I've taken call many, many times before this, but never with the same potential for frenzied activity, 27 hours straight (24, for my readers on the Bell Commission). After the first few calls for the medicine ICU, I grew efficient enough to get in an hour or two of sleep. But, unlike floor medicine, where the overnight intern is awoken a dozen times for generally trivial concerns, all my pages in the ICU were genuine problems.
I performed more emergent intubations, more lines, more spinal taps, and about a thousandfold more ABG's than in any single rotation before this. Running a code no longer paralyzes me with fear. Most incredibly, from my perspective, was that I was making so many of these critical decisions.
Because of the crazed sleep schedule, in which I'd be unconscious for about 15 of my 21 free hours post-call, life outside the hospital became filled with malaise and dysphoria. My apartment has never been messier. So many obligations got punted to September -- relationships, phone calls, emails, workouts, blogging.
Nothing was getting done -- nothing was worth doing. I didn't get out much, and when I did, things seemed unbearably slow or purposeless. I never felt really alive until I was on call again. Isn't that a lark? Maybe I was so conscious of my agency because most of the people around me were heavily sedated.
I did call my parents a lot, often to thank them for happy childhood memories that would surface at odd times. This was likely prompted by the wrenching conversations I would have with families about their sick loved ones. Until now, too often, talking with families in the ED was been a chance to gather history and transcribe medication lists, or explain why someone is going to be admitted / discharged (when all the family wants is for them to be discharged / admitted). But this month had more than its share of conveying painful news, of asking families to make difficult decisions.
It's remarkable, how thoroughly and abruptly lives can be disrupted, how strong people are forced to be, at their most vulnerable.