Post-Call

There's no feeling quite like being post-call from a 30 hour shift. Looking back, I'm not sure how I did it every fourth night in intern year for nine months. I can't even easily put it into words. There are ebbs and flows of energy, lulls in the day (or night) where you are on the edge of sleep before that racket of a pager shakes you awake. Yet you also go through these energy rushes where you are running from one emergency to another, feeling (or at least thinking you feel) as awake as ever. In the morning, the light of day, when all your decisions overnight are being scrutinized, you shy away from the bright lights, encounter word-finding difficulty in presentations. Little bits of information slip away. Small to-do's are lost, forgotten. You develop a system, to ensure that you keep track of all the tidbits that happen over twenty-four hours. You learn to be more efficient, simply because you have to; otherwise you'd fall asleep typing mid-sentence. The world is a blur; you walk upstairs and forget why you did; when you get back downstairs, you realize you wanted a new pair of scrubs and trudge back up. Time elongates and shrinks just as daylight does. It's the strangest thing. Now, when I hear about interrogations that keep detainees awake for 80 hours, I shudder. That is a cruel and awful state to live in.

Afterwards, driving home, all that energy rushes out, deflating like a balloon. There is a Stanford class called Sleep and Dreams where the motto is "drowsiness is red alert." Driving home post-call is red-alert. You don't want someone who has been tending to critically ill patients for thirty hours on the road. I don't want to be on the road. When I get home, I tip easily. I stumble. And when I sleep, it's like being submerged; I try to surface, and I simply cannot come up. The dreams are vivid. When I awake, it is dark.

I have a lot of mixed feelings about it. The way medical education is going, it is doing away with these ferociously vicious and borderline inhumane calls. It's certainly not safe for us, especially if a commute is involved. It's probably not great for patients. It may soon be relegated to a rite of passage of times past. Someday, it may be relegated to legend, to stories beginning with "back in my day..." I don't have that many twenty-four-plus-hour calls anymore, and I am grateful.