At five I had plenty of rest
I was happy, well-fed and dressed
But my attitude sours
With the wrong kind of hours
Before I got back to my nest.
Synopsis: I’m a family doctor in Sioux City, Iowa. In 2010, I left my position of 22 years to dance back from the brink of burnout. While my one-year non-compete clause ticked off, I travelled and worked from Alaska to New Zealand, and now I’m back working part-time (54 hours a week) at a Community Health Center.
As a favor to a colleague I agreed to take call the evening of one of my days off.
I enjoyed my leisure before I started to work at 5:00 PM. I took a friend to an outpatient procedure, did some regulatory tasks and some grocery shopping. I slept in the afternoon.
I power nap better than anyone I know. Given 18 minutes, I can go through a complete sleep cycle and awaken feeling rested if not euphoric; given 45 seconds I can recharge my batteries.
But this time my post-lunch siesta went for hours.
The beeper started to chirp at 5:03PM. I handled calls from the inpatient units at two hospitals.
About 7:00PM I got my first ER page for an admission. I briefly considered bolting a snack before I left, but then I thought about my large lunch and my desire to reduce my waistline.
I admitted the patient in the hospital closest to home, and stopped in the Newborn Nursery on my way downstairs to admit the newest addition to the practice.
The beeper sounded as I walked in from the garage. Not really hungry, I took the call and went to the other hospital, feeling chipper and well rested.
I could get used to duties as a nocturnalist (the sort of doc whose main function consists of admitting patients and caring for problems that go wrong in the middle of the night), I thought.
That hospital grew across a street, and I had to cross a bridge from the old section to the new. A man stood in the bridge, looking out over the city, talking on his cell phone, the sun setting as the last snow melted.
Confidentiality doesn’t apply to information spoken in a public place by a person not my patient; the words directed to a cell phone registered as I walked past.
“Yeah, his blood counts all messed up now and it looks like he’s got leukemia, and he’s just about had it, he doesn’t want to fight it.”
The drama and irony hit me in four strides of involuntary eavesdropping. I didn’t look up.
I arrived in the ER still energetic and smiling. I got as far as introducing myself to the patient, when the beeper started into an unbroken orgy of interruption lasting half an hour.
I left that ER and got halfway home when another page brought me back. I had to admit two more patients over the course of the next two hours while another at the other hospital deteriorated.
Midnight found me in the ICU with that patient, talking in hushed tones to the family and shaking my head in unison with the pulmonologist, my nerves jangled, my optimism crushed, and not very much in favor of the idea of being a nocturnalist.