Night-float

Last week I started on night-float which means I'm the doctor in the hospital on-call between 5 at night and 7 in the morning. So if anything goes wrong with one of the patients in the middle of the night, I get paged. Some people try to take cat-naps during the night and then stay up part of the day when they're not at work. I elected for complete day-night reversal so I've been staying up all night and then sleeping all day. And although I always kind of feel like I'm in a weird kind of fog these days with my circadian rhythm all screwed up, I've actually really enjoyed night float.

The hospital at night is so quiet and deserted and I like the feeling of being one who keeps watch until the morning. There's also a sense of team-work with the nurses who are on overnight which isn't quite there during the day.

My favorite thing though has been having enough free time to just have some good conversations with patients. At the beginning of the night I like to go check in on most of those I'll be responsible for over the next 14 hours. When I'm seeing patients during the day it's always very focused on getting a medical history and doing a physical exam and the time is always short. But at night I just round by myself and check in with people. Sometimes I'll do elements of a physical exam but usually it's just me saying hello, letting the patients know that I'm the doctor responsible for them overnight and asking if they have any questions.

Without the usual day-time expectations of doctoring I've been able to have some interesting conversations with some elderly patients. I listened to the life story of a 95 year old gentleman last night. He told me of his one-armed grandfather who was a doctor in Mississippi. He told me of fighting in the Philippines and New Guinea in WWII, of coming back after the war to Rhode Island, of how he met his wife when he saw her getting on the train and helped her with her heavy suitcase, of how she sent him a post-card with the Empire State Building on it, of how he stole her away from the rich man she was to marry, and of raising a family with her in Texas. Then he told me of his sadness when she died in '98 and how the first thing he does "if he makes it through the pearly gates will be to go to the complaint desk." This saddened me but I understood. He was still telling me his story when we were interrupted by the "beep beep beep" of my pager. As I rose to answer the page I could tell he was thankful that someone had listened and he asked me to come back again. If he's still in the hospital tomorrow night maybe I'll stop by to hear some more.

I also spent some time with a 91 year old man who told me of his time stationed in Morocco after the war and how he and his wife toured Europe in the early 1960s.

Thankfully there haven't been any emergencies over the past few nights I felt like I couldn't handle. But I know that they will come and I know that like every other thing I felt like I couldn't handle being an intern (and there have been a great many) that with God's strength and providence I'll get by.

On the first night I drove to the hospital, dreading the 14 hours ahead of me, feeling relatively alone and responsible for so much, a prayer came to mind which is one of my favorites from the Compline service in the Book of Common Prayer. I thought of myself and the nurses watching, of my patients suffering and perhaps dying and of their families weeping. So this is my nightly prayer this week...

Keep watch, dear Lord, with those who work, or watch, or weep this night, and give your angels charge over those who sleep.

Tend the sick, Lord Christ; give rest to the weary, bless the dying, soothe the suffering, pity the afflicted, shield the joyous; and all for your love's sake.

Amen.