Labor and Delivery

I'm always surprised how grueling labor and delivery call feels. I've probably worked hundreds of 18-30 hour overnight shifts in training, but each time I go through a call night like that, I am just exhausted. It makes me really respect the obstetricians who do this all the time. It's a recipe for burn-out.

I think the challenge is the unpredictability of the call night. When I take call in the main operating room, I know what's coming: a hip fracture, an appendectomy, an ectopic pregnancy, a craniotomy. It may be a nonstop marathon all night, but at least I know what to expect (especially since we aren't a trauma center). On OB, though, there is so little certainty. I may feel like I've tucked in patients; everyone with an epidural is asleep, all the "multips" (those who've had a baby in the past, and for whom the process is usually faster) are blocked, all the "primips" are still in the early stage of labor. But half an hour later, two people show up in active labor requesting epidurals at the same time a C-section is called. The night can go from quiet to hectic in a blink of an eye.

I didn't get any sleep whatsoever last night, but one thing that did make my day was running into an old friend I hadn't seen in years and catching up. Time grows very long between one and four in the morning, and company helped me push through those witching hours.

Image is from xkcd, drawn by Randall Munroe, shown under Creative Commons Attribution License.