Once in a Blue Moon

I was on-duty in the ICU Wednesday night last week. To say that it was busy was an understatement.

When I started my call at 5 PM, my partner who was covering the ICU during the day, signed out to me that there were already 3 pending admissions that have not arrived yet. One was coming from another hospital 30 minutes away, who was in septic shock (meaning: overwhelming infection with very low blood pressure); another one was already admitted in the hospital but needed to be transferred to the ICU as he was going into severe alcohol withdrawal; and another one was a cardiac arrest that the cardiology team was still working on in the cardiac cath lab, who was very unstable requiring life support.

I knew right then that it would be a busy night.

Sure enough, the admissions kept on coming. And they got sicker and sicker than the ones before. There came another septic shock, one with confusion from low serum sodium level, one with respiratory failure from COPD requiring intubation and mechanical ventilation, one with seizure from meningitis, another one with cardiac arrest, one with liver cirrhosis with active bleeding from his gut, and so on and so forth, and a partridge in a pear tree.

By the time it hit midnight, I had 10 new ICU patients, on top of the 20 or so patients we already have. My medical resident and I were like chicken with our heads cut off, running from one room to another just trying to put out fires, that is, stabilizing patients who were crashing and keeping them alive. If our patients were in survival mode, so were we, just trying to get through that awful night.

My last admission came at 5:30 in the morning. The patient presented with severe abdominal pain and was found to have perforated bowel and in septic shock. We called the surgeons who took him immediately to the OR for exploratory laparotomy.

As I was finally cooling my heels in our call room around 6:30 AM, waiting for my reliever to come who would take over the reigns of the ICU at 8 AM, I turned on the TV and watched the local morning news. That was when I learned that it was a Blue Moon the night before, and they were showing photos of the extra huge full moon. It was also a Super Moon as the moon was the closest to our earth for this year, at 222,043 miles away.

A Blue Moon is the term they use when a full moon happened twice in a single month, which it did on August 30, 2023. The occurrence happens so rarely that the saying “once in a blue moon” means it occurs very rarely.

The newscaster also said that the moon will set at 7:10 AM, and urge his local audience that they still have a chance to get a glimpse of the Super Blue Moon before it disappear. Though I have no energy, nor desire, to go out and see the moon. In fact, I even hated it a bit.

I am not superstitious, but I was blaming the Blue Moon for my horrible night.

Around 7 AM, just before the moon finally sets, I was urgently called back to the ICU for a Code Blue (medical emergency). A Code Blue on a Blue Moon. It was one of my recent admissions, the one with cirrhosis who was bleeding. He went into cardiac arrest and the team started doing CPR. We tried to revive him for some time but to no avail. His family ultimately decided to stop our resuscitative efforts, knowing that he was already gone.

When my call was over and done, I cannot remember a night that was busier than this. I ended up admitting the most number of patients for one night in my 20 years of working in this hospital. I really hope this would only happen once in a blue moon.

(*photo from the Des Moines Register)