On Call...

So I'm on the fellow on-call tonight at Mass General Hospital. As I've mentioned before, being "on-call" typically involves fielding telephone calls from home and giving advice. However, if there's a true emergency, it may be required for me to head into the hospital and do my dialysis thang. Which is precisely what I'm doing now, at just after midnight on a Wednesday-going-into-Thursday night!

The situation: within 30 minutes of arriving home, I get the a page from one of the docs in the Emergency Room stating that a regular dialysis patient (he gets dialysis for 4 hours, 3 times a week: Tuesday, Thursday, and Saturday--a pretty normal schedule) came in because he felt weak, and his potassium was 8.1 (that's really high). Why was his potassium high? Because he didn't show up for one of his dialysis appointments this week. Why is this a problem? Because a potassium that high can in fact result in fatal heart rhythms if not treated immediately, in this case with dialysis. Is it fair that I (or any other doctor or nurse for that matter) should have to come in late at night to dialyze this guy because he didn't feel like going to dialysis this week? I won't answer that question, because I've already decided that as I don't have much control over these issues as a fellow, there's no point in getting bent out of shape over them. But it is certainly a philosophical question for another time...

Here's to hoping a get some sleep in the call room tonight...