life Work

Last call of 2020

November 3, 2020
(Map via NPR. Fun fact: I have spent my entire life in swing states: PA, NC, FL!)

I have a great job. I really do. I honestly can’t think of a better combination of responsibilities or a superior schedule to the one I have right now. I have enough flexibility and space for deep work to keep me happy (without having TOO much — turns out I really do like to have some structure).

I truly enjoy my patient care days, which are usually Mondays and Wednesdays. But then I’m also grateful to move onto other projects on the other days!

Seriously, I feel so lucky. In the words of Liz Craft from Happier in Hollywood: “It’s a fun job and I enjoy it.”

The only part of my job that I don’t always appreciate or enjoy is (duh) . . . CALL. Because the ratio aligns with my clinical FTE%, my call weeks are less frequent now — on par with what endocrinologists at some of the larger academic centers take. Approximately 6 weeks/year. Really not bad!

Yet when it looms on my calendar, I don’t usually feel gratitude. However, I will never stop trying to turn things around. My success with drastic change in the technology use realm proves to me that I CAN DO HARD THINGS. Including (I hope) change my mindset and attitudes around call.

One wise reader previously mentioned that she had managed to reframe her narrative around being on call (including being constantly interrupted/woken up at night). It is a privilege to have a job where your expertise is such that you can actually help others and make a difference, even when they are scared and without guidance at night. Her comment:

I am in academic medicine where things like doing research and publishing papers in medical journals count for the most weight when it comes time for promotion.

But I am also in a clinical position where I am on call 24/7 for 50% of my time (usually every other week or every two weeks) I used to resent getting interrupted by my pager going off, but then I decided that hey, more than 50% of my time (I run outpatient clinics too) is supposed to be spent with patient care, teaching residents, and BEING THERE for my colleagues. People call me for my expertise so I decided to EMBRACE the interruptions.

I remembered what it was like to be an intern in the emergency room having to call the subspecialist for advice. The perfect situation would be when they answered promptly, let me explain the situation, didnโ€™t make me feel stupid, answered my question in a clear way, gave me a plan for the patient that was doable, and even taught me something during the call. After I started being ALL IN for getting paged, I felt my days (and nights!) were more meaningful and enjoyable.” — NeuroMD

I mean first of all – she is on 24/7 call 50% of her time, which puts my dinky little percentage into perspective. And second of all – what an amazing and inspiring answer. I am going to try really hard to embody her sentiments during this call week, which begins in ~2 hours.

BIDEN 2020

Also, it’s election day. I am going to continue to operate under the assumption that we won’t know anything for weeks so that I will not be disappointed. But I guess we will see!

Hopefully not another The man wan” video. From November 2016 . . .


  • Reply Grateful Kae November 3, 2020 at 6:47 am

    That commenter really does have a great perspective on it. As a nurse, I’ll never forget some of the times during my clinicals or as a new 20-something nurse having to call physicians/ other providers about an issue. When you just don’t totally know what you’re doing yet (or not confidently enough, at least), that is just the WORST. You feel stupid and mortified if they are snarky/ rude/annoyed acting to you on the phone, but you’re just trying to do your job (take care of the patient, which should be an equally shared goal between all providers) and learn from their expertise. You’re not *trying* to call to pester them and just wake them up for kicks.

    Trust me, the person on the other end probably wishes just as much you do that they didn’t need to be calling you! ๐Ÿ˜‰ I’m sure you are at least nice on the phone though. ๐Ÿ™‚ Hope your call week is an easy one!

    • Reply Y November 3, 2020 at 9:29 am

      I’m a nurse too and while I no longer work in the hospital setting, I totally remember those nights, especially as a terrified new grad, making those dreaded pages to the on call doc. Do not miss those days at all. And yes, you are so right, the person on the other end wishes that call/page was not necessary! Eventually it came down to a decision between A. I page this person, and he/she gets upset, or B. I don’t page, and things escalate in an unfavorable manner. Choice A always wins.

  • Reply Chelsea November 3, 2020 at 6:51 am

    As someone who has made a few (thankfully not many!) calls to medical professionals during the night and on weekends or holidays, it really is an invaluable comfort to patients and families to know good advice is just a phone call away.

  • Reply Pankti November 3, 2020 at 7:48 am

    Wow, how reflective! As someone who’s trying to get into med school – the excitement of someone possibly waking you up to consult on your expertise is truly fascinating! I hope I remember the same sentiment and perspective when I am a doctor. BTW – as a native Texan, it’s so weird for me to see Texas as a swing state this year!

  • Reply Lisa of Lisa's Yarns November 3, 2020 at 9:22 am

    I like the advice givers perspective, especially thinking about the person on the other end of the phone who probably feels terrible and nervous calling you… we’ve all been the junior person so putting ourselves in that person’s shoes can really help us respond with more compassion and patience! But ooh – 50% call time. Yikes that is rough!

    Love the video of Annabel – hate thinking back on that night. I am on pins and needles and just feel a general level of anxiety right now… Our son is 2.5 but because we have the news on when he is around, he knows names like Joe Biden. So we taught him that Joe Biden is a good guy… and Donald Trump is a bad guy. Most of my family are Trumpers so this may come back to bite us, but I am sorry – his behavior is atrocious and he is a terrible role model and not someone to model behavior after, so he IS a bad guy.I would be appalled if our son took on his characteristics so I feel right saying he is a bad guy. So if it comes back to bites us, I will just explain that his behavior is so mean, rude, immoral, etc, and he is a bad guy in our eyes. In a normal election, I wouldn’t say either side is a bad guy, but this is a new world we are living in. I just hope and pray Biden wins and that the Republican party returns to the era of people like John Kasick who I like and respect. We just really need a return to civility.

    • Reply KGC November 3, 2020 at 11:44 am

      It’s been interesting to try to explain it to my son, too (age 4.5). He knows that I do not support Trump and I’ve tried to explain as ‘I don’t agree with some of his decisions, but I also think he’s not a very nice person.’ My son – very seriously – looked at me and said, “Does he call people names? Does he call people STUPID??!” And I could honestly answer YES! Yes, he does, and that’s part of why I don’t think he’s a good leader. I figured that was at least a concept he could really latch onto. But beyond that, I’ve tried not to get too heated about things because our family has a mix of political views and there are actually plenty of issues that my husband and I don’t see eye to eye on. So rather than try to make one of us out as the bad guy for supporting candidate XYZ, I’m trying to focus on the things that we all agree on – and in this case, it’s a lack of morality in the current leader. It’s been an interesting year for sure, with little ears listening!

    • Reply Milly November 3, 2020 at 3:43 pm

      Wow. This is interesting to read. I do not like Trump but I see plenty of things to dislike about Biden and Harris. Things that I would argue warrant the same “they are bad people” argument you are saying to your child. I simply tell my son that voting is a deeply personal thing and no one is required to share. He has no idea who I voted for.

      I’ll be honest… I think you are setting a poor example by using the phrases good guy and bad guy. People are not inherently good or bad. The decisions they make are, sure. Your son is 2.5…. a toddler. Projecting your anxiety on him by labeling people…. I think there needs to be some reflection on your end there.

      • Reply KGC November 3, 2020 at 4:09 pm

        @Milly – agreed. My son also does not know who I voted for, and I have told him that no one is ever required to share this information. Interestingly, he has asked me the question of who I voted for (and actually seemed fine with my lack of answer) but he has not asked my husband. I doubt there’s anything to make of this, but I think it’s interesting!

        • Reply Brooke November 3, 2020 at 6:46 pm

          @milly @kgc I can’t help but feel that the reason you haven’t told your kids who you are voting for is because you aren’t proud of who he is and how he behaves and speaks. Shouldn’t that be a wake up call?!

          • Milly November 3, 2020 at 9:01 pm

            Ha! And here it is… this is the typical liberal response to my statement that voting is personal. Itโ€™s always the assumption I voted for the โ€œbadโ€ orange guy because otherwise Iโ€™d be โ€œproudโ€ of my vote. Well, you can assume what you want. My vote is my own private business ๐Ÿ˜‰ And you can go right on ahead assuming what fits your narrative.

          • KGC November 3, 2020 at 9:02 pm

            @Brooke – no, for me it’s because that’s how I was raised and what is ingrained in me. I can only think of one election in which I know for whom my parents voted, and it’s because my mom offered it up in conversation once (somewhat randomly). I have never told anyone who I voted for in any election, ever, even those that were significantly less dramatic than this one. For me, it has less to do with being proud and confident in my candidate (or not) and much more to do with the view that speaking about specifics of voting was sort of taboo in my house. General political discussions – fine. But flat-out asking or telling someone how you cast your ballot? Not done.
            (not saying that this is the ‘right’ way to do things at all, but it’s what I know and – apparently – what I have chosen to carry forward)
            I also want my kids to be able to make their own political decisions without direct input from me or their father. When my 4.5 year old asks about the election, I make a very concerted effort to explain some of my general thoughts but also point out that others disagree and that’s okay – that everyone is entitled to their own opinion and that they can exercise their right to vote just like I can. I should also note that my husband has never told me who he has voted for (nor have I asked). It probably better for our marriage that it stay that way!
            Your point may be correct for some people, but I don’t think it’s the case for me personally.

          • Sarah Hart-Unger November 4, 2020 at 7:18 am

            very interesting; I am not saying wrong or right, but I definitely always knew how my parents voted. And all of my relatives, even my aunt from Louisiana who usually voted opposite ๐Ÿ™‚

          • KGC November 4, 2020 at 8:18 am

            @SHU: Maybe it’s an Ohio thing! Several of my friends from childhood say the same thing – voting is personal and one’s specific choice is usually not discussed =) Or, in my house, I sometimes wonder if it’s because my parents (one republican, one independent) voted differently from each other and were trying to avoid conflict…ha!

      • Reply Donna November 4, 2020 at 9:36 am

        My parents were always up front with me about who they voted for and why. We also discussed any ballot measures as well. This is how children learn and form their own opinions. My own boys are 17 now (twins) and they definitely have their own opinions. We watched some of the election results come in last night and discussed our own state as well as the Senate race. Again…discussion is how they learn, grow and form their own opinions. My two cents…Sarah…you do you girl!

      • Reply omdg November 4, 2020 at 9:49 am

        People may not be *inherently* good or bad, but they can become good or bad by their actions as we have seen repeatedly over the last four years.

  • Reply Katie November 3, 2020 at 11:58 am

    That video of Annabel is adorable – however if that man โ€˜wansโ€™ again, I AM going to get upset! ๐Ÿ˜‚

  • Reply everydayhas November 3, 2020 at 12:12 pm

    From here, having a limited and specified number of call weekends sounds kind of fabulous. I am an engineer/manager in industry and am on call for all weekends that I do not specifically arrange to be away, and I have to be within a one hour response time to my assigned site. Earlier in my career in other roles, I was likely to get called multiple times for most of those weekends, but the problems could usually be solved over the phone. Thankfully I get called less often now, but when I do it is more likely to be a complex problem requiring many hours and a site visit. So, tradeoffs. Not competing AT ALL, but maybe/hopefully a helpful comparison?

  • Reply Rebecca November 3, 2020 at 1:12 pm

    When I was going through chemo this summer (in remission now, yay!), there were a couple times when an issue came up on a weekend and I had to call the hospital switchboard and be put through to the on-call oncologist to get some advice. (Both times it happened to be *my* oncologist; there are actually only two medical oncologists at the local cancer center, so I suppose each of them must be on call 50% of the time!) I always felt so bad for bothering him, but he was always SUPER nice about it and made me feel more calm about whatever weird thing was going on with me. So, thank you to all doctors who do this!

    Completely off topic for this post, but – when you post your Wonderland 222 review, could you also talk about what pens you’re using with it? I’ve only recently graduated from using whatever cheap pen was handy to actually caring about my pens, and I’m still a total newbie at figuring out what pens are good for what use (eg. headers versus regular writing!) with what sort of planner/paper.

    • Reply Sarah Hart-Unger November 3, 2020 at 6:28 pm

      I use the Uniball Jetstream (same as what comes with Hobonichi). There is definitely still ghosting, but it’s not a dealbreaker for me – just the price to pay for a compact system with LOTS of pages ๐Ÿ™‚

  • Reply Jessica November 3, 2020 at 3:51 pm

    Funny timing that you mention the Happier in Hollywood podcast today…I read your blog post and then an hour later I am listening to an episode of her other podcast, The Happier Podcast, from about a month ago (I’m behind!) where they are talking about suggestions for getting Liz’s kid to eat more veggies. There was a recommendation from a Sarah that is a pediatric endocrinologist with three kids to eat more veggie sushi. I’m guessing that’s you! haha! I had to come back here and tell you ๐Ÿ™‚

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