It's day four and the first day after Christmas. As Santa Claus spent the night of the 24th working hard, I spent the 25th of December in a constant state of wakefulness.

Ah, the life of a surgical resident: always in search of sleep. One of the more interesting (and amusing) things I've seen is the surgical call "pain scale."

Pain control is a big deal for patients, and one of the devices nurses use to assess patients' pain complaints is a pain scale. Patients are asked to rate their pain from one to ten, ten being the worst possible pain. To assist in their assessment, we sometimes use a rainbow colored scale from blue to red, red being the worst possible pain. Colors can help bridge language barriers, and patients who are intubated generally can't talk.

One of the photos below is a pain scale which has been modified for MDs and is basically a scale of call pain. As you can see, neurosugery has been rated as the most painful call and anesthesia, the least painful. What aspects make call painful? Generally, the frequency with which your pager goes off is proportional to the amount of pain. It's not uncommon for my colleagues and myself to get upwards of 100 pages (each) in a 12 hour period (the record is 139 or something).

So here are some non-people pictures. More Steve pictures tomorrow.

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