Night | Elbrecht's Corpuscle

cast away

Posted on August 14, 2016 by Elbrecht

I awoke to pitch black darkness.

The voices were close. And interspersed with laughter.

My cerebral cortex quickly determined the voices were causing each other to laugh; and coming from two lone individuals.

They seemed friendly.

But I wanted to scream at them for awakening me from the depths of my restless slumber; yet I hadn’t quite determined if they were real.

I wasn’t even certain where I was.

As I stared into the darkness surrounding me, my eyes began to accommodate as the voices continued in their laughter.

My body felt heavy. My mind was confused.

Instinctively, I bolted straight up from my position; I realized I was lying in bed. Unaccustomed to its small size, I nearly tumbled to the ground.

In the midst of the darkness, my neurons began flashing in an electrical brilliance, trying to understand where in person, place, and time I was.

My right arm reached across my body as the fog in my mind abruptly lifted.

The restless slumber I had been inhabiting came to a crashing halt, as my thumb flicked the push-button on my phone to reveal “2:07PM”.

In that moment, my hippocampus determined I was located in the 2nd floor call room of the hospital.

A cataclysmic series of events brought me to be located in person, place, and time in the 2nd floor call room of the hospital on that July afternoon at 2:07PM.

Twelve nights had passed since I was shipwrecked on Night Float alone.

The plan, as it had been outlined to me several weeks earlier, would revolve around me undertaking a never-before-attempted solo excursion on Night Float.

My immediate fears had been squelched by promises of rearranged schedules and responsibilities, a junior resident as an occasional wingman, and deeply bound faith by my superiors that I was the only physician who could succeed in this plan.

My Ego led me to believe I could handle it.

But on Night Float, or “Black Betty” as I like to call her, all plans go quickly to hell.

Between the hours of 7PM and 7AM, a major metropolitan hospital is unlikely to have significant periods of down time. Instead, it becomes the breeding ground for Chaos Incarnate.

Which is directly where I found myself for the first 2 and ½ weeks of my third year of Residency.

Alone with Black Betty.

Nestled in her bosom.

cast away.

And longing for rescue.

By the beginning of my second week of Night Float as a PGY-3, my confidence had been rattled, but not deteriorated, like a rock face in the ocean having succumbed to centuries of waves bearing down it.

PGY-2 had been tortuous, but while working so many random weekend days and nights had crippled my life outside of the hospital, they had shaped my abilities as a physician, both in and outside of the hospital.

Ultimately, nothing could have prepared me to be cast away.

Another senior resident had been assigned to work on Night Float with me originally, but that had fallen through due to her unforeseen circumstances.

Then a thorough review of the remaining options turned up the following: unleash Magneto into the depths of Chaos Incarnate alone and see what happens.

{Note: I was assigned a junior resident as a “life vest” for a few of the nights, but he had to leave by midnight, like a mirage, to leave me alone, carrying 4 pagers, anxiously awaiting the next sunrise.}

At times over those 2 and ½ weeks, Magneto conquered the tasks set before him. But many a times, Black Betty rattled him to his core.

The toll of spiritual, emotional, professional, personal, and existential fatigue came to a head on the day I awoke at 2:07PM in the hospital call room

I found myself there not because I longed for the sweet caress of a crisply dry-cleaned set of linens, but because I had left my apartment the previous night in a fugue state.

Said fugue state resulted in me dropping my keys through the hole in the bottom of my book bag; they came to a clattered resting place in my building’s entryway.

I was none the wiser because NIN’s “Terrible Lie” was blaring through my ear buds.

Only when I rummaged through my book bag for an hour the following morning, proceeded to walk to my apartment hoping to find the keys lying on the sidewalk like a trail of bread crumbs, and had left two babbling and pleading voice messages on my landlord’s answering machine, did I begrudgingly saunter back to the hospital.

So when I awoke to the jovial laughter of two newly reunited long-lost colleagues, I hoped to find a message on my phone indicating the safe recovery of my highly-sought after keys.

Alas, at 2:07PM, there were no messages on my phone.

Nor were there any messages at 6:30PM when the melodic alarm emanating from my iPhone jostled me awake again. My mind was still cloudy. My body was still aching.

But Black Betty wanted another go.

So I meandered from the call room into the locker room, proceeded to strip down from my wrinkled scrubs and hit the showers.

The searing ice cold water streaming from the shower head caused my body to shiver, reminding me of my morning showers in Dominica, but I managed to cleanse the fine film of solitude from each and every square inch of my being.

I dried off, turned my socks and boxer-briefs inside out, and slowly pulled on a new set of pressed green scrubs.

As I passed the half-length mirror in the locker room, I quickly assessed my physical form and found my two-week-old beard to be quite fitting a man so unfamiliar with his surroundings.

I wondered if I would ever be found…

{lost and found}

Black Betty

Posted on April 23, 2016 by Elbrecht

At 2:17AM on a recent Friday morning I couldn’t sleep.

Not in the sense that I was laying awake in bed, thinking about the cosmos, or wondering how “The Walking Dead” Season Finale would play into any future cross-over series that might be developed, or anxiously awaiting the sun to rise again.

I was actually physically not able to sleep.

As my body was beginning to shut down at the cellular level, the efflux of potassium and phosphorus from every cell beginning to overwhelm my blood stream, the pager holstered upon my left hip started chiming again.

The pager transmitted electrical energy, similar to that of a defibrillator, into my body; the potassium and phosphorus blasted back into the cells, preventing a super-saturated metabolic derangement which would have caused my cardiac activity to cease.

Simultaneously, the loudspeaker in the Emergency Department blared, “Septic Shock Alert, ED 47.”

“Septic Shock Alert, ED 47.”

I unholstered the pager from my hip, quicker than Doc Holliday when he penetrated Ringo’s brain with a lead slug, and glanced down at the message awaiting me.

As I swiveled and rose from the stool I had been atop for only a matter of moments, I read the message. Thankfully, it only read “Septic Shock Alert, ED 47”, the electrical companion to the overheard communication, instead of 555-9095.

Or 555-9030.

Or 555-9494.

Those numbers belonged to the Hospitalist medicine service, the Intensive Care Unit, and the ED Nursing desk, respectively.

Responding to any of those calls would have meant either another patient was waiting for me to admit them to the hospital or an already admitted patient was trying to die in the ICU.

If any of those three numbers had been present, I would have needed to take over the care of the actively dying patient in the Septic Shock Alert, while simultaneously trying to:

1) figure out how in god’s name I would possibly get all of the work done I still had to do

2) supervise my junior resident

3) not lose my mind.

I also probably would have taken the pager and rifled it into the closest wall, hoping to have it explode in a wave of energy like the Death Star in Episode IV.

My Junior Resident sat beside me, near catatonic from Night Call’s siren song; I tugged at his scrub top, motioned for him to follow along, and let out a long sigh.

I could not sleep.

I was the Senior Resident on Night Call.

Or as I prefer to call her, Black Betty.

Black Betty is the anthropomorphic representation of Night Call, the overnight shift when physician staffing drops to a skeleton crew and the statistical probability of all hell breaking loose starts creeping up on 100%.

As the sun begins setting on a hard day’s work for most of the physicians, nurses, and ancillary staff in the hospital, Betty begins to rear her ugly head.

Her darkness requires the fortitude of a special type of physician.

Unless you are a Resident like me. Then you are required to show up to spend some time with Black Betty as a part of your training.

You are not a special physician. You are a Resident. And the only thing special about you is your ability to not spontaneously combust from the lack of sleep you have sustained.

Every Resident dates Black Betty. Some for a night here and there, with no specific frequency or expectation. She does not discriminate.

Others join her for a two week stretch; where her smooth skin becomes chapped and dry by the third night, her velvety caressing hands become stiff and arthritic by the seventh, and her formerly gentle kisses become vicious flesh-tearing wounds as the sun rises on the tenth.

Black Betty invites the denizens of the night to start shuffling into the Emergency Department.

And the critically ill whose lives are sustained by technological marvels in the ICU to begin their physiologic derangements.

They are joined by the sickly and elderly who become unpleasantly delirious as a result of her rancor.

—–

To this point in my Residency, I have spent over 20 weeks with Black Betty. A majority of those weeks have come in two week chunks, spread over In-patient Medicine, Surgery, and Obstetrics.

But as a now as a PGY-2, the Senior Resident, I have also had more than my fair share of random Saturday date nights with ‘ol Betty.

She and I have been intimate more times than I would care to admit.

Each date brings about something unique, whether it’s a patient hurtling a chair through a 7th-story window, a near-dead woman’s heart beating in full view of the audience in the trauma bay, or stabbing a needle into a man’s chest to hear the whoosh of air escape and provide his lung the opportunity to re-inflate.

She is fertile with opportunities for us to perform our duties as physicians.

Black Betty had a child, the damn thing gone wild.

dont-scare-your-kids

At 2:43AM on a recent Friday morning I exited ED 47 with my Junior Resident in tow.

Black Betty had provided us an opportunity to exercise our clinical judgement, initiate resuscitative measures, and stabilize an elderly gentleman who had tangoed with the Grim Reaper several times in the past two months.

The Reaper’s grasp had tried to choke off the man’s air supply. But we would have none of that.

Black Betty didn’t care. She shrugged it off.

She knew other opportunities awaited.

And my Junior Resident and I would be there. Waiting.

I would not sleep.

Not when Black Betty has anything to say about it.