I wrote this, while sitting at an airport at 3 am, waiting for a 6 am flight
I was very tired.
Another late night
The feeling is very familiar, though it’s been a long time.
I’ve got a headache and I’m nauseous.
I’m tired, sweaty and I pity anyone who has to be close to me.
I’d like to sleep, but I can’t. I don’t have a comfortable place to sleep. But I also simply can’t, panic stricken by the slightest vibration of my cell phone.
I’m awake, and I see and hear everything, but not everything makes sense. Most things do make sense but I’m grateful I’ve haven’t been pushed harder to make sense of more complex things.
The last time i was in bed, it was 6 AM, 21 hours ago.
I’m sitting in an airport, on a laptop collecting my thoughts of the day that just passed.
When morning arrives, in my fatigued state, I’ll have to talk about everything that happened today. Details are hard to remember in this mental fog, but they mean everything. Details save lives.
I’m not on call, but i remember this is what it feels like.
It feels like it was just a few months ago, (but actually several years ago) I was taking ICU call every 4th night. 6 am to 12 pm the following day. 30 hours. Back then, this was considered, better and more humane than what my predecessors experienced.
Today, I can tolerate the idea of sitting in an airport for 24 hours without sleep. But what I cannot accept is critically ill patients being cared for by young doctors trying to function in my fatigued state.
It really is a good thing that we’re doing away with draconian call schedules in residency.
The nights were long, dreary, busy and frightening with the knowledge that as each hour passed,I became more and more tired, and less and less capable of performing at maximal capacity.
The mornings were painful, mindlessly filling out progress notes trying to recall the events, struggling to explain the new stories that rolled in each night.
Walking from bed to bed, surrounded by clean, showered colleagues while wreaking of “Call stank,” I used to count the minutes when the day would end.
When will this endless night end.
When will I take my last call? when will I never have to do this again?
Lady with leukemia in a blast crisis, septic and dying?
When can I leave?
Guy with hepatitis C, and in DIC?
When can I go home and take a shower?
Girl with endocarditis and MRSA sepsis?
When can I crawl into bed?
New admit for ARDS.
I feel nauseous, I can’t breathe, I need some fresh air.
The old-timers can argue of the virtues of long call shifts, the toughness it takes and the sense of responsibility and accountability it takes to perform under duress.
But the truth is, human physiology and billions of years of evolution demand 8 hours of sleep. Patients deserve doctors who function at optimal mental capacity. Doctors are humans and they deserve not to have their mind stripped, their bodies battered and their soul drained by “call.””
It’s almost 4 am. and my night here in the airport is almost done. I won’t have to do this again for quite a long time. I’m also grateful I never have to do overnight calls.