Three Months of Adulting: Flashback to my First Call

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Today I’ve been working for three months. It’s almost hard to believe. My first rotation is almost over, and my next rotation will be anaesthesiology (they just won’t let up, will they?).

My first call of Internship was on a Sunday. I was so nervous that I had an upset tummy that morning (but not upset enough to call in sick). It was terrifying and exhilarating. I had a big breakfast – perks of living at home!

I wasn’t even halfway to hospital when my phone rang. We don’t have pagers, we just have speed-dials so we are reached directly via cell phone. I thought maybe the medical officer was calling to shout at me for being late, but I was not actually late YET.

More like 24-hour float, but anyways. Click image for source.

It turned out to be a nurse from casualty informing me of a threatened miscarriage that I had to see. I informed her that my shift hadn’t ACTUALLY STARTED YET, but I’d be there soon.

On our calls, we see all OB/GYN patients, but those in labour or near viability take preference. There weren’t any of those waiting to be seen, so I headed over to casualty to see the “threatened miscarriage”. At said hospital, you basically have to cross the road via an underground tunnel to get to the main hospital from the maternity section. We all need the exercise, right?

Turns out in the fifteen minutes between the call and my arrival, the threatened miscarriage became a miscarriage with placenta undelivered. Quick chat with the medical officer – it was my first day of call, right, so I had the pressing need to clear everything with someone senior before doing ANYTHING (that changed before the end of my shift).

It really was all pretty routine – I had delivered many babies AND placentas before, so once the uterotonic was given I did not anticipate anything funny. Even the patient was calm. There was the little matter of me using a wound pack to deliver the placenta because casualty did not have any L&D packs, but the cord was so tiny that the stitch-holding forceps seemed quite adequate for cord traction.

But it would so happen that I was working in a poorly ventilated room and one without a gynaecological bed. Aaaaand while I was twisting myself like a pretzel to see between the poor woman’s legs, I started feeling woozy.

Because minions.

Well, not a problem, I thought. It’s not like my patient was unstable, so I left the room, drank some water and returned. I hadn’t been back for five minutes when I started feeling even worse. That dreaded pre-syncopal feeling. Put down my instruments again, de-glove AGAIN, but this time I could not quite reach the bathroom so I just leaned against one of the desks in the general area.

Spotted: by the casualty officer. “Are you feeling dizzy?”

I had hardly managed to nod my head before, I swear, he picked me up and plopped me down on a stretcher, took my blood sugar and blood pressure (former fine, latter low) and force-fed me some dextrose water. If not for my protestations he probably would have tested my urine, too!

He wheeled me into an empty room and ordered me to stay put while he delivered the placenta. Very sweet.

But to add insult to injury, he called my Medical Officer. I did NOT hear the end of that for the rest of the day.

Intern nearly faints on first call. Rookie error.

The rest of the call went quite fine, if you consider two hours of sleep to be fine – I was lucky enough to work with a medical officer that helped out when she saw that I was a little slow, as is wont to happen when you’re a fresh intern.

At any rate, that call was much better than a friend of mine whose first call was for internal medicine. Her shift had hardly started when she had to take the lead on a code blue.

Do you remember your first time on call after med school? Any horror stories?

11 thoughts on “Three Months of Adulting: Flashback to my First Call

  1. Oh my, that poor friend! Ah, rookie mistake..must have been embarrassing but do keep in mind you were managing that patient all alone. I would have freaked out if that would have been my first day of call. Keep being awesome, I’m sure you’re doing an amazing job at adulting😉

  2. It sounds scary. I asked one doctor a year ago about these ”calls”, and why it’s so long. She said it’s the nature of the job. I CAN’T imagine working for 24 – 30 hours straight without sleep. Well done on your first call. I hope it gets better.

    • It certainly has gotten better, although some of them have been quite rough. I don’t really believe that it’s just the nature of the job – in some places, people don’t do 24 hour calls because there are enough doctors around to do 12 hour calls instead. Those are a lot more humane. But it is something most of us end up having to deal with, and you will adapt when your turn comes. It gets more manageable the more you get used to it.

  3. If it makes you feel any better, I have come close to passing out on multiple occasions during my medical training. First time in the OR (and many times after), first time watching a minor procedure (so much blood), and first time delivering a baby, to name a few. The only way I survived my surgical rotations was to carry energy bars with me and eat them immediately prior to the OR; I was probably the only person to gain weight on a surgical rotation. Drinking lots of liquids also helped, but that was only feasible if the operation was going to be short, as I also have a small bladder.

    Congrats on surviving your first three months!

    • Good to hear – I’ve also taken to carrying small snacks around with me but sometimes even that does not help (for example we recently had a very difficult ectopic on a hot day with no air conditioning in the OR). Usually the anaesthetist will bring me a chair and untie my mask, and then I don’t have to scrub out. I have to say I am blessed with a big bladder so at least that’s not a problem for me!

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