An Intern on Duty: The Longest Day

What is it like to work a 36-hour shift? That is precisely how long Dr. Edward Condon, 28, was on virtually continuous duty" recently at New York City's 970-bed Elmhurst Hospital as part of his internship. The log of his prolonged "day":

Assigned to a ward that was designed for 40 patients but is sometimes crowded with 50 or more, Condon reported for duty at 8 a.m. He immediately began taking blood samples from patients, then at 9 a.m. broke off to accompany a resident as he stopped at patients' bedsides. At 11:30 he wolfed down a sandwich and spent the rest of his lunch hour in the library reviewing patients' records to prepare himself for teaching rounds, when he would tour the ward with an attending physician. From 4 p.m., when the tour ended, until dinnertime, Condon continued his morning routine.

Condon had planned to share the overnight duty with another intern, covering the ward from 6 p.m. to midnight while his colleague slept, then catching a few hours' sleep himself while his partner watched the ward. But at 7 p.m. the hospital admitted a heart-attack victim, and Condon's plans quickly changed. While the other intern took over the ward, Condon and the resident administered powerful drugs and oxygen to the patient. When he failed to respond, they inserted a tube in his windpipe to assist his breathing. In an effort to ease the burden on the patient's heart and lungs, they drew off some of his blood and then infused only the red cells back to him over a period of several hours. Condon stayed with the patient until his condition stabilized at 7 a.m. then tried unsuccessfully to catch a catnap on a stretcher. At 8 a.m., after a three-minute breakfast of toast and coffee, he was back in the ward starting another day.

At 6 that evening, as Condon prepared to leave for home, he learned that despite the intensive care, his heart-attack patient had died. The intern then had to call the patient's family, notify them of the death and ask permission to perform an autopsy.

Condon admits that such hectic shifts are not routine, but feels that for him they occur too often. He believes that tired physicians may overlook things in their examinations and "minimize the symptoms." He argues that, while fatigue is bad for a physician, it is even worse for his patient.

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