Last Night

 I can think of at least a dozen things I should be doing instead of sitting in front of my computer, clacking away at the keyboard. My dirty house, my stack of board review cares, the appt I need to leave for in 20 minutes, and my bed are all loudly calling to me. 

But sometimes, you just gotta write.

Last night was my very last call night of residency. 

While there are still quite a few more days in front of me before the end of residency, they are mild and benign compared to what lies behind me. 

Nights are the worst time to be a doctor.  It is when people get the sickest, the decisions have to be made the fastest, and you feel the most alone. During the day, surrounded by colleagues and consult services and social workers and interns, everything feels safe and manageable and yes-I-can-do-this-I-am-okay. But then night comes and the bustling crowds teaming around each patient bed are gone. The fatigue sets in. The hour counting starts (20 hours awake, 21 hours awake, 22...) And things just happen. It feels like night is when hearts choose to stop and strokes choose to start and metabolic derangements choose to declare themselves. Insecurity and doubt and sleep deprivation and loneliness press in from every side.

Yet decisions are still made, vent settings are changes, medications are started and stopped and labs values are corrected and pagers beep and are answered and I find that I can do this. 

Morning arrives and fresh, rested faces appear back in the hospital and all the patients from overnight are just fine.

In the pre-dawn bustle, I head to the hospital cafeteria.  I, the soon-to-be anesthesiologist, stand in line between the soon-to-be neurosurgeons, orthopedic surgeons, trauma surgeons, and obstetricians. We are all bleary eyed and pale, ordering our scrambled eggs and breakfast sandwiches and coffee.

There is camaraderie between us as residents, wearing our fatigue as war medals beneath our eyes.

I wonder to myself, now that the last night is over, I wonder will I miss this?

And that's when I realize how tired I am. Because no. From now on, every night will be spent in my bed. I will come home every evening. I will not count how long past 24 hours I've kept my eyes propped open and flogged my brain to decide, work, choose.

The last night is finally done. And all I can feel is gratefulness to have survived yet another thing. To be done with another thing.