Post-Call = Split pea soup

*AS I'M WRITING THIS I'VE BEEN UP FOR 32 HOURS*

For those of you not in the know. After we interns have been been in the hospital for a full 24 hours we are referred to as being "post-call." Per the current regulations we can stay for an additional 6 hours while we are post-call. It's really not the first 24 hours that's hard. It's that transition into being post-call. Something about hitting the 25th hour of being awake make all your systems shut down. Your depth perception is off. Your thermoregulators shut down. Your filter disintegrates.

Of course by this time you probably haven't eaten in the last 8 to 12 hours so you are definitely dealing with some hypoglycemic issues. And if you did drink anything it's been super caffeinated so you are dehydrated. Not to mention that you've had anywhere from 5-20 bouts of high intensity cardiovascular activity. Whether it was a critical lab, a trauma, a code, a scary attending. Something kept you running all day and all night.

They've done studies on what sleep deprivation does to a person's reflexes, recall ability and even judgment. I am sure there are interns out there who gripe about it so often they have these stats memorized. I for one am not griping. I approve of this system. Don't get me wrong I don't think the days when surgeons spent 80 hours straight in the hospital made any kind of sense. But this 24 + 6 system is a good one.

By the time you hit your post-call mark the entire team has reassembled. You are no longer responsible for patient care decisions, you are no longer allowed to operate. You are there solely to maintain the patients' continuity of care. You can tell each and every member of the time exactly what happened for each patient after they all went home last night because not only were you there but you managed each situation. And in managing the situation is where true learning starts. Yes there are dozens of safety-nets in place, from the nurses experience to the computer binging every time you order contraindicated medications. Not to mention the mid-level, senior and chief residents who are all available for you to call (if you are brave enough). But the autonomy of being the only person on the floor, and sometimes the only one physically in the hospital gives you the balls you need to take charge of a situation. And, yes mistakes will be made, but that's why the overly redundant back-ups to make sure they caught before ANY damage is done the patient.

But, I digress - as one is wont to do after 32 hours of sleep deprivation. One is also wont to wax philosophical and use high-falauting phrases one would never normally use for fear of sounding like a pretentious jack ass.

Anyways, back to my point. Which is that when you are post call it often feels like the rest of the world is coming at you through a dense fog of split-pea soup. Everything is insipid and murky and bogged down. When people talk to you the words sort of float past you and you can't quite grasp what's being said until the third repetition. Simple tasks like a dialing a 5 digit extension become monumentally difficult. Was that 5-6561 or 6-5651? Remembering that PCs use Ctrl+C to copy and not Command+C like your mac at home leaves you hunting for that damned command key for a full 30 seconds before you realize idiocy of your mistake.

All-in-all I've never really been a fan of split-pea. It had something to do with it's ickiness and goopiness and greenness. But that doesn't mean I won't shovel down a full mouthfuls if there is absolutely nothing else (hospital cafeterias have the worst soup selections so this has been the case before).

So that is the simile I wanted to put forward. Post call like split pea soup. Check.

Falling asleep with computer on lap. Must shower and sleep. I haven't showered in 32 hours either. It's kinda gross.