Once again I’m reminded of how much I hate getting up in the morning. Today I rose at 5am to catch an 8:30 flight. Completely in keeping with my contrary nature, however, I love early morning, just before dawn when the sky is starting to get light. It must be the years of working the midnight shift. My first job out of nursing school was on a telemetry floor, 11pm to 7:30am, five nights a week. Driving home was a hair-raising affair. I’d keep the window rolled down and would occasionally pour cold water on my neck to stay awake. One morning, the last thing I remembered was driving through an intersection. The next thing I know, I’m going over train tracks, 20 yards down the road. I found another job soon after.
If you’ve ever worked nights, you know the feeling: 3am comes and your circadian rhythm wants to drag you back under to the sweet darkness of sleep. In the ER, this was always our slowest hour. People would usually pour in until after midnight, then a lull until 5 or 6am, when the flow would pick up again. Then you’d start to look busy, so the day shift wouldn’t think you’d been sitting around eating and gossiping all night. My friend Charlie, who had just had knee surgery, would sometimes lead a group of us out to the ambulance bay to do exercises with him, in between cigarettes. Somewhere in all of this, imperceptible, the sky would go from black, to navy, to purple, to the faintest pale inside-a-seashell pink.
I had a moment like this recently. I had gone out on a Wednesday to a hospital for a referral, was there until 10 o’clock at night, left and returned again on Thursday morning. We got consent and I wound up staying the night, leaving at 7am the next morning. As the OR time approached, I glanced out the window, amazed to see the sun coming up. Was it dawn already? I had spent the night sharing the organs, taking the donor to the cath lab, trying hard to share his heart then working with respiratory to increase his oxygenation. Around 2am I inhaled a couple slices of pizza and a coffee. I felt drained.
Northern New Jersey is dotted with industrial, 19th century, mill towns. Places you wouldn’t normally associate with beauty. More likely they are the butt of jokes, along with the Turnpike, the Jersey attitude and the air quality (or lack thereof). Witnessing one of these towns at dawn is like looking back on another century. Passaic, Paterson, Hoboken, Jersey City. Traveling South through Newark, Elizabeth, Rahway down to New Brunswick. Go far enough South and you’ll eventually come to Trenton, then Camden. Cities made of brick, fired from local clay, giving each its own distinct glow in the morning sun. Row houses and hospitals, court houses and schools, all come alive again with a rosy light. Look out the corner of your eye and instead of morning traffic, you’ll swear you see a guy delivering ice with a team of Clydesdales. I expect it’s similar in cities throughout the Northeast.
By the time I leave the OR it’s gone. Walking outside I’m confronted again by the graffiti and litter and the sounds of morning rush hour traffic. For a moment, though, I was someplace else, and that is enough to get me home.