Yes sir – it’s a killer of a shift, yet seemingly a necessity of medical school for some unknown reason. I remember once trying to explain to a patient as to why I had been up 24 hours and how I had only 12 hours left and how this somehow made sense. Part way through I realized that I hadn’t been speaking to a patient at all, but rather debating with a plant that was in the lobby of the hospital. It was sleep deprivation, pure and simple. Why we do this still escapes me – I figure we must have a rather poor union to negotiate 120 hours a week at ~$1 an hour. I suppose at least we get paid something, although at such a low rate it almost adds more insult to injury.
Now it’s not all bad, I mean that there are some nights where you do get to sleep (for a couple of hours) while on call. This results from the fact that hospital work is variable and that call is completely dependent on the patients on the ward. There are those rare occasions when the patients simply fall asleep after they’ve been tucked in for the night and there is nothing exciting for a young doctor to see or do. But then there are also others, like last night for me, that are freaking insane.
Last night, while on call, I got sucked into the drama of the ER. My mistake was to walk by at 9 pm on a Friday – when things were just beginning to heat up. I initially stayed to do a little stitching – a man had come in with a cut to his forehead which needed three stitches (I gave him four). By the time I was done, the first of the traumas were beginning to come in and things were suddenly very busy.
There was a young fellow in a car accident who was thrown through the windshield into a field (no seat-belt). He then picked himself up, dusted off his jeans and walked over to the nearest house to phone the ambulance. Needless to say, he had many a laceration across his back. He may not have cried when he crashed his truck but he sure didn’t like the needle. This made me a little nervous as he was a big guy, who obviously could take a bit of pain. I didn’t want to make him too angry, but at the same time I needed to give him a little morphine to dull the pain and a little lidocaine so I could sew him up. And after debriding his back I got to sew up the many lacerations and it was glorious. It really was. I wish you could have been there to see it. I did vertical mattress, horizontal mattress, simple and continued stitches. Truly it was fantastic! Really – by the time I was done – it was a work of freaking art. Also, by the time I was done, the ER was really jumping.
This time there was a young lady who decided to code (arrest) and another young lady who had been a car accident. Both came in at the same time which suddenly made the little ER a very busy place (remember I am working in a rural hospital and there are few beds with few doctors at anyone time). I helped stabilize the young woman who had had the car accident, and then went over to the patient who had arrested to see if I could help there as well. This too was freaking awesome – kind of like that TV show ER (except it didn’t suck).
Even though I was rather enjoying myself in the ER I had to run and answer a couple of calls on the ward. There was delirious patient and the one who fell on her face on the way to the bathroom. there was the hyperkalemic patient and then another who couldn’t make up their mind whether to stay in normal sinus rhythm or to go tachy. By 4 am my high from the ER had worn off – the wards will do that, i.e. wear you down slowly. By 6 am I was spent … my eyes hurt and it felt like I was moving through water when I walked…
Luckily, this was only a 26 hour shift for me and I was able to head off to bed by about 9 am. I don’t remember walking home or getting into bed – but I must have at some point. I woke several hours later – glasses on my face, scrubs still on and the afternoon sun shining through my open window. Now the countdown until the next on-call shift starts. T minus 4 days … ack!