Sunday, November 04, 2007

Idle call

Rarely but occasionally during our tenure as residents, we have slow call days in which there are no or few admissions, and which can be spent at our own leisure. These usually occur on the weekend, when patients are too preoccupied with their own interests to bother coming to the hospital. Greatly appreciated, they help to make residency bearable: without a lucky break or two somewhere along the way, few residents would likely survive. Often a light call seems to come just when you need it most, when another rough one would surely have done you in.

There's something wonderful about getting paid to sleep, or to read, or to write on your blog. Online shopping at the hospital is scandalously fun. One of the nice things about being stuck there for thirty hours is that, if there is truly nothing going on, you have few distractions. E-mails long delayed get written. Schedules long left unchecked get reviewed and revised. Resumes get updated, bills get paid, books get finished. Being in the hospital is not unlike boarding an airplane and knowing that for the next several hours you will be stuck there, alone with your thoughts, free from outside demands on your time. I tried to keep a journal in college, but the only time I ever wrote in it was when I was flying home for vacation or back to school. Many people only read books when they fly. Surely great medical ideas must have been conceived by physicians whiling away time in the hospital.

The slow call night that lets you sleep is triply rewarded: not only are you able to relax instead of working in the first place, but there will be fewer patients to follow up in the morning, and your post-call day will be spent awake rather than sleeping. It is a gift that carries a generous momentum. A downside does exist, I suppose, in that your idleness can beget laziness. When you do receive that rare page on an otherwise still day, you resent it all the more for disturbing your peace. When busy, you accept such pages matter-of-factly; when resting, you do not want to be called to work. You spend your entire day just hoping and wishing that your pager will remain silent. A call day with just two admissions is doubly as painful as one with four.

Even on the most quiet of calls, though, meals are eaten quickly, and the resting heart rate is rapid. The pager pressing into your hip reminds you of a fact that you would never forget anyway: disaster could strike at any moment. Better, therefore, not to admit that you're having a good call day. Better to deny it. Someone might overhear you and decide you need work. Of that, even on your slowest day, you certainly already have enough.