Black Cloud, White Cloud

A new doctor started at my office this week and in typical doctor fashion, one of the first questions that was asked of her was “Are you a black cloud or a white cloud?” This is an important thing to know about a colleague, probably more important than where they went to med school or how long they have been practicing and possibly more important than superfluous information like their name. (By the way our new colleague said she is a white cloud. Just in case you were keeping track at home.)

For those of you who did not go through residency, a ‘white cloud’ is someone who has good things happen to them at work. They always have good call nights, they never get a lot of admissions, they never get the really difficult patients, their patients never crash or when they do, the code goes smoothly.  Things always seem to fall in place for them. When you look at this picture it makes you feel warm and happy and calm.

Which is exactly how you feel when you are a white cloud. And it is also how you feel when you are working with a white cloud, because their white-cloudness is like a brilliant white bubble which envelopes those around them and makes things better for everyone.

A ‘black cloud’ is pretty much the exact opposite. They always have the ‘worst night ever’ with record setting numbers of admissions, every patient is crashing and every patient is a problem patient. Not only that, but the elevator stopped working, the McDonald’s was closed for repairs and the computer system crashed.

Looking at this picture you can feel a chill overtaking your soul and you abandon all hope. Worst of all, it spreads to everyone that the black cloud comes in contact with and it sucks the life out of everyone around them, kind of like this….

It is unknown at exactly what point of residency you get labelled as a black or a white cloud, but once you receive your cloud, it is yours for life.

Interestingly, people have done studies about being a white/black cloud and found that there is actually no such thing. Most everyone has about the same experiences, the only difference is the individual’s attitude/response to the events that happen. Despite this evidence, most every doctor I know will swear to the fact that they are a white or a black cloud.

I am a white cloud. So was my best friend from residency and we both felt that this was part of why we were so successful during residency. People thought we were really good doctors, but we were convinced that it was all a big charade because we were nice, smiled and were friendly. Therefore, people enjoyed being around us and assumed we were good doctors, but we knew deep down that we were not. The power of the white cloud made things better for us. Recently though, I was worried that my white cloud had left me. When I started last month at the satellite hospital where I was working by myself, the white cloud was in full effect and it had spread to the entire group. Our group had 1 newborn total. There were no pediatric ward patients and no babies in the special care nursery for a total of 10 days. Life was great. But then, there was one premature baby, then another. Then a pediatric patient. Then an explosion of babies. Okay, I could handle some action, no big deal. But then, black cloud tendencies started popping up. Everything I touched that day turned to crap. (Which caused me to try to figure out if there was a term for the anti-Midas touch. If you have suggestions, I am happy to hear them.) There was a child whom I was about to send home when I decided to talk a consultant about what I thought was a minor issues. Instead, I discovered that I was an idiot and not only did the child need to stay in the hospital for another week, but I also needed to increase the intensity of his care and talked to about 10 people to try to coordinate parts of his care. That was a fun conversation to have with the parents. (On the plus side, after doing some more research and phoning some friends, I discovered that I was not such an idiot. But that didn’t prevent me from feeling like the worst doctor in the world. At least now I am felling back to normal about my skills, mediocre.) Then, every baby was rather jaundiced, even the babies who were being fed formula who should have no reason to be jaundiced.

The best part was that this was heading in to a holiday weekend in which I was on-call. If this was what life was going to be like going in to my call, I couldn’t imagine what horrible things I was going to come across when I actually was on-call. Even when I found out that the inpatient team was sending all of the patients home, I was not relieved. It only made me wonder what kind of problems were going to beset me over the course of the next three days. The ward was being emptied only to get filled up by me. See, what the fear of the black cloud was doing to me? It was sucking me in to its vortex of doom!

Thankfully, I did not fill up the pediatric ward last weekend. I even got to stay home on Saturday morning because we still had no patients. (Instead, I got to enjoy the Zionsville Farmers Market with my family. And purchase a pie.)

Unfortunately, this is not a picture of the actual pie. This is just a representation of that pie.

The rest of the holiday call weekend flew by uneventfully. My white cloud was fully intact and the warm and fuzzy feelings were restored, banishing the bad vibes like a patronus charm. Because if I am going to believe in something that doesn’t actually exist, it needs to at least act reliably.


About ironsalsa

I'm just a man who likes to hear himself talk, yet pretends he can't stand himself.
This entry was posted in Academic life, Medicine, My Life. Bookmark the permalink.

2 Responses to Black Cloud, White Cloud

  1. Kimberly Schneider says:

    Well, said, although myself being a white cloud (which i wouldn’t trade for the world!!), and therefore observing the black clouds, i do have to say that there is something to be said for you skills, confidence and comfort level having been through some of those rough painful, horrible times. I know of at least one profoundly black cloud who trained with me who has developed much greater skills than I due to her “black cloud” experiences! none the less, i will happily keep my white cloud and pray it stays white!!!

    • ironsalsa says:

      I agree completely. There were many times that I felt like did not learn as much as should of because I never had any bad nights. For example, I had never taken care of a patient that had meningitis until I was a faculty member. I have still never laid hands on the abdomen of someone who had appendicitis. But in retrospect, I did have bad nights. (Including a night that I did 13 admissions, fell asleep writing an H and P and still got to lay down for 45 minutes.) I just “enjoyed all of my learning opportunities.”

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