step one: make friends with that adorable little girl with portal hypertension. play fishing, make play-doh food, watch over her while trying to overlook the fact that in a few years, months, her liver will fail her. that her promising life will be cut short, and all you can do is give her happy memories of ward 9.

step two: waive ABGs everyday for a 4-month-old permanently on ventilator support because he can never breathe on his own. listen to his irritating mother unload (i mean it, she gets on everyone's nerves) while monitoring all the q1 and q2 patients because you admire her genuine concern for her baby. because once you get past her constant questioning of how you're managing your patient, you realize that she's losing hope. she has done everything in her power (and ours) to pay for the ventilator, procure all the anibiotics and seizure meds, make sure the labs are done. she says she will never give up on her child, but on mother's day, she was crying softly, saying over and over how hard everything was.

step three: steel yourself as you are left alone in the nursery obas late in the evening with a pre-term twin gestation (with an fdu second twin) on the way. try hard not to panic as you tell your resident over the phone that you have to go because the mother suddenly delivered in the labor room, and that the baby is being brought to the nursery as you speak. try hard not to cry as the baby is placed in front of you - bradycardic, not crying, not moving. try hard not to panic despite the fact that no amount of thermoregulation, tactile stimulation and suctioning will get this baby to cry. remember your resident telling you that bagging the patient is the best you can do if you cannot intubate. heave a huge sigh in relief as the baby starts wailing after bagging.

i'm barely a month into internship, and i feel like so much has happened. thank You, Lord, for never leaving my side.