Working back there last night however, I thought I was in the middle of a construction site. To borrow a phrase from National Lampoon's Christmas Vacation, it sounded like a dump truck driving through a nitroglycerin plant. Somebody must have been doing ductwork or maybe rearranging things on the floor above, but quite honestly I thought there was a jackhammer about to burst through the ceiling. For a good hour the patients and I debated whether there was a tank doing doughnuts on the second floor or two elephants trying to get lucky. Either way, the noise eventually abated and were left with the regular soothing tones of the ER instead.