Saturday, April 2, 2011

The Wretched Hour

The beeper goes off. Groan. What time is it? My hand fishes around for the pager in the darkened call room. Good God it's 5:10 AM. Jeez, the surgeon just booked an appendectomy to start ASAP. I stumble my way to the operating room. The bright lights of the hospital hallway are like electroconvulsive therapy on my optic nerves. My eyelids feel like they are lined with sandpaper. My fingers rub my eyeballs raw trying to wipe the crud out of my inner canthus. I hate starting a case during this wretched hour.

If patients want to know what a doctor looks like to his or her spouse first thing in the morning, come to the O.R. during the predawn hours. It is not a pretty sight. Bedhead? Halitosis? Dark baggy eyelids? Check, check and check. It is the antithesis of a professional presentation. And grumpy? Though we try really hard to keep a cheerful demeanor, it can be a losing battle when we haven't had a shower and that first cup of coffee. 

This twilight zone period of the anesthesia call is the most painful time get a case going. It's too early to have the morning anesthesiologist come in to do the procedure. The case will start late enough that I will finish it past the end of my shift. Though it's tempting to ask the morning shift to come in just a little early so that I won't have to do this case, I know from personal experience what it feels like when I get that phone call in the morning to come in early when the night shift doesn't want to work anymore. It is aggravating and won't make you many friends. So I go ahead and start the case despite the sun starting to peek over the horizon.

Surgeons think they can just squeeze one more case into the night before the start of the OR schedule. But getting patients into the operating room never occur that smoothly. There are delays all along the way. Between getting the patient out of the emergency room to the paperwork that needs to be processed in preop, the case usually doesn't get started until it is dangerously close to the first scheduled start of the day.

Inevitably the surgeon will be in a rush to get the case finished. He will complete his work with great flourish, proudly waltzing out of the room right before the the morning cases start. But of course he doesn't factor in the time it takes for me to wake up the patient. Also the room needs to cleaned and turned around. The surgeon whose case was delayed will be pacing in the doctor's lounge, grumbling about operating room inefficiency.

For me, I don't care anymore. My shift has ended. I stumble to the parking lot, heading into the teeth of the morning rush hour on my way home. Time to catch up on my sleep before work resumes the next day. And I will have brushed my teeth and combed my hair by then.

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