A whole doctor for a whole weekend


As the weekend comes to an end

 I do not try to pretend

That I’m not getting tired.

But at least I’m not mired

In a narrow subspecialty trend.

Weekend call has a definite rhythm. As Friday afternoon ripens towards evening, vigilance circuits in the brain start to ramp up. Saturday morning brings the hard part, getting to know the inpatients. Saturday afternoon the beeper rules your consciousness. The phone calls from Saturday night to Sunday morning determine whether the weekend will go down in the books as a hard or easy. Sunday morning offers a more leisurely reiteration of Saturday, and if you can just make it to Sunday at noon, you figure, you can handle it.

Because you’ve handled worse. No matter what gets thrown at you, you can survive it for another nineteen hours. And after the weekend, you’re happy to see Monday come.

Thus the melody of the weekend progresses, and onto it is written variations on a theme, such as the time my beeper went into meltdown mode at 11:30 on Saturday morning and I couldn’t move for three hours, fielding more than a hundred calls. Or the many times when obstetrics dominated the action for twenty hours. Or the one time when I hurried back and forth between the hospitals delivering babies. Or the lab calls with the panic values. Or the eight calls about one nursing home patient between 1:00AM and 4:00AM. Or the calls to come work Urgent Care.

I took holiday call for a another clinic that belongs to our group and this Sunday morning I cared for patients in both hospitals and I felt like a whole doctor again. A visit to a postpartum unit, elsewhere to deal with the ravages of alcohol, tobacco, diabetes, rheumatoid arthritis, and just plain bad luck. My colleagues told me it was good to see me on weekend rounds again. I told them the truth, it was good to be back. Hospital work adds to the length of my work day, but the hours come at the beginning. I’m a morning person now and by 7:00 AM I’m ready to be productive and to be moving efficiently.

I got a request from a subspecialist for a consult on a patient from our clinic, and I had to explain that my partners no longer want to have anything to do with inpatient work. I got the distinct impression that the subspecialist would really rather have me on the case than the hospitalist. I didn’t have to move especially fast this morning because I didn’t have to see that many patients at the two Houses of Pain.

I took an hour in the late morning to go with a friend to destroy clay targets with a 12 gauge shotgun. The two of us shot brilliantly; none of my forty targets escaped unshattered. From there I hurried to one of our Urgent Care clinics.

Bethany brought me lunch at about 1:30, after that I kept a brisk pace till 6:30PM. I saw about 40 patients. Three needed hospitalization. Cough was the most common presenting complaint. Six came in with problems festering for more than three weeks. About one in five were from out-of-town. One patient, with the worst headache of her life, was sent to the emergency room. One test came up positive for RSV, four came up negative. Five tests came up negative for influenza. None of the eight smokers wanted to quit. All four urinalyses showed no urine infection. One of four strep tests showed positive.

I started calling the other clinics’ partners at 8:30PM to check out patients; by 9:00 I was done. It started to feel like the end of the last weekend call for my group.

Sunday night passed to Monday with only three phone calls, none of which I remember.

Not a bad swan song for spring.

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