If you wonder why good food is more important than mortality and why ordering too many unnecessary consults worsens the food and doesn't impact mortality - this episode is for you. Tramadol is not well understood by many prescribers and some emerging facts we all need to know are shared. A flashback to diuretic use in congestive heart failure fluid overload and elevated creatinine is also somewhere in the mix. Ohhh...and stop systematically prescribing nicotine replacement at high dosages for all hospitalized smokers.