Exhausted

I'm post-call today, meaning I just came off a 28-hour work day. Slept less than an hour last night. My resident called last night a 7 out of 10 in terms of how busy we were. It's the first call night I've experienced that is actually representative of what call is really like for interns and residents.

This was the fourth call night I've taken in 12 days. We have to take call a total of 6 nights spread over 8 weeks. I front-loaded on purpose for two reasons: 1) so I will have more time and energy available toward the end of the block to study for the departmental exam, and 2) to experience the exhaustion that surgery interns and residents have to go through taking overnight call every 3-4 days.

So, how did I handle it? I was surprised by how easily I stayed awake and alert when there was action, like when I had to get a history and physical exam from a patient in the Emergency Department or lay eyes on an unstable ICU patient.

I also noted with some sadness how I had much less patience for the circumferential responses my patients would give to open-ended questions like "Tell me why you're here tonight." What I really meant, I realized, was "Tell me why you're keeping me from sleep." Even as much as I wanted a busy call night, it's amazing how sleep deprivation makes everything except sleep seem much less important.

I hope that my impatience wasn't apparent to my patients in the way I interacted with them. This is something for me to keep an eye on in the future when I'm similarly exhausted.

Ironic, I thought when 4am rolled around and I had been working all night, that this is the time when I would have been waking up for the next day's work. It used to be much later. I learned that a half-hour "nap" before pre-rounds can make a huge difference in getting me through the rest of the morning.