Call

My first night on call was interesting. As a third year student, you hope for an early admission because once you work up that patient, you can go home. When you're on call as a sub-intern, it's a dilemma. You can hope for a bunch of admits early so you can work them up and get them "tucked" by evening. If you "cap" (reach your maximum) early, you have lots of time to take care of them, write notes, update sign out, consult, and then sleep. On the other hand, if it's a quiet day, you hope that it remains that way until 3am (when the call team stops admitting patients and any new admits get worked up by the night float resident and given to the short call team the next day). The worst is getting a bunch after midnight; you have a lot of patients and a lot of work to do; sleep is out of the question.

My first call cycle wasn't too bad; I admitted a comfort care patient, a community acquired pneumonia (rule out TB), and an ICU transfer of a patient recovering from presumed Still's disease flare (that's almost a Moffitt case). We were "slammed" early on; the interns were in clinic and we got six or seven admits by early afternoon. On the other hand, my second call cycle had an almost unheard of lull; our team as a whole only admitted one patient (perfect for the third year student) and I didn't get any. I spent most of my time catching up on my work and indeed, writing blogs.