getting_through_the_night.docx

Apr 30th, 2015
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Getting Through the NightI am from the bad old days. Not the very worst old days when I was a medical student and a pediatric resident in the 1980s, attendings who'd trained during those even older, very worst old days let us know that we were soft, we had it easy, we'd never understand what it was like to learn and practice in the days of the giants. But still, in my bad old days, we took call every third or fourth night and did not necessarily (read: never) get real sleep and did not necessarily (read: hardly ever) go home the morning after call, no matter how intense the night had been.Instead, we did other things. We asked people to check our calculations (particularly in the neonatal intensive care unit [NICU], where a decimal-place error in milligrams per kilogram or milliliters per hour could kill). We fell asleep during noon lectures. We wrote disorganized or perfunctory notes. We snapped and snarled at colleagues, nurses, friends, and family. And yes, we probably put our patients at risk. I definitely put the population at large at risk when I drove home postcall.Of course we complained and boasted, often simultaneously. What a bad night I had. How many admissions I got. How the stable kids decompensated, the sick kids crumped.But any sane person would know that it was bad. Looking back, I wonder whether everyone was a bit nuts, entrusting patient care to people who were predictably, by design, as tired as we were.Yet as proof that I'm becoming what

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