Sometimes, call is nice. Sometimes, call is tough. Sometimes, call is just motherfucking awful. And I've had my fair share of nice calls, but in my 3rd year now, my calls have been absolutely miserable.
I have not been dealing well with the stress. It's tough work, and it's a lot of weight to carry. And the only thing that keeps me going is coffee. I need coffee to survive these calls, because after 24 hours of living hell, I can't make it another 6 hours without some help, and the cafeteria doesn't carry amphetamines.
And then, I had my worst call ever. I was covering the ICU, and capped out with really sick patients. I had in one call: 2 family meetings, 3 patients terminally weaned off the ventilator, 4 or 5 central lines, a couple codes... It was that nightmare call you pray never happens to you. It was the Moby Dick of calls. I had one code while I was intubating another patient. The only worse thing I can imagine is simultaneous codes (I've had that happen to me too, but not this time).
And when the worst of it was over, all I wanted was a cup of nice, decent coffee. So I went to the cafeteria at 5AM and poured myself some coffee. It was burnt, nasty, and tasted miserable. It threw me over the edge. I was yelling at staff, critical of my interns, and my signout to the on-call senior was: "You take care of them. I'm fucking done with this."
Everyone knows me, though, and knew that I had gone through hell that night. But we cut each other a lot of slack post-call, because we all know that calls can suck, and sometimes suck very hard. And sometimes without that little saving grace, it's easy to be crushed.
I apologized to one nurse the next day, as I had yelled at her, and implied that she had no idea what she was doing. Her reply: "Oh, don't worry about that. If I had the night you did, I'd be running around shooting people!"