As I sat down to start writing this today, Owen was sitting on my lap finishing his dinner. It didn't take too long before the computer was a lot more interesting than his empty bottle. Needless to say, my hands spent more time keeping the keyboard away from his slimy fingers than typing, so I just gave up and let him have at it. That should explain "Part I" you may have read earlier. He had something important to say, but he must have got it out of his system. Now the fabric of the recliner is way cooler than this hard, white computer.
Last night was my first night ever of taking "home call." Even though I think I spent more time driving back and forth to the hospital than I did sleeping, it was a nice change of pace from the types of call I'm used to.
"Call" is a big part of being a resident, and, for that matter, of being a doctor in general. It is something that most doctors, at any level, dread. Unless you've experienced it, it can be pretty confusing, but I'll try to explain it here because it is such a significant part of my life for the next year and beyond.
Simply put, call is a period of time (e.g. overnight), in which a physician is designated as the physician for a group of patients that includes not only their own patients, but also all the patients of the other physicians in the group/team who are not on call. During this period of time, the physician answers questions and addresses concerns about the patients, follows up on tests and procedures, responds to any Code Blue, and admits new patients to the hospital.
There are two basic types of call: "home call" and "in-house call." The duties of the physician don't really change between the two, the only difference is where you are when there aren't things going on with your patients. During "in-house call" you are not allowed to leave the hospital. That is, for 30-hours straight we don't breathe fresh air, we survive on coffee and the occasional cafeteria food, we generally don't take a shower or change our clothes (don't worry, we usually brush our teeth), and we if we ever see our call room, we sleep in uncomfortable beds in 10-minute stretches between the relentless beeps of our pagers. On the other hand, during a home call shift, although you still have to deal with the relentless pager and you still spend a lot time at the hospital dealing with stuff, when there is down time you get to leave and be a normal person within a 30-min radius of the hospital for a little while. Most practicing doctors (not residents) do home call.
Because I've been so used to in-house call that when I was planning for my home-call yesterday it actually crossed my mind just to stay at the hospital anyway. Driving back-and-forth in the middle of the night didn't sound too appealing, and I've had the experience of being the one at the hospital who had to call a resident who had just pulled into their driveway and tell them they needed to come back for something else. But, I decided that I would give the home call system a try.
Yesterday was treated as the July 4th holiday so we were finished after our morning rounds and I was home before noon. My first call woke me up from a good nap at about 3:00 and to the hospital I went. The afternoon was steady with a few patients and the one who was actually in labor was someone else's private patient so that doctor came in to be with her. By the time I made it home Owen was already in bed, but it was good to crawl into my own bed. My good feeling and optimism that I wouldn't get any more calls was ruined at 1:00am when I got called back. As I wrapped things up with that patient, the laboring patient from earlier in the day was about to deliver so I stuck around and watched. (I don't think I'll ever get bored delivering babies!) At 3:45am I debated going home knowing that I'd be back in about two hours anyway. However, a shower sounded really good so back home I went. My eyes didn't get much more rest, but it just felt good to be able to peak in at Owen sleeping during a night on call.
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