Nights Like These: Lessons After 32 Years In Acute Care Medicine

When the rest of the world is asleep, medicine becomes something different.

At 2:00 AM, there are fewer resources, fewer people to call, and no easy answers.

There is only the patient in front of you, the information you have, and the judgement you bring to the moment.

In Nights Like These, veteran hospitalist and Fellow of Hospital Medicine Arn Facklam shares the lessons learned during more than three decades in healthcare working nights.

This is not a textbook.

This a book about what happens when experience meets uncertainty, when confidence is tested, and when the night shift becomes one of medicine's greatest teachers.

Inside you'll discover:

• The Five Question Framework for navigating clinical uncertainty
• What is the Circadian Trough
• How fatigue affects decision-making and situational awareness
• Why experience can be both a strength and a hidden danger
• Practical lessons in teamwork, leadership, and communication
• The emotional realities of caring for patients when resources are limited
• Strategies for avoiding burnout while preserving compassion
• Personal nocturnal narratives that reveal medicine's most powerful lessons

Through personal stories, clinical reflections, and hard-earned wisdom, Nights Like These explores the moments that shape healthcare professionals- not only as clinicians, but as people.

Whether you are a nurse practitioner, physician assistant, physician, nurse, resident, student, or anyone who has ever worked while the rest of the world slept, you'll recognize the challenges, uncertainty, and meaning found in these pages.

Because some lessons can only be learned after dark.

And some of the most important moments in medicine happen during nights like these