Let’s see…it’s 7:19 a.m. as I start writing this. I was on call for work Sunday, starting at 8am and I’m on call for another 41 minutes. I just walked in the door from a call that came in at 4:30 a.m. this morning from a patient who lives out in the middle of absolutely nowhere - - in a winter weather advisory with freezing rain and horrible visibility.

I left the house at 4:30 a.m., but only after I had gotten home from a call I needed to go out on at 1:30 a.m. I had just stripped off all my clothes and crawled into bed and was just falling asleep when the page at 4:30 came in.

Of course, that was all after already being out and seeing patients starting at 8 a.m. through 3p.m. this morning - - and triaging a bunch of calls between 4 p.m. and midnight.

I haven’t slept yet. I’m exhausted. I dealt with the most unreasonable doctor at 5 a.m. this morning, who wasn’t very happy to be awakened at that time in the morning - - about as happy as I was at being out in the winter weather at that time.

I don’t know - - call me idealistic, but when a doc gets a call on a home patient and receives the message that the patient is no longer safe in his home because of acute agitation and restlessness due to his cancer diagnosis - - that his wife can’t handle him, he’s confused, delusional and has fallen 5 times in the past 24 hours because of his total lack of safety awareness due to his acute confusion and agitation - - I don’t know, call me silly…but I expect the doc to do something about it.

I wanted to admit this guy directly to acute care. He could not be left alone any longer - - the wife can’t handle him. Luckily, the 5 falls didn’t result in an injury worse than a few abrasions and bruises - - I’m not so confident that we’ll be so lucky on the 6th fall. So I call Dr. G.O.D. - who starts the conversation by telling me not to talk so loud, because I’ll wake the dead. I’m on a cell - and I nicely apologized.

I explain the situation to him and his answer is to wait until 8 or 9 am in the morning when he can call the wife and the son and discuss what their wishes are. I tell him that the wife is awake right now, and is very agitated herself because she hasn’t slept all night either. He tells me he will wait until a more reasonable hour of the morning to call her. When I explain that the situation is unsafe and our home hospice agency does not have any staff to sit with him until then, at this short notice and I’m afraid for the guy - - would you believe that asshole told me, “Well that’s your problem, not mine, it would seem - - I will call her in the morning, now goodnight.” And he hung up.

I can’t even keep blogging about the rest of the story - - because like everyone else, I’m agitated and lacking total sleep. If I keep telling myself this job is worth it - - I might start believing it? Or maybe I should get some sleep first.