My First Overnight Call

Happy belated New Years. 2019 is going to be a great year (hopefully) since it’s going to be the year I finally graduate and my journey as an undergraduate medical student comes to an end. I can’t believe things are finally coming to an end. It still feels like I was just a first-year medical student yesterday, completely in awe of how I was able to interpret a complete blood count report and see what kind of anemia a patient could possibly have. Not that long ago, I was a second-year student, completely confused and unsure about how to do an abdominal examination on a simulated patient. Back in third year, I had no idea how I was going to get through pharmacology and microbiology. And fourth year? Fourth year really was just yesterday.

During fourth year and even in fifth year, I felt like as a teaching department, gyne and obstetrics was probably one of the best. As a student, you get to interact a lot more with the patients and especially in final year, it genuinely feels like you’re actually doing something for the patient. I never felt like that during my medicine and surgery rotations. Those rotations felt more like we were studying the patients as though they were a clinical case out of a textbook. I wouldn’t really feel like I was helping anyone except myself and it wasn’t a very good feeling honestly.

Since gyne/obs is my first rotation, it has been going pretty well so far. I have been keeping up well with the course and taking genuine interest in what’s going on with the cases, reading up on them and planning out how to manage the cases afterwards. I discuss my patient with the consultant I’m assigned to and while sometimes they talk about things that go over my head and I can’t keep up sometimes, things do end up falling into place and I can’t believe I’m saying this, but it’s actually pretty great. The feeling of understanding what’s going on with your patient and then having a senior doctor validate your management plan and agree with you is a really great and can’t be replicated by correctly answering test questions when you’re studying for the USMLE.

If there was anything that I was dreading in my final year of med school though, it was definitely the overnight call. 

In final year, we do have calls. Calls basically mean that you’re assigned to watch over the inpatients in the wards and the labor room. They start at 4pm once classes are over and initially, they were up till 10pm on weekdays. On weekends, you were expected to report at 9am and leave at 9pm. This is exactly how things were going until the Wednesday of this week.

For a variety of seemingly unexplained reasons centered around ‘improving performance’ and ‘get students shaped up’, the senior teaching faculty decided to turn these evening calls into overnight calls. So from 4pm of Wednesday till 6am of Tuesday, we were expected to be in the hospital. Oh, did I mention that class was 8am? If you start counting up the hours, that’s a whopping 32 hour stretch away from home!

I came somewhat prepared to spend the night. I had brought along a tote bag with an extra set of clothes and my shawl and for any extra things I would need to stow away in a locker. I also emptied out my bag quite a bit so it would be lighter and I wouldn’t have a problem with carrying it around everywhere. I knew I probably wouldn’t get any studying done so I just had my gyne book and my tablet. I didn’t study at all, as expected.

During the course of my call, I assisted in a delivery. I basically held the head of the baby and then the baby as it came out. It didn’t feel as much of an experience until I had my call-mate break it down for me. I might’ve just ‘assisted’ a delivery, but for that baby, I was basically the first person who had ever held him. It’s a little mind-boggling now that I think about it. Afterwards, I kept a watch on the mother and the baby. They were having trouble with breastfeeding so I tried to help out with that. Unfortunately, the issue didn’t get resolved while I was around.

I’m not going to lie- I did waste a lot of time. Mostly sitting around waiting for food or eating or making rounds up and down the stairs and looking for a place to sleep. It took some time to find a Medical Officer (MO) room that my friend and I decided to bunk in. There were three bunk beds and we took the top bunks (since no one else really wanted those) and settled in for the night.

In the morning, we took our time getting out of bed and fixing ourselves up to look a little decent before getting things signed. I looked around for my patient but she seemed to have gotten discharged. After that, we went downstairs to find the cafeteria still not functional at 7am. With class at 8am sharp, we didn’t really have a choice except to go out and visit one of the streetside cafes open right next to the hospital.

Called a ‘dhaba‘ in the local language, we ordered parathas, omelettes, channay and finished it off with a hot cup of tea. Out in the cold, it certainly felt like a revisit to the breakfast we had at Nathia Gali not too long ago. 

The rest of the day went as usual. While everybody else who had been on call with me had left, I ended up staying until the end of the day, completing the 32 hour stretch. I was rather amazed with how much I was able to get done on 4 hours of sleep. When I got home, I jumped straight into the shower, had lunch, tried to get some studying done but ended up going to sleep and taking the next day (Friday, which is today) off to recover. 

My next call is going to be on Tuesday. Now that I know that overnight calls aren’t that bad, I am no longer as frightened of them as I was before. Sure, they still feel like a rather inefficient use of a night, since I can’t get any proper studying or rest done, but it’s still an experience!

In fact, I’m still processing things in my head. I just might end up writing a few more posts about night calls and my thoughts and experiences on them! What do you think about night calls? 

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