Another call night is over. Overnight call really isn’t that bad. There are only a few parts that are nearly unbearable: The ER calling two minutes after you lie down, to ask you to see a patient whose chief complaint you’d noticed in the computer hours earlier, and have been asking repeatedly whether they’re sure they really wouldn’t like you to consult. They keep saying no, it doesn’t seem surgical, we’ll handle it; and the minute you finish every other piece of work in the house, and finally get up to the call room, then they call. Or the nurses, who seem to have arranged to save all their concerns all night for that moment when I’ve calculated that if I start right now, I can maximize the last fifteen minutes’ nap, and still get all the scutwork done before rounds. But instead I have to run around and take care of all the low urine outputs, uncontrolled pain, inconsolable parents, and dangerous vital signs which somehow weren’t worth calling about (or mentioning, when asked if there were any problems) till right before rounds. That’s when I lose it completely – internally; externally I think I’m just moderately grumpy, but mostly polite still.

Those moments, and then that one hour of rounds, when a night without sleep adds up to make every single statement by anyone so gratingly annoying that it’s all I can do to keep from screaming. After about one hour, the routine kicks in, and being still awake seems normal. For that hour, I try not to talk, and people just assume I’m tired. . . I guess I am, but I perceive it as frustration, not tiredness.

And after all, it’s not so bad. I met a lot of nice families, and even more nice children with hopelessly irresponsible parents. I got to cuddle with a neglected baby (neglected by its parents, not the nurses). I got to explore most of the possible variations on “right lower quadrant pain, not appendicitis.” (And also work on my ability to make diagnostic/therapeutic decisions regardless of my personal desire to do another appendectomy. Don’t worry, the senior levels did not want to do a case, and their judgment was better than mine.)

Q3 call makes the month go fast. The days run into each other. I only have to wake up and drive in to work once, and it makes two days go by.

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