Being responsible for my own inpatients was a deeply rewarding experience, but I won’t pretend it was all rainbows and lollipops. For one thing, it meant visiting the hospital 365 days a year unless I happened to be out of town. In addition to commanding a significant chunk of my time, it paid poorly. Despite these drawbacks, there was one very big plus: it allowed me to care for my patients when they needed me most, i.e., when they were sick enough to warrant hospital admission.
Every Wednesday and some weekend days I’d be on call for the ER for 24 consecutive hours. In order to accommodate my ER obligations, my receptionist always booked a lighter office on Wednesdays. This allowed me time to shuttle back and forth between my clinic and the emergency department. The ER tended to be reasonably quiet between 6:00 and 8:00 p.m., so most evenings I’d be able to sneak back to my apartment for supper and a power nap. After that I’d return to the ER and see outpatients until midnight. The void between midnight and 8:00 a.m. was highly unpredictable and ran the gamut from wonderful to bloody awful. On a good night there’d be no outpatient visits after midnight and I’d be able to get a solid six or seven hours of shut-eye. More often than not, though, people would continue trickling into the department well into the wee hours and my sleep would get hopelessly fragmented. Once in a while I’d get no sleep at all. That gets old very fast. It’s hard to face the new day when it feels like your head is screwed on backwards.
Aside from missing the action at my old ER in Winnipeg, I was pretty much hooked on my new job right from Day One. There was something immensely satisfying about sending an acutely ill patient from my office to the ER, meeting them there to start treatment, admitting them to the medical ward, rounding on them daily until they recovered and then having them follow up with me back at the office. It was like being an office-based practitioner, an ER physician and a hospitalist all rolled into one. Of course, it’s not like I invented that particular enterprise. Most rural (and some urban) generalists have been playing endless variations on that theme ever since Og fell off the first stone wheel and got rushed to the Healing Cave back in 20,000 BC.
Jan and I conducted a long-distance relationship during my first year in Ontario. In July of 1992 we tied the knot and she joined me in my northern adventure.
Devolution
For the first few months after we got married, whenever I was telephoned at home in the middle of the night to go see patients in the emergency department Jan was the epitome of concern. The instant I hung up she would ask me if I had to go in. I’d fill her in on the details as I stumbled around in the dark looking for my clothes. Before I left she’d always say she hoped it wouldn’t be long before I was back. When I eventually returned home and crawled under the covers she’d wake up and murmur something appropriately sympathetic in my ear. Ah, those were the days.
As time passed she gradually stopped asking what I was being hauled out of bed to go and see, but she never failed to say, “Do you have to go in, honey? That’s too bad.” It became a comforting little ritual.
One night I answered the phone at 3:00 a.m. and glumly listened to the ER nurse explain that she needed me to come see some intoxicated yo-yo who was going to require a truckload of stitches. When I hung up Jan rolled over and said, “Do you have to go in, honey? That’s too…zzzzzzzzzz… .” As I lumbered out the door I thought, “Uh-oh. Things are definitely slipping.”
After that she completely quit waking up for those maddening nocturnal phone calls. I can’t really say I blame her – it’s probably a sanity-preserving defence mechanism. It certainly preserves her sleep! You could nuke the house next to ours and she’d snore right through it, guaranteed. Some nights I’m recalled to the emergency department three or four times after midnight. Our alarm clock invariably goes off 20 minutes after I’ve limped into bed for the final time. Jan usually sits up, stretches luxuriously and announces, “What a great night! You didn’t get called once!”
“Great night,” I croak incoherently.
A few days ago our prehistoric bedroom telephone finally gave up the ghost, so we replaced it. The new phone rings like a klaxon from hell. Last night I was on call. This morning Jan didn’t look quite as well-rested as she usually does.
“I don’t like that new telephone,” she complained. “It woke me up!”
I had to work hard to keep the grin off my face.
The Big Smoke
Not long after we moved to northern Ontario, Jan and I decided to spend a romantic weekend in Toronto. We planned to fly out after work on a Friday evening and attend The Phantom of the Opera, then spend the next day shopping. Saturday night we’d have supper at a cozy restaurant. On Sunday afternoon we’d pack up and fly home.
First we made our flight and hotel arrangements. Next we phoned the theatre to purchase tickets. They cost a small fortune, but we’d heard so many wildly enthusiastic reviews about the show we would have gladly paid double the asking price.
The last thing we needed to organize was our Saturday night soirée. Being recently displaced prairie folk, neither of us had the faintest idea where to go in Toronto for a good meal. We solicited advice from our co-workers and one of Jan’s colleagues recommended a restaurant he and his wife liked. Jan asked if I’d need to wear a suit or jacket and was assured dress pants with a shirt and tie would be more than sufficient. We called the restaurant and made reservations for 7:00 p.m. on the Saturday.
A couple of weeks later we packed our bags and left for the airport to begin our much-anticipated weekend in the Big Smoke.
After checking into our hotel we spruced up a bit and caught a cab to the theatre. The lobby was packed with excited people. Through one of the doors nearby I glimpsed a portion of the stage as well as the first few rows of seats. I surveyed our tickets: row K, centre. This is going to be great - 11 rows from the stage!
We joined one of the queues and slowly inched our way to the nearest door. I handed the usher our tickets. He looked at them, frowned deeply and passed them back to me.
“Is something wrong?” I inquired.
“Sir, these are for row K, upper balcony. This entrance is for the seats on the main floor.” He said “upper balcony” like it was some kind of STD.
I quickly re-examined the tickets. Of course he was right.
“Which line should we be in?” I asked.
“Over there.” He pointed to a long line at the far end of the lobby. Jan and I mumbled apologies and shuffled over to the proper line-up. Eventually we made it to the balcony. I looked down at the stage and was disappointed to see the view wasn’t that great. Oh well, 11 rows from the front of the balcony will still be okay. When we got to row K I motioned to my wife and started to edge in.
“Wait a minute, this isn’t right,” said Jan. “This row is full.”
“Really?” I backed out.
“Look,” she continued, her eagle eyes fixed on the dark nether regions at the rear of the theatre. “Right now we’re in the main balcony. Our seats are in the upper balcony!”
I thought back to what the usher downstairs had said. Jan was correct. Row K? More like K2! Our seats were going to be so remote, we’d need Sherpas to find them. We steeled our jaws and continued on our quest.
A couple of postal codes later we arrived at row K in the upper balcony. It was one row from the wall at the very back of the theatre. The only people behind us were a few pimply high school kids. They were busy having a lively discussion about the latest Guns N’ Roses album. I turned my attention to the stage. From our vantage point it was about the size of a shoebox. A well-decorated shoebox, but a shoebox nonetheless.