One of the attendings the other day was trying to debunk some of the superstitions of medicine, particularly the one which warns against saying “quiet” about the ER or the OR, if you want it to stay that way. This myth can be almost paralyzing at times, since all of the nurses and a good many of the doctors subscribe to it. Sometimes at night I find myself running down the thought exercise, ‘try not to think of a pink elephant for a whole minute,’ in other words, don’t consider how much you’re enjoying the night being quiet, because if you think about it being quiet, it’s as bad as saying it.

The attending, as I said, was mocking this superstition. Very well for him, but there’s another piece of magic which is real, even if the taboo on “quiet” is ignored.

It works like this: Anytime the most junior person on call gets close to lying down on a bed, something will happen. I’ve tested this. I could go work on the computer list; I could do busy work somewhere; I could even conscientiously get out an ABSITE book and study – and nothing will happen. But the minute I lay out a blanket on the bed in the call room, and go to lie down, then the trauma will arrive, or the ER will finally decide that the kid in 3 must have appendicitis (after having thought about it for five hours), or all the nurses on the floor will think of some urgent questions (to be asked one at a time). This phenomenon is so reliable that I’ve considered doing a scientific study on the subject, but I can’t quite figure out how I would control it: maybe have one intern who never tries to sleep all night, and one who tries to sleep whenever not actually standing up?

I don’t have enough experience yet to be sure whether the principle applies for the seniors on call; I suspect not quite as rigorously, since the ER has to call the intern first. When I finally get back to my own hospital, and get to be the senior on call again, I’ll let you know my results.