Night float had always been this mythical monster to me, an intimidating prospect that conjured up some of my greatest fears about a residency rotation – jetlag, nocturnal clock, lack of continuity with patients or a day team, multiple pagers and multiple admissions every night. Maybe it was the uncertainty of the unknown that had seemed so daunting.

Somehow, after three admissions on my first night, I found myself still awake yet exhausted and on my way home – I had made it. As the nights went on, my internal clock adjusted a little more each day. I became more comfortable and familiar with the night team nurses and more efficient with admissions through sheer necessity. I missed the moments I had with patients and families on day rotations though, when I had developed rapport with them over the course of their hospital stay. By the time I had wrapped up admissions and pages on night float, the patients were usually asleep, and there wasn’t much of an opportunity to connect with them.

Nevertheless, there were still incredible patient encounters at the VA, which provided unexpected sparks and carried me through my two weeks.

One patient in his 70s with multiple comorbidities came in with edema – he had end-stage cancer and a stroke had previously incapacitated his wife and was now in a special care facility. You would never have guessed this patient had been dealt such an unlucky hand, as he was dressed in rainbow overalls and expressed to me how he’s felt grateful ever since so many of his friends in Vietnam never made it back home from the war.

Another patient in his 90s had been feeling lethargic for a few months and went to the ER; his WBC was in the 30,000s, and the smear was positive for blasts. When he received the news that he could have leukemia, he took the assessment in stride and calmly asked if he could still go on his morning walks. He then smiled and proceeded to reassure me that everything was going to be OK. For an inexplicable reason, I truly felt that I would be OK for the rest of my night’s rotation, and I was. If this patient could face his mortality the way he did, I could face the rest of my night rotation.

I have always admired my patients whenever and wherever I met them. Even when the days were long, they inspired me and motivated me with their strength and how they handled the challenges they faced. This was especially true with the veteran population, who had already gone through so much before presenting to the hospital. Though fewer of these moments were on a night rotation than on a day one, they were still there. And they were still special each time.

This mythical monster, night float, was hard, but I had done it and given it my all. Nights were very different from days, but the key to finding joy in the work remained the same:  along the way, I remembered to take a step back and appreciate the raw humanity present in every patient encounter.

Johnathan Yao is an internal medicine resident.