Things are hard at work. It would be easy to say that this was because I'm working too much, and this has been true.

But it's more correct to say that I had a particularly terrible night on call last week, with several truly horrible things happening. I can tolerate the ones that are not my fault - I didn't cause the intrauterine fetal demise, or the terrible laceration, or the 19 week previable delivery. But some of the others are...well, not my fault, exactly, but suboptimally managed, shall we say, which is doctor euphemism for "some bad s**t went down."

In any case, I find myself really shaken right now. It would, actually, be easier not to go back to work for a good, long time.