How to have a truly crappy week.

1. Go in for a minor surgical procedure that requires a regional nerve block. End up with an autoimmune demyelinating disease that nobody recognizes and can't seem to treat.

2. See your doctor about a week-long bout of back pain after you spend a weekend moving. Discover a golf-ball sized metastatic tumor in your spine.

3. Feel vaguely faint during your son's Bar Mitzvah. Find out you have a dandy case of cancer in your liver, lungs, and brain, and wonder where the origin is.

4. Get your lumbar spine pain dealt with, then bleed out on the table because some genius nicked an artery. Receive more than twenty units of various blood products. Be transferred to Sunnydale General and get more blood products. Feel like hell later.

5. Go from walking to not moving in a week's time because of another weird, rare demyelinating disease that doesn't respond to treatment.

6. Have all of those patients, each young and previously healthy and inescapably cheery and hopeful, as yours for several days in a row. Throw in a couple of long-time patients who have returned to your floor for palliative care. Add two enormous technological and management blunders. Stir well and pour over ice.

It's not often that I ditch Chef Boy at the end of a long week and come home and have a good howl, but last night was one of those nights. I am spent, emotionally and physically, and I don't want to go back to work tomorrow. My patients this week haven't been hard in the sense of having a lot going on--no tube feeds, no ventilator-dependent folks, no ten medications to hang and crush by 8 am--but they've been hard emotionally.

What you don't realize when you start being a nurse is how fiercely you're going to love some of your patients. They don't come around often, but when they do they're the type that you remember for years afterward, or forever. I had five of those this week, along with their families. When a kid asks you, looking dead in your eyes, if his mom is going to be okay and all you can say is, "We don't know", well, that's the definition of helpless.

The floor feels uneven under my feet, and it's not just because the house's foundation has shifted again. 

Back to bed, back to bed. Everything looks better after a nap.