Posts Tagged ‘reliability’

Valuable lessons learned from an unreliable cell phone

April 17, 2011

Whether tool or weapon or crutch

For patients and family and such

     It’s not that I’d shirk,

     But if my phone doesn’t work

I don’t worry about being in touch.

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  On sabbatical to avoid burnout, while my non-compete clause ticks away I’m having adventures, visiting family and friends, and working in out-of-the-way places.  After a six-week assignment in Barrow, Alaska, the northernmost point in the United States, I’m working on the North Island of New Zealand. 

In residency, a mentor who rightfully commanded a great deal of respect talked about the responsibility of being on call.  One evening early in his career he’d had a glass of wine with dinner, and when duty brought him into the hospital for an after-hours call, the patient smelled alcohol on his breath and commented on it.  Subsequently, that doctor would never drink in town.

One evening, during those days, I came back to my apartment exhausted after a hard night of call followed by a long day of work, and fell into an iron-clad sleep.  Two hours later a patient’s relative phoned.  I tried to talk intelligently but it took me a good five minutes and a review of everyone on my census before I had fully awakened.  I tell the story sometimes because it gets laughs, but I can still remember the active struggle for consciousness, the feeling of mental molasses behind my eyes.

Eight months later, while on OB call, after I had given myself whole-heartedly to sleep in the residents’ call room, the phone rang at 2:30AM.  I kept falling asleep trying to get out of bed, tie my shoes, and get out the door.

A few more embarrassing incidents like those taught me how to not fall completely asleep.  I think most doctors have similar experiences during their training; for one reason or another, most of us cannot sleep well when we have call.

I knew a doctor who slept as well on call as off; he said he just told himself he wasn’t on call right before he went to sleep.

Another physician of my acquaintance avoided accessibility.  To the consternation of his partners, he refused to get a cell phone.  His beeper’s notorious unreliability came from failure to charge and failure to carry.  In the last year, I’ve come to understand that his cheerful good humor and the depth of his emotional resilience stemmed from his ability to get restorative sleep on call and off, and his capacity to relax and recharge when not working.  I don’t think he’s capable of burn-out. 

Three companies provide cell phone service in New Zealand.  My agency issued me a cell phone when I arrived; and, whether from hardware, software, or service issues, it didn’t reliably receive calls.  Frustrated at first, I learned how to not worry if I went out without it.  I have since become accustomed to not having a piece of my mind devoted to vigilance.  Though the agency replaced that phone with one from a different company, I sleep as if no one’s life depends on me awakening promptly.  If I’m on call, I’m on call, and I stay at the clinic.  When I’m not on call, we walk away from home and I don’t bring my phone.  We stroll down to the beach and I don’t run up out of the water to check my beeper. 

Yes, I work 40 or 50 hours a week.  I still feel like I’m on vacation.