The common room looks abandoned and the couches are cold, proof that nobody has been staying overtime. I put the food in my locker and head back toward a phone. Dr. HC, I'm ready to start...
Good. Meet me outside the intensive care unit.
The elevators take too long, even at night and the fire-stairs is the path that takes me behind the emergency department. The eerie corridors stubbornly kept illuminated by fluorescent lights freak me out as I hear the echoes of my footsteps; something normally very rare during daylight hours. But night shift is different - we maintain patient's vital signs until the teams arrive in the morning. In other words, we are just mobile labour eliciting a degree of critical judgement to a patient's deteriorating state. We only see people that are acutely unwell on the wards and the emergency department deals with the community's acute care.
-------------------------------------------------------------------------------------------Fast Forward-------------------
It's now 0300hrs and I've had my first break for food. The pager goes off again at 0307 and I'm asked to put a few intravenous cannulas into patients. I head down to the ward and after practicing with needles for about 5 hours, I get the each of them in on the first attempt. Quite the confidence booster.
I'm about to head back to the common room to continue my food break and the nurse stops me. Can you put in another cannula? It's pre-operative. I agree and turn back.
Karen is her name and her veins are absolutely horrid. There is no chance at all I'm going to get this. To an extent, I don't want to ruin my untarnished successes with cannulas. The intern was concerned about this lady's veins and really, I wasn't in any position to start poking until she screamed.
She was uncomfortable, but not because I was looking at her from the end of her bed, holding a kidney dish full of needles for her... she was concerned about death. Something we often forget about in hospital, even as medical professionals.
I've got a problem with my heart and my cardiologist told me I should not have anaesthetic unless I really need it.
She looked upset, stressed and anxious. Not the right mindset in the early hours of the morning before her laparoscopic cholecystectomy. So I decided to sit down and explain the importance of her procedure, the role of the anaesthetic doctors and nursing staff. Ten minutes later she felt better and the physical manifestations of her anxiety had waned. It was very interesting to watch somebody's physiology change after hearing and interpreting a few words; more of comfort than information. I promise I'll visit you tomorrow morning and the first thing I'll say is: "You're still here." We exchanged smiles and I left to go back to the common room.
-----------------------Fast Forward---------------------------------------------------------------------------------------
It's 1900hrs the next day and I'm ready to leave. I've been awake for 36 hours and the break I had was to partially eat some food at 0300. At this point, most of what people are telling me aren't making sense and I'm on autopilot; responding spontaneously but definitely not concerning myself with the consequences of my words to people, especially doctors.
I'm about to leave and so I decide to see Karen. She looks tired from the door and I sneak in until the IV machine starts screaming about an occlusion somewhere in the line. It startles the lights out of Karen and she's awake now. She laughs when she sees me and then squints in pain. You're still here, Karen.
She smiles back and now we're both relieved, despite the pain she's in. I tell her that she's allowed to ask for pain killers. I asked for pain killers at 2pm and I haven't received anything. I remind myself that it's now 1915hrs and this poor lady has been in pain for 5 hours. That's bordering on ridiculousness in my books. When I bring it her nurse's attention, I get told: I'm busy. I promise Karen to annoy the nurse a little more before I leave the ward.
Just when I was heading over the nurse's station, one of the other patients sees me. Doctor, please can you help me? I correct her: Medical student madam. What can I do for you?
Well, I haven't eaten in three days... and they just placed some jelly and custard on my table here and I can't open the lids.
I promised I would leave after this last patient I wanted to see. She was under our care during my Geriatrics rotation and I saw her the day before in another ward. Obviously she had been re-admitted for another problem and I promised to visit her later. I went over and she was also eating her dinner.
I sat down and realised that she too was struggling with her food. I really want some fruit and the only fruit they give are these peach slices smothered in custard. But I can't eat them because they're too big to chew and too hard to swallow. So I've just been eating the custard.
Not sure what anybody else would do, but my first reaction was what I followed. I took her eating utensils and cut the peaches into tiny little pieces that she could swallow and she was so happy she was able to taste fruit again after days in hospital.
People ask me why I stay back. People ask me why I feel the need to stay back. I don't know what they expect the answer to be. Because my question is why are they asking me that question?
All these patients in the hospital that may be incapable of doing the simplest of things, such as eating, drinking or walking to the bathroom. And I notice a few people that could not access their food, so I help them with it as any person should.
What keeps me awake and concerned is that there is an entire hospital filled with patients who may be being denied the basics of living. Putting a plate of food in front of someone doesn't actually mean they can eat.
People don't get sick during business hours. People always get sick. And if people are more concerned about their leisure activities, their hobbies and their rest and recreation, who the fuck is going to look after those who are in need outside business hours?
"I want a good lifestyle," is what I keep hearing. I don't know what that means and I don't understand how people are able to live with that; knowing well that there are people at their fingertips waiting for help at arbitrary times of the day and all they can do is brainstorm a good perception of lifestyle.
I don't want a lifestyle. I want to be there for patients when the rest of my colleagues are thinking about their dinner, their television shows and exercise. I always want to be there.
Always.
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