My senior and I had been on night float together for a few weeks. That night, the dimmed lights of the hospital corridors spilled into the workroom which was lit only by my computer screen, but that was enough.
Despite the few months that I had been there as an intern, I could describe each inch of this room with my eyes closed. The stack of protocol binders on the overloaded shelf, the unclaimed, dirty coffee mug with the peeling cartoon print, the see-through bag of pinwheels hidden behind the seizure monitors, and the tack board of busy algorithms with handy phone numbers.
These were the only consistencies in a room where a different list of children’s names and room numbers were scribbled daily on a whiteboard. No matter how variable the vital signs or how novel the medications on any given day, the relics from interns past had reliably and simultaneously accumulated over the years and were forgotten in the midst of pended order sets and rehearsed difficult conversations.
I assumed this floor also always sounded the same at night. The monotone fan must always have synchronously blended in with the hum of the computers. The footsteps in the hallway must always have belonged to a nurse, a parent, a nurse and a doctor — in that order. The gurgling of the shared coffee maker at 3 a.m. must always have meant that the mother of a cancer-burdened toddler couldn’t sleep again. The occasional squeaky wheel of a new patient’s stretcher, the buzzer of the parent of a seizing child, and the unexpected phone calls from different workrooms of the hospital must have always sounded the same to the interns.
There were also the sounds we anticipated no matter how many hours we spent waiting for them. The small but weighted pagers limply hung from the waist of our scrub pants , though we were always aware of their presence clipped onto our bodies. The tone, frequency and pitch of the beeps elicited our different physiologic responses because they marked the difference between the news of a newborn baby and a dying child.
It was also always cold at nights. No matter how hot the season, how full the floor or how thick our sweatshirts, a cool breeze was always present and blowing from the double front doors to the playroom. On quieter nights, we snuck in warm blankets that we wrapped around our shoulders as we waited for the sun to rise. On others, the flights of stairs we repeatedly climbed to and from the emergency room were enough to keep us warm.
And some nights, holding the creased, coated and warm skin of a brand new baby, rubbing his soft head to feel for any missteps and listening to the lub-dubs of his miniature heart eagerly beating rhythmically all helped us ignore the night’s harsh chill.
Although the rest of the hospital smelled of sterile solutions and plastic gowns, a newborn baby’s room smelled of his mother anxiously waiting to have her baby back in her arms. It smelled of teary-eyed grandparents, skeptical older siblings and scared, new fathers. But it was also scented with first touches, first sights and first smiles.
At 7 a.m., we unloaded the gripping pagers and tangled stethoscopes off of our bodies and signed off until the next night. Walking out of the hospital in the morning after a night call was a feeling unlike any other. The calm morning dusted with a misty fog was a stark contrast from the stillest night brushed with a fluorescent glow.
Outside, there were no flashing monitors or hissing blood pressure cuffs; rather, there were only the beams of a distant bus and the rustling of the trees whose leaves had changed seasons overnight. I walked against the flow of the foot traffic of nursing assistants, medical students, volunteers, dietitians, social workers and MRI technicians who were only just starting their shifts.
The hospital was just waking up.