The Nine Shifts: Shifts 3 and 4

Pre-shift 3: I wake up in good spirits. I realize there are two threats to me successfully completing The Nine Shifts. The first is infection. At any time, I could be stricken down with a gastrointestinal virus, pneumonia or any number of maladies I face daily in the ER. The second is laundry. With about 2 hours of waking hours at my apartment, I don’t have time to do my laundry. I have already run out of white socks which are my clear preference for the ER. My feet might feel the effects. I think I have enough underwear. I hope.

Shift 3: I engage in a turf war with nurse practitioners for my POD until I realize that each room they take over is one less patient for me. I feel I’m in a place without time, a place without beginning or end but not in a bad way. As if I had been born of the ER and this is the only life I have or will known. For better or worse, at home. The shift flows by with near mechanical efficiency, a master of my craft. Until I face an 11-year-old girl with abdominal pain that moves and much more attitude than I think an 11-year-old girl should have. For reasons that escape me, she alone undoes the momentum of hours and days and shifts until I am nothing but a sad patchwork of guesses without conviction, actions without emotion. I feel like an El Camino on blocks. Or at least what I think an El Camino on blocks would feel like if granted somehow the ability to feel. At hour 9, I grab a snack and drink from the cafeteria. I guiltily consume a bratwurst with kraut, potato cakes and an orange soda. I don’t eat my chips or my sandwich.

Post-shift 3: I ride home in the fog. It is very creepy. I am overcome by a feeling of déjà vu. I fall asleep on the couch watching the Cosby show.
Pre-shift 4: I listen to “I Get By With a Little Help From My Friends” repeatedly. I realize that I, too, am getting by with a little help from my friends. My friends, in this case, are various legal drugs.

Shift 4: I manage to get assigned the 3-6 POD again and bask in the independence and isolation. The ER is surprisingly less busy than days before, so while other PODs are getting closed down my rooms enjoy a constant flow of patients. I work happily unaware until my POD is invaded by nurse practitioners. I feel that I have been targeted for some reason. They must know that I am on the edge of greatness and are conspiring against me. I try to hold my ground but am ultimately unsuccessful. In shame, I begin to float and see patients wherever they may be. I am sad and wonder if I am uncovering just a small part of a larger conspiracy. I wonder if the entire staff is out to see me fail, if my success would destroy the mystique of the ER. The ER fellow Eric's jesting barbs seem to hold a deeper purpose. I decide to fight back in the only way I know how – to annoy people with random facts about lupus. I raise the question of the possibility of lupus in all patients, not just my own. I find an unlikely accomplice in the overnight ER resident who joins my cause and raises the classic war cry “It might be lupus”. I feel like William Wallace -- even down to the Argyle socks. I am truly my father’s son. With the slower pace of the shift, I steal away at hour 9 for a bacon cheeseburger and fries. I finish my shift strangely giddy, more aware now of my opponent and the stakes.

Post-shift 4: I walk home alone. The rainy weather has been causing muddy scrubs and I couldn’t afford to run out of clean scrubs. I am overcome again with a strange sense of paranoia. The building seem to a be a poor veneer hiding emptiness and deceit. I feel as an accomplice to it all. I shouldn’t think when I’m tired. I fall asleep on the couch watching the Cosby show.