Viagra (Niagara) Falls.

Sleep, the final frontier where few doctors have gone before.

As a physician you learn to compromise on a good night sleep.  While on-call you get phone calls of various nature at all odd hours of the night. Just recently I received 24 pages from 11 pm till 7 am. So you can imagine the quality of sleep one gets.

Every doctor has a plethora of stories regarding the calls we receive during a given day or  night. Ninety percent of these calls are appropriate and the rest, I better not say any thing. I will give you samples of few remarkable calls I have received during nights in the last few years.

·         4 AM, call from a nurse, “Doc, I just want to inform you that patient has dark urine”, I inquired “you mean patient has blood in urine”. Nurse, “No, It is just dark yellow in color”. I replied, “Please keep a very close eye on it, if it turns blue let me know”.

·         5 AM, last month from a nurse, “We just want to tell you that patient is allergic to Diovan and he is on Labetalol”. I asked, “Is he on Diovan?”. Response, “No”. I was speechless and sleepless after that.

·         2 AM a nurse from ICU: “I just want to inform you that patient has a critical BUN level of 3”. My response, “STAT transfuse 2 units of BUN”.

·         5 AM during residency: Code beeper goes off: I ran to the patient’s room. Code team was at bedside. I touched the patient, he is cold and stiff but I was still asked to run a code. Of course I refused for obvious reasons; rigor mortis never responsive to resuscitation.

·         I was called during my first year of training by nurse around 3 AM for medication for headache. I gave her the quick orders while in an attempt to catch a quick 2-3 hours sleep before going back to the ICU rotation. In the morning the same nurse told me that she did not give the medication I ordered. She told me that she heard me say, give 1 tablet of Viagra. She was unsure so she called the pharmacy to find out if there were any indication for Viagra for headache, they told her that there were none. She gave the patient Tylenol instead and notified me in the morning.

I strongly believe that in a hospital setting a dedicated nocturnist, can improve safety and decrease errors related to “burn” effect.

About the picture: While walking in New York.