* * Anonymous Doc

Wednesday, July 29, 2009

My body feels very confused about what time it is.

I had my first overnight call last night, was at the hospital until around 10AM, got home, ate a Pop Tart, and collapsed into bed. Just woke up. With about 11 hours until I have to be back at the hospital for a 12 hour shift. So do I force myself back to sleep in a few hours and try to get back onto a normal schedule? Or do I stay awake, and then crash right after tomorrow's shift? Does it even make a difference, since four days from now I'm back overnight again?

It's taken as a given that a bunch of us have to be there overnight, and of course I understand why-- anything can happen to a patient at any time, plus you never know when there's going to be a flood of new admits and doctors needed to see them. But from everything I've heard, and from what I experienced last night, usually it's pretty slow. Usually there's not a lot to do, usually the patients make it through the night okay... so why can't they at least give us a real bed to sleep in and maybe even a shower? Heck, convert a patient's room-- we'd have a TV, a phone.... Instead, there's a closet they call the on-call room, with a cot, right next to the nurse's station, so we hear the noise from there all night long... no one can possibly sleep in there. I went in there at about midnight, tried to fall asleep, but couldn't. Maybe I fell asleep for five minutes at about 2, but then the phone rang, a nurse wanted me to take a look at something. And then I was pretty much awake for the rest of the night. It wouldn't be so bad if they spent, I don't know, the cost of one diagnostic test on a patient, to make it just comfortable enough that being on call all night wouldn't feel like torture. I'm totally willing to order a couple needless MRIs just to fund this thing. A nice pillow, some white noise, maybe even a working air conditioner....

It's like it has to be unpleasant or it's not really the intern experience. It's like they have to keep us there for 27 hours straight or it's not really the intern experience. I get it. I get that it's all a hazing ritual. I get that everyone in past generations has gone through it-- and gone through it worse, before the work hour limitations became law-- and so we have to do it too. But who's it serving? Not the patients. Not the hospital, since if I'm tired and I screw something up, they're the ones getting sued too. Not the interns. Not the residents and attending who have to work with tired and cranky interns. No one. It serves no one. It's a relic from the past. We don't use leeches anymore, we shouldn't make people stay all night in closets on cots that wouldn't even pass muster in a homeless shelter.

I realize I'm not a victim. I signed up for this. Everyone else goes through it. And I don't have it anywhere near as bad as the patients. I'm healthy, I'll survive some missed nights of sleep, I'll survive a vending machine dinner. The patients are the ones suffering. I'm just mildly inconvenienced. But even recognizing all that, it doesn't make it okay. Just because they're suffering more doesn't mean we should have to suffer just for the heck of it, without any real reason behind it. It doesn't make me a better doctor, I promise. It doesn't make me a better person. It definitely doesn't make me a better colleague, or a better friend to whatever friends I might have left even though I haven't even had time to send someone an e-mail longer than two sentences in the past month. It makes me annoyed at the system, and annoyed that there's very little energy that ever goes toward trying to make systems like this any better.

I'll watch some baseball, maybe Top Chef, and then I'll force myself back to sleep. I'd rather have too much than too little. I'd rather build up some extra reserves than be a zombie by lunchtime tomorrow. I'd rather know at least I'm trying my best to give it my all, even if that means I literally do nothing else but work and sleep. Maybe that's just what everyone does, no matter what they do. We're spoiled as students, but real life is just 40 years of work and sleep. Can't wait.


  1. Please keep up the writing.. even though I'm in a completely different line of education and work I'm seeing a lot of your thoughts and reflections that correlate with my experience from my time in the military. And it's so nice to see that someone else also has thoughts like this. Please, never forget your honesty.

  2. Hmmm. You're supposedly a medical professional and don't know leeches are actually used in the profession. I suspect crack in the mask here.