Snakes and ladders

I've noticed that hospital nights tend to bring out the superstitious in everyone. Some interns will never take the elevators, some will never enter the stairwells. Everyone has a strategy for making the night as smooth as possible: "if you walk three rounds of the two adult critical care units before you eat dinner, the nurses will let you sleep for a few hours." "Don't ever get midnight snack at the cafeteria, you always get called with a new admission the second you pick up a tray." Etc.

Intensive care south has a ghost named Thomas who's been known to change vent settings and discontinue IV drips overnight. Elderly patients get confused, weird patients get weirder, hallways seem to move and you have no idea how you ended up in the F building when you thought you were heading for the ER.

I've noticed myself fixating on seemingly random events as prognostic indicators on how my patients are going to do. But I do seem to see a clear trend emerging.

The elevator of hope: Once in a while, I'll get called for a patient that sounds terrible, like about-to-die terrible. I'll book it over to the elevators and, about four times a night, there will be an elevator there just waiting for me. Warm and light and open and empty, waiting just for me, and always with the arrow lit in the direction I need to go. This never happens during the day. It doesn't happen when I'm heading towards not-so-sick patients, it never happens when I'm with anyone else. I sort of see it as a sign that I'm going in the right direction. It's always good news.

The fishbowl of dispair: The hospital has a television channel, called "Mr. Fish," that's essentially a camera inside a dirty fish bowl with a few hungry looking goldfish swimming around. This is soundtracked by a continuous loop of three benign classical string quartet pieces and one new-age dolphin/synthesizer duet.
If my patient is watching Mr. Fish (usually the nurse or a family member leaves it on for them. Sometimes Thomas the ghost will do it), they're essentially going to die. It's the worst. When I hear the viola starting up from outside the room, I don't even want to go in.

This morning two of my patients were watching Mr. Fish. And I'm only covering four patients today. Disaster. You'll see.