If anyone had asked me on July 31st how I thought my NICU block would be, I’d have immediately responded with one word: awesome. Much of my desire to become a doctor in the first place was sparked by my fascination with neonatology; the epic stories my mom would tell about how I spent my first month of life in a NICU probably brainwashed me to the point where I felt like going to the NICU would be like a homecoming. The children’s hospital at which my residency is based has its own NICU where senior residents staff and take call but the interns are sent to the level III NICU of the local general hospital which is run by a team of attendings and neonatal nurse practitioners. It’s a state-of-the-art 60 bed facility where babies as young as 23 weeks are managed and ECMO can be performed if necessary. I remember how brightly I smiled on the first day, thinking of all the deliveries and resuscitations I’d be able to attend, all the tiny babies I’d be able to care for and all the things I’d be able to learn from the attendings. I’d even imagined myself well-prepared because I’d had a 4-week NICU elective in med school. Looking back, I realize how terribly naive I must have seemed. The shock of reality was like icy water in the ear.