1/ The #blackcloud. A thread. When I was a resident @uiccom @UICDom I was often known as a “black cloud.” For those not in medicine, this can mean a variety of things. For example someone who has very busy inpatient months, admits very complex patients, and is overall very busy.
2/ in my case being a #blackcloud meant when I was on service, we always had a full service, often w very complicated patients, & when we discharged 1 patient, 3 more would be admitted. The attendings and residents knew when I was service, it was more than likely we would be busy
3/ Keep in mind, this is all anecdotal and more superstition than evidence based, but when I came back to @UIHealth @UICancerCenter I wondered if my black cloud would follow me. I jokingly warned my team the first day I was taking over the inpatient service about my history.
4/ Lo and behold, our service went from not very busy to full of complex patients overnight, and our team jokingly asked if my black cloud had followed me to my attending life. I couldn’t argue with the evidence of a full census with a myriad of medical problems.
5/ some ppl complain about having a black cloud. Having a lot of admitted patients increases the work load. It often means later nights, busier days, and many family meetings, difficult conversations, and a LOT of reading, educating and learning.
6/ but i have to say, I wore my #blackcloud as a badge of pride. With a full list of complex patients as a trainee I learned how to be efficient in my work. I learned how to diagnose and treat many patients, remembering not only their medical problems but also their families.
7/ I learned about my patients children and grandchildren through conversations about birthdays and pictures and flowers that decorated their hosptial rooms. I became a better diagnostician by looking beyond the problem list and really listening to my patients.
8/ it helped me as an attending when I had to manage, diagnose and treat many patients both in the hospital and in the clinic, remembering all of their medical problems, their diagnoses, the workup already completed and what still needed to be done, and potential barriers to care
9/ If you are a resident or fellow and you are known as a #blackcloud I encourage you to be proud and learn from these incredible experiences you are having in your training. I know it can feel like you are drowning sometimes. Your attendings are here to help and teach you.
10/ a patient yesterday who communicates by writing on a pad told our team we were doing a “good job.” The team had diagnosed a very complex and rare complication and treated it and the pt was ready to go home. We have learned so much from our patients in the last few days.
11/ #covid19 has changed the way we found, the way we teach and the way we learn. Continue using these difficult and challenging situations to learn and grow and become the best clinicians you can be. I still wear my #blackcloud as a badge of honor and you should too. 
