Diary

Patient came in this afternoon. 34-year-old male. Paroxysmal arrhythmia and fatigue, onset three weeks ago. The attending called it idiopathic. I didn't call it anything out loud.

I circled three things in his chart and asked for a 24-hour Holter and a cardiac MRI. Reyes said it was unnecessary. I said I understood. I went back to rounds. I was professional about it.

I ran my own analysis tonight. It took until 2 AM. The pattern — the specific interval variability, the way it clusters — it matches something I've seen before. Not in the textbooks. In Frank's charts. From before. From when I didn't know what I was looking at.

I don't know what that means yet. I don't know if it means anything. I'm not going to say it to anyone until I do.

Frank's monitors showed a spike at 2:47. Probably an artifact. Equipment drift, magnetic interference, the building settling. I've run three diagnostics and the hardware checks out clean.

I logged it anyway. I log everything. That's the one thing I haven't stopped doing.