“Let’s do the Time Warp again!”  – The Time Warp, The Rocky Horror Picture Show

 

I am always a little out of sorts in the days that follow the time change every fall and spring.  I find it easier to get up in the morning when it is light out. In the fall, that is only temporary, and the light continues to slip away and fade as we pass into winter, when the days – or at least the daylight hours – are shorter. So changing the clocks only provides transient respite from the coming dark mornings.

I think people might like the idea of adding an extra hour to their day, as we change the clocks in the fall and despite the annoyance of resetting clocks, as much as they dislike losing that hour in the spring. We all imagine a luxurious extra hour of sleep, though that fantasy is usually thwarted by the reality of our schedules and our internal clocks (especially if you have pets or small children, even if your own internal clock can be ignored). Those internal clocks take frustratingly longer to adjust, so you end up simply waking an hour or so early. When we lose that hour in the spring, we almost invariably sacrifice an hour of sleep, as our busy schedules end up  overriding both lost hour and internal clock. We can be out of sorts with a side of zombie as we tackle those first few days.

The view of the time change is a little bit different for doctors, and anyone who must be on call for their job, though much of what I have just observed still holds. I can speak best to my experience of this as a doctor, though, so it is that perspective I will use. I view the time change, and much of my world in fact, through the prisms of being on call and the on call schedule.  I end up with even more ambivalence towards this whole concept of changing the clocks. I tend to think of it as one more hour of call in the fall, one less in the spring. This year may be one of the first times in ages that the luck of the draw for the call schedule hasn’t placed me on call for this time-change weekend. Writing this is how I spent that extra time. (I’m usually not so lucky in the spring, and lose an hour on my weekend off).

Being on call changes how you look at time and the time change. How you approach being on call depends on what your likelihood is of getting a call, the possibility you have to go in, the urgency of the situation, and how critical the situation is likely to be. For most surgeons, all of these likelihoods are apt to be pretty high. These factors govern the reaction to being on call, and behavior while on call…at least for me.

For me, when on call, I am on edge, on alert, vigilant. Ready to jump up at any moment to head back in to the fray, to deal with an emergency. Tensing at every beep, buzzer, chime, chirp, and ring of any of the myriad devices surrounding me to keep me accessible. I refer to these as my electronic leash, keeping me bound to the hospital. I alert to the sound of other people’s devices, checking and double checking to be sure it was not mine that went off. Always with “I do not know what this is, or who is calling, but it might be bad” popping up somewhere in the back of my mind. As an aside, bless you to the E.R. doctors and all of the nursing staff who preface their conversations with “This isn’t an emergency,” or “You don’t need to come in for this,” or “This is for the morning.” I feel my tension ebb as my attention sharpens and they proceed with their query or report. But I digress.

For me, I can’t relax on call. I can’t rest well, sleep is fitful, and I wake frequently even if the beeper is not going off. Sometimes, it is worse when the phone or beeper are completely silent, and I am periodically checking to make sure that the landline, the cell phone, the beeper, and the answering service are all up and running. There have been times when they weren’t working (dead batteries, power failures, broken cell towers), and I was unable to be reached, and so being vigilant about that, too, adds to the stress that is being on call. Telling myself, “If I had known I would not have gotten any calls, I would have done [anything]” provides no comfort, nor does it alleviate the stress, but is merely salt in the wound, rubbed in by hindsight. Even seemingly minor tasks, like a run to the grocery store, picking up take-out food, or doing a load of laundry, can be thwarted. Abandoning the shopping cart in the aisle, uneaten/untouched take-out left to get cold the car, wet clothes forgotten in the washing machine… all potential outcomes, all things that have happened, more than once, and not just to me. So, no movie theaters, no restaurants or dinner plans (unless my companions are very familiar with the vagaries of being on call, and have their own transportation), nothing that will take me longer than about 30 minutes from phone call to walking in the door, nothing I can’t just drop. That’s how it goes for me. Call can be emotionally exhausting even when it is not physically exhausting.

So I say, “No, thank you !” to an extra hour of on call.

But today, I am not on call. I get to sleep in!

Or not, I’m just up an hour early, (effing internal clock), and writing this.

Happy Standard Time, Everybody!

 

“The hours of folly are measured by the clock; but of wisdom, no clock can measure.” – William Blake