Last week, I worked more during the 16 hours I was on call that I had during the preceding day – or the following day for that matter. I was so tired that I almost fell asleep during one particularly contemplative portion of the art therapy session I was conducting. I fell into bed just a few hours after getting home.

Most of my life, I have not taken call. I took call as a medical student and resident but, once I had young children at home, I forsook a university career in favour of work that would allow me not to have to regularly work overnight – other than as a Mom. Occasionally I would have to stay late with a patient, and all my patients had a number where they could reach me in emergencies, but all my patients understood that I had young children and that I had to look after them first.

When my youngest child was 15, I returned to university work and the burden of taking call. Make no mistake about it. Taking call is a burden, working in unfriendly hours is a burden and working more than a certain number of hours in a day is a burden. Ask any of the people who do it: firefighters, police officers, nurses, paramedics, doctors, military personnel. Along with that burden of extra hours, in each of these jobs, there is also the worry about the critical nature of the work that all these professionals do. At any point in their day, there could be a critical situation, an urgent situation, a life-and-death situation. All of this takes its toll – physically and emotionally.

Most people have worked extra long days and even overnight in the course of their jobs. Sometimes they believe that this allows them to understand what taking call, or working nights, or working in urgent situations means, but it doesn’t. I have worked in these situations and it has taught me not to presume that I understand what a firefighter or a nurse goes through in their work. I don’t even presume to understand what a doctor working many more call shifts than me endures. It doesn’t work that way – I believe that empathy can be limited.

I have, however, done enough reading and have enough personal experience to know that these jobs take a toll on family and relationships as well as on the person themselves. The impact of the loss of sleep is well-known, and this has an impact in many aspects of life. The impact of specific other jobs is beginning to be researched, but the problem is that the world of work for the professions whom we depend on for emergency services are likely stuck in work cycles that are not good for them or their families.

I have been a doctor for 40 years. There have been some changes to the way we take call, but not many. Mostly, we get used to a way of life, if we want to work in a certain setting. Mostly my on call shifts do not require as much work as they did this past week, just less sleep – because you cannot necessarily sleep restfully when you could be called at any minute for something critical, for a situation when someone might die.

In a few months, I will reach an age when I no longer have to take call. When I mention this to older colleagues at work, they smile. All of them have told me that I will enter an enlightening new phase of my life as a doctor. All of them said that they had an entirely renewed vision for their careers once they no longer had to take call.

Until that day comes, I will continue to approach my days and nights on call as I approach any day of trial. I will prepare physically and mentally for the extra work. I will studiously approach that day with extra patience and with a more generous heart. I will strive to be gracious and kind to all whom I serve and to those I serve with.

During one moment of great fatigue last week, just before I finally went home, I looked up and took great pleasure in the changing winter sky. It sustained me until I could get home. I guess that will have to do for the next few months.

(I took this picture late in the afternoon last week.)

Note: I dedicate this to all the people whom I know work harder than me. Thank you for doing that work.

8 thoughts on “Life and Death and On Call

  1. Susan Engels says:

    Dear Dr. Beck, what a kind a good generous reflection. In my 30+ years of nursing, I worked years of shift work and on-call. Working alongside colleagues who recognized the toll of shift work, call and unpredictable crisis environments was like a healing salve that helped us all get through the tough situations. The team was essential to ensure that each team member maintained the best possible patient and family engagement. In the early days of my retirement, I am reflecting on the extraordinary nurses, physicians, paramedics and police officers with whom I had the good fortune of working. I am truly blessed and know that your approach means a great deal to your night owl colleagues.

    1. drgailbeck says:

      Thank you for the reminder about teamwork – it makes all the difference.

  2. Cautious driving when exhausted Dr.G.B. As an RN with 2 week swing of days/nights starting @ 40 years. (nursing is my 3rd career). On nights of course @ 6 am. Code blues happen frequently and so much for finishing by 7 am. Often you could not leave on time and you would be back at 21:00.

    1. drgailbeck says:

      This is a great reminder – the driving was terrible from a snowstorm as I returned home last week. You are so right!

  3. Hi Dr. Beck- a quick note to let you know that I follow your blog and this morning I was touched by the gratitude you expressed for the professionals in the healthcare and service industries.  I am a retired registered nurse who worked for 30 yrs in rehabilitation and oncology nursing.  I did shift work, job sharing, weekends, holidays, mostly full time while raising a family of three.  Challenges yes, both with the inflexibility in a system that truly lacks an understanding of how services are delivered under the conditions such as sleep deprivation, multitasking, life and death situations while in the trenches.I therefore forwarded your blog to The Ottawa Citizen, letters to the editor to reflect such a wonderful story expressing thanks.Regards Joanne Ready

    Get Outlook for iOS

    1. drgailbeck says:

      Thank you for sending this to the Citizen and for reading this blog.

  4. Cheryl Jensen says:

    Good morning. What a touching post. I sent it to Lorraine with kisses and hugs.

    1. drgailbeck says:

      Your daughter who is a veterinarian probably also takes call. Many farmers I knew growing up had their livelihoods saved by a veterinarian.

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