For the past week, I’ve reveled in the simple pleasures of being home: eating fresh food, sleeping in my own bed, fearing for my life from Hurricane Irene. As dawn dissipates night, my state of usual mental health returns.  Which highlights how cognitively scrambled I was for the two weeks we traveled in the UK. How emotionally unstrung. How demented. From jet lag.

The discombobulation wasn’t as bad— but almost— as that on-call-night-from-hell when I was an intern. The first two years of residency training, I was on-call every third or fourth day, depending on the clinical rotation. Which meant a thirty-six hour shift, usually with no sleep, every three or four days.  

I had just finished admitting a patient to the floor from the E.R. It was 4:30 a.m. At 6:00, the regular workday started, leaving an hour-and-a-half to catch some zzz’s if, pleasepleaseplease, the pager didn’t go off.  I bolted from the desk to go to the call room and the pager went off. A sick feeling impossible to describe came over me. 

When the E.R. nurse told me the patient was 86 years old, a nursing home resident, febrile and delirious, I knew: urinary tract infection, blood culture, IV. I put my head down on the desk and sobbed, completely undone. Why? I had to calculate the osmolality of the IV fluid and could not call up the equation. It was gone. 

Maybe I fell asleep and dreamed this...