So I’ve finished up at one job and moved on to another. I was a director for a year, and it was a learning experience. Right now I’m nearing the final approach after working a long run. Last week I had five nights, 12 hours duration each. I stayed in a hotel near the hospital. Then, after two days off at home, I started a run of five days, of 12 hours duration. I have two to go. I’m working out of town. Not locums, as I’m employed and working in the same place; it’s just a couple hours away, so I stay here.

A few observations: It’s hard to turn around from nights to days in 48 hours. I find myself reading a novel at 1:00 am when I’m getting up at 4. I find myself drifting to sleep at the keyboard at 1 p.m. I find that caffeine is nice, but sometimes doesn’t help a lot.

When I’m tired, I eat. I started my long run intending to diet and eat well. To limit my carbs and drink lots of water. I was going to do pushups and squats in the room. I was planning to resist temptation! Vade retro satana! And it worked. In my mind. The longer I went, the more I craved food. Sure, for energy. Not entirely untrue. I was focusing on vegetables and protein, unsweetened green tea and water, apples and low-calorie pre-packaged food. At first.

Fast forward to today: I had a breakfast burrito from Sonic, a reasonably healthy hospital lunch and part of a candy bar. (Leave me alone, it’s dark chocolate!) I did have an apple, so take that! Tonight I had half a Pizza Hut Supreme. (What? It was thin crust!) Too much sweet tea, some fried pork skins and the rest of my chcolate bar. No need to judge me. I’m judging myself.

I rememer thinking, “I’ll do lots of pushups.” But after my latest day shifts, full of very, very sick people, I come home and lie down on the couch. And it feels really, really good. I don’t even care what’s on TV. I just want to sit.

Emergency medicine can be an exhausting gig. I’m not whining. I made my bed, and I lie in it. Or, should I say, I made my couch. But the thing is, this is a very physical thing we do. And coupled with circadian chaos, it takes the wind out of my sails.

I’m not going to play the “I’m 53” card. I feel young, and I feel fit. However, at the end of the day, there’s nothing like eating bad food and putting your feet up. Maybe it helps me decompress from the stressors of the day.

Or maybe I’m just weak. Either way, I’m headed back to the couch.

Edwin Leap is an emergency physician who blogs at edwinleap.com and is the author of the Practice Test and Life in Emergistan.  

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