This joke is requiring a lot of explanation

Much of life on labor and delivery revolves around The Board. This is a big white board with all the patient rooms on it, and rows for their name, their gestational age, and other important info, like how dilated they are. The last row is for "Comments", which means it gets filled up with everything: epidural, magnesium, history of chronic hypertension, etc. The Board serves as a communal brain for the L&D team - attendings, residents, nurses, everyone.

It's rather universal (or it has been at the hospitals I've worked at) that when you put a "to do" on The Board, you put a little empty box, like this:
 [] start penicillin.

Then, once you've done it, you put an X in the box, like this:

 [x] start penicillin.

That way, everyone knows that this patient a) needed something and b) it was taken care of. The x'd boxes are, of course, the best, because they're done.

So that being said, much time on L&D is spent adding little boxes to The Board, or staring at little boxes on The Board, or just kind of loitering near The Board while thinking about the little boxes .

And when I was doing those things last night,  I saw this:

And it made my night.*

*Partly because it was funny, and partly because it was DONE. We are efficient even in our humor!

Pleasing tone #4*

We've probably all slept through our beepers before. I know I have - it was once, when I was the chief on Labor and Delivery, and my third-year resident couldn't get hold of me. Nothing terrible happened; or rather, it did, but it was nothing terrible that I could have prevented (although I still maintain that I would have diagnosed it a bit earlier).

But we all have ways of making sure this doesn't happen in general. Sleeping on call is a sketchy proposition in any case - you're in a strange room, on sheets that have never known fabric softener, sleeping in your day clothes. They're scrubs, which are essentially pajamas, but you know, you've been wearing them all day. So, ick.

You can't control the temperature; it's too hot, it's too cold. There aren't enough blankets, the bed is tiny, and the bathroom is really far away. It's too dark to find your pager, but it's too light to sleep properly, and the anesthesiologist/pediatrician/midwife keeps slamming his call room door on the way in and out. There is never a reasonable place to put your eyeglasses.

But because you are terrified that you could sleep through your pager (even though everyone knows where you physically are and if necessary could actually WALK OVER and wake you up, but Lord, it's such a terrible feeling that sometimes it's not worth the risk), you perhaps add tricks to make sure that won't happen.

I know some people sleep with their shoes on, claiming it adds just the littlest bit of discomfort that keeps them out of deep sleep. I had one friend who would only sleep in the chair, rather than the bed. I myself have multiple strategies, but at my current institution, in the window-less call room, I've resorted to leaving a desk-light shining near my head, and clipping my pager to my collar. You know, so if it goes off, it goes off directly in my brain, and even I couldn't miss that.

But the real problem, for me, is that you can be woken up at any time. AT ANY TIME. By a shrill pager about 2 inches from your inner ear. (Yes. I know that I've created this problem.) I wake up feeling a bit like I'm in a movie, or a nightmare, or an insane asylum, or a movie about a nightmare in an insane asylum - panicked, wearing a uniform, wrapped in scratchy linen, with shrieking in my brain.

And if you hate getting woken up then it's a real incentive not to go to sleep.

So if you have such amazing luck as to have some quiet time, the incentive for someone like myself is to stay awake anyway: fooling around on the internet; wandering around the vending machines; avoiding any productive work. Partly stupidity, partly because unpredictable sleep is perhaps preferable to the terrible pager.

And if you have such terribly amazing luck as to have a lot of quiet time, you feel stupider and stupider as the clock ticks on. Because you could have been quietly sleeping in a chair with your shoes on and a desk light in your eyes and a plastic pager digging into your neck, and who wouldn't want that?

You know, of course, that I don't do all of this (or any of this) all the time. Details have been conflated in the interests of blogging art.

*You can pick the ring tone of your pager; this is the one I use. Needless to say, none of them are really interested in being pleasing.