Mallory McClester, MD, is a first-year geriatric fellow in the Division of Geriatrics at the University of North Carolina (UNC) School of Medicine, Chapel Hill, NC. She was previously co-chief resident, Department of Family Medicine, UNC. Dr. McClester's blog is about her experiences as a geriatric fellow.
Bzzzzzzzz…beep/beep! It was my own fault, but I just wrapped up 11 days in a row fearlessly carrying my pager everywhere I went. The grocery store, spinning class, out for my friend’s 30th birthday—everywhere I was, that noisy box was clipped to me somehow. This is probably a phenomenon many seasoned physicians are accustomed to, but it was a new and quite different experience for me.
In residency, I took home calls only while on our maternal childhealth service. If someone woke me up in the middle of the night, I typically had to go in to catch a baby. When I was on calls those nights, I never went any place where I couldn’t be at the hospital within the next 10 minutes if needed.
So imagine this new freedom I experienced! I guess it was more like my electronic leash with new freedom. I take night calls for a local hospital a couple times a month and happened to stack four of these nights in a row just before my first week on geriatrics call. After four nights of being woken up to discuss admissions to the wards, my calls suddenly became varied, from dealing with “chest pains” and “fever of 102 in a 99-year-old woman” to “the patient would like to be free to go out with family tomorrow”; I dealt with medication changes; I discussed a daughter’s concern for infection over the phone on a Saturday to avoid an ED visit; I helped with insulin management; and I received calls about incident reports regarding patients I had never met (my favorite of which was the night that the telephone nursing staff decided I was on call for anyone over the age of 65 based on my family medicine background and kept having facilities page me no matter what). I (too easily) went ahead and ordered a urine culture in a woman who complained only of burning with urination. The calls were frequent and also quite interesting. It is an incredible opportunity as a fellow to have the chance to learn from these wonderful attendings by simply answering calls on their patients and looking into their management plans. It brought up new issues to ponder and read up on. It also left my quite sleepy.
The experience was fun while it lasted and I will have another week at bat in December. I would be lying if I didn’t say it, I am thrilled to finally put down the pager, have a glass of wine, and sleep through the night.
