Too tired to be tired

Being on call can be a good or a bad experience. At it's best, it's like a big sleepover with good friends, food and a tidy room you don't have to keep clean. At it's worst, it's an unbroken 28 hour marathon of demeaning busy work in a discipline that will produce no positive impact for the people you care for or your education.

Sometimes it's easy to predict whether call will be good or bad.

Some call shifts I've enjoyed. Even when I get called I don't mind, as long as it's something I can help out with, something I can learn from, and if it's not going to interfere with my sleep too much. There have been a few times on call when all these things have happened and I go home the next day feeling pretty good about it. It sure doesn't hurt that I get the afternoon off after I've been on call. Getting 5 hours off work in exchange for having worked an extra 19 hours overtime doesn't seem like a great trade, but that just goes to show how good call can be. I prefer working 19 hours overtime sometimes if the call experience is good. It's even better if I'm skipping out on something I hate postcall, like GI clinics. God. What kind of doctors like making people squeeze their fingers with their anuses? Gastroenterologists, that's who.

The bad call shifts are pretty shitty. It's those times that make me question whether or not medicine was the right choice. It doesn't take much to make my call shift the reason why I hate a rotation.

I just finished 3 weeks of obstetrics, and I was on call 5 times over those 3 weeks. Twice I was on call on Saturday, which means you start work at 7am on Saturday, and stay in hospital working until 7am on Sunday. You get Sunday off, and on Monday you go right back to work like everybody else. The difference with obstetrics call versus the other call rotations I've had to do is that there is virtually no sleep. Over those 5 call shifts I've averaged 1.2 hours of sleep a night. The rest of the time I've been dealing with OCD doctors, superiority complexed nurses, and all kinds of women squirting out blood, feces, and baby juice on my shoes.

The bad nights are the ones where you're too tired to even sleep. It gets to the point where the grogginess associated with an abbreviated nap is worse than just staying up an extra hour or so to wait for that patient to get to the hospital.

Being chronically fatigued screws around with the internal chronometer too, so when you fall asleep you have no idea what time it is when you wake up. Going to bed at midnight and waking up at 1215 feels the same as waking up at 630. It sucks pretty hard when you go to bed dead tired at 4am and wake up thinking it's morning and time to go home when really it's been ten minutes since you went to bed and there's still a whole night of work left for the nurses to page you about.

It's like an office gift exchange. When you give in your gift, you put a fair bit of effort into picking something people might like, and do your best to please. You have no idea whether or not your gift will be properly compensated though. I put in craploads of energy trying to perform on call, but the effort I put in has no bearing on how much sleep I'm going to get.

Holy s*** I'm tired. I'm going to bed.