It’s a little after midnight and you’ve completed all of your duties—for the time being, anyway. All of your fellow interns did an excellent job of signing out their patients to you and none of them seem “sick sick”. You’ve already received a few “Tylenol calls” (”Mr. Payne is complaining of of a headache and he doesn’t have any meds available—you wanna give him some Tylenol?”), but thus far, no one has spiked a fever, fallen out of bed, or stopped breathing.

Not yet, anyway.

You’ve already admitted two patients from the ER and during your last visit down there, the board was practically empty, the beds in the hallway were unoccupied, and the ER residents were sitting around in front of the computers, reading those “weblog” things. The nurses even had time nod hello to you, rather than push past you like the non-existent peon that they usually believe you to be.

You’re walking past the ward where six of your patients (along with at least seven of your cross-cover patients) are located. The hall lights are dimmed and only the occasional hacking cough echoes through the dark hallway (is it your guy in isolation due to tuberculosis?). One nurse is watching the squiggly red lines of the cardiac telemetry monitors trace sharp mountains and valleys on the black screen before him; the charge nurse is looking over her clipboard, quietly tapping the yellow barreled pencil against the desk surface.

You see them, but they don’t see you. You could easily slip past them and retreat to your call room to lay down—you may not have this chance again for the rest of the night. You also remember, though, that you haven’t heard anything about any of the patients for over six hours… and common hospital lore holds that if you don’t check in with the nurses before you lay down, they shall definitely call you—and perhaps with alarming news. On the other hand, if you check in with them and get an updated report, they may end up keeping you there for another half hour or forty-five minutes with non-urgent issues… and that’s up to forty-five minutes of lost sleep.

If you decide to risk losing precious sleep and check in with the nurses to receive an updated report, turn to page 28.

If you decide to go straight to your call room to lay down—hey, if it’s that important, they’ll page you, right?—turn to page 32.

So that’s one story idea that’s bouncing around in my head: Write a Choose Your Own Adventure story featuring the narrator (reader) as an intern… or medical student… or resident. It could be both entertaining and educational—my friend enthusiastically remarked that I could write one for each specialty! this could be included in pre-clinical medical school curricula! these books could augment “problem based learning” and help students study for clinical “shelf” exams and the like! Hooray!

And then I wondered if I’d be infringing upon the Choose Your Own Adventure copyright/trademark/whatever it is. (That is, I wondered if I’d be doing something illegal.) And the Choose Your Own Adventure people have yet to reply to my polite inquiry.

I apparently made the wrong decision and landed on a page that sends me nowhere.

The text file that contains all of the blog entries from November 2000 through January 2007 is huge; it contains over 11 megabytes of data. That, however, includes SQL tags and comments from readers. It’s a mine of material that is awaiting refinement to become a book of beautiful stories. I know this.

Lately, several of my friends and acquaintances have “remembered” that I maintain a weblog and have successfully (and easily) found it. They have graciously praised my writing and encouraged me to write that book, though they recognize and understand the obstacles in my way.

“You’ll have more time when you’re done with training,” they all say, as if on cue.

I have a plethora of excuses: Sorting through 11 megabytes of data is daunting. There are other areas of my life I’d like to cultivate. I’d like to read even more so I can finally know what the heck I’m doing with patients. I appreciate sleep.

The real reason I balk at this task, however, is self-doubt.

My best story, though, remains unwritten. And by “best”, I mean “most compelling, most engaging, and most thoughtful”.

However, “best” also encapsulates “most painful, most difficult, and most tender”.

The story has yet to end, though few events have occurred in recent years. I still hope for a happy ending, though part of me believes—fears—that a happy ending would only occur in a world of fiction.

In order to write the story, I must think about it. And, though I can tell the story is vague terms (and only in vague terms) with a straight face and an unwavering voice that betrays no emotion, just thinking of the story still causes me to feel more sadness than anything else I’ve ever experienced.

In the meantime, I write what I can with hopes that, one day, I’ll write what I currently cannot.