Sunday, January 20, 2013

Post Call Operating

A new paper from JACS reviews outcomes of elective procedures performed by surgeons operating the night after being on trauma call.


Performance of general surgery operations the day after an overnight in-hospital trauma shift did not affect complication rates or readmission rates. At this time, there is no compelling evidence to mandate work-hour restrictions for attending general surgeons.
This is right up my alley.  I am a general surgeon in a practice of two who takes call every other night, every other weekend.  I also cover the trauma pager 7-8 times a month.  Most of my post call days involve attending to electively scheduled cases.  All I can say is that I agree with the above findings.  I do not need naps post call.  I do not feel compromised by interrupted sleep.  This is my life.  I am a general surgeon.  This is what I bought into all those years ago.  Perhaps the paradigm and the expectations are changing.  Perhaps the millennial generation of surgeons will see me as some sort of strange anachronistic oddity-- what the hell is he doing trying to operate this morning?  I heard he only slept 4 hours last night???

Unfortunately the effects of such papers are doomed to fall on deaf ears.  The wheels of change are grinding.  Work hour reform is already entrenched at the residency level.  Papers such as this have an ever diminishing audience.  A generation of super-specialized, fellowship-heavy, shift work ingrained surgeons cannot comprehend what a paper like this even means.  It's inexplicable, a relic from an expired era.  The loss of an old ethic, a noble professionalism goes unacknowledged. 

Everyone gets tired.  The call comes in.  The alarm goes off.  It's time to rise again.  You say to yourself: That patient needs me.  Somebody loves him.  This is what you are meant to do.  Rise.  Run the cold water across your face.  Somebody loves her.  It's time to work again.  With all your heart and all your mind.  Do your job.  There is a transcendent joy for you too, if you just hang in there.....

1 comment:

Frank Drackman said...

Thats right, y'all are better than every other occupation that deals with life/death(is a Hernia really life/death?)...