I just came off what I hope is the worst call in my career.
In terms of patients, it wasn’t too bad. I did four admissions, but they were mostly very early; only one came in after the resident had gone home for the evening. I even got a few hours sleep (sitting up in a chair, because you do what you gotta do).
Then the next morning, I got a worrisome personal text just before rounds, and didn’t have a chance to follow up. So I was admittedly distracted as I was trying to present the single complicated case to the attendings. We have two attendings on service at once, which is usually excellent for teaching purposes, but sometimes contributes to the shitshow, see below.
Frequent interruptions, which made me lose my mental place repeatedly, at one point confused patient A with patient B, failed the pimping questions… it just got worse and worse and worse. Meanwhile, my mind is running to all kinds of crazy-bad scenarios re personal crap.
So by the time I got to the assessment and plan, I had tears running down my cheeks which I was trying to pretend weren’t happening. I started off addressing the chief complaint, at which point one attending said to start with the “main medical problem” so I switched systems, then he was like “no, as you were,” and then the two attendings started duking it out as to which problem was the “main” one, meanwhile I’m sitting there totally confused, and sleep-deprived, hypoglycemic and watching the table rise toward me. My team is mouthing all kinds of encouragement and thumbs up, you’re doing great, etc. And then one of the attendings turns to me, acknowledges my distress, and whatever little bit of internal reserve I had came crumbling down at the kindness, and turned into full-blown sobbing, blowing my nose, apologizing to everyone, until my resident sent me out for some water. At which point I stole an apple juice from the morning report room and ran and hid in the bathroom, which is actually the worst possible place to cry because the tiles just magnify all sounds. Which is where my intern finally found me, twenty minutes later, reassured me, and sent me home.
So basically. Yeah. Shitshow call. Never ever ever want to go back to the unit ever again.