nap?” on our first 28 hr call together, and I told him, “when our ICU patients are stable” (which never follows a normal meal or bedtime schedule).
I sent him downstairs to go eat dinner at 11pm while I finished night rounds with the attending, so he wouldn’t pass out from hypoglycemia. Rule number one – carry infinite snacks.
We never did get to sleep on any of our 28 hour calls, but I did cover his pager at night and sent him home early a few times on our non-call days at least. Rule number two – keep the intern alive.
There’s a certain level of stamina you just build up – with each 28 hr shift your body gets used to it … although there’s a certain point after X number of 28 hr shifts which your energy reserve goes down.
Yale Internal Medicine is not one of the residencies where you’re always doing 28 hr calls and working over 80 hrs a week thankfully – I definitely believe there’s a certain number of hours after which learning plateaus. The next cycle of 4th year medical students have just submitted their applications (man, that seemed so long ago!). I always tell the applicants a healthy work life balance was important in when I ranked my residencies – enough patient volume/autonomy to learn of course, but also enough faculty support in our well-being.
After all, a burnt out resident is no fun, and I’d like to be able to eat a home cooked meal/exercise every once in a while and also see my husband 😉
I learned a lot, but this was a particularly sad ICU rotation. Almost every day someone passed, and I taught my intern to sign his first of many death certificates.
Since I had just been in the step down unit, many of my patients whom I had just taken care of declined and moved up to the ICU; some of then died as well. One cancer patient whom I treated multiple times in the step down (he was a lovely gentleman) came to me after a cardiac arrest with multi-organ failure, and there was nothing we could do. I watched his sweet elderly mother in her 90s hold him as he passed.
Another sad case was a young mother whom we were fighting hard to keep alive just one more day so her teenage daughter could fly back home from her international study abroad program to say goodbye. The patient was very ill when she came to the ICU. Several days later, she declined rapidly on my 28 hr call despite maximum life support.
In the middle of the night, the nurse paged me her heart rate was in the 30s while on continuous dialysis on 4 pressors (meds to keep blood pressure up) at max dose; I sprinted upstairs knowing there was no hope and called her husband immediately. Her family had gone home for the night, and even they couldn’t drive fast enough to the hospital in time; she passed with all of her doctors beside her instead.
The daughter had changed her plane ticket even earlier to arrive that very morning, she missed her mother’s death by a few hours 🙁
I apologize for the depressing stories, so I’ll turn to more cheerful topics instead. Cookies (especially heart shaped ones) will cheer anyone up. I had bought culinary lavender from the Hill Country in Texas and wanted to try them out forever but just didn’t know how to use it.
I partnered with Bare Honey, and I knew I had to combine their amazing lavender blossom honey with my culinary lavender. My sister always makes shortbread, but I never tried myself – I thought lavender, honey, and shortbread would be a great recipe.
I only have a heart shaped cookie cutter, but I thought it suited the recipe well. This Lavender Honey Shortbread recipe is adapted from Ina Garten.
Bare Honey unique honey flavors, such as vanilla bean, chocolate, hot and spicy, bee pollen, wildflower, and more. I’ve featured the vanilla, chocolate, and lavender blossom honey here – the packaging is so beautiful. I really like the lavender blossom because you can taste the lavender – I’ve put it in these cookies, and my tea, and my yogurt parfaits for a floral hint.
I made a LOT of cookies, so I shared them with many people in the residency, like a “cookie fairy.” They were a pick-me-up after a hard day in the hospital, an argument with a spouse, a rejection from a research application, or a bad date (and many other sad stories I heard from people while handing out cookies)… I’m just spreading some much needed love with heart shaped Lavender Honey Shortbread cookies apparently.
Lavender Honey Shortbread
1 1/2 sticks unsalted butter, at room temperature
1/3 cup sugar
2-3 tablespoons honey (I used lavender honey)
1/2 teaspoon pure vanilla extract
1 1/2 cups all-purpose flour
pinch of salt
1 1/2 tablespoons culinary lavender, plus extra to top
With an electric beater, mix together the butter and sugar until fluffy. Add the vanilla and beat. Add flour and salt to the butter-and-sugar mixture. Mix on low speed until the dough starts to come together (I do this mixing manually to avoid overbeating). Shape into a flat disk, wrap in plastic and chill in the freezer for 15 minutes.
Roll the dough 1/4 to 1/2-inch thick and cut shapes with a cookie cutter. Place the cookies on parchment paper on a baking sheet. Press more culinary lavender on top as needed. Chill again in the freezer for 10 min, so the cookies hold their shape while baking.
Preheat oven to 350F. Bake for ~20 minutes, until the edges begin to darken (shortbread should be a light color). Allow to cool to room temperature.