Lots of great cases, rare stuff, people sick as stink, dying right in front of your eyes, their survival dependent on your actions over the next few minutes. There are several patients that would clearly be dead had I not done what I did on nights. That aspect of knowing what to do, and having the courage to do it, is characteristic of all doctors but particularly important in certain fields; ER, ICU, trauma surgeon come to mind. I love that aspect of the ICU--I am one of the few medicine docs I know that actively enjoy chaotic and high pressure situations.
There's also a lot of heartache, as it's really difficult to sit down with a family you have just met, gain their trust, and then tell them that their loved one is dying and there is nothing we can do to prevent it. That may be my favorite part of the job, however, because I'm good at it. The Grim Reaper and I are old friends, and speaking of his coming is not quite as scary to me as it is to most docs. I take special joy in helping families get through that part of life called death. It's one of the reasons I thought hard about oncology before settling on critical care.
So now it's on to med consults, which is probably the worst rotation for me outside of the CIMR outpatient month. I hate being ortho's whore. But in the words of Dr. Eric Prime Walker, "You can hurt me, but you can't stop the clock."