For the past two weeks I’ve been back in the ICU. 6am-7pm or later for 12 out of the past 13 days. It’s been hard at times, but also very rewarding. Things that were challenging the last two times around are now becoming old hat. You don’t realize you are learning all this medicine, it’s not an active process as during these months you have absolutely no energy, much less time, to read when you get home at night. Somewhere along the way it just sort of happens. Without really doing anything different, you start to have a better grasps of your patients, what needs to be done for them, what others are doing for them, what’s going to work and what won’t. The flow of information feels like it starts to slow down and becomes a bit more manageable. And it’s nice when the attendings start to address you more as a colleague and less as a med student. It feels good to know they are starting to trust you just a little bit.