54201--i can't say your name without a crow flying by

Even though I knew it was coming, I was surprised by the july rain today as I looked out the window from the room where my patient struggled with a dying liver, the result of taking too much tylenol over a relatively short period of time.

We sent blood tests every six hours, hoping that the levels would improve, but each time they came back a little worse. It's a slow but steady process, and there's not much we can do to stop it. I called her son in Oakland and told him that she was about as sick as you can get. He didn't have a car, and was looking for a ride.

I stood near the window kept an eye on my orientee as she fine-tuned the iv drips that were keeping our patient alive. I taught her the fine art of titrating vasoactive drugs to get just the desired effect, and minimize side effects.

I watched the july rain fall, and told her that we don't get to save everyone, but that each patient teaches us a little something about how to do it better. And those experiences help us to save one every once in a while, when we thought there wasn't a chance in hell that they would survive. Nothing is wasted.

I could see in her eyes that she understood.