BEEP! BEEP! BEEP! The pager goes off at about 5:30 a.m. One of my patient’s was having some respiratory distress and got admitted to the hospital during the night. Of course, I have never seen the patient before, as she was followed by a recent graduate of the residency program. I will have to review her chart pretty closely. Looks like I’ll have to start my day a little earlier to get to clinic on time. It sounds like a simple COPD exacerbation, but you never know. Well, at least it’s Friday and I get the weekend off. Then, I finish getting ready and head to the hospital.
My patient is stable and seems to be doing fairly well. She seems like a pleasant lady with a good supportive family. Of course, she seems to have a long laundry list of chronic medical problems and medications. Luckily, most of the conditions are all stable. I finish my note and complete some orders, then head off to clinic for the morning.
Arriving at clinic, it appears my schedule is jammed full. There are several return visits with chronic conditions. There is also a new patient, which can always be interesting. Sometime it feels like playing the lottery. To top it all off, there are the acute visits. Usually these are pretty benign, with earaches and sore throats and the like. But today I’m lucky enough to get two patient of other residents, one with a worsening of chronic depression and her meds don’t seem to be working and another with chronic knee pain who wants stronger medications.
During clinic, things run pretty smoothly. I had a no-show and I’m running close to on time with my schedule. Then, as I’m about to finish up, I get another page. My first assumption is it is about my lady in the hospital. But actually, I get some unfortunate news. It seems the medicine resident that is on call today has become ill, and the team needs help covering the call. A resident has already helped cover the day, but they need someone to help the night. Being the team player, I agreed to help cover after my rotation in the afternoon.
I quickly finish up my clinic notes, then rush off to grab some lunch before heading to the occupational health office, which happens to be on the other side of town. The afternoon is slow and steady, seeing a lot of musculoskeletal injuries and a burn. I get to do a few trigger point injections in the middle of the afternoon, which is nice as I always enjoy procedures. Then around 4:30 my pager starts to go off. A resident wants to sign out his medicine patients. Luckily the occupational medicine office is a part of the network and I can print off a list of medicine patients.
At 5 o’clock, the clinic closes and I quickly walk to my car. But before I make it, the pager strikes again. It is one of the nurses from the office telling me there is an attending’s patient in the Emergency Department who will be admitted. I arrive at the hospital shortly after, my pager going off a few more times about patients on the floor. When I arrive, I meet with the resident covering the daytime, who tells me that she was just paged from the E.D. with another admission. Sweet, I think as I change into my scrubs. Nice start to the night.
Luckily, after the two admissions, things slowed down for a while. No code blues or rapid responses. No falls or x-ray reads, just some pages about patients on the floor, one on Vancomycin with a case of Red Man Syndrome. And luckily, to my surprise, the resident who was coming in at 11 p.m. for his E.R. shift has volunteered to finish the medicine call instead. This is quite a nice surprise to my eventful day. So I sign out and make it home in time to fall asleep in my own bed before the day is over.

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