Oh did I mention?

I carry two pagers at night.

One is good and one is evil.

Good pager pertains to my actual patients. This pager is for good phone calls:

"Hi Dr. S! Don't wake up. I'm so sorry to bother you again. Patient A has a fever, she looks fine, you don't have to come examine her. I've already given tylenol from your orders and was wondering if I can get a verbal order to give x mg of motrin in four hours so I don't have to bother you again. Yay thanks!"

Evil pager pertains to the 50 odd patients I possess only one sentence of information about: Ashley is a 4 year old here with acute renal failure, chronic lung disease, recent head trauma, a UTI, and the flu. She'll be fine overnight! They won't call about her!

These are my cross-cover patients, the patients on all the other teams that I do my best not to break overnight.

Occasionally evil pager will yield an actual medical problem with one of these cross-cover patients. Then I'll go see them, read through their chart, talk to the parents, and try to patch them together well enough that they'll make it to the morning. These are not the evil calls.

Unfortunately these are not the majority of calls evil pager produces.

Here are some typical evil-pager calls (always between 2:30 and 5:30 am)

"Hi Dr! I was bored and looking through the chart and I noticed that this patient you've never heard of has an old prescription for antibiotics that they're not getting anymore that wasn't cancelled. Can you come look at the chart and then call pharmacy and figure out why the order is still in there?"

"Heeeey, I'm taking care of random-completely-healthy-baby-who's-ready-to-be-discharged-tomorrow-and-who-you-know-nothing-about. I noticed that on his eating schedule he's supposed to get a feed at 4am and I was just thinking that it would be nice if mom could sleep a little later. Can you come down, calculate his calorie needs, and see if you can rearrange his feeding schedule?"

"Yeah, I was just looking through the orders from today on extremely-complicated-patient-you've-never-laid-eyes-on and I'm not quite sure why he's scheduled to get x treatment tomorrow night instead of y treatment. Can you talk me through the team's reasoning? And then can you come talk to the patient's mom about it? Also, he doesn't feel like eating right now, can you convert his list of 24 rare medications you've never heard of from oral to IV."

Or the very very very very worst:

"I have call orders to let you know about a heart rate over 150. It isn't 150, it's actually 134, I just thought I should let you know."

Thanks.