I am used to call.

I get sent to psychiatrists, many of whom have not read the latest on PANS/Pandas and/or don't believe in it. They ask "Do you ever go without sleeping?"

I laugh. No, not voluntarily. Call starts 3rd year of medical school, so in 1991. I continue to be on call some nights until January 6, 2021.

The last ten years of call is fairly quiet. My patients figure out quickly that there is not much I can do over the phone. There are no all night pharmacies and with an average patient age in the 70s, if something is going bad, emergency room. I get occasional calls. Less then one a week over the last year. Covid-19, I guess.

In medical school and residency, when I get tired, I choose sleep over food. I go to sleep whenever and whereever I can. Call room, meeting room, during meetings, during classes, standing up, sitting down. I can sleep on airplanes, in busy airports with tons of people and televisions blaring. I really like to sleep.

Post residency there are times when we are on every third night call and every third weekend, 72 hours. Friday 8am until Monday 8am. I take Mondays "off" though I never understand why it is considered "off" after working 8 hours. Some people work in clinic Monday. I don't know how, I am useless postcall Mondays.

I sleep 6.5 to 7 hours. I often wake up once. Today I am up after just five hours of sleep. But two days ago I took two daytime naps and then slept from 9 pm to 5 am, unusually long for me. It balances out. When I wake and can't sleep, there is something bothering me. I write.

I am used to call.

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