1. The definition of “emergency” is broad and all encompassing.
“It’s 2am in the morning and I’ve run out of tiger balm.”
“I went to the movies and I think I have popcorn stuck down my throat.”
“I lost my girlfriend.”
“We don’t have that.”
“Did you finish your diet coke?” (Carbonated drinks are actually recommended for food boluses).
2. Your team is your ride or die
Emergency shifts are not conducive to socializing with anyone outside the department. When you have time off none of your friends are free to play with you, and when they have time off, you are busy doing a PR exam on a poor gentleman at 11pm on a Saturday night. The doctors, nurses, allied health and clerical staff become your baes by default, and you become intimately inserted into each other’s lives. You hear about someone’s new vibrator when checking schedule eight drugs. You know your registrar is in the tea room eating a container of noodles even though he’s on a “no carb diet”. You buy a ring watch from an overseas market to satisfy her desire to wear a watch under the “bare below the elbows” policy that only allows wedding rings. It becomes like the baby-sitter’s club – your friends are always there.
3. Sleep deprivation delirium is a real thing.
Things get weird at 3am in the morning after four night shifts in a row. Very competent doctors become unnecessarily distressed down when they cannot get the child lock off the hot water tap. Junior doctors develop chilblains (red, hot, itchy, swollen fingers) from carrying ice cold cans of diet coke too far from the vending machine and become hysterically paranoid that their fingers are about to fall off. Nurses who never used to like you suddenly decide to do your cannulas for you. Its 3am and anything can happen.
4. Consequently, sleep is a thing you need.
It sounds like a no brainer. but I have tested its limits. Caffeine is not the same as sleep; it just makes you need to pee all the time during a resus. Watching an entire season of Keeping up with the Kardashians is not the same as sleep; it just makes the patient whose burns you are de-roofing wonder aloud why someone who is supposed to be smart would be watching something so stupid. Getting on a plane to go on a holiday hours after finishing night shift is not the same as sleep; the first time you will get away with it, the next time you will get diarrhea and your colleague will get bacterial pneumonia.
5. Sustenance is key.
Hangry is a real thing. I once got told by a consultant to go make myself a toasted cheese sandwich because I was scaring people. You don’t realize how important the coffee runs, sweets from the lolly trolley and lunches stolen from your parents’ house are until you see your intern who has spent fifteen minutes looking for his lost lunch about to cry and consider calling a code black personal emergency.
6. Poker face is your secret weapon.
The infected foreskin of a gentleman who received a DIY penis tattoo. The dislocated jaw of a poor girl who just wanted to kiss her boyfriend. The traumatically amputated toe in a plastic bag handed to you by an unfazed ambulance officer. A gentleman telling you he had the “best orgasm of my fucking life” when you lanced his pus-riddled back cyst.
Poker face is a way of life, or at least a way of my life, according to a fellow doctor who once told me “It doesn’t matter whether you have just finished a night shift or you’re just going to start a day shift, you always look the same: unimpressed.”
7. And nothing is sweeter than victory.
There is nothing, absolutely nothing, that can compare to the feeling of walking out the front doors of the emergency department at 8am with greasy hair, smeared mascara and bloodied scrubs into the too-bright sunshine, a run of nights behind you and a boozy breakfast and the best sleep of your life ahead of you.
Except maybe having your pus-riddled back cyst lanced by yours truly. I should have asked that guy.