I. AM. TIRED.

I am tired today.

It was a call night, after a full day of operating. The pages came in steadily. I don’t mind the ones that have to do with patient care. Most are just from people trying to do the right thing for the patients. But the calls about whether the patient should be observation or inpatient at 3 am push my button. My internal ire rises after the call and I can’t fall back asleep right away, stealing at least 20 minutes of precious sleep. I wish these things didn’t bother me, but they do.

I’m tired of having to negotiate with the OR desk to get my patient in the operating room. I’m just trying to fix a problem. This isn’t about getting to a golf course. It’s about the patient and their family being in pain and fear. If you are too nice, you get put in line behind the surgeon who yells and stomps their feet, even if your patient is more urgent. Negotiating takes energy, and I have none left.

I am tired of insurance companies telling me what I can or can’t do for my patients. Even if they “pre-authorize” the operation, they retroactively refuse to pay for the operation. Why should I be the bad guy sending a bill to the patient for their cancer surgery in the midst of chemo for the insurer’s doubleback? I’m just trying to take good care of the patient.

I’m tired of the EMR making things harder instead of easier. The only thing worse than dealing with the EMR is trying to take care of patients when it goes down.

I am tired of patients not showing up for appointments and even operations. Please don’t send me suggestions about appointment reminders, billing for no-shows, etc. We do all those things. They still don’t show. Until they arrive in the emergency room. With a non-emergent problem that needs elective surgery. Demanding it be done now. On my night of call.

I’m tired of eating processed food from a package in my coat pocket because there’s no time for sitting to eat. Getting to the gym means subtracting from the small bank of time with my family or sleeping even fewer hours than I do already, and I’m just to tired to climb on some piece of equipment and make it move.

Sigh….Pager went off again. Someone needs a surgeon. Wake up and do the job. It’s a privilege to serve. Even if you are tired.

Danielle Walsh, MD, FACS is a pediatric surgeon and Associate Professor of Surgery at Brody School of Medicine at East Carolina University. She is a past president of the Association of Women Surgeons.