Serotonin Syndrome


When I was a very junior neurosurgical resident in France, I always thanked my lucky stars I had not overused coffee.  Mme. M., who ran the cafe below my apartment throughout the first part of my studies, which were mostly classroom, had an Italian espresso machine and little demitasses (half-cups) of potent brew — so potent that I could not consume more than one in the morning.  Arabica, fragrant, and aromatic, it was a true joy.

After I moved closer to the hospital center, I heard for the first time the expression “pump yourself full of coffee.” (se pomper pleine de cafe)  It was foul tasting stuff, consumed in an infinity of Styrofoam cups, and strong — really strong.  There were rumors that it came from the same “common market supplier” as the wine, which was supposed to also be from a a mixture of common market (it had not yet become the European Union) countries.  All the food was free, as we were government employees.

Nobody ever figured out where the coffee had come from.

There was an open bar 24/7, about as well outfitted as Mme. M’s.  I was afraid to be in the same room with it.  I am delighted to report that I never saw anyone use it on an on-call night.

This is the place I could access a small bed — iron tubes for headboard and rails, mattress probably stiffened with starch.  The joke, which may well have been true, was that it was Napoleonic non-issue, meant for a barracks.

After the first night I lay upon it sleepless, answering a beeper that whenever it rang told me to call the operator and they would tell me who to call, my then-young back was killing me and I was fighting tears. Read more on Save Lives — Let Doctors Sleep!…

Filed under medical errors by on . Comment#


She was nearly thirty, dark haired and round-faced and ambitious, and wanted to be a drug and alcohol counselor, maybe.  Maybe not.  She had only three months of sobriety from alcohol; probably wanted to be one of those people in power.  So many programs dry people out and let them “stay on” a bit.  So many people use their own exaggerated stories to “help” other people stay sober.  A closet industry of subjective touchy feely, trampling, as many do on my long years of difficult, mind boggling training with cheap feel-good.

Her drug and alcohol counselor had told her that she would feel rotten for a while, so she had accepted that. But she felt obligated to tell me that she had felt rotten, so I let her talk and tried to listen.

People coming off alcohol may take as much as a year to get their sleep cycle back (alcohol represses Rapid Eye Movement sleep) and to stop feeling a little bit nervous.  But this was not that. Read more on Serotonin Syndrome: Less Is More…