Let the day go loose.

I consistently tell residents, doctors still training, it is best not to plan anything for at least 90 minutes after the scheduled end of a shift. Two hours is better.

If you’re well organized, you mostly finish on time. When the day escapes expectations though, more sick people need more of your time, you’ll stress less about being there longer if you’re not letting a dinner date down. More importantly, you won’t be tempted to take a short cut, talk yourself out of a lumbar puncture after the story of a sudden headache and create a headache for yourself.

It’s also fun giving advice and not following. Me:

Shift’s over at 4. Handover, chat, drop the scrubs, I’m out at 430 at the gym by 5, then then then then. Plans on plans. Last night, though, my shift ended an hour earlier than I thought so I had two hours until my next then. Two hours in the ER is, like, ten anywhere else. It’s all the time in the world.

So I let the day go loose. In those two hours: gifts.

Handed over my patients, debriefed with my student, fixed some of my charting. I mostly deflected more medicine (“Can I ask you to look at this EKG?”), but I was able to watch a woman who came in after a fall1 wobble when she stood to leave and decided she would be better off with us at her elbow for a couple days. I called Medicine, gave them her name.

A person’s CT came back clean and I delivered good news instead of having the next doctor do it.

”I want to thank you,” he says.
”My pleasure.” I smile.
”No, not for the news, though I’m glad to hear it.”
”Ok.”
”I want to thank you for sitting down.”

Right.

I did.

That moment is with me still. That’s another thing I’ll tell residents: it shines back.

Tomorrow I’m done at seven, no plans until nine.

(Image: ‘The biggest cake in the world’ - Acrylic on Canvas, Natasha Kudashkina)

1