Nighttime in our community hospital was something to be dreaded when I was a resident. It meant I was on overnight call, following a regular day’s work. The hospital emptied of the day staff and visitors, leaving limited lab and imaging services, fewer nurses, a couple of physicians and emergency room staff–tag, you’re “it”. When the pager went off, if it were the emergency room, that wasn’t good—most likely a new admission, possibly unstable, requiring at least an hour for a thorough assessment, plan and documentation. Multiple admissions were “hits”. It could be a nurse calling for any patient in the hospital, likely unfamiliar to me, for something aggravatingly simple (you woke me for that?), or something quite dire. Did I need to get out of bed to attend to the issue, or manage by phone? Did I need to call for backup from another resident or attending, which involved waking them up and risking their ire? If there were a woman in labor, it usually spelled long hours and the anxiety of two lives at risk if we missed a problem. Was there any chance I could get enough sleep to be able to function the next day? My mind played games as I tried to sleep in the hospital’s converted nun’s cells; I would physically jump, my heart pounding, with each pager call.
Trudging through the darkened halls it was a struggle to overcome my own grumpy fatigue mixed with mild terror. It was clear that I was not a night person. Then there was a gradual change as the O-dark-hundred hours waned and the day staff reappeared. My circadian rhythm kicked in, allowing me to join the morning rounds, report on the night before, and find a way to finish the rest of the day ahead.
Most of the hospital work was done in rooms without a view but coming down from the nun cells/call rooms on the top floor, it was possible to look out a window to the east. Sometimes I would stop there in the early morning turning of the earth, captivated by the line of the Cascade mountains and the reddening sky before the sun appeared. In that quiet and beautiful alone moment I could breathe, wonder, and find space to carry on.