Scenes from Life On Call in the OR
EVS Journal 7

Every member of the OR EVS team takes emergency call on assigned weekends. The call shift starts at 8 am, ends at midnight, and takes place on two consecutive days. It’s an exercise in underpaid exhaustion. You get $5/hr every hour that you’re on call but not actively on a call. Once you get a call, you suit up (in scrubs) and punch in.  Once you suit up and punch in for a case, you get paid time and a half: $21/hr. When you’re done with the case, you punch out–you’re supposed to punch out–and go back to $5 an hour. Overtime past midnight is penalized, regardless of when the call comes in.

Calls often come in for unscheduled emergency cases–mostly fractures from car accidents, sometimes falls, sometimes appendicitis, and the like. You’re guaranteed $80 a day or $160 a weekend, whether or not you get a call. The chances of getting one call per shift are 100%. The chances of getting two are about 80%. The chances of getting three are about 70%. The chances of getting four are better than even. The chances of getting a last minute bloodbath in the last few minutes of your second day on call are low but never zero.

Nov. 24, 2020
12:05 am

First day of emergency call. Did a 12 hour shift, noon to midnight. Sat around waiting for two emergency cases to open, both fractures, so we could clean them–the rooms, I mean, not the fractures. Cases ended around 11:20, took 40 minutes, so we clocked out exactly at midnight, taking home about a half hour a piece of dreaded overtime pay. I think that’s a total of $21 of overtime split two ways. We’re sure to get our asses kicked by Surgical Services over this tomorrow, but tomorrow is a whole 13 hours in the future. Future =  unreal and unimportant, so it’s hard to care. Not really sure how we were supposed to clean two ORs in ten minutes. But ours is not to reason why.

Occurs to me that “tomorrow” is today. Still don’t care.

Dec. 6, 2020
Just after midnight

Second day of emergency call. Call comes in just as I’m starting to eat lunch. They need us in quickly–turnover in OR 1. I cram the food into my mouth, then get in the car and race there, but co-worker Samantha gets there ten minutes before me, and is already at work in OR 1 when I arrive. We race through the turnover. “They need it fast,” she says. We do it fast.

On to OR 4, which is a terminal clean, so we do it in a more leisurely fashion. A fair bit of time has gone by. The assumption is that we have to hang around after we’re done with OR 4 until they’re done with the emergency in OR 1, then we terminally clean it, and get to leave. It’s a simple-sounding case, so it shouldn’t be too long. So we putter about a bit waiting for the case to end. No one clocks out.

We’re supposed to close the door after we clean a room, so we’d closed the door to OR 1 after we finished it. I guess we assumed that the clinicians went in through the back door to do the case while we were doing other things.

“This is an awfully quiet case,” I tell Samantha.

Samantha gets this worried look in her eyes (all I can see of her face besides the mask), which is the look that the “girl” in a horror movie gets just before some macabre discovery is made or event takes place. I’m dying for her to say, “Yes, quiet–too quiet,” but Samantha isn’t cliché enough for my script.

“Where the fuck is everybody?” she asks.

“Maybe the call room?” I venture.

We walk there, and find it abandoned, with the light out.

We walk around for about fifteen minutes. Absolutely no one is in the OR but us. We gingerly open the door to OR 1. It’s exactly as we left it hours ago. Nothing has moved. There’s no one there. No one ever was there. We now know where the fuck everyone is. They went home.

“Thanks for telling us,” Samantha says to no one in particular. “We’re sitting here like assholes waiting for a case to close that’s never opened.” We are.

I go to the call room, and write the morning shift a note about how I found a trapeze sitting around in Holding, and could someone find it a home? Meanwhile, Xavier, the guy from Sterile Processing comes up. “What’s going on with your emergency case?” he asks. “They haven’t sent any instruments down.”

“They’re not in the room. No one’s around. It’s a mystery,” I say. I feel important in a Socratic sort of way, owning my ignorance.

Xavier shuffles a few papers on a nearby desk. “Look at this. The case is cancelled. It was cancelled hours ago.” He points to a single line someone has drawn through a case that seems like it might have been the one that was probably scheduled in OR 1 (maybe).

“But look at the screen!” I insist, pointing to the screen, which indicates a case waiting to be scheduled.

“No, look at the paper,” Xavier insists back. “The case on the screen is the one they canceled. Always look at the paper. Forget the screen.”

The Luddites will inherit the Earth. The aggressive Luddites from Sterile Processing with Cuban accents, who put no faith in screens, only in paper.

“Thanks for fucking telling us, you lazy pieces of shit,” Samantha chimes in, once again to an off-stage listener. “I could have gone Christmas shopping this whole time.”

I know it looks like I’m reinforcing some terrible stereotype here about women and shopping, but that’s literally what she said.

She should be grateful. I mean, we just got a whole lot of pay for doing a whole lot of nothing. How does Samantha think she’s going to pay for those Christmas presents, anyway?

I don’t mind the overtime, but honestly, this was a waste. Last week, they yelled at us for taking a half hour of overtime. This week, they wasted time and money on us through a communication breakdown. It’s always the same: clinical staff forgets that EVS and SPD exist and take call; we sit here waiting out a phantom case; then Admin gets mad that EVS and SPD are “running the clock.” Is it really “running the clock” when you’re waiting for a case to close that never opened? And never opened because no one told you it was canceled? No, but we’re going to get yelled at anyway.

Tomorrow, though. Tomorrow is another day.

Dec. 12, 2020
11:45 pm

Third day of emergency call. At this point, I’m just desperately trying to stay awake until midnight so I can end my on-call status and just hand this whole health care thing over to Kojo on the graveyard shift. If you’re going to have a traffic accident or fall down a flight of stairs at 11:30 on Saturday night, you’re just going to have to learn to plan better, because my ass is not getting up at this hour to mop blood off the floor.

It’s a myth that working in the helping professions makes you a better person. I’m not a better person. I’m worse. Before I started working in health care, I used to follow that old Jewish tradition of saying a silent prayer whenever I saw an ambulance go by with lights and siren. You’re supposed to say a prayer for the well being of the patient: “Let this person recover fully and with the least pain…” Such a noble sentiment—when you’re a spectator.

Now I hear ambulances heading to the OR (like: right now), and all I can think is: “Please, God: let their surgery end after midnight. Let Kojo have to clean the room. Please, God, don’t let them interrupt my having this hot and sour soup.” I want to prolong someone’s misery so I can have hot and sour soup. What the fuck is wrong with me.

Kojo is the guy on the shift after mine. I know for a fact that Kojo prays for cases to end before midnight so I have to deal with them. He told me so–openly and without shame. And what’s sick is how often his selfish petitions to God seem to go answered. Why not mine? If Kojo lacks shame, why should I have any? I’m no better than Kojo. Equality in depravity: The Calvinists talk about total depravity. We practice it.

It’s depressing to wish misery on strangers in exchange for uninterrupted engagement with some deeply mediocre Chinese food. That’s where I’ve ended up, three months on the job. It makes you wonder how much farther there is to go. Is there depravity after total depravity?

So this is what it comes to, in the end. Every service you render your fellow man becomes a disguise for a new and subtler form of narcissism.

Happy to be running out the clock with these misanthropic aniadversions. Shift’s almost over. Soup is finished. They’re wheeling the patient into ER. Please, God. Please. It’s late and I can’t do any more. Make Kojo do this one. I admit it. It’s not about the soup.