The Nine Shifts: Shift 8

Pre-shift 8: Each morning I lay in bed a little longer, putting off the inevitable as long as I can. I have run out of milk for breakfast cereal. I eat my cereal in yogurt. I have also run out of bread and chips. Considering that all I eat is breakfast cereal and peanut butter sandwiches and chips, I am almost completely out of groceries.

Shift 8: I feel strong. I float for the first half of the shift but preferentially take the high acuity patients. I feel at peace in the ER able to lose myself in the work. My first rotation in the ER as an intern was my first real rotation as a doctor. While hardly a great pediatrician now and in fact bordering on incompetence at almost every turn, I was lost, dazed and confused then. I was in fear of what the next patient would bring, always afraid that the next patient would expose me as a fraud. The year-and-a-half that has passed has been good for my knowledge and confidence. We talk how the rotations and months and even years pass quickly but without the feeling of actually learning or progressing. It is times like these that allow me to look at myself and realize that I have grown. I admit a lot of patients. At one point I count and realize that over half of the patients I’ve seen have been admitted. I don’t know if that is good or bad luck. At least it is a change from the feeling of not seeing anything significant. With the last hour of the shift, the fates start to rail against me trying to finally break me in a way the previous 7 shifts haven’t been able to. I treat a girl with altered mental status lasting weeks who has been admitted multiple times at another hospital with countless tests and no diagnosis and a boy with the worst foot odor I’ve ever encountered in a patient under 10. I wear a mask to help mask (pun intended) the smell and say that it is for infection control. I remember that a large reason that I became a pediatrician is for utter disdain and repulsion by the smelly feet of old people. The boy is sadly years ahead of his time. I eat hummus and grapes for dinner. I find it strange that our hospital has hummus and grapes.

Post-shift 8: I ride home in a light snow fortunate that enough hasn’t accumulated to compromise my bike ride. It feels that my only connection to a world outside of the ER, my couch, and the road in between is when I check my mail. It reminds me there are places out there beyond my small sphere now. All I get is junk mail. I fall asleep on the couch watching The Cosby Show.