Shift work

Nearly all veterinarians working in emergency medicine have worked overnights. And most of those doctors dream of being able to do their emergency medicine shifts NOT overnight. Of course, there are a few people who flourish at night. I am not one of those people.

I accept that my chosen focus requires me to be up when most sane people are sleeping. I get that I have to make my brain work more at 3 am than most people would dream (why does everything actively dying come in at 3 am, anyway?). But I would give my teeth (which I end up grinding during the day when I'm trying to sleep) to occasionally have a normal job.

Wait, I lie, I'd be boarded with a normal job. I just want normal hours. And by normal, I mean a normal 10-12 hour shift, not the 8 hour shifts found with people who are not doctors, or with people who aren't in the medical field. Or truckers, cops, fire fighters, or even factory workers. And in that last sentence, I am poorly writing how I recognize that those folks have long, shitty hours too (not that they have 8 hour long shifts).

Tonight, I am staying awake in preparation for working the holiday weekend, Friday through Sunday, for 14 hour each night, overnight. Obviously, the sleep drain is already causing me to lose portions of my functioning brain rapidly. In fact, my mentors can easily guess which day of the week it is by the number of vocabulary words that no longer make it to my mouth. (Me: the patient has that wacky heart rate thing where it's going super fast and scares the techs. My poor suffering mentor: you mean tachycardia?) It's scary, and ugly, just how quickly I revert to survival thinking when I'm on overnights: Mara sees cookies brought in by a grateful client whose pet she has never seen, mine! she thinks as she hordes a handful for later.

When I'm actively working (and not prepping like I am tonight, where I allow myself to be a dumbass because no one will die if I think the wrong thing), and busy, I do okay. My brain gets in a pattern of dredging up useful information, I am able to converse appropriately, and I spend what little downtime I have pacing back and forth in front of my patients. But if it's slow, it's as if I'm swimming through molasses. Yes, I can still catch the important stuff for the most part, but it is painful, and there is constant worry that I'm missing something. That worry stays with me when I go home for my 8-10 hour break from work, and manifests itself as horrific dreams where I'm failing my patients, or pissing off my colleagues, or getting myself sued by a client. And then I wake up refreshed (not), and go back to another 14+ hours of just barely keeping up.

Beyond the brain-numbing aspect of shift work, I find the overnights physically destructive as well. I start out the night, relatively warm, my hair combed, with clean scrubs. By the mid point, my hands are like ice, I've got both a jacket and a blanket on me as I huddle in front of the space heater. I develop bags under my eyes, my vision gets blurry, and every joint makes me feel like an arthritic grandmother in the frozen tundra cackling that snow is coming soon. By 4 am, I am shivering and nauseous, with blotchy skin and chapped lips. My skin either reeks of the hand sanitizer, or my cuticles have split and are starting to bleed. I generally have at least one bandaid on some part of my body. It's a wonder that any clients trust me with their pets when I look that beguiling.

What I'm trying to say is that I really, really, really, really, really, REALLY hope that I'll get to work days or swing shifts if I ever make it through this residency