They say your first overnight call shift is the worst.

It gets better from there.

Every day you’re learning a little more.

I’m headed into the hospital on a snowy evening. Supposed to be some sort of record storm tonight. Thick clouds rolling in all day.

Overcast skies. 1/
I’m going to be the night-float intern. It’s my first overnight shift.

My heart is racing with adrenaline. A semi-queasy feeling, laced with excitement.

I enter the house-staff lounge to get sign out from the day teams.

They give me updates and tasks.

Then say goodbye. 2/
I will never see them again.

I don’t know that yet.

The shift begins as the clock strikes 7PM. Together with my fellow interns and residents, I start heading to the floors to begin my night-float rounds.

Checking tasks off my list, one by one.

Time ticks by. 3/
Outside the storm has really intensified. I pause by a hospital window to look outside. Snow is falling heavily, whipped into a frenzy by the howling wind.

The clouds are dark, almost inky black. There are occasional flashes of lightning, and rumbling thunder.

I shiver. 4/
Something feels strange in the air. Like there’s a heaviness. A stillness.

I decide to quit thinking about it and get back to my work.

The night passes.

Around 3AM I get hit by a huge wave of sleepiness.

My work is pretty much done, so I decide to nap. 5/
I fall asleep as soon as my head touches the couch in the lounge.

It is a dark and dreamless sleep.

I jolt awake after what feels like only a few moments.

Something is wrong. It takes me a moment to realize it. The clock isn’t working. It must’ve gotten stuck.

7PM. 6/
I sit up and rub my eyes, then glance at my watch. 7PM.

Frowning, I look down at my phone, and my pager. 7PM.

What the… but I just went through the entire night.

I look down at my checklist, and none of the boxes are checked.

What? How is this possible? 7/
My fellow house staff are heading out to the floors. As I listen to them speak I get a dizzying sense of deja vu.

I know these conversations.

Maybe… maybe it was just an elaborate dream? Maybe I fell asleep for a moment at the start of my shift and just dreamed it? 8/
I get up and leave the lounge, heading to the floors. Again.

And I start to do my rounds, my tasks. Again.

It really feels like I’ve done this before. People say things I remember.

But that’s not possible… is it?

I stop by the window again, and look out at the storm. 9/
The storm looks different. It’s not snowing. Now there are sheets of freezing rain lashing the window. The sky seems even darker, somehow. The flashes of lightning seem closer.

I feel an icy stab of fear in my heart.

Am I losing it?

I return to my work. 10/
Around 3AM, I’m suddenly so exhausted I can barely keep my eyes open.

I remember this.

Before I sleep this time I take the piece of paper with my tasks on it and carefully rip it in two. I put the two halves on separate tables.

And I collapse asleep. 11/
My eyes open slowly, and I yawn.

Then I remember, and sit bolt upright immediately looking for my sign out paper.

It’s intact, in one piece. Not ripped into two halves.

My heart sinking, I look at the clock. 7PM.

The night-float teams are leaving out to the floors. 12/
What’s going on? Am I really waking up at the start of my call shift over and over?

Am I stuck in some sort of time loop?

I try and dial my family, but my calls are all going to voicemail.

Actually every single number I try to call is either a busy signal or voicemail. 13/
Only the hospital phones are working.

Feeling a rising panic, a bitter taste in the back of my throat, I leave the lounge.

Screw my to-do tasks, I need answers.

I start asking a fellow intern if they’re noticing anything weird, and they say no, and look at me blankly. 14/
Nobody remembers having lived this night already. Not the patients, not the nurses, not my colleagues.

Only me.

I pause by the window, and look out at the storm.

The storm is different, again. It’s the only thing that seems to be changing.

No rain. No snow. Just wind. 15/
The wind is howling almost violently. The sky is so dark it almost seems to have its own gravity, pulling me towards it.

Lightning is still flashing, except this time I hear no thunder.

An idea hits me.

Don’t fall asleep. Just bypass the 3AM nap. That should work. 16/
I try drinking a ton of caffeine. Doesn’t work.

Eyes open. 7PM. Damn.

Have to try again. Ignore everyone. Ignore tasks.

Have another idea. Am going to steal some epinephrine from a crash cart, and shoot up just as 3AM rolls around.

I’m sick of this Groundhog Day BS. 17/
Stop by the window, again. Storm looks different, again.

Wind is even louder. Howling. Sounds like people screaming.

I want to scream.

Lighting flashes in the distance. I think I see shapes in the clouds. People. People in the clouds.

I leave to find the crash cart. 18/
3AM is here. I get hit by the wave of fatigue. I inject myself with the epinephrine.

Eyes widen. Heart racing.

Except… no. Dammit. Eyes shutting.

But something different happens here. I wake up!

I wake up and the clock says 4AM!

YES! But… something’s wrong. 19/
I can’t move. I can only look around.

I see something I can’t put into words.

My colleagues are all frozen, just like me. And something is moving among them. A creature. Can’t describe it. Terrifying.

Oh God, it sees me! It sees my eyes are open!

IT’S COMING!

HELP-
I jolt awake. 7PM. What? It was a dream? No. I know better.

Something is experimenting on us. Something is “resetting” this night over and over.

I must figure a way out.

I go to the window and look outside. I can’t see the city anymore. Just a thick fog. 21/
Days pass. I wake up at 7PM, over and over.

I try leaving the hospital, but I can’t. Leaving the front door instantly makes me wake up again.

Medicines don’t work.

Even death is just a reset. I tried.

I’ve talked to every person in the hospital. Nobody believes me. 22/
Time passes strangely in this place, and doesn’t pass at all.

I guesstimated the other night. I think I’ve been trapped in this loop for years.

The storm outside has disappeared completely. Now it’s just brilliant white light, streaming in.

Nobody sees it. Only me. 23/
They say your first overnight call shift is the worst.

It gets better from there.

But what if they’re wrong?

What if there only ever is one call?

One eternal, perpetual call.

And even death can’t set us free.

I’ve been here so so long.

But it’s only 7PM.

Back to work…

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Sayed Tabatabai, MD

Sayed Tabatabai, MD Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @TheRealDoctorT

26 Oct
“How many letters in the alphabet?”

I had been expecting a question, just not this one. Damn.

Uhh. Twenty-six. Right?

… Right? Argh, this is so simple, but why is it so difficult?

“Twenty-six,” I say.

The cardiology fellow who asked me the question grins, “Perhaps.” 1/
Perhaps? What does that mean? I glance at the other house staff, and there are a few nervous shrugs.

The fellow continues, “It might be 26, or it might not. Depends on the language.”

Oh, right.

Medical training tends to create a singularly stressful environment. 2/
You’re trying to learn an art and a science, immersed in an entirely new highly technical jargon with thousands of words.

You’re trying to figure out what you want to do with your life within this vast world.

And you’re trying to make a good impression while doing it. 3/
Read 16 tweets
14 Oct
One of the things that makes medicine so maddeningly difficult, is also one of the very things that makes it wonderful:

You can think you know a patient, understand an illness, and unexpectedly find hidden depths you never knew were there.

It’s been a while since I worked. 1/
I took some time off. Found my focus. Breathed deeply.

It was a needed break. A needed distance.

However, as the days passed, I realized I was missing something. A part of me.

Now I’m back in my office seeing clinic patients again. 2/
My patients today were all rescheduled from earlier dates because of my time off.

The first one I see is an elderly woman I’ve followed for several years.

As I enter I noticed she’s watching anime on her phone. I can’t help but smile.

I didn’t know she was into anime. 3/
Read 13 tweets
28 Sep
There was a time once, when every day brought with it a glorious purpose.

When there was a genuine sense of fulfillment.

When grief was a transient thing, not lingering to carve out hollow people.

When hearts could heal, and learn to let go. 1/
My eyes open before my alarm goes off. Old habit.

Except there’s no alarm set today. I’ve taken some time off work- a whole two weeks.

It’s the most time I’ve taken off in over a decade.

I’m not sure what to do with myself.

I’m exhausted, but sleep won’t help. 2/
My parents are going to be visiting from Houston.

I will myself out of bed and make the decision to get some groceries, so my fridge isn’t pathetically bare.

In the shower, I turn the water as hot as I can bear.

Trying to purge the lingering tension in my muscles. 3/
Read 21 tweets
13 Sep
Have you ever done something so many times, you sort of forget why you started doing it in the first place?

Perhaps there was a time it brought you joy, but now it’s just a routine. Muscle memory.

My mind is far away as I walk the path to the hospital entrance. 1/
The experience of each COVID surge in a city hospital in South Texas has been the same, and yet distinctly different.

The first surge felt disorienting, frightening.

The second surge felt the same, and also tragically unnecessary.

This third surge… 2/
I round in one of several COVID ICU units.

These units were hastily created in the very beginning of the pandemic, then shut down as cases waned, then reopened again.

It’s soothingly quiet. Hisses of pressurized air, distant beeps.

Patients tethered to life support. 3/
Read 18 tweets
2 Sep
The longer I practice medicine, the more I feel that time is circular as well as linear.

We see orbits within orbits, everywhere we look.

Cycles of life, and death.

Cycles of growth, and stasis.

Cycles of mistakes made, and lessons learned.

The past is never far. 1/
It’s the early 2000s.

I am a medical student, inhabiting that eternally stressful space of self-doubt, and lack of clarity.

I am taking a clinical skills class.

The standardized patient sits before me, and I watch as my classmate presses his stethoscope to their chest. 2/
As I observe, for a moment I think of a child listening through a door, their ear pressed to it.

We press our ears to the human body, listening for the secrets it might whisper back in murmurs, gallops, rubs.

“2/6 systolic murmur and an S3 gallop,” he announces confidently. 3/
Read 18 tweets
26 Aug
The smooth purr of my car’s engine, and the highway before me, are intoxicating. The roaring wind feels like freedom.

I have a free weekend.

No hospital, no calls, no COVID.

Seized by an impulse, I drive North.

Open road, past small Texas Hill Country towns. 1/
About an hour Northwest of San Antonio on I-10, I reach the town of Comfort, Texas.

Comfort is a sleepy little town, population 2363 as of 2010.

I’m not sure why I choose to stop here, but I do.

I drive through the quaint historic downtown district, with its old shops. 2/
I enjoy exploring new places, especially small towns.

There’s just so much character that you often don’t find in bigger places.

Admittedly, it’s not uncommon here in the Hill Country to see occasional Confederate flags and bumper stickers.

The past is never far. 3/
Read 17 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!

Follow Us on Twitter!

:(