Medicine is a hybrid of science and art. The science in in the medicines themselves, the evidence, the intricate web of physiology, pathology and biochemistry that runs you day to day and with which we tinker with drugs and surgery. The art is in understanding where people are coming from, eliciting the hard symptoms from them, reassuring and cajoling and explaining what is (or often as not, isn’t) happening in the broadest variety of terms. There is also an art to diagnosis when nothing is as it appears in the textbook – cardinal signs are normally missing and ultimately, sometimes you ‘just get a feeling’ that something is wrong (I have learned to trust that feeling the hard way).
Point is, despite the science we medics are a superstitious lot. Heaven forbid that you mention that an on-call is ‘quiet’ – that’s like volunteering for a shit sandwich of referrals and a crash call in some godforsaken part of the hospital grounds that no-one on the crash team has ever heard of. And after you’ve all run around outbuildings for a while hunting for this arrest-in-progress, it will turn out someone just fell over their own shoelaces.
On the note of superstitions, allow me to introduce a basic and commonly-found pair of characters: the polar opposites of the on-call team. Teflon, and the shit-magnet.
The shit magnet is a some unlucky soul who, by apparent coincidence, always has the worst on-calls known. The bays will be full, there will be people lining up outside waiting to be seen and all of them will be horribly unwell. If you’re on with a shit magnet, there will be no breaks and no time for lunch because you’ll be running around like a headless chicken, pulled in eight directions at once, with the sound of bleeps and phones and people rushing in with questions about their inexplicably-deteriorating patients for a full 13 hours of joy. This will happen every time they are on-call, and there is just nothing you can do about it. The best you can hope for is just a busy day.
By contrast, the teflon doctor drifts through their occasionally-so-serene-you-check-your-bleep-is-working on-calls to the soothing sound of a gently babbling brook. Referrals just slide off them like water off a duck’s back, where they are made at all, and patients just seem to spring out of bed and be ready for home without much intervention whatsoever. Even when seriously unwell patients come in, the diagnosis is obvious and the treatment works beautifully, simply, and without undue incident. The very best of shifts for the shit-magnet is the very worst it gets for the teflon-coated on-call team.*
The cynical amongst you will say that everyone gets equal shifts, and it’s just the nature of humans to remember the bad, or remember the good, and explain everything away. You might be right. Just don’t tell it to the shit magnet – they know better.
*Note that even teflon-coated on-calls often cannot match the mind-altering, busy-shift inducing powers of a full moon.