Chronicles Of The Night Shift

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There are a lot of perks to working in healthcare. Scrubs are at the top of that list, because any job is better when you get to wear pajamas to work. The warm, fuzzy feeling of helping people is up there too, although it’s easy to confuse that with hunger. I’m either happy or hungry a lot when I’m at the hospital. However, one of the downsides of healthcare careers is that you’re virtually guaranteed to spend a significant portion of your career working overnight. Apparently hospitals don’t close, and unlike Ty Dolla $ign, when I’m always on that night shift I don’t have the girls from Fifth Harmony (or any girls for that matter) sending me dirty pictures. Instead, the only messages I’m getting are coming in hot on my pager.

Having a pager is a little bit like wearing a time bomb strapped to your waist, and not just because it causes a lot of people to stare at you in horror when you go out in public wearing one. At any given moment that, hellish contraption can explode into a frenzy of beeping, and the message waiting for you has the potential to ruin your night.

The vast majority of pages I get are from nurses. Some nurses are absolutely phenomenal. To be honest, I work with quite a few who are probably more qualified to do my job than I am at this point. Thankfully, a lot of them are willing to go the extra mile and throw out helpful advice so I don’t spend my entire day looking like a bumbling idiot. When these nurses are working, it’s a relief because you know your night will be smooth sailing. As the first page of the night blasted in 12 minutes after my shift started, I prayed to everything holy, as well as Chris Harrison, that it would be one of those nights.

“UNIT 3200 THIS IS TAMMY CAN I HELP YOU?”

This would not be one of those nights.

You know how I said most of the nurses I work with are helpful? Tammy is the opposite of helpful. Tammy is less helpful than Rose Dewitt-Bukater floating on a door in the middle of the goddamn Atlantic, except instead of crying in anguish and promising “I’ll never let you go!” she’d say “TOODLE-LOO MOTHERFUCKER” and start painting her nails and laughing maniacally as my cold, frozen body sinks to the bottom of Davey Jones’ locker. In case you missed it, I’m Leonardo DiCaprio in this metaphor.

“Hi Tammy, it’s Dr. Watson. You paged?”

“THE PATIENT IN 3208 IS NAUSEOUS.”

Tammy does not have an inside voice.

“Ok. Does he not have anything ordered for nausea already?”

“Well I appreciate that, Tammy.”

I did not appreciate that, but as Selena says, kill ‘em with kindness.

“I’m looking at his chart right now. He has Zofran ordered.”

“Let’s get him some of that Zofran and I’ll swing by in a little while to see if it’s helping? Sound good?”

The line clicked as Tammy hung up on me. Cool. I’ll just go fuck myself.

The next few hours of the night went by quickly and uneventfully. Typically, my early evening consists of checking on our sick patients to make sure they’re still okay and shooting the shit with our funny ones. Tonight was no exception. I was in the middle of watching a particularly rousing rerun of Antiques Roadshow with my favorite patient, who’d been in the hospital for over a month because bad things happen to good people when a piercing series of beeps interrupted our nice evening.

I breathed a sigh of relief when Tammy’s number didn’t light up the screen of my pager. However, my relief was short-lived when I realized the sources of this page was almost as bad: the emergency room. I called down to the ER and was met with a frantic sounding voice.

“Hi Dr. Watson. There’s a patient down here in 7 we’d like you to come see. Chief complaint is abdominal pain. Labs are normal. Not really sure what to do with her.”

“Sure, I’ll come down,” I replied. “Has she gotten a CT scan?”

“Well…no. She…no she didn’t get a CT scan. Just let us know what you think,” the voice on the other end of the line sputtered out.

This was strange. Abdominal pain is like a mysterious black box in the world of medicine. There are about a million different things that can cause it, and more than a few of those can kill you pretty quickly if you miss them, so it’s a complaint you can’t blow off. However, for every one of those big, bad, and ugly conditions there are probably three dozen other causes that wouldn’t necessitate a trip to the emergency room, but out of fear of litigation, almost all of these patients end up getting imaging of some sort.

As I reached the ER and found Room 7, I noticed that the privacy curtain was open, leaving the occupant in full view. The person sitting before me looked like what would have happened if The Mountain from Game of Thrones got really invested in Pokémon GO – but instead of catching a Snorlax, made sweet, sweet, love to its gigantic doughy body instead and some time later this individual hatched from an egg born out of their forbidden passion. I stopped in my tracks. One of the nurses came up and whispered in my ear “They tried to get a CT scan but she didn’t fit through the scanner.” It was by far the least sexy thing that had ever been whispered in my ear.

This is a problem that we encounter far too often. God bless America. For a while, the solution was to send plus-sized patients to the zoo to get imaging with their larger equipment, but animals started getting sick, so that trend ended pretty quickly. I made a mental note to skip the 1 a.m. mozzarella sticks tonight and to sign up for an Orange Theory class later in the week.

I walked into the patient’s room. “Hi, I’m Dr. Watson. I hear you’re not having the best day.”

Without looking up from her game of Candy Crush, the patient acknowledged my presence with a grunt.

I continued. “So the doctors here in the emergency room wanted me to come down to see you. I understand you’ve been having some pain in your belly?”

Her swiping paused. “Yeah,” she replied, never breaking eye contact with her phone.

“Can you tell me more about it?” I asked.

“I already told the nurse. Read the fucking chart,” she snarled, making eye contact with me for the first time. My testicles retracted to the depths of my stomach. This is going well.

I tried to be cordial. My go-to is the good cop routine, with a bit of pleasant but dim-witted mixed in to attempt to be endearing. As I started to ask another question, an explosion of sound from my pager derailed our conversation. I excused myself and stepped out to the nurses’ station.

The phone rings.

“UNIT 3200 THIS IS TAMMY CAN I HELP YOU?”

Damn it.

“It’s Dr. Watson, what’s going on Tammy?”

“Okay.”

There’s a silence. Usually when I get paged, the person on the other end asks a question. I am perplexed at the point of this call.

“…Is there something else I nee-“

“THE RESULTS ARE BACK” Tammy interrupted.

“And?”

“NO. FOR SPERM.”

There’s a second silence as I scream inside.

“ANYTHING YOU WANT ME TO DO FOR THAT?”

“I don’t think so.” Maybe a “Congrats on getting someone to go dicks out for Harambe on you immediately prior to coming to the hospital” cake? Short of drinking to forget, I’m not sure what to do in this situation. “Thanks for letting me know, Tammy.” The line clicks as Tammy hangs up on me again, and I return once again to face the patient in Room 7.

It was time to cut the shit. I launch into a litany of questions, trying to figure out what the hell actually brought this patient to the emergency room. I was running out of steam as I approached my least favorite question to ask a patient.

“When was the last time you had a bowel movement?”

Every time I ask this question, which is multiple times a day, I can just hear my student loans laughing at the amount of money I spent to have the privilege of prying into people’s shitting habits. It’s a great way to stay humble.

She pondered for a moment. “I don’t know. Maybe three weeks ago?”

“I’m sorry- three weeks?” I questioned incredulously.

“Yeah, that sounds about right.”

If I went three days without dropping a deuce, I would certainly explode like a shit-filled Gusher and perish. Three weeks? Was the mass of her entire body comprised of nothing but shit? Not figuratively mind you, but literal, actual, steaming shit?

I pressed on. “So you haven’t had a single bowel movement – nothing at all – for three weeks?”

“I mean, I guess I went a little bit this morning. And twice yesterday now that I think about it. But they weren’t as big as they should have been.”

I was afraid to ask the next question. “When you say they weren’t as big as they should have been, what do you mean by that?”

She didn’t answer me with words. Instead, she simply motioned with her hands as if she were a mime auditioning for a Subway $5 foot long commercial. It was both horrifying and effective.

“Got it.” I replied. “Just to make sure I’m understanding you – when you say you haven’t had a bowel movement for the past three weeks, what you mean is that you’ve had three bowel movements in the past two days?”

“I guess so,” she conceded.

“Is there anything else that’s bothering you, or is that it?”

“No, that was all. I just figured I should get it checked out.”

I wrote a few prescriptions for laxatives and fiber supplements to clear her pipes out and made an appointment for her to see a primary care physician during regular business hours before flying out of the ED like a bat out of hell, eager to avoid getting sucked into any more bullshit.

I had a few administrative tasks to complete, so I found a computer to try to power through some paperwork. Just as I typed my login info, my pager cut through the silence with its familiar, unwelcome tri-tone ring.

I sighed, dialed the number on the screen, and braced myself.

“UNIT 3200 THIS IS TAMMY CAN I HELP YOU?”

“THE PATIENT IS 3208 IS STILL NAUSEOUS. I THOUGHT YOU WERE COMING UP TO SEE HIM.”

Shit.

“You’re right, I apologize. Got a little busy there and it slipped my mind. Did the Zofran not help?”

“I NEVER GAVE IT TO HIM. HE WAS HUNGRY AND WANTED DINNER SO I DECIDED TO WAIT AND SEE WHAT HAPPENED.”

What a funny little game, Tammy. Let the nauseous patient eat hospital food and see what happens?

“I’ll be right up.”

The line clicks as Tammy hangs up with her signature middle finger of a goodbye.

I made my way to Unit 3200. As I entered the unit, I caught a glimpse of Tammy glaring at me over the top of her computer screen out of the corner of my eye. I smile and wave. She continued to stare, unblinking.

I entered room 8 and introduced myself to the patient and ask how he’s feeling. He launches into a play-by-play account of everything he’d done, watched on television, and ate that day. I quietly checked his monitors, waiting for him to finish. As he continued on, I started to hear a suspicious gurgling drowning out the late night infomercial blaring from the overhead television screen. It was oddly reminiscent of a garbage disposal winding down, and in my experience when that type of noise is emanating from a human body it almost certainly signals something is about to go very wrong. I turned to look at the patient, who had abruptly stopped talking. I was met by face I have made many times at home in my bathroom at 3 a.m., several times at a bar, and once out the window of a friend’s Honda Pilot. Homeboy was about to spew, and it was at that moment I’d realized I’d made an intern-level mistake: I was standing between him and the barf bucket.

Normally, I am not an agile person. Just today, I’d tripped going up the stairs (twice, if we’re being honest) and slammed my head into my own car door. But in this moment, as my patient-turned-foe opened his mouth to unleash a putrid tsunami, Jesus took the wheel and somehow gave me the ability to Matrix the shit out of that barf. Time slowed down and I watched pieces of poorly chewed hospital corn sail past me like bullets.

As what appeared to be the remnants of meatloaf, corn, and something entirely unidentifiable came to a rest on the floor of Room 3208, my surge of adrenaline abated, leaving me feeling like a mere mortal once again. Apparently my virility has devolved to the point that my body thinks coming into contact with vomit is a life-or-death moment and reacted accordingly. Regardless, I chalk it up as a win, although getting a spew shower would probably make for a better story to tell at Thanksgiving, if I had Thanksgiving off this year.

The patient and I turned to look at each other. “That was a close one!” he laughed. I heard a gasp from the door and looked over to see Tammy, who’d just arrived to witness the carnage caused by hospital food projectiled everywhere. I took a long stride, crossing the muddy lake of hatred on the floor and headed for the door.

“We’re probably going to need that Zofran now.” I whispered to Tammy as I walked out of the room.

It was going to be a long month on the night shift. .

Image via Shutterstock

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Crick Watson MD

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• @CrickWatsonMD