Effing pager.

If I have learned anything in medical school, it is this: if your pager is going to go off, it will inevitably do so within a 5 minute time range of lying down in bed. If you were to plot this out, on a graph of pages vs. time, the peak of the curve would fall at the exact moment that your eyes close, immediately after turning out the light.

Knowing this law to be true, I had some tough decisions last night. My mettle was tested.

It began at 9:30 pm, as I was preparing to get ready for bed. My pager went off, followed closely by a series of expletives. There was a new patient just arrived in the unit with confusion and very low blood pressure. "You might like to see this," says the attending on call. Translation: "Be here within 5 minutes." I'll be right over. Eff.

At 11:45 pm came the first major decision point of the night. There was a gun shot wound on the way, to be arriving shortly via helicopter. Should I stay? "You can go home if you want to." These are very tricky words for the astute medical student to interpret. Because honestly, I did want to go home. I wanted that very much. But does it look bad to want to leave? Is chosing sleep over a potential learning opportunity a one-way ticket to medical mediocrity? Will it be worth it tomorrow when I am incredibly tired - will it look worse if I am groggy and slow during rounds? I deliberated over these questions for a good 10 minutes. And then I decided to go home. After all, they can page me if they need me.

As I made the 7.5 minute walk back to my apartment, I looked up at the clear starry sky. Cold. Beautiful.

Without taking my scrubs off, I climbed into bed, my pager in its customy place of honor on my bedside table. All laws of physics were satisfied when that pager went off literally the exact second that I closed my eyes, announcing the upcoming arrival of the next patient. I lay in bed staring at the ceiling for many minutes, weighing the benefits of continued sleep versus the perception of laziness. The thing is, I am not needed at that code. The patient will in no way benefit from my being there, as I cannot actually do anything to help them. I will more likely be a hindrance, my mere presence occupying valuable space during a flurry of activity. The last code I was at, I was directly asked to leave becaue I wasn't doing anything useful and was "getting in the way". I thought standing next to the patient, blocking the surgeon's access was fairly useful, but apparently I was wrong. This was in no way humiliating or demoralizing. Do I want to get out of bed only to be kicked out?

The helicopter passed overhead, wings beating violently against that beautiful sky. Bearing tragedy through a star-studded veil of calm.

In the end, I decided to get out of bed. Somehow it seemed like the right thing to do. Of course, when I arrived I found that I was indeed completely irrelevant. People in gowns were yelling things and rushing around with great purpose. I stood in a corner, and noted a hint of annoyance when I was slow handing a nurse the paper towels that I was standing in front of. No one aknowledged me. My attending was not there. The patient went to surgery and I walked home.

The sky was once again calm, the stars spread out above the desert. My pager did not go off again.