I’m tired. So very, very tired. I haven’t slept properly in over forty hours. My head feels heavier than normal. Maybe it’s the thick, purple/black bags that have developed under my eyes that are weighing me down. Or maybe a lack of sleep has somehow caused my brain to swell and feel heavier than normal. Unlikely, but when you’re this tired any and all logic goes out the window. One thing is for certain though, the weight of responsibility and the growing burden of incompetence bares down on me like a tonne of bricks. I find myself doubting my abilities to perform in these early hours of the morning. I know that when I am well rested, well fed and functioning properly I can do my job. But at this moment nothing about my capacity to function can be assured.

I glance over toward the computer and try to only read the key words. Chest pain, 87 years old, male. On a normal day I might ponder the epidemiology of certain pathologies associated with these words. I might think about the anatomy and physiology of the cardiovascular and respiratory system, its intricacies, creating a visual reference in my mind’s eye as we head toward this patient. But not now, I lack the cognitive horsepower to get the job done. I want to make these mental leaps between theoretical concepts that might be relevant but the chasm between them has grown so unfathomably large that I don’t even try.

I reach for my water bottle. Surely aqua, the elixir of life will restore some semblance of alertness to my struggling mind. None left, should’ve filled it up ten minutes ago when I was still at the hospital. I look at my lunch box, should’ve eaten dinner three hours ago at midnight when I still had an appetite before my body had metabolised the caffeine in the coffee I willed down at the start of my shift. Defeated I sit quietly not wanting to bring down the mood at this hour by voicing my frustrations at my own ineptitude. I have learnt to resist the urge to speak my mind at these hours as tensions can wear thin between some of my colleagues. It can be easy to think that you’re the only one struggling, but that’s never the case. It’s better for everyone if we just have some quiet time whilst driving, and save the talking for the 87 year old man with chest pain.