Thursday, May 13, 2010


02:30 AM: The beeper sounds.
Please call the ER x2222
Why are they calling me? I'm not on call.

A flash, then a clap of thunder outside.

"Your patient who you worked on a few days ago is here in the E.R...."

The mind races. You remember the case clearly. No problem at all. What could be going on? You ask twenty questions. You get twenty answers. All of the bases have been covered. "... doin' better now," your told. "We'll just admit 'em and you can see 'em in the morning." Hesitantly you return to bed, mind racing.

The lump of blankets next to you rolls over, "Everything okay?"

"Yeah," you lie. "Sorry, honey. Get back to bed."

The head meets the pillow but the brain does not. There are differentials to review. Seemingly infinite differentials. But it couldn't be that, they checked for that. What did I miss? Over and over again.

The thunder outside claps in unison with your mind. You wonder, maybe I should go in? What if they missed something?

The horror. The horror.

Over and over again. Maybe's. Doubting. Thunder.

Thirteen years into my trade and the hauntings, I've learned, are part of the job. Every doctor knows about the the 800-pound gorilla that watches us each day.

Sleep is his easy victim.



The Happy Hospitalist said...

That's why I don't take call. LOL If I'm going to be haunted, I'd rather be at work getting paid to be haunted

James said...

This is an awesome post. Thanks for sharing.

The Happy Hospitalist said...

By the way. I have three blogs I read every day, without fail.

Keep up the great work.

Jay said...

Sometimes the only way to shake the demon is to just get up and go in. My wife understands me enough that she'll even suggest this while I toss and turn.

I don't think I've ever regretted the trip, once it's done. In the end, I actually get more rest that way.


Jodi said...

Thank you for sharing this story. Good to know my husband is not alone in this kind of thing.

I don't know how you guys do it. It's far too much stress for me, and most other people I know.


Anonymous said...

did they need to call you at 2:30 in retrospect or would it have been just as good to have you notified at 8 am?
i understand your commitment to your patient once you are notified, but that is one aspect of why call is shared--so that you can function at your peak as a result of regular nights of uninterrupted sleep. jmo.

Seattle Plastic Surgery on Lake Union said...

I've never regretted going in to lay eyes on a patient- getting out of bed is the most painful part- its like injecting local anesthetic into a patient--

Techknowdoc said...

Absolutely true. I often prefer going in and putting my mind at ease rather than toss around. Saves a lot of sleep in the end.

Dreaming again said...

I wonder if that is what went through my general surgeon's mind a few days after he'd placed a portacath.
I was about to get my first treatment of IVIG through the port and my arm felt 'odd'. Half way through the infusion it LOOKED odd and the home health nurse called the doc. He said to elevate and call when infusion was done.

By then, it was swollen and mottled (is that the right word, splotches of purple and white and red) and the nurse tried to explain it to him, apparently not well. He asked to speak to me and in a very patronising voice said "better meet me at the ER, I don't want you to think your needs aren't being met"
He walked into the room an hour later and went white as a ghost as he realized my port had caused a blood clot.

He was never patronising to me again.

Anonymous said...

When one works with human lives, they can be worried about making the right call. As an educator, I often think did I make the right call to contact CPS, the sherriff's department, etc. If I was able to bond with the student, maybe they would not killed their parent, teacher, friend. When human contact is made as a provider, there will be always a question "Did I do right?"

Lisa said...

Great post! You are one of my favorites online: a doctor with a conscience. It might seem obvious of course you care, but honestly a lot of doctors just don't. It's a money-maker, you get paid if the patient drops dead or lives. But you're a guy with a heart doing medicine. I like that.

Now is a really tough time to be a doctor who actually cares about patients. Nothing is more stressful than this. Yes, some doctors are losing sleep because their revenue stream could be impacted negatively. But what if you lost a patient? That bothers you. I LOVE how much that drives you insane. I hope you love it too, because it means that God made you a doctor, it's what you're supposed to be doing, and even though it might end up a worst prospect than that Burger King job, it is nonetheless why you are here and what you are supposed to be doing. Keep doing it!

You can feel like quitting nowadays: it simply means you aren't supposed to.
From your bestie in the twitterhood, Lisa30092