Well, yeah, I am. There are certain things that, as a health care worker, you don't do. You don't, for example, have a sexual relationship with a patient. You don't divulge patient information without prior consent. You don't lie to or otherwise deceive a patient. And you never show up for work intoxicated. Ever. Regardless of whether or not Romano carries out his threat to turn Benton into the hospital disciplinary committee, Benton ought to turn right around and nail Romano's hide to the wall -- showing up for surgery drunk is grounds for losing your license to practice medicine.

In my mind, it doesn't matter that nothing bad happened to the patient; that isn't the issue. The issue is the willingness of a physician to knowingly place his patient at risk, and you only have to do it once to demonstrate you're unfit to practice. Romano should lose his license. I kept hoping Don Anspaugh would show up so that he could ream the Rocket out, but I never get what I want. Peter: turn him in. It's the ethical thing to do.

I loved the elf, and the stain on the carpet shows where the diet Coke landed after it flew out of my nose. Standard treatment of reentrant supraventricular tachycardia usually involves adenosine, verapamil, or diltiazem; if those don't work, you grab the defibrillator; ectopic SVT, however, should not be shocked. I'm not sure why the elf was so insistent on being shocked, mostly because cardioversion hurts. I like to sedate patients before I do it, but in this case I might have made an exception to the rule. Torture by LifePak -- I'll have to remember that. :)

Asystole is the complete absence of electrical activity in the heart; if you were to open the chest, you'd see it sitting still, not beating. Contrary to popular belief, defibrillators do not shock the heart back into operation, rather, they send an electric current across the chest wall to depolarize all the tissue in the heart, effectively "breaking" the abnormal rhythm. It's kind of like pushing the reset button on a computer, actually; you reboot the heart to see if you can make it behave again. The problem is there has to be something there to convert. Using the computational analogy again, if you trashed your hard drive, no amount of rebooting is going to fix the problem; similarly, if there's no rhythm to convert, the defibrillator is useless, which is why you can't shock asystole. That said, usual treatment for asystole is to do CPR, load up on atropine and epinephrine, and pace like mad, although with a down time of 45 minutes I'm frankly amazed they got him back (but not amazed at the neurologic deficits).

And just because I know somebody's going to ask, here's my $8.00 on Amanda Lee: There's something wrong with the woman, no doubt. It is not, however, as simple as saying "obsessive compulsive disorder" -- like most psychiatric terms these days, OCD doesn't mean what most people think it means. OCD is an anxiety and personality disorder that has to interfere with someone's life; it usually involves compulsive behavior like washing or cleaning. It's more likely that Amanda suffers from what's called "erotomanic delusional disorder." The Diagnostic and Statistical Manual of Psychiatric Disorders has this to say about erotomanic delusional disorder:

     This subtype applies when the central theme of the delusion is that
     another person is in love with the individual.  The delusion often
     concerns idealized romantic love and spiritual union rather than sexual
     attraction.  The person about whom this conviction is held is usually of
     higher status (e.g., a famous person or a superior at work), but can be a
     complete stranger.  Efforts to contact the object of the delusion (though
     telephone calls, letters, gifts, visits, and even surveillance and
     stalking) are common, although occasionally the person keeps the delusion
     secret.  Most individuals with this subtype in clinical samples are
     female; most individuals with this subtype in forensic samples are male.
     Some individuals with this subtype, particularly males, come into
     conflict with the law in their efforts to pursue the object of their
     delusion or in a misguided effort to "rescue" him or her from some
     imagined danger.