1/
PICU rotation, 1998

I leaned over the sink with its rust-stained drain and ran cool water over my hands. Patting my fingertips over my face, I stared in the mirror. I’d been awake for >24 hours. It showed.

I tried to give myself a post-call pep talk.

Me: “C'mon, sis.”

2/
I was tired. But not just tired from the lack of sleep. It had been a cognitively hard night with sick-sick patients. While it had gone mostly fine, my brain was still steaming. Not to mention the sustained tachycardia I had every time I took call in the PICU.

It was rough.

3/
This was before duty hours reform. And it’s relevant here is because it explains why I had clinic that afternoon--even though I was post call.

I had just one wish:

To get through rounds in time to finish all my work and avoid having to return to the PICU after clinic.

4/
7:30AM.

Morning report was about to start, and rounds would be right after. I silently prayed that we could finish by 11:30 to afford me time I to tie up loose ends before clinic.

But deep down, I knew this wasn’t likely. Not with this attending it wasn’t.

Nope.

5/
This attending liked to teach. And teach and teach. His Socratic soliloquies were legendary. And mostly, he was considered a great teacher.

Yup.

But even the very best teaching needs the fertile ground of a teachable moment. In other words, timing matters.

It does.