Alternative

This article “What Do Doctors Say To ‘Alternative Therapists’ When a Patient Dies?” by Ranjana Srivastava appeared on my Facebook newsfeed yesterday.  I couldn’t resist reading it.  I think you should read it too.

First of all, it is clear I am a big nerd when this is the most eye catching thing I saw on Facebook.

But, the big reason it is eye catching is because I was curious what it would say.  And it said what I thought it would.  We say nothing.  We don’t talk about it with others.  We talk about it amongst ourselves.

It also echoed a lot of feelings I would describe having around alternative therapies.

I am probably one of the more “loosey-goosey” of the people in my department when it comes to alternative therapies.  I am touchy feely, I inherently trust people and I do believe that there is value in a lot of things we can’t or haven’t necessarily studied.  I’m that kid who did a presentation on medical marijuana in research rounds and concluded that it isn’t all bad and we really need to look into the stuff more because people are using it whether or not we think they are or should.

I ask people what they take over the counter or with supplements.  I explain why I ask.  You see, some products, although “natural” act in ways that counteract the actions of chemotherapies or radiation or other drugs.  Sometimes in terribly harmful ways.  Ways that make cancers not respond to treatments.  Or ways that make side effects worse.  I ask because I care.  Not because I want to judge you or make you feel foolish.

Actually, some of the drugs that we give people are “natural.”  Some chemotherapies are plant derived.  They are natural and very toxic, but when used appropriately can treat cancers.

I see nothing wrong with trying something different when nothing is working.  I see nothing wrong with adding things that have low risks of harms that may help.  I see nothing wrong with doing things that are healthy for you.

I do see something wrong with people who are encouraged to spend their life savings on a “miracle drug.”  When people risk their lives to procure enough cannabis to make the oil they were told online was a “cure.”  When people entrust their health to internet “doctors” and people who make a profit from preying on the sick and the scared.

Many of the “miracle” agents on the internet are anecdotes.  Sure, everything starts as an anecdote.  But, that is why things are tested, because we are often wrong and they are one-off events.

There is some laboratory in anecdotal data about cannabinoids.  I’m not refuting it.  I’ve read it.  But, there is no cold hard evidence for it as a cure for cancer in humans beyond the odd case.  Could it be coming?  Maybe… But that day isn’t today.  And there is cold hard evidence for other treatments in some cancers.

It scares me that some people believe the person that will make a fortune off of them buying their concoctions is more trustworthy than the person who makes the same amount of money whether or not they take the treatment.   It upsets me that people think I am the one brainwashed because I am offering medicine with evidence behind it, with the experience of time, the monitoring of governing bodies and the backup of provincial funding.

It terrifies me to know that supplements and some complementary therapies (not all) are not regulated at all.  In fact, often they aren’t even containing what they claim or have contaminants that can be harmful.    And people die from complications from these therapies.  Just like conventional medicine.  But in a lot of cases we don’t even know some of the risks.

When something claims to work almost all of the time or have no side effects… It probably isn’t for real.  Too good to be true is something I see a lot.  But people want it to be true.  And why not?  Some people have nothing left to lose.  But really, everyone has something to lose.

It also makes me sad that some of my colleagues think all complementary or alternative therapies are bad or dangerous.  It is scary to see people doing things we don’t understand, so I get it.  And it is hard to trust when people you cared for and gave your all for die, sometimes because they gave it all up for the wrong choice.

Miracles happen.  There are things we don’t understand how they work, but they do.  There are things we know do work and they scare some people because of misinformation or lies spread through all kinds of media.

When people forgo conventional treatments or risk counteracting treatments for something advertised on the internet or sold by an alternative provider, it makes me uncomfortable.  I’ll be honest.  When people die doing this, it makes me sad.

Complimentary and alternative therapies can be many things… I send people for massages, acupuncture, reiki and I think chiropractors do good work. I encourage spirituality and  and exercise.  I preach good diets and appropriate vitamin supplementation depending on need.   I think cannabis can be an option for some people for symptom control.  I am okay with you doing something else so long as it isn’t putting you or your treatment at risk.  I can’t stop you from doing something I don’t agree with or trust because you are your own person.  But, I can be honest and tell you why it is concerning.  I can review the evidence.  I can help you interpret it because I have a background in reading that kind of stuff when many people don’t.   I’d rather know than not know in any case because your health is important to me.  And I make no gains or losses by having someone take “my treatments.”

I just want people to be healthy and safe.

Conventional medicine can’t save everyone.  Neither can alternative medicine.

It is scary, but things go wrong.  Alternative therapies (namely the various supplements and drugs and cleanses) can cause a lot of problems.  But, we don’t talk about it when things go right.  We also don’t talk about it when things go wrong.

Talking would be a good start. Regulations would be wonderful.

There will always be people out there trying to make money and preying on the sick and vulnerable. Sadly, these people give everyone a bad reputation and are the source of my distrust and skepticism.  I know there are practitioners out there who think they are doing good and maybe are not.  That is where better regulations and research could make a change.  And I know there are practitioners out there doing amazing work with the best interest of the patient at heart.

An open mind is good.  Educated professionals are better.  But, I think that opening up the lines of communication between professionals but also with patients could make a movement towards making a difference.  At least in some cases.

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My new favourite vaccine mock PSA

Anyone who has followed this blog has had to put up with my intermittent vaccine rants.

Here we go again.

Jimmy Kimmel had a little rant on his show this week about vaccines complete with “real doctors” saying why vaccines are important.  I don’t often like Jimmy Kimmel’s humour.  He is sometimes a bit too much for me.  But, this was perfection.

Perfection.

Check it out.  Show your friends.

Teacher, teacher

I’m doing an education elective this month.

I have almost always wanted to be a teacher (and an author).  Well, after I got over the wanting to be a vet (my parents quashed that dream when I was about 4 when they informed me that if I was a vet, I would have to take a bath every day) and work at KFC (I was a chubby kid who really liked the way it smelled, despite the fact that I was informed I would no longer like KFC if I smelled it every day… I didn’t even have to smell it everyday to develop a dislike for KFC as an adult).  Honestly, medicine came much, much later in life.

I realized as a teenager that I hate kids in mass, so perhaps teaching elementary or middle school was out of the question.  I also realized science was very fun.

Once I hit medicine, though, I came to this crazy realization that maybe, just maybe I could “have it all.”  Who knew doctors teach?

Probably most people.

But, the fact that it could be my reality blew my mind a little.

So, I have always thought teaching was important.  I tutored in med school, mentored new students, all that stuff.  And now, I am doing an education elective and launching some new education related stuff in my department.  It has confirmed that I want to teach more.  I think I might even start working on my masters in the next year or two (depending on how this whole juggling residency and baby thing goes).

The funny thing is about the elective is that, for the first time in a long while, it is like being a student again.  Sure, there is no call and my hours are a bit more set, but I have assigned readings and projects and assignments.  Plus, the studying/prep for my usual program academics.  I forgot a bit what it was like to be a “real” student.  I have a love-hate relationship with being like a “real” student.

My focus is suboptimal.  Lectures from 8-12 and 1-4:30  That is a lot now.  Friday afternoon half-day is like torture and that is just 1-5 one day a week.  Plus, the degree of interaction is much more than I’m used to.  Group work?  Heck, usually my whole program is the size of a group they have me working with.  Non-clinical assigned readings are novelties.  Doing assignments and writing papers are things I do much more rarely now, but they are becoming regular occurrences.  Presentations and teaching practice prep is similar, but different.  And then there is switching focus completely to study for my usual departmental half-day stuff and exams.

That being said, it is neat to learn more about being a better teacher.  And knowing that it is something I can do.  And will do.

Seeing the enthusiasm of the Med 1s in tutorial and how everything is challenging and exciting is super cool.  Learning about what always seemed to be the top secret world of designing OSCE stations and training standardized patients makes me realize how much goes in to our learning.  Finding ways to make things better for newer trainees is encouraging.  Even figuring out how and why I learn the way I do and how to make that work for me is useful.

Most of my friends are teachers.  Heck, I’m married to a teacher.  And I am realizing that in more ways than I originally thought, I am a teacher too.

I know, I’m a huge geek.  But, I’m okay with that.  Just humour me.

25 Faces (reblog)

I stumbled upon this awesome piece on Buzzfeed by Aemun Reza called “25 Faces Everyone Who Went To Medical School Will Remember.”

Check it out.  It is worth the click and the laughs.

My favourites (and most common expressions) are number 9, 15, 22 and 25.  But seriously, I think I have made all of these faces at one point or another.

Work in the midst of call

This weekend, amidst all of my call-y goodness, I am trying to get some work done on a few upcoming projects/presentations.

I have a journal club a week from Tuesday, so I picked some articles.  Head and neck cancer supportive care.  Look out world.  I’m about to critique the pulp out of an article on prophylactic versus reactive feeding tubes and hemoglobin levels and transfusions in head and neck folks.

And then, I spent a bunch of time looking into stuff for career day.  Every year, I help out with career day.  And every year, I say we will make it better next year.  You see, Rad Onc, much like me in high school, is kind of one of the nerdier, quiet and obscure specialties out there.  As a result, most people walk right past our booth.  Seriously.  You should see them all flock to the surgical simulators and fake airways at Gen Surg or Anesthesia.  And everyone wants to know how much the Radiologists make to sit in a dark room.  But, the Rad Onc folks.  They have creepy masks and a powerpoint.

Image from ebroc.com.

Not this year.  Okay, we will still have creepy masks and a powerpoint running.  That is who we are.  But this year, I am cracking out some YouTube videos of some of the “cooler” aspects (that’s right… big machines and computer animations).

They are cool to me.  And at least they give people something to ask questions about.

Plus, I think I have found an online application that we can use to make ourselves “interactive.”  A try your hand at contouring station, perhaps.

I know, not as cool as intubating a dummy.  But, maybe we’ll get to tell another couple people who we really are.

I just have to get approval from the powers that be (and acquire the technology to make it all happen).

Today I decided to clean out my email inbox instead of starting to actually work on the journal club.  Because that is just too much energy.

I got about 2 minutes in when I realized something.  I have something like 30+ One45 emails.

For those of you in the world who don’t use One45, it is an online evaluation system people in the medicine world love.  And we evaluate every single flipping session we ever attend.  And get evaluated almost as often.

Image from imerrill.umd.edu.

Usually, I’m on top of those things.  I hammer them out once a week or so.

The last two months or so, not so much.

I know what I’m doing this evening.  It involves a likert scale, good music and trying to reach back into the recesses of my memory.

Reblog: “In Defense of Doctors”

I read this the other day on a friend’s Facebook page and I liked it enough to want to share it with other people.  Check it out, it is called “In Defense of Doctors” by The Murrays.

In a day and age where everyone has information at their fingertips, it seems that distrust of the medical system is everywhere.  I work and function in that system every day.  I also am a patient in that same system.  I have to trust it.  I can be well educated and informed, but I go in expecting my physician or nurse or other caregiver to know their stuff too.  These people go to school for years.  They sacrifice their lives.  They don’t want to do stuff to harm you.  I’m certain of it.

I have on more than one occasion come home and worried about a patient I left at work.  Or spent hours scouring the internet for the right answer.  That is what it means to be in a caring profession.

Please trust that we care.  And we have your best interest at heart.  We sacrificed a lot to get here.  It doesn’t stop with you.

The saddest airport

Today marks our last day visiting the city where I did med school and where we spent our first 3 years of marriage.  

It was a great trip.

I’m sad it is over.

I’m sure I will share more of the awesome stuff I learned and the places we visited.

But for now, I must share that the airport here is one of the most depressing airports I have ever been in.  It isn’t the ugliest, or the sketchiest, or the smallest or biggest or any of those.  I have been stuck here a few times but not as many as in other places.  But, to me it is always sad.  

Maybe it is because I arrived here too many times with nobody there to greet me (actually I did have friends pick me up sometimes, but often it seemed we were on our own).  Maybe it is because I was always dropping off people to leave .  Or sometimes I was leaving people.  

The airport is on two levels.  Arriving, you can see people awaiting those who they love.  It is great when you see your person from either end.  It stinks when you are on your own.

But worse is when you are leaving or having someone leave.  There is an escalator to the secure area.  So, it is like they leave slower.

I’m sad to leave today.  We had fun with great friends.  I nerded it out at a good conference.  But, now it is time to get back to real life.  And likely not see our lovely friends for at least a year or so.

This airport makes me sad.  Okay, it is probably the circumstance.  But, I blame the airport.

How Did That Happen: How I Got Through Med School Orientation

I realized today that it is about time for med school to be starting up again.  It blows my mind that about a 6 years ago, I hopped on a plane with 4 giant suitcases and my drugged mother (she was hopped up on cough syrup) to move to the town where I did med school.  Interestingly, I am leaving today for that same city to visit some friends and attend a conference.

I had been there twice before.  Once for my interview and once on a whirlwind room renting hunt.

To be honest, I was less scared of moving or even starting med school.  The thing that produced the most anxiety in me was orientation.

Yes, you got that right… Orientation.

I mean, yes, of course med school was terrifying and being told some of us WILL fail in orientation did not help.  Each first had its own level of terrifying… First lab, first exam, first standardized patient.  But orientation still wins in my books.

Thus for all of you shy, introverted (I say both because they are different) new to everything about a place people, here is my How Did That Happen? for the week.  How I Got Through Med School Orientation.stethoscopes1

I know some people love that kind of stuff.  Socials, dances, sporting events.  Not so much my scene.  I get that some people consider these sorts of events a highlight.  Or at least they don’t dread them. I dread them.  That’s just how I roll.

My med school took the whole orientation thing seriously.  I’m talking a full week of stuff.  And it was “mandatory.”

Seriously, mandatory “fun”?  Sounds like cadet camp all over again (seriously, they had these evenings where we were obligated to attend a “fun” activity like sports (ew) or the zoo (okay the first time, but it was a pretty lame zoo) or a movie (probably a bad one).  We called it mandatory fun night.  It was funny because it was by far not the most fun night of the week (dances or concert nights or parade nights won every time).

Events for this mandatory fun included whale watching (the best part by far).  An 80s mixer (ummm… I like the 80s, but when you stick them in a mixer, not so much).  Outdoor games complete with a slip n slide.  A pub crawl.  Various talks.  Photo scavenger hunt (epic, but not as fun when you don’t know where you are or who you’re with).  Dinner with some Med2s followed by a dance.

I was not pumped.  Except for the whale watching.

I knew one person I went to high school with.  Not well.

70% of people knew most everyone.  They all did undergrads together, they did their masters together, heck, they did all of their schooling together and they live down the road.

Just shoot me.

So, enough whining… I’m supposed to be talking about getting through it.

First of all, I tried to embrace the fact there were other people as lost as me.  I found them.  Found the first one lost in a hall as ridiculously early as I was.  I stuck with them.  She fell asleep on the bus on the way back from whale watching.  I fought the urge to run away.  As it turns out, we sat togther through most of our classes.   The randoms I stumbled upon ended up becomign some of my best friends through med  school.  So, find someone looking as lost and sad as you and say hi.

Realize that med school is like high school.  There are cool kids and cliques.  It did not take me long to conclude I was not cool, nor would I be part of the key cliques.  They were already formed before I even came in.  That’s okay.  I’ve never been one of the cool ones.

Show up for events.  Seriously.  They said it was mandatory, but not everyone came and this ticked some people off.  When you are as shy as I am this is nausea inducing, but it was also how I actually was forced to meet people.  Nothing says get to know people than getting thrown in a 2 door car with 4 other people you have never met to tear around the city taking pictures (especially when we ended up breaking into a more senior med student’s (who I also didn’t know)  house…).

Have fun.  I mean, if you have to be there and people worked hard to plan it, there probably is some fun in there.  Some of our stuff was really awesome.  Other stuff was awesome for people who weren’t me.   Just try to have fun.  Fake it until you make it.  I was pleasantly surprised.

Find out what is okay to skip and know that it is okay to take a breather.  Yes everyone will question your decision.  At least the people who noticed you exist.  But mental health for the win!

Participate.  If everyone is doing something to make themselves look stupid, you might as well do it too.  It might end up being fun, or at least make for a funny story.  My team in these messed up olympics they held won.  We got gift cards for coffee or booze.  It was thrilling.

There is free stuff at some of the events.  Free reflex hammers (which is like gold when you are just getting started and anything “medical” is the best thing ever), free bags, pens and best of all, free food!  Moving and doing a million more years of school is expensive.  Love the free stuff!

There really is useful information in there.  You won’t remember it all.  But they do tell you some important stuff.

If your school is anything like mine, the dean of something or other will get up and tell you scary stats about failures, people crying and people quitting.  This really does happen, but it will be okay.  It is an important reality check, but it does really sting.  Especially when odds are you were already nervous.

Tell yourself it will be fun and okay and all that good stuff.  It will be.  At least some of the time.

Remind yourself that despite the social anxiety and such, this really is one of the most relaxed times in med school.  Embrace that.  The real work is coming.

Remind yourself it is just a week (or less, if you’re lucky).

If you’re from away, it gives a chance to at least kind of figure out how to get to and from school, where some key stuff is and get settled before the real work starts (although the hours were so crazy, it was still tough to get any real unpacking done).

Things like orientations are just a bit awkward.  They end and eventually you know people well enough, you kind of wish you could have done that with the same people a year later.  Not all of that stuff, but some of it.

As much as I think I could have done without so much mandatory “fun,” I really do think orientations are important.  I still say they are overwhelming.  But once it was over with, I had other stuff to worry about, so no need to dwell.

What was your orientation like?  Do you love or hate them?  Do you have any tricks to get through orientations and mandatory “fun.”

How Did That Happen?: How I Survive Breaking Bad News

It is due time for another How Did That Happen? post. This one is How I Survive Breaking Bad News. Not how to break bad news. That gets covered all over the place. I’m talking about the facing people later, living the rest of your life kind of survival.stethoscopes1

This one is a result of my week of breaking bad news. I know, I am an oncology resident. More days than not, I break bad news. I tell people about pathology reports they don’t want to hear about. I tell them they have cancer (not always for the first time, but sometimes for the first time they really process it). I tell them their cancer is back. That it isn’t curable. That they need treatments they didn’t want. That they are going to die… Soon.

Breaking bad news is tough. So tough it is its own section in many med school communication classes. So tough most people do a crappy job of it because they are scared.

I’m a weirdo. I don’t love breaking bad news, but I like to do it. Because I believe people have the right to know the truth. And to hear it in such a way it is understood and compassionate.

This week has been especially bad newsy. From clinic to call to pediatric brain tumor clinic, I have delivered or been in on delivering all kinds of crumminess. It wears on a person.

  • It is okay to cry. Seriously. Sometimes, stuff is really tough and you just have to let it out. I’m not saying sob on the shoulder of the person you are talking to, but it is okay to shed some tears then or later.
  • It is okay to be angry or disappointed or relieved. Emotions are good.
  • I’m going to sound cliché, but reflect on it. Sometimes, you say stuff that is stupid or comes off the wrong way and other times it goes well. Actually think back on it, even if it is tough and then learn from it and move on. I tend to really stew on things, so this is something I’m working on.
  • Find the rays of hope. This is also helpful when delivering and discussing the news, but I really mean it is important for me too.   Sometimes, I start to feel like I am the grim reaper or that life is a miserable existence. It is good to find the bright sides, like how fortunate I am, how that person will have a good outcome or good days or whatever. Just something positive.
  • Count your own blessings. If I get really discouraged, I find it helpful to think of how fortunate I am despite the bad in the world.
  • Talk about it. Confidentiality is important to maintain, but there is nothing wrong with discussing it with co-workers involved in the case, or even just your thoughts around it without disclosing details with a friend or family member.
  • Have an outlet. I sing and dance like a fool. Or exercise. Or write. Just something not work that helps get some of that badness out.
  • Do something happy. I like ice cream. Or spending time with friends. Or music. Or books.
  • Mix it up. This isn’t always an option. But, I love that my job involves lots of time on the computer doing technical stuff or research, not just difficult conversations. I also love that there are really good positive things mixed with the difficult in clinics.
  • My faith is super helpful to me at those times too.

What are your bad news survival tips?

How Did That Happen?: Surviving Call

I am way overdue for a How Did That Happen? post yet again.stethoscopes1

This week’s How Did That Happen? is all about surviving call. I did buddy call last weekend with our new first year resident (did I mention I love teaching?) and I have been briefing our other junior resident about what to do in certain situations and stuff like that. It had me thinking back to my first full weekend call as an R1 and my first gen surg call (shudder) and all that good stuff.

  • Like anything else, show up and do your job. Seriously. I have met some mighty lazy people who just want to slack off or get others to do the work. Other people notice. It makes you look bad. It puts patients at risk. And if the other staff get wind of it, they can make your life pretty much miserable.
  • Answer your pages. This goes along with doing your job. I mean answer your pages when you get them. Don’t make people wait if you can help it. Nurses notice if you’re being a jerk and not answering. They will also take pity on you when your pager stops receiving pages in the middle of the day and you failed to answer them the first two times they called (true story, my pager decided to konk out this weekend for about 4 hours… The fact that I am usually answer saved me from a ton of trouble).
  • Trust your nurses and allied health professionals. They are my superheroes. A good nurse can tell when things are going south and give you tips and suggestions when you are new and unsure.
  • If you are rounding on inpatients you don’t know, take the time to skim their chart and figure them and their current issues out, especially if they look unwell.   It can save a world of touble.
  • Before you leave after rounding, ask the floor staff if there is anything else you can do. Sometimes it creates work, but most of the time, it saves calls and it is the polite thing to do.
  • Get handover. I’m serious. It is a huge safety issue. Even if people aren’t seeking you out to give it, check with the regular team if you can. If someone is unwell, find out what the regular team would want you to do in the likely scenarios. Ask for that plan. If they don’t know suggest something. Going in knowing what to do about certain expected issues can make life easier.
  • Give handover. This is the safe and polite thing to do. Find the person coming on the next day and tell them either in writing or in person what happened to their patient, especially if it something that changes the plan.
  • Know who you are on call with. If you are a resident, you will always have at least a staff person on with you. Often, a senior resident too. Know their name and number in case it is asked of you or you need to get in touch with them.
  • Keep notes. Notes about the patients you need to give handover on, notes about things like outside calls. All that good stuff.
  • Ask for help. There are situations that you just can’t handle on your own. Or you aren’t sure of yourself. Do the best you can, but ask for help. Try to know what your plan might be, but admitting you don’t know or trying to figure something out is good learning and much safer.
  • If someone offers to lend a hand, take it. Sometimes, I had more senior residents tell me to text them if something weird came up that I just wanted to run by them. I was immensely grateful to just bounce a plan past someone without having to always run to the staff, especially when it was something simple that I was just new at.  
  • Sleep/eat when you can.  I feel like I say this often. But, I have been burned many times by staying up to wait for that last call or waiting to eat at a certain time. Just do it.
  • Some nights just suck. You can’t do anything about it. Just count down until it is over.
  • Bad stuff will happen on your watch. Someone will die (both expectedly and unexpectedly). Someone will get worse. Something crazy will happen (like a piece of suture hanging out of a drain that nobody can explain). Someone will hate you (because you told them they needed something they didn’t want). Someone may come at you with a weapon (people get creative sometimes).   Someone (including yourself) will make you look stupid (for instance, no matter how many times you tell a certain nurse not to do chest compressions because the person has a pulse and you need to manage their airway because they aren’t breathing, if the code team arrives and that nurse is still doing chest compressions despite your repeated attempts to tell her to stop while you are trying to ventilate because she just wouldn’t listen, they will still think you are the fool because you were “in charge” and it wasn’t even your patient, you just happened to be down the hall and arrived on the scene a minute before to help) know that. Learn from it.
  • Sometimes, you just have to go curl up in a ball and cry because the badness is just too much. Other times, you have to beat the pulp out of a pillow. And at times, you will need to leave a room to laugh your face off.
  • That paniced feeling of not having a clue what you are doing subsides. I don’t know when it goes away. I’m not there yet. It still comes in waves.
  • Have good references on hand. Don’t be afraid to look stuff up.
  • Prioritize your time. There are times where you are pulled in a million directions. Know what needs to get done. The sickest people are your priority. Computers and phones make good friends to help with reviewing results and doing quick orders.
  • Document stuff. Because, as above, bad stuff will happen on your watch. So does good stuff. The medical record is important, both for patient care and legal purposes. Plus, the day team will appreciate knowing what all went down.
  • If you are sick when you start call, odds are you will be sicker when it is over. One night, the nurses on a certain unit found it both sad and humorous that over the course of the night, my voice disappeared and my cough/breathing progressively got worse than half the patients I was managing. The whole illness being worse at night is amplified if you don’t sleep.
  • If you do home call, don’t forget things like your stethoscope. Nothing is worse than carrying your tired body back to the hospital at 3am only to realize you have to use one of the crummy “fisher-price” stethoscopes because yours is in your other bag.
  • If something can wait until morning for the regular team to take care of it, then let it wait. They might have a plan you weren’t aware of.
  • If you feel annoyed at that 2am call for Tylenol or a sleeping pill, just be glad it isn’t a new onset fever in a chemo patient or wound dehiscence.
  • Hospitals often have mice or rats. They come out when normal people are sleeping. Brace yourself.
  • There is a rule when it comes to call… If you have big plans the next day, stuff to get done, etc. it will be busy.  That being said, always bring something to do if you have down time.  But, know it will likely be interrupted.
  • Phone chargers and tooth brushes make the stay in hospital much better. So does take-out!

What are some of your surviving call tips?