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Have you ever been labeled a white cloud or a black cloud by your friends and colleagues, and wondered what that meant?

A white cloud has an easy, painless, perhaps even fun shift or call.  “Ahhh, what a good night!” a white cloud might say while stretching, smiling ear-to-ear, and appearing quite refreshed.  A white cloud survives unscathed.  A black cloud encounters hell and meets The Four Horsemen themselves.  Sirens blaring.  Nonstop pages.  Chaos and dismay.  A black cloud’s once-clean and neatly-pressed scrubs are tattered, bloodied, and shredded.  Bags under the eyes.  Arms sore from perpetual chest compressions.  At the end of the shift, a black cloud merely shakes his or her head in disbelief, yearns for a hug, and desperately wants to go home.  A white cloud always leaves work on a sunny day and can’t wait to go to the gym, go for a run.

A white cloud gets no new patients.  Or if they get one, that patient is always a pleasant, straightforward, but interesting case.  A white cloud gets a full night of undisturbed sleep on an unusually comfortable bed with freshly-washed linens.  A black cloud sees anywhere from 30 to 30,000 patients, all of whom are best labeled as “train wrecks,” and they all happen to arrive at the same time, sometimes life-flighted and usually intubatedThey are all poor historians.

A black cloud gets no more than eight minutes of sleep and it often takes place in an improvised spot: the empty bed of a recently deceased patient, the top of a conference room table, or on three swivel chairs of roughly the same height.  If a black cloud happens to find a free call room bed, he or she will catch scabies.  A black cloud’s few moments of rest are always interrupted by a patient’s acute change in medical condition.

A white cloud never deals with a crashing patient.  But not a black cloud.  A black cloud encounters at least three codes and is always the first one to arrive.  Always.  Even when a black cloud moves as slowly as possible and takes the longest path.

A white cloud pees clear urine since he or she can stay adequately hydrated.  A black cloud hydrates only with prn caffeine, and suffers from either lack of urine output or formation of kidney stones.  A white cloud eats a delicious and nutritious breakfast, lunch, and dinner.  If lucky, a black cloud eats a graham cracker out of a hospital drawer.

A white cloud is caught up on paperwork.  A black cloud is forever behind.

A white cloud makes new friends on call, and finds time to catch up on phone calls, emails, and Netflix shows; no drama.  A black cloud unearths new mortal enemies and archnemeses; it’s all about the drama – drama, drama, drama.  A black cloud loses contact with all friends and loved ones.  A black cloud’s phone always dies in the middle of the night.  A black cloud is lonely; everyone avoids black clouds.

If a white cloud were to stumble upon a box full of kittens, there would be nothing but fun, love, and cuteness.  If a black cloud stumbled upon that same box of kittens, there would be both cat-scratch fever and toxoplasmosis.

If a white cloud cries, it is tears of joy.  A black cloud always cries, needs a beer, and often benefits from psychotherapy.

If someone calls you a white cloud, you respond by saying, “Shhh, don’t jinx me!”  But you’ll never be jinxed; that is the nature of being a white cloud.  However, if someone calls you a black cloud, you’re a black cloud for eternity.  Trouble will always find you.  The sickest of the sick will always find you.  And even if you’re lucky enough to have a few white-cloud nights, don’t be fooled: you will forever be a black cloud.

Now, do you know the difference between…
a medical student and a deer in headlights?
a medicine service and a garbage dump?
arthropods & orthopods?
medical students & residents?
RICE & rice?

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Dr. 99
First there was Dr. 01, the first robot physician, created to withstand toxic levels of burnout in an increasingly mechanistic and impossibly demanding healthcare field. Dr. 99 builds upon the advances of its ninety-eight predecessors by phasing out all human emotion, innovation, and creativity completely, and focusing solely on pre-programmed protocols and volume-based productivity. In its spare time, Dr. 99 enjoys writing for Gomerblog and listening to Taylor Swift.
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