The Rounding Orb

One of my ICU attendings during residency, whom I will call Dr. Cool, was not only a multi-talented, brilliant academic - English lit major at Amherst, francophone, thoracic anesthesiologist, critical care specialist, musician - but also a very funny guy, in a dry sort of way. Some people might have seen him as stern or crotchety on the outside, at least at first, but he was deeply compassionate underneath it all, and fair. During rounds if we said something stupid he would offer grumpy but, unlike many attendings, highly constructive criticism. Occasionally he would even crack a wry smile. I thought he was great.

One day when we were wrestling with some issues involving several patients, he suddenly broke away from the team muttering to himself, "Where's the orb...we need the orb..." and disappeared into his office, where we had once taken a break as a team and watched hilarious GI Joe spoofs on his computer (with him). We all stood there stupefied looking at our notes and flow sheet, murmuring to ourselves about this much IV fluid in, that much urine out, propofol infusion still at 1 mg per kilo per hour, weaning vent settings...Finally he emerged and rejoined the group carrying a small, spherical, bright orange, plush object with a face embroidered onto it. Its name, according to the tag, was Tiffany. (I'll try to reconstruct the ensuing conversation but it'll be more accurate as to the tenor of the thing rather than the specific details.)



"Now, where were we?" Dr. Cool began. "Oh yes - who wants to transfuse Mr. So-and-so in Bed 1?"

"His crit's 27. I think we should," said one of the residents.

He hurled Tiffany against the desk in front of us as hard as he could, and she emitted a loud, sarcastic, high-pitched "I don't THINK so!"

Without changing his expression Dr. Cool announced, "The Rounding Orb has spoken," and respectfully challenged the resident who had spoken up, asking for a defense of the suggestion in light of the patient's currently stable blood pressure, heart rate, and oxygen saturation. Soon our group was discussing the various problems Patient So-and-so was also facing. Another one of us made another suggestion, and this time accompanied by an almost imperceptible smirk from Dr. Cool, The Orb went hurtling once again to the desk top and then yelled, in the same, sarcastic, Valley-Girl tone, "Loo-ZER!" The resident had to smile too, but bravely began to defend the suggestion, as did others, and after a minute or so of us arguing different points back and forth Dr. Cool slammed the orange toy down a third time, eliciting from it an attitude-filled "What-EVERRRR!" The cycle was repeated several times during rounds that morning, with "What-EVER," "I don't THINK so," and "Loo-ZER!" audible from each bedside at least once.

For this memory alone I could almost look back fondly on my ICU time during residency. I hope one of these days Santa brings me a Rounding Orb for Christmas. Silly Slammers, as these toys are really called, seem pretty hard to come by these days, but I have faith. Someday I'll have an Orb of my own with which to tease hapless students or colleagues and make sure they don't fall into the trap so many folks in medicine fall into, that of taking themselves way too seriously.