Code Lavender with Monica Stemmle, MD
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Why does the episode begin with a privacy disclaimer and what does it mean for listeners?
At The Nocturinous, we are careful to ensure that all stories comply with healthcare privacy laws. Details may have been changed
to ensure patient confidentiality. All views expressed are those of the person speaking and not their employer.
This episode of The Nocturnous was made possible with the support of the California Medical Association.
Taking care of patients is hard, and when we're on the job, it's common for feelings to come up. But what should we do with those feelings? Indulge them in the moment, suppress them and express them privately at a later time, or avoid them altogether? This is The Nocturnous, stories from the world of medicine. I'm Emily Silverman. In this episode, pediatric hospitalist Monica Stemley and I talk about becoming emotionally numb at work. And how it's impossible to cope perfectly with the struggles of the job.
It's alright that that kid was really sick, it's fine, whatever, another kid with cancer, it's fine, whatever, another kid with a car accident, it's fine, whatever. But then something something checks you.
How does Monica describe the unique culture of night‑shift work for pediatric hospitalists?
But first, Monica tells a story about her favorite way to work, on the night shift.
Okay, you see what that says up there? Well, embarrassingly recently I found out despite that name, you guys are not all nocturnists. Like me. Well you should be, because it's awesome. Here's why. When you work days and you need help with something, they're gonna say, first you have to get approval from this guy, from that lady, from blah, blah, blah, blah. And when you work nights they just say, Sure, we can help. When you work days and a protocol isn't working, they say if you want to change that protocol, you're gonna have to have a meeting to form a committee, to write a memo. And when you work nights, they're gonna say Protocol, what protocol? When you work days, they're gonna say, Didn't you get the memo?
We have a protocol. Now we can only have water and vegetables at all our future meetings forever. And when you work nights, midnight potluck. But even if you do get a gig working nights, they do make you come in in the day once in a while. And my once in a while happened to be when we were having an in-service with water and vegetables about a new code. So you guys have the same codes in every hospital, right? You got a code blue, it's a medical emergency, code red, it's a fire. Well, I don't really care about those codes because I'm a pediatrician.
What is “Code Lavender” and why do the doctors feel conflicted about using it?
And as I constantly find myself saying, like when I'm arguing with MRI over who gets to go the scanner first, kids are more important. Adults have had their lives.
So I really only care about the code white, which is a pediatric emergency. Well, this is a new code, the code Lavender. Have that one yet? That's for when something depressing happens, like you have to break a bad diagnosis or there's a death or whatever. Anyway, the residents have a really big feeling about it and they get to call code lavender. Yeah. They get to go in a room. They get to be nice and quiet. They get to have milk and cookies. They get to talk about their really big feeling. And we attendings get to hold the resonant pagers. Yeah. I could not wait to tell my friends the night shift nurses about this, so I popp my head into the break room where, huh, midnight polluck. It's the usual mix of things you would not normally eat together.
We got Filipino egg rolls, Mexican lasagna, cupcakes of a really unnatural color. But before I can eat, there's an overhead call, there's a code white in the ER in five minutes. So I rush down to the ER and I get there before the patient, but after the trauma surgeon. Now, you don't go into trauma surgery because you want bad things to happen to people, especially kids, but you do go into trauma surgery because if bad things do happen, you want to be the one who's there to do something. So that's my friend the trauma surgeon, Miss Do Something. So she says, we're having a classic kid, car, crash. So this kid comes in in full arrest getting CPR. And what I think isn't do something or colour code lavender.
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Chapters
8 chapters
1
Why does the episode begin with a privacy disclaimer and what does it mean for listeners?
0:00–1:06
2
How does Monica describe the unique culture of night‑shift work for pediatric hospitalists?
1:06–2:32
3
What is “Code Lavender” and why do the doctors feel conflicted about using it?
2:32–5:37
4
How did the team handle the traumatic code‑white case and what emotions surfaced afterward?
5:37–8:00
5
What coping strategies does Monica use when she feels emotionally numb after a shift?
8:00–11:58
6
How does working nights affect Monica’s home life and relationship with her husband?
11:58–14:41
7
What does the discussion about the SRO patient reveal about social determinants of health?
14:41–25:54
8
What final reflections do the hosts share about resilience, humor, and the purpose of the show?
25:54–32:29