4 pm. You start worrying about the beginning of call. You line up pager, cellphone, pen and paper, and lie under the covers, hoping against hope.
5 pm. Pager beeps. ‘Dr. J? I’m the Medical student on call with you.’
You explain, ‘Yes, but My call doesn’t start until 8. Why don’t you page the day call person?’
‘Oh? Do you know who it is?’
You obligingly hunt down the call schedule and provide the student with the day call person’s name, the correct pronunciation of their name, their pager number.
7 pm. You’re finally warm under your comforter, and the book is about to drop out of your hands. Pager beeps. Its the day call person. ‘Just giving you a heads up. There are two patients coming in tonight.’ (This, only if you’re really lucky. Mostly, the patients just show up.)
8 pm. Page from the ER. ‘There’s this, uhh, fellow in his twenties who came in for a headache. He isn’t suicidal or crazy or anything, uhh, but he wants to speak to a shrink about his coke habit.’
‘Um, you know we don’t do drug rehab here. Would you give him outpatient rehab numbers?’
‘Well, you know, I think he deserves a psych eval. (translated- Giving patients follow up phone numbers is NOT my job)
‘He wants to talk to a shrink. He’s a nice guy, really.’
‘ I know..but do you think he needs admission?’
‘ No, but really..’
At this point, you give in. Get out of bed, put on scrubs and a sweatshirt, insert pepper spray into pocket, and head out towards the hospital. Talk to the patient, who is really homeless and was kicked out of the shelter because he snorted some coke. However, he is a nice guy. You give him the address to a different shelter, numbers for other rehabs, then spend two hours trying to page the attending. Seems like they forgot their pager when they went out to dinner. You scrounge for a cellphone number, talk to the attending, discharge the patient, dictate your consult.
Thats when you realize you forgot to call the medical student.
In shame, you trudge back home. Change into pajamas, put on warm socks, grab some chips for comfort, get back into bed. Its 9:30 pm.
10 pm. The pager beeps. Its the floor. ‘Your patient is here, and he’s as sick as a dog.’
You run back.
Turns out the patient has a slightly low potassium, a slightly high pulse, a urinary infection and is completely asymptomatic. He does have six other diagnoses and a list of 23 scheduled medications and 10 as needed meds. You spend an hour trying to translate and pare down the list. You talk to the patient. You give him some TLC and some potassium. You write for medicines, labs and dictate your admission note.
Its now 1 am. You debate between going back home or just staying in the hospital. An investigation of the call room reveals a complete lack of blankets and a dirty pillowcase. You go back home.
And thus it goes. Until the next morning. For one whole month.