Series of firsts

First stroke actually requiring paperwork and orders
First day successfully narrowing antibiotic therapy on all my patients (goodbye, vancomycin!)
First conversation regarding a new diagnosis of cancer
First call from a pharmacy to clarify a prescription.  Advair comes in multiple strengths, who knew?!
First time seeing a patient (or family member, with whom I had nearly equal contact) in a grocery store...
First time being introduced to a senior resident with the words "I've heard really good things about you."
First weekend overnight admitting shift tomorrow... I have no idea how to jack my sleep cycle in the next 24 hours that will keep me awake/functional for an entire night

It's funny what a microcosm the hospital is, so septated yet overlapping.  It's a kaleidoscope constantly re-introducing the same colors in different sequences.  A place of healing, but also of grief, pain, and outright mysteries.  Of contrasts and irony: one patient hugs all the residents on the med team for giving her antibiotics and sending her back to the nursing home; another threatens to leave "against medical advice" for not receiving the graham crackers she had requested only a matter of days after chest compressions and 360 joules brought her back from the brink.  Where I might carry an inflated title, but any practical knowledge I have comes from the nurses, aides, pharmacists, and hospital phone operator.  And senior residents.  Who are amazingly helpful and smart and patient.  Someday maybe I'll have my act together enough to have some worth as an educator in my own sphere.  Next month I outrotate, and that's a scary thing; I'm almost used to my hospital, and I like the niche I have in my own team.  But first things first; tonight, I am sleeping.