For those of you who might be new to my blog (and there might be one or two, since the weekend), I wear many hats in life, and one of them is a senior resident in internal medicine. Residents are, for the most part, physicians who have attained their MD, but who still require many more years of training before they become fully qualified (and get their license). I’m thankfully near the end of my training, but am still required to do “call” every now and again for the General Medical service.

Being “on-call” is like doing shiftwork, except that its a really, really, long shift. “In-house” call means that we have to physically be in hospital to take care of patients, and the length of time is usually mandated, where I train anyway, to be up to 32 consecutive hours. That’s almost three consecutive 12 hours shifts. Sometimes we get sleep. Sometimes we don’t.

Last night I was on-call for General Medicine, and it was a typical night. Got about 1h of sleep, saw a lot of patients, supervised a medical students and junior residents, and otherwise tried to make sure things go smoothly. Got home, showered, took a two-hour nap, and then got back to spending time with the family and some other work for Work, the BlogHerald and so on.

As I write this, it’ll be about 42 consecutive hours that I’ll have been awake, save for about 3 hours of sleep here and there. Its funny, being what residents refer to as “post-call”. Some people feel exhausted and sleep until the next day. Some people (like me) feel *so* exhausted its tough to sleep. Others (like me) also find they tend to get mentally disinhibited for periods, and at times (also me), find they have problems with word-finding, manual coordination, and verbal dexterity.

Its part of the reason why residency training has changed somewhat since the “good ol’ days”. In times past, residents, where I train, could be “on-call” every third day, and might be in hospital for 36 straight hours at a time. They didn’t name them “residents” for nothing, because many of them felt like (and were, in some ways) “residents” of the hospital. The problem, however, is that its hard to function normally after being so sleep deprived; after a while your brain gets used to it, but there is still room for enormous error. When couched in patient-safety-terms, its easy to see why there has been a movement to try and make things more humane for medical students and residents.

Actually, there was a Grey’s Anatomy episode where a resident got into a car accident post-call, and never remembered falling asleep at the wheel. Unfortunately, an not-altogether familiar phenomonon — and in fact, we’re discouraged (somewhat seriously, somewhat jovially) from making big decisions post call, driving post call, or making signficant purchases post call.

So, what’s it like blogging after being awake for almost 42 straight hours?

I guess its different for everyone.

My experience is that I ramble (look how long it took me to get to this part!). I find that its hard to put words together in a way that makes sense. There are periods that are punctuated by episodes of particular lucidness. Sometimes its followed by worry over what I’ll need to do the next day. Finding the right words can get difficult. Its like trying to grab water from a stream, only your hands feel like a sieves.

Metaphors get mixed up. Similes get smacked around. Spelling mistakes and grammatical errors become sparring partners who pummel you with relentless ease. Distraction beckons with every stray thought, and overwhelming fatigue is the fuel which makes it into an overpowering force of nature. Motivation takes a back seat to every concievable want, while logic and coherence become mere annoyances to getting your thoughts down on proverbial paper.

Oh … did I tell you that its kind of hard?

Blogging at full strength requires different parts of your brain working in harmony; I suspect blogging while extremely sleep deprived creates funny creations that don’t often make sense. Who knows what I’ll think once I wake up in a few hours and read this. Rambling drivel or interesting peek into a bloggers life?

Perhaps I should ask some mommy-bloggers what its like for them as well. Since we had a baby a few months ago, my wife finally knows what its like to walk around like a zombie at times as my son, for better for worse, only seems to be consoled by her when he’s really upset.

Have any of you blogged while being sleep deprived? What have your experiences been like? I’d like to hear from you about them. But … ahem, you’ll excuse me if I don’t wait around for that to happen, since I need to catch a few zzz’s in the meantime. ;)