Thursday, October 6, 2011

Welcome to Night Float

Night Cityscape 2

It's enough to give a night person an identity crisis. Working night float, that is. Oh, and while we're on the subject, why do they call it night "float," anyway? Does staying up past the witching hour somehow render a person more buoyant? If so, I sure hope it doesn't mean extra mass, too, because, like Scott Calvin (The Santa Clause, 1994), I've tried to be diligent about watching my points lately.

Truthfully, I think "night float" probably does refer to the idea of rising up from the day shift, like a bubble, and floating along its surface from 6 PM to 6 AM. If there are any readers who know the derivation of the phrase, please, feel free to leave a comment. Inquiring minds would love to know -- especially mine.

Anyway, the reason I say it's enough to throw a night person into an identity crisis is, there's nothing like working from sundown to sunup to make you appreciate daylight. When I was younger, I would wake up just as my parents were paging Mr. Sandman. It made trying to get me into bed an interesting proposition sometimes, I'll tell you. But working overnight isn't quite the adventure staying up late once seemed to be.

True, from the perspective of seeing patients in the ER, it's perfect. For reasons I've never quite fathomed, most sickness hits after dinner. Ever notice that? You're fine until 3 AM and then you're hugging the diagonal dimension diver. Partly, we hope whatever has us in its grasp will let go if we just pretend we're fine. Of course, it doesn't, and in days of old, when doctors still made house calls, dad got on the phone while mom mopped our foreheads with a cool washcloth.

Maybe that's the image many of us retain, only now, we have to go to the doctor rather than have her or him come to us. I've heard of a few died-in-the-wool family docs who still get the Jeep out of the garage when it's fifteen below and the snow is piling up like paperwork at tax time, but they're the exception, not the rule. More commonly, folks show up at the emergency room where a medical student like me is waiting, making them wonder if coming to the hospital was such a good idea, after all.

Bushy-tailed and bleary-eyed, I'll introduce myself and explain I'm the first in what will surely feel like the 300 Spartans before we've finished asking the same questions over and over, trying to figure out what the patient already knows: they're sick, otherwise they'd be home in bed, where I'd be too, if I had any sense. We talk, I take their history, do an exam, and then the resident comes along and together we decide what needs to be done. It's a learning experience and one I'm grateful for, but I'm glad last night was my last for a while, because after night float comes morning report.

Morning report is where you realize what sleep deprivation really means. That's when your attending physician asks you the details of the case you admitted the previous evening, only now your brain feels like a bowl of cold oatmeal that has the consistency of cement. The data is there, you're certain of it, because you spent two hours writing up the case. Except what you thought expressed medical brilliance hours before suddenly looks like, "Oh, God, how could I have said that?!" You glance over at your resident who's smiling encouragingly, remembering their own third year and what it's like, being in the hot seat.
Eternity eventually passes, rounds are finished, your attending tells you "good job," and you're left, wondering whether you've got the energy to get home or should you simply fall asleep in your chair. It feels so good, so soft, so nurturing, it would be so easy to just...drift...away...and then your pager goes off.

Welcome to night float.

(Creative Commons image "Night Cityscape 2" by Kent C via Flickr)

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