Shortly before 6:00 am, a distinct and unmistakable smell would waft into the residents’ call room from the cafeteria in the basement below — bacon grease.

This was my “olfactory alarm clock,” my cue to splash some cold water on my face, comb whatever hair I had left, and gather my dwindling resolve. 

For each morning at 7:00 sharp, we had a meeting to review cases seen by the resident on call the night before.

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By this point, I’d typically been awake for 25+ hours straight. My whole body ached. And I probably smelled like a combination of unpleasant ward odors, my own sheer unbridled adrenaline and the bacon grease.

The cases were presented to my family medicine residency director and her husband, a rheumatologist who generously joined most of our morning meetings, as well as to my fellow residents and rotating medical students.

I presented whatever case I could find, usually the most unusual or educational one. Specific cases are omitted here to comply with HIPAA regulations and out of respect for the patients themselves. That said, some of the cases were so bizarre that no one would believe them anyway.

As a family medicine resident in a rural Kentucky hospital located smack-dab in Appalachia, I worked with the internal medicine service while on call, seeing and admitting patients through the ER.

Each time my pager went off — typically ten or fifteen minutes after I had finally had a chance to fall asleep — I knew it was time to go down to the ER to evaluate and admit another patient.

Once the patient was tucked in upstairs and all my orders had been written, I would head back to the call room to record my notes on the phone dictation system — an anachronism by now, I’m sure. 

Some poor soul would later have to transcribe my middle-of-the-night doctorly ramblings for the patient’s record. Medical residents are known for their very thorough histories and physicals, and for covering every imaginable base in their notes. 

That’s because they know their work is under constant scrutiny and subject to criticism if the slightest detail is neglected.