No matter how much trouble I have with a rotation, I always get nostalgic for it during the last few days, and uneasy about leaving to do something different. Strangely enough, I feel the same way about night float, the rotation that everyone in the program loves to hate.

Despite the difficulties of switching your schedule around by twelve hours, to the exact opposite of everyone else’s, and then having to stay awake for conference on odd days (and in my case, wake up for church on Sunday), night float has its benefits. We own the night. There’s a sense of empowerment in surviving the worst rotation of the residency (and having nearly all of my patients survive it, too). If I can do this – since I have done this – I can do anything. (So, ok, every one of the chiefs was more than annoyed with me on at least one occasion, and I managed to say something idiotic to just about every surgery attending in the program, but still – only two chiefs were upset enough to chew me out a day or two later, and no attendings have sent angry messages by intermediaries. . . ) No individual service will ever be harder than handling all the services at once, alone, at night. There is no phone call that will not be easier for not having to wake the recipient up for it (whether calling a family with bad news, or an attending about a new patient).

Not having to preround in the mornings; not having to sign in with a team; not having to round with the attendings. . . At night, as long as you get the work done, you are your own boss.

I like the hospital at night. There’s a sense of camaraderie among the staff stuck there. A lot of ancillary services and radiology tests aren’t available at night, but the ones that are available are easier to get: if you’re ordering a CT at night, the techs understand that there’s a good reason, and it gets done reasonably soon.

Coming off nights, the schedule change is one of the worst things about the whole arrangement. On the other hand, for the last month I’ve spent nearly every night dealing with the sickest patients on the service I’ll be switching to, so there won’t be the usual disorientation of picking up a new list of patients and trying to become immediately expert in all their idiosyncrasies.

But whether I’m feeling nostalgic for the lonely freedom of night, or glad to be done with the crushing responsibilities, it’s only two months till I’ll be doing this again. And by that time, the weather will be better, and there will be a lot more traumas; which will make that month about twice as bad as this one. . .

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