That Dreaded First Page

There are a lot of trends noted on call. This one is a trend much discussed among colleagues.

You can never know how a night of call will turn out - at least not before it starts. But it doesn't take very long to figure it all out. Typically, within the first few pages of the night, the pattern is set.

Suppose the first pages are soft balls - easy consults or things that don't even require my presence at the hospital. Generally the rest of the night will be similar, quiet or at the very least with just a few simple things. On the other hand, suppose the first page is a complicated lid laceration or an open globe injury - the two things which commonly make us go to the operating room in the middle of the night. You can then expect the rest of the night to go poorly. Now it may just be because going to the operating room in the middle of the night requires a lot of leg work and eats up a ton of time. But it's no exaggeration that one bad case generally means another will follow too soon.

Though I have never literally gotten the "Your call will suck balls," page, that is certainly what I see sometimes.