All tired on the southern front

I haven't seen the sun in four days.

This is, as some of you know, because I just started work as the night shift junior doctor at hospital. The days(nights) had started to blur into each other, and by Wednesday night I was so glad to come up for air and experience real human contact again (not to discredit the nursing staff I've been working with, who are lovely people.)

All this, and I have yet to experience the full seven-night working week that my roster calls for.

I've been told by my colleagues that they are being run off their feet during the day, the poor soldiers. Internship, for them, has been more or less what we were told to expect - lots of busy-work that is half what we've been training for, half learning new ways to cram more tasks into a working shift.

So I don't think I can complain about night shift. It has been so far uneventful - no catastrophes, no code Blues (an emergency where a patient goes into cardiac arrest). I've had to insert a few intravenous cannulas (5 from 8), some urinary catheters (0 from 2; damn prostates) and attend a few patients who had minor chest pain and chase blood results.

In between I wander the hospital, which is an eerie place at night. All the hustle and bustle of the day seeps away at night, the chatter of medical staff and air of purposeful if hurried movement replaced with silence punctuated by lone footsteps, or the moans of a patient in pain.

As poetic as I'd like to make it sound, though, there are things about working on nights that border on the absurd. I have to make a conscious effort to remember where the damn light switch is on the wall; Although patients have a light switch on the end of a remote, it's best not to grope around in the darkness for that particular button. In the dim light at five in the morning I managed to ensnare a patient's cathether tube on his bedrail as I pulled it down. and couldn't interpret his flustered gesturing for a good few minutes.

This gentleman I've attended to each night of my week, and he's a nice guy. He was unfortunately afflicted with a neurological disease such that he is virtually quadriplegic and has difficulty speaking. We get by on half syllables, hand gestures and twenty questions. We had a laugh at the Scud's expense a couple of nights ago together.

The lady in the bed next to him, despite being Polish, can speak perfectly in fluent english, and yet I can't understand her at all. She is old, much older than the gentleman, and is convinced it is her time to go. Granted, she has a fair few afflictions, but I doubt she's heading to the pearly gates in the immediate future. I doubt even, that she suffers as much as her neighbour.

The nursing staff have seen to her three or four times already during the night and tell me she's fine. I go to see her myself on the fifth time and run the usual checks. Pulse regular, within normal limits. Respirations within normal limits. She talking to me in full sentences without the aid of an oxygen mask. She complains that she's short of breath. Chest sounds clear. Heart sounds are unremarkable. I reassure her that she's fine, and to buzz if she needs anything. She buzzes within half an hour and we go through the checks again.

Despair is her disease, and I have nothing for it. It worries me, because I have no immunization against it for myself either. Everything I had been told about treating your patients with respect, everything I had tried to brace myself with against becoming jaded - they seemed a futile defence against the cracks I can see forming in my foundations.

I try a different tack on the second visit. I'd been reading Art Spiegelman's Maus, a graphic novel about Polish Jews and the Holocaust, so I tell her this - maybe we can strike up some rapport, and that'll help me reassure her.

Twenty minutes and the full agenda of the Polish Retirees Club later, I'm no closer to helping her relax and go to sleep, and frustration sets in.

A couple of days later now, I can look back on this episode and wonder about how people ever made it through the Holocaust sane. All I had to do was get through twenty minutes with *one* despairing patient - some people had to live through years where despair was what you breathed in every minute of the day.

If Roche ever makes a pill for Patience(R) or QuikEmpathy(R), tell me where to sign up. I'm scared I'll need them.

***
I'm off to see a buddy and see whether he survived his first week of surgical internship. In the next blog: part 2 of this meditation, gossip from hospital, The Little Prince, James Frey and egg on Oprah's face and Australian Workplace reform/facism. Let me know how you're all doing.