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Saturday, April 9, 2016

Being On Call

When I was a kid, my dad was on call all the time. I am not exaggerating. He was in practice with my grandfather (his father-in-law.) Nat (my Popop) had been in solo practice for years and so when Dad joined him, Dad took over call. Nat was always willing to cover if my parents had plans; mostly Dad was just - on call. 24 hours a day. Seven days a week. My mother finally forced him to take an actual vacation after eight years.

Now, Dad would be the first person to remind me that this was in the 1960s. No ICU. No CCU. No tPA. No push to get patients out of the hospital - people with uncomplicated MIs (if they survived) stayed inpatient for at least ten days. You could admit people for evaluation of new diabetes. No urgent calls on abnormal labs in the  middle of the night. And he genuinely loved his work and his patients, and he didn't need all that much sleep, and of course he had no responsibilities at home because my mother did everything. But still - on call EVERY SINGLE NIGHT. I can't even imagine it.

I'm thinking about it now because last night was One Of Those Nights. I was exhausted after a long and difficult week and I went to bed at 10:00 PM. The beeper went off at 11:00 PM, 1:00 AM, 2:30 AM, 4;00 AM and 5:30 AM. The 5:30 call was from the ED about a patient who needed urgent admission to the inpatient hospice unit, which meant three more phone calls, so I had to get out of bed. I tried to go back to sleep - and then my daughter's alarm went off at 6:10. She's away for the weekend. She didn't turn her alarm off before she went.

I think I'm too old for this. And then I think of Dad and feel like a wimp. And then I remember that he was 20 years younger than I am now, so perhaps I should let myself off the hook.

Am I the only one who has grown to loathe being on call overnight?

11 comments:

  1. I hated overnight call, and I had no spouse or dependents at the time. I think there's no question that the call of your father's (and your grandfather's) era was vastly different from the call of today, and the ease that comes from having a stay-at-home partner cannot be overestimated.

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  2. I don't mind call (yet) but I think that's because it's in-house. I have some home call next year and I fully anticipate disliking it. It seems like fake free time to me. Additionally, I already really dislike having to field phone calls in the evening about work since I usually have to placate my daughter AND pay attention to the caller. And no, I cannot imagine having home call every day! Ugh!

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    Replies
    1. "Mom, are you on call AGAIN? I hate it when you're on call." I had to walk away so she didn't see my cry- she was 10.

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    2. Oh yeah, we already have that and she's only 4. Sigh.

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  3. I hate call. I don't know how I could really stop taking it, but I will never like it. Nights like that are the worst. I think it would only be bearable in some kind of shift situation.

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  4. I LOATHE being on call. Home call is slightly better than in-house. If only there was a way to do this job without call...if only... The older I get, the longer it takes to recover from calls like the one you mentioned. Getting a post-call day off helps, but life would be a lot easier without call or post-call days.

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  5. As someone who has occasionally had to wake up on-call doctors in the middle of the night, I just want to let you know that your sacrifice of a decent night's sleep is very much appreciated. The times when I've had to make that call, I always felt a little bit bad about it -- but the doctors who responded were always both helpful and kind. For someone who is scared about a loved on in the middle of the night, that means a lot.

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  6. I completely don't mind call. I have a really low sleep latency, so I fall back asleep almost immediately and I like taking care of acute/critical cases. My daughter knows to respect the "doctor phone" and wait until I'm done talking (we've had hiccups, because being a very junior attending at the same program I trained at, I'm friends with most of the fellows, and my daughter knows them so she'll get skeptical that it's a work call rather than a social call, but that's the worst of it.)

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  7. I loathe call. As an OB, not only do you get amazingly dumb questions that are obviously not emergent, you get the holy crap calls & speed as fast as you can to the hospital. I will say, I strongly prefer middle of the night deliveries to middle of the night patient calls.

    The older I get, the more I understand the urge to drop OB. I've been out of residency for 10 yrs, I figure I have about 5 more yrs of OB left in me. It takes a physical toll.

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  8. No one likes call - whether you are the surgeon (I am ENT), general practitioner, or support staff. In the OR, when I get called in, most of the time the entire OR crew comes with me. What we need to realize is that some of us (not all) have picked a profession that this is part of our job. It sucks - for all of us. But that is what we do. I wouldn't want anyone else taking care of my patients - and if roles were reversed and my child needed immediate care - I would pray their doc had the same feeling.
    We all love our families - I am the mother of three boys ( 12yo, 10 yo and 7 yo) but they understand. We communicate. They are great kids and come with me when they can but they know that this is what mom does.

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  9. I have call for toxicology. It is a rare event that I go in for in the middle of the night. Sometimes the calls interrupt but I am usually back within 10 minutes.

    I do, however, have overnight shifts. And as I age, bouncing around day to night is harder and harder physically. I stick to evenings and overnights and try to sleep extra after I've gotten the kids to school. Helps some.

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