No electric sheep for me: Sleep is fragmented
People often ask me if I ever have bad dreams relating to the things I see during the day. Short answer: yes. When I say that, I don’t necessarily mean that I am haunted by graphic images or the cries of the dying. It’s more that my brain gets very very confused when it has a break from the intense daily routine.
I am regularly a vivid dreamer, which I attribute to the fact that my sleep hygiene (i.e. orderliness) is very poor and I never go to bed or wake up at the same time each day; an unpredictable sleep schedule means that I am often wake up in REM [the more in flux the sleep schedule is, the greater the proportion of time spent in REM]. I do have lucid dreams too, where I am aware that I am dreaming and exert some control over the content therein, but usually the images are just a mishmash of the day’s events.
I’m currently on an Obstetrics rotation. I like delivering babies, I like pregnant ladies, I even like the nurses. One thing I very much dislike, though, is waiting around for my pager to go off or sitting on the ward waiting for it to be the right time to check a patient’s cervix. Overall, Obstetrics is just not for me.
Sitting. Waiting. And then, often, a moment of excitement, joy, and a lot more stress. 9 months of life – or 25 years of it for that matter – can be ruined in an instant, if one isn’t smart at the time of delivery. I’m the first to admit that I would never make a great Obstetrician or GP who delivers a lot of babies. My lack of interest means a lack of a knack for the finer points, though I do understand academically how to manage labour, and I think my manner with patients is pleasant and reasonable.
I am almost always an outwardly calm person, but there are times where I am inwardly stressed. Usually it is shame, guilt, or uncertainty and I try to express these things or deal with them before they get me into trouble. But negative thoughts can still linger, and the generally ‘unsettled’ feeling I have when on-call for Obstetrics persists. I know it is an area of weakness for me.
When things are really crazy, it means sleep after is all that much sweeter. On one shift, as I lay my head to the plasticky hospital pillow in the call room (not adequate for a pre-emptive daytime nap, but so soft when awake for 20 or 30 hours), I dreamed.
Well, actually, each of the first 3 attempts were interrupted by a phone call or page before I could fall asleep. But the fourth time, I dreamed. Free of much obligation, as everyone in active labour had delivered and there were no new patients coming in the doors, I dreamed.
It’s like that massive headache that headache suffers get when they go on vacation, or that let-down illness that waits to strike until a giant period of stress is over.
I dreamed. I woke a few times. First, convinced my pager had gone off, I was surprised to see no numeric message flashing across its screen. Second, I woke, and had the most vivid impression that there was someone in active labour who I had examined and was expected to see again.
How this was possible when I was certain I had not left my on-call sleep room, I did not know. I thought “hah, that’s a silly dream!” and went back to sleep. Again I woke. Not annoyed at the fragments of Zzzzs I was getting, I was more concerned that I was forgetting something important.
I had the distinct idea that I was to deliver that same baby from my last thoughts. But no one had called me or paged me or otherwise alerted me to do so. And the nurses and clerks in the perinatal unit are very good at communicating things to me. So I went back to sleep. And in my superficial sleep, I imagined that the babe was crowning and I returned to my call room to sleep again. I had the odd notion in my mind that I should go back and complete the delivery, as anyone knows that within seconds [if minutes], the shoulders (and rest of baby) will follow the head. I never leave the room when someone is crowning.
I was so confused by the bizarre idea. I had started to convince myself that while a pretty wonky idea, the general feeling that there was someone on the ward who might be having a baby, might be a legitimate one. To set the record straight, I called the RN in charge.
Embarrassingly, I said
“It’s Jessica, the resident. I just thought I’d check in to see if there was any action on the ward… since I was having a dream that there was … er… nothing? okay, thanks”
Oh, I feel like a crazy. But in the delirious fog of sleep deprivation, the stress of being on the least comfortable rotation for me (due to a lack of experience), and the fact that sometiems my pager DOESN’T work in the call rooms, I was glad that I had called to be sure.
After that, sleep was easier. And I don’t recall what I dreamed about, except – consciously – more sleep in my own bed at home. And they wondered why I was “a little fuzzy” around the eyes when I stumbled back to the ward for handover before I headed home.
And then I went to the street where I had parked and discovered that my car would not start.