A Night on Call

I am so tired. Falling in and out of restless sleep. On my last night of night float. It is 3am, early July. The three pagers are silent next to me, staring at me, taunting me. I am so close to be finished, so close to be done with this week of transient existence pushed forward by anxiety, exhaustion, and apathy. I think about the new intern down the hall curled up with a different pager–transmitting the details of clinical care, the stool regimens and diet orders and restraint orders that require careful negotiation with the challenges of compassion, respect, confidence, frustration, and power. I am stuck somewhere between fully awake and physically asleep. It is a space that is occupied by insecurity and responsibility, haunted by imagined errors and unfinished tasks and the awareness that outside this space is a page or phone call–that, in the end, is a call to confront vulnerability. 3:30am, the pager vibrates. A 20 day-old neonate, a Nepali refugee. A clinical history about turning blue, feeling warm, and looking scared, about a mother who is far from home in a cold emergency room whose history must travel through a plastic phone to a stranger seemingly unable to effectively translate across the linguistic, cultural, and social ocean between us. I realize what lies before me, a procedure that I am uncomfortable and unequipped to perform that requires me to explain why it is necessary to insert a large needle into this infant’s back and what sepsis and meningitis represent in a child this young. The sun is rising somewhere outside this windowless world and there is an infant crying out with his whole being as fluid is pulled from around his spinal cord and his observant mother crowds the space beside me. It is 5:30am and would like this twilight space between night and day to end, to move out of these shadows of illness and into the warm, intense sun of the summer morning. By 7am, the day team arrives and the responsibility is transferred and the experience crawls into my exhaustion and starts to sleep.