Lesson: Should you decide to commit suicide by pills and then get into the bathtub, make sure you turn off the water before you pass out.  Because, when the tub overflows the downstairs neighbors will, eventually, break down your door, and you’ll come to your ED unconscious, cold, wet, and undead. 

Thanks: Overdosing on a mixture of meds almost did you in, especially the beta-blockers: they’re great BP meds at normal doses, but hell when abused.  Thanks for letting me have a nice review of tox, 2 pressors and a glucagon drip.

Lesson: Tell people when you go outside to get a smoke late at night, especially when the low is 22F.  When you trip, fall, and bang your head into unconsciousness, if nobody comes looking for you your core temp when they find you will be about 70.  That is really very cold for a person, and though we’ll spend the next 4 hours rewarming you, the damage is more than done before you showed up, and all the CPR and warmth we can give you won’t be enough.

Thanks: Thanks for letting me put last year’s hypothermia resuscitation talk to use.  I haven’t placed a DPL catheter in 5 years, and have never done significant hypothermic rewarming on my own.  I’m terribly sorry it was ultimately futile, but you had 10 people working exclusively and hard for you, for hours; thanks for the teamwork and its demonstration.

Thanks to you both.